Basics of Oncology

Course guarantor:

Anna Jelínek Michaelidesová

Lecturer:

Anna Jelínek Michaelidesová

Tutor:

Anna Jelínek Michaelidesová

Supervisor:

Department of Dosimetry and Application of Ionizing Radiation

Synopsis:

The course provides an introduction to the biological and clinical foundations of oncology. Students will learn about cell structure and function, cell differentiation, stem cells, and the epigenetic regulation of gene expression. The course subsequently covers the causes and types of DNA damage, DNA repair mechanisms, mutation formation, and cell death. Particular attention is paid to the roles of the immune system, proto-oncogenes, oncogenes, and tumour suppressor genes in cancer development.

The course also explains the multistep process of oncogenesis, the properties of cancer cells and cancer stem cells, and the significance of the tumour microenvironment, hypoxia, and alterations in cellular metabolism. Students will gain an overview of the mechanisms of invasion and metastasis, circulating tumour cells, tumour markers, tumour histology, and classification. The final part of the course focuses on epidemiology, screening, basic diagnostic methods, and current cancer treatment options, including the assessment of treatment response and prognosis.

Requirements:

Course credit is awarded upon successful completion of a final written test. The test consists of 50 multiple-choice questions, with students selecting one correct answer from four options for each question. The minimum passing score is 30 correct answers out of 50 (60%).

Syllabus of lectures:

1. Introduction to Oncology and Fundamentals of Cell Biology

Definition and scope of oncology. Structure of the eukaryotic cell, cellular organelles, biomolecules, DNA, chromosomes, genes, transcription, and translation. Cell communication, the cell cycle, and its regulatory mechanisms. Basic types of human tissues and organ systems.

2. Cell Differentiation, Stem Cells, and Epigenetics

Embryonic development and cell differentiation, genotype and phenotype. Embryonic, adult, and induced pluripotent stem cells, self-renewal, and differentiation potential. DNA methylation, histone modifications, non-coding RNA, and the role of epigenetic alterations in tumour development.

3. DNA Damage and Repair, Mutations, and Cell Death

Endogenous and exogenous sources of DNA damage; the effects of chemicals, ultraviolet radiation, and ionising radiation; oxidative stress; and mitochondrial DNA damage. Types of mutations and chromosomal aberrations. DNA repair mechanisms, cell-cycle control, apoptosis, necrosis, and senescence.

4. The Immune System and Its Role in Oncology

Barrier, cellular, and humoral components of immunity. Innate and adaptive immunity, the principal types of immune cells, and their functions. Recognition and elimination of transformed cells, antitumour immune surveillance, and mechanisms of tumour immune evasion.

5. Proto-Oncogenes, Oncogenes, and Tumour Suppressor Genes

Properties of transformed cells and mechanisms of oncogene activation. Oncogenic viruses. Signalling pathways and the role of RAS and HER2 genes. Functions of tumour suppressor genes, inherited cancer predispositions, and the significance of BRCA1, BRCA2, and TP53. Basic approaches to molecular genetic testing.

6. Oncogenesis and Cancer Stem Cells

Multistep tumour development, accumulation of genetic and epigenetic alterations, loss of heterozygosity, and genomic instability. Replicative senescence, telomeres, telomerase, and proliferative immortality. Tumour heterogeneity and the properties of cancer stem cells.

7. The Tumour Microenvironment and Metabolism

The tumour as a complex ecosystem. Cancer and stromal cells, the extracellular matrix, fibroblasts, macrophages, lymphocytes, endothelial cells, and pericytes. Angiogenesis, hypoxia, and necrosis. Energy metabolism of cancer cells, the Warburg effect, metabolic heterogeneity, and the influence of the tumour microenvironment on treatment efficacy.

8. Invasion, Metastasis, and Tumour Markers

Epithelialmesenchymal transition, local invasion, entry of cancer cells into the blood and lymphatic circulation, and the formation of metastases. Circulating tumour cells, circulating tumour DNA, and liquid biopsy. Properties and clinical applications of tumour markers and biomarkers, including PSA, CEA, AFP, CA 19-9, HER2, and EGFR.

