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Molecular Pathology of Cancer and Application in Cancer Diagnosis, Screening and Treatment

Module description

This module is available either via blended learning with contact days on-campus, or as fully distance learning via our online platform. There may be some variation in scheduled teaching and learning activities depending on your mode of study. 

This module will equip you with detailed knowledge and understanding of the molecular mechanisms involved in cancer development. This will include the ways in which interrogation of a person’s own genome, and the genome of tumour cells, can facilitate the diagnosis and treatment of cancer.

Module aims - intentions of the module

This module covers the molecular mechanisms that underlie cancer development, growth and metastasis, and the differences between different cancers. It will explore the different molecular and cellular actions of anti-cancer treatments, the genomic factors affecting response and resistance to treatment, and the research approaches to anti-cancer drug design and development. Broad situations which confer a high cancer risk to a person and/or to other members of the same family will be discussed in the context of how genomic information may be integrated into cancer screening programmes. This module will prepare you to interrogate the cancer data sets from the ‘100,000 Genomes Project’.

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

On successfully completing the module you will be able to...

• 1. Analyse the molecular and cellular processes leading to cancer development and emerging changes in tumour classification
• 2. Appraise the genomic basis of cancer predisposition, and how this is used to identify people and families at higher risk of cancer
• 3. Critically evaluate how genomic information is currently applied in the diagnosis, classification, prognosis treatment selection and monitoring of cancer (e.g. leukaemia, breast cancer, melanoma, lung cancer).
• 4. Analyse how information from genome analysis of neoplastic cells, and RNA sequencing data, can be used to investigate the molecular and cellular processes leading to cancer development and inform strategies for drug development.

ILO: Discipline-specific skills

On successfully completing the module you will be able to...

• 5. Describe in detail the role of tumour suppressor genes and oncogenes in the development of cancer.
• 6. Explain and summarise the eight ‘hallmarks’ of cancer.

ILO: Personal and key skills

On successfully completing the module you will be able to...

• 7. Critically reflect on personal practice and make connections between known and unknown areas, to allow for personal development, adaptation and change.
• 8. Respond to innovation and new technologies and be able to evaluate these in the context of best practice and the need for improved service delivery.
• 9. Communicate accurately and effectively with peers, tutors and the public.

Syllabus plan

Whilst the module's precise content may vary from year to year, an example of an overall structure is as follows:

• Cellular properties of tumours: growth, division, invasion, aberrant hormone or toxin production, immunogenicity including T cell and B cell repertoire profiling
• Tumour classification systems
• Factors in tumour formation: molecular mechanisms and role of microenvironment, molecular signatures & changing classification
• Diagnosis, molecular sub-classification, aggressiveness (prognosis) characterisation of metastases
• Breakthrough tumour /metastases and molecular mechanisms
• Genomic testing of solid tumours and haematological cancers
  • Importance of sample quality
  • Testing of cell free tumour DNA in blood, for diagnosis and monitoring of solid cancers
• Analytical and interpretation challenges in genomics as applied to cancer
  • awareness of standardised nomenclature used when reporting results
• Genomic and cellular markers and optimal treatment regimes in haematological cancer and solid tumours
  • Companion diagnostics in cancer
  • Shared decision making with the patient
• Monitoring disease following treatment (medical, surgical or bone marrow transplant)
• Molecular basis of germline mutations for cancer predisposition
  • genomic testing strategies
  • interpretation of results for pathogenicity
  • familial implications, including presymptomatic testing and options for screening and prophylactic treatment
• Approaches to identify new genes and susceptibility loci: GWAS studies; other predisposition biomarkers
• Environmental factor and lifestyle predisposition and protection; molecular action; genomic interaction; epigenetic factors
• Role of genomics in drug development and the role of clinical trials as part of treatment options

Learning activities and teaching methods (given in hours of study time)

Details of learning activities and teaching methods

Formative assessment

Summative assessment (% of credit)

Details of summative assessment

Details of re-assessment (where required by referral or deferral)

Re-assessment notes

Please refer to the TQA section on Referral/Deferral: http://as.exeter.ac.uk/academic-policy-standards/tqa-manual/aph/consequenceoffailure/

Indicative learning resources - Basic reading

• Weinberg, R. (2014). The biology of cancer. New York: Garland Science.

• Read, A. and Donnai, D. (2015). New clinical genetics. Bloxham, Oxfordshire: Scion.

• Turnpenny, P. and Ellard, S. (2012). Emery's elements of medical genetics. Philadelphia: Elsevier/Churchill Livingstone. (electronic access through University of Exeter library)

• Strachan, T., Read, A. and Strachan, T. (2011). Human molecular genetics 4. New York: Garland Science.

• Strachan, T., Goodship, J. and Chinnery, P. (2015). Genetics and genomics in medicine. New York: Garland Science.

ELE – http://vle.exeter.ac.uk/course/view.php?id=6142

Indicative learning resources - Web based and electronic resources

Henry Stewart Talks Cancer Genetics:

https://hstalks.com/playlist/941/cancer-genetics/?biosci

Key words search

Tumour, cancer, diagnosis, classification, treatment, risk