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Summary Oncology Partial Exam 1

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Comprehensive summary of all course material for the first partial exam for the course Oncology.

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Summary Oncology Lecture
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Table of content
Week 1................................................................................................................... 2
Lecture 1a – Introduction and planning...............................................................2
Lecture 1b - Ch1 Introduction: The Nature of Cancer..........................................3
Lecture 1c - Science journalism and introduction science journalism assignment
............................................................................................................................ 8
Lecture 2a - Ch2 DNA repair mechanisms and therapeutic strategies..............10
Lecture 2b - Ch3 Regulation of gene expression...............................................19
Week 2................................................................................................................. 27
Lecture 3a - Ch4 Growth factor signalling and oncogenes................................27
Lecture 3b - Info Master Oncology and Personalized Medicine..........................36
Lecture 4 - Ch5 The cell cycle............................................................................37
Week 3................................................................................................................. 43
Lecture 5 - Ch6 Growth inhibition and tumor suppressor genes........................43

,Week 1
Lecture 1a – Introduction and planning
The course consists of the following topics:
 Definitions and epidemiology of cancer
 Exogenous and endogenous factors involved in the development of cancer
 Growth inhibition and tumor suppressor genes, growth factor signaling,
oncogenes and miRNAs
 Cell biology of tumor cells: proliferation, immortalization, invasion,
metastasis, angiogenesis
 Tumor immunology and immunotherapy
 New developments in cancer research, diagnostics and therapy
 Molecular diagnostics for colon and lung cancer

Course aims
 Describe the general principles of dysregulation in cancer in relation to
healthy cell biology
 Explain the most important molecular, immunological and cell biological
processes that are dysregulated in cancer
 Explain the genetic, viral and chemical factors involved in the emergence of
cancer
 Compare the different methods of cancer treatment and cancer prevention
 Evaluate a science journalism article using the basic principles of science
communication
 Analyze a DNA sequence with the help of genome database systems
 Understand the concepts, technology and the clinical relevance of molecular
diagnostics in oncology

Grading
Exam 1 Book Chapters 7-13
Book Chapters 1-6 Keynote lectures
Multiple choice questions Molecular diagnostics in pathology-
40% NGS-based mutation analysis
(Practical)
Multiple choice questions
50%
Exam 2
Book is leading!!!

,Lecture 1b - Ch1 Introduction: The Nature of Cancer
Cancer is a complex group of diseases characterized by uncontrolled cell growth,
invasion of surrounding tissues, and the ability to metastasize. This introductory
chapter provides the conceptual framework needed to understand cancer
biology, including epidemiological definitions, clinical terminology, the biological
nature of cancer, its causes, hallmarks, and current therapeutic strategies.

Epidemiological Definitions
- Incidence of cancer: absolute number of new cases in 2025 (in a particular
region). To compare populations or track trends, incidence is expressed as the
number of new cases per 100,000 persons per year. In the Netherlands,
approximately 130,000 new cases were diagnosed in 2024, a number that has
doubled over the past 30 years.
- Prevalence of cancer: absolute number of all persons who at any time have
been diagnosed with cancer. For example, the 5-year prevalence on January
1st, 2025 includes all people diagnosed since January 1st, 2020. In 2024, the
5-year prevalence in the Netherlands was about 420,000 people (2.4% of the
population).
- Mortality of cancer: absolute number of patients who died as a result of
cancer. It does not include cancer patients who die from unrelated causes.
Dutch cancer mortality in 2023 was approximately 46,000 deaths, a number
that has remained stable for several years despite rising incidence.
- Survival of cancer: percentage of patients who are still alive after a certain
period of diagnosis. Relative survival corrects for expected mortality in a
comparable population, approximating cancer-specific survival. Over the past
50 years, 5-year survival in the Netherlands has doubled from ~35% to ~70%,
reflecting major improvements in detection and treatment.

Cancer Incidence Trends
Cancer incidence varies strongly by cancer type. Gastrointestinal cancers, lung
cancer, and skin cancer show distinct patterns over time, influenced by lifestyle,
environmental exposure, and screening practices. For example:
 Lung cancer incidence differs markedly between men and women due to
historical smoking patterns.
 Skin cancer incidence has risen sharply, reflecting increased UV exposure
and improved detection.
These trends highlight the importance of prevention and early diagnosis.

, Clinical Definitions: Tumors vs. Cancer
Tumors are masses of cells, but not all tumors are cancerous. Only tumors that
are invasive and capable of metastasis are considered malignant and therefore
classified as cancer. Benign tumors do not invade surrounding tissues or spread
to other parts of the body and are therefore not cancer.
Cancer is a group of more than 100 diseases characterized by uncontrolled cell
growth, invasion of surrounding tissues, and the ability to form metastases.
Malignant tumors are life-threatening because they:
 Invade organs and disrupt normal organ function
 Compete with healthy tissues for nutrients and oxygen
 Can obstruct vital structures such as airways or blood vessels

Nomenclature of Cancer Types
 Carcinomas arise from epithelial tissues (and account for ~85% of all
cancers).
 Adenocarcinomas originate from glandular tissues (e.g. breast).
 Sarcomas arise from mesodermal tissues such as bone or muscle.
 Lymphomas derive from (progenitors of) lymphoid cells.
Carcinomas are most common because epithelial cells line the body’s surfaces
and are therefore most exposed to carcinogens.

Causes of Cancer and Carcinogenesis
A carcinogen is an agent causing cancer (compound, radiation, etc). This causes
alteration in the DNA of a cell (Chapter 2). The accumulation of mutations in the
DNA of a cell causes stepwise development of cancer (oncogenesis,
carcinogenesis). Environmental insults, replication errors, and metabolic
by-products all contribute. Cancer is generally not inherited, because most
mutations arise in somatic cells. However, some germline mutations increase
cancer risk and can be passed to offspring, though they rarely cause cancer
directly.
Cancer risk increases with age because mutations accumulate over time and
because longer life expectancy increases exposure to carcinogens.

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Written in
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