9. Types of Tumours, Biopsy, and Tumour Histology

Tumour-like lesions and true neoplasms; benign, intermediate, and malignant tumours. Nomenclature and classification according to tissue of origin. Epithelial, mesenchymal, neuroectodermal, germ-cell, and haematological tumours. Types of biopsy, tissue fixation and sample processing, histological staining, and immunohistochemistry.

10. Tumour Classification, Epidemiology, and Screening

Grading, staging, and the clinical stages of cancer. TNM classification and examples of other classification systems, particularly Gleason, FIGO, Dukes, Clark, and Breslow. Cancer incidence, mortality, and age distribution worldwide and in the Czech Republic. Cancer prevention and screening.

11. Diagnosis of Cancer

Medical history, clinical examination, and laboratory diagnostics. Examination of blood, urine, and stool samples. Ultrasound, endoscopy, X-ray imaging, computed tomography, magnetic resonance imaging, and nuclear medicine techniques. Diagnostic approaches to selected types of cancer.

12. Cancer Treatment and Evaluation of Treatment Outcomes

Curative and palliative treatment strategies. Surgery, chemotherapy, radiotherapy, hormone therapy, biological therapy, targeted therapy, immunotherapy, and gene therapy. Combination treatment approaches and examples of the treatment of selected cancers. Assessment of treatment response, follow-up, recurrence, survival, and prognosis.

Syllabus of tutorials:

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Study Objective:

The aim of the course is to provide students with a comprehensive foundation for understanding the development, progression, diagnosis, and treatment of cancer and to link knowledge of cellular and molecular biology with its clinical applications. Upon completion of the course, students will be able to describe the basic structure and function of the human cell, the organisation of genetic information, the cell cycle, and the basic types of human tissues; explain the principles of cell differentiation, the functions of stem cells, and the basic mechanisms of epigenetic regulation; characterise the causes and types of DNA damage, the principal DNA repair mechanisms, and the possible consequences of unrepaired damage; distinguish between the main forms of cell death and explain their significance in the development and treatment of cancer; describe the roles of innate and adaptive immunity in the recognition and elimination of cancer cells; explain the differences between proto-oncogenes, oncogenes, and tumour suppressor genes and describe the significance of RAS, BRCA1/2, and TP53; explain the multistep nature of oncogenesis, genomic instability, tumour heterogeneity, and the importance of cancer stem cells; characterise the composition of the tumour microenvironment and explain the roles of hypoxia, angiogenesis, immune cells, and tumour metabolic reprogramming; describe the principal stages of invasion and metastasis and the significance of circulating tumour cells and circulating tumour DNA; distinguish between the basic types of tumours and understand the principles of histological examination, biopsy, grading, and staging; explain the principles of TNM classification and provide examples of other classification systems; understand basic epidemiological indicators and the principles of cancer prevention and screening; describe the principal laboratory, imaging, endoscopic, histological, and molecular biological diagnostic methods; and characterise the main treatment modalities and explain the principles of treatment response assessment, patient follow-up, and prognosis.

Study materials:

Key references:

[1]ALBERTS, Bruce. Essential cell biology. 4th ed. New York: Garland Science, c2014. ISBN 978-0-8153-4454-4.

[2]WEINBERG, Robert A. The biology of cancer. 2nd ed. New York: Garland Science, c2014. ISBN 978-0-8153-4528-2.

Recommended references:

[3]HAYAT, M. A., ed. Methods of Cancer Diagnosis, Therapy, and Prognosis [online]. Dordrecht: Springer Netherlands, 2010 [cit. 2020-02-05]. DOI: 10.1007/978-90-481-3186-0. ISBN 978-90-481-3185-3.

[4]VERMA, Mukesh, ed. Cancer Epidemiology [online]. Totowa, NJ: Humana Press, 2009 [cit. 2020-02-05]. Methods in Molecular Biology. DOI: 10.1007/978-1-59745-416-2. ISBN 978-1-58829-987-1.

Note:

Time-table for winter semester 2025/2026:

Time-table is not available yet

Time-table for summer semester 2025/2026:

Time-table is not available yet

The course is a part of the following study plans:

• Jaderné inženýrství - Aplikovaná fyzika ionizujícího záření (elective course)
• Radiologická technika (compulsory course in the program, elective course)