MSc Oncology Including PG Certificate and PG Diploma
Part B, Clinical Sciences
Module Guide 2016/17: Cancer Treatments 1
Contents
1. Module Overview
3
2. Key Contacts
5
3. Urological Malignancy
6
4. Gastro-Intestinal Malignancy
8
5. Gynaecological Malignancy
9
6. Acute Oncology
10
7. Palliative Care
11
8. Sarcoma
12
9. Skin / Melanoma
13
10. HIV-related Malignancy
14
11. Appendix –timetable 2015/16
15
DOCUMENT CONTROL
Uncontrolled if printed
Document ID: ICR/AS/14/CT1/01
File Name: Cancer Treatments 1 Module Guide 2016-17
[for ICR MSc Oncology]
Approval requirements: Updates to be approved by relevant Course Director(s). All substantive updates must be consistent with regulations, policy and practice agreed by the Taught Courses Committee and Academic Board. Original approval history (with Minute references): Created in 2014/15 further to new module structure agreed by Academic Board 17 July 2014, Minute A/7/14/4(i), and using details previously held in individual Module guides with agreed changes and annual updates. Review requirements: Annual update and review required
Equality Impact Assessment date: n/a
Last reviewed/updated by:
Name: Anna Pili
Position/Dept: MSc Course Manager
Date: 27 September 2016
Last approved by:
Name: David Bloomfield
Position/Dept: Course Director
Date: 27 September 2016
Next review due date:
Summer 2017
Cancer Treatments 1 - Module Guide 2016/17
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1
Module overview
Module details Full Title:
Cancer Treatments 1
Part of Course:
Part B: Clinical Sciences
Compulsory or optional:
Compulsory
ICR Reference Number:
MS2011
Academic Level:
Level 7 (Masters)
Credit Value:
20 Credits
Module aims This module, like its sister module Cancer Treatments 2, is about developing knowledge and critical understanding to aid the clinical management of cancer, across a range of common and rarer malignancy types and tumour sites. The specific aims are: To guide you to acquire a comprehensive knowledge base of a range of topics related to malignancy (as per specific curriculum), so that patients can be managed clinically at a level appropriate for specialist training in a UK Cancer Centre setting. To enable you to recognise presentations and initial management of the rarer cancers, and develop critical awareness of the problems addressed by site specialist colleagues. To be able to apply theoretical knowledge to the practical management of patients with cancer. Intended learning outcomes Students are expected to be able to demonstrate, through passing the assessments, that they have achieved the following learning outcomes: To develop an in depth understanding of the principles underlying the management of malignancy. To synthesise, evaluate and apply these principles to the clinical environment. To evaluate and critically analyse the research base in the management of these cancers. To critically evaluate the knowledge base for these cancers in order to obtain awareness of the controversies and limitations which exist.
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Structure and curriculum coverage This module covers 3 major ‘core’ topics and 5 ‘specialist’ (less common) topics, as follows Core topics:
Specialist topics:
Urological
Acute Oncology
Gastro-Intestinal
Palliative Care
Gynaecological
Sarcoma Skin with Melanoma HIV-related malignancy
Teaching is structured in blocks corresponding to each topic, mostly run as half-days (with one topic in the morning and a different one in the afternoon. Each topic has a designated Topic Leader who co-ordinates that teaching. For each topic the following areas will be covered: Epidemiology, cancer biology and pathology of the tumour Assessment of a patient with the cancer Application of principles of local and systemic management Evaluation of the evidence base for treatment Identification of problems in managing this site More specific details about each topic area, including the syllabus and curriculum are given for each topic later in this Guide. Assessment Please see the separate Part B Assessment Guide for full details of how this module will be assessed. Link to Cancer Treatments 2 The Cancer Treatments 2 sister module operates in a very similar way but covers a different range of topics and tumour sites. The two modules function independently, but at least one major essay from either module needs to be on a ‘core’ topic (i.e. assessment cannot be focused solely on specialist topics). It is not necessary to take Cancer Treatments 1 assessment before moving on to Cancer Treatments 2 – they may be taken in any order. Page 4 of 21
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2
Key contacts
Note: Students should forward any administrative matters (e.g. timetabling, arrangements for assessment) concerning the module to the course administrators, at
[email protected] Any academic matters should be forwarded to the Topic Leaders, Joint Course Directors or Course Manager as appropriate. Course Administration Subject
Name and contact
Post
Affiliation
General course queries
MSc Administrator,
[email protected]
MSc Administration team
Registry, The Institute of Cancer Research
MSc Course Manager
Registry, The Institute of Cancer Research
Tel: 020 7153 5228 (Mon-Weds) Tel: 020 7653 3709 (Thurs-Fri) Any specific concerns
Anna Pili,
[email protected] Tel: 020 7153 5386 (Mon-Weds)
Topic Leaders Subject
Name and contact
Post
Affiliation
Urological
Dr Alison Tree
Consultant Clinical Oncologist
Royal Marsden Hospital
Consultant Medical Oncologist
University College London Hospital
Consultant Clinical Oncologist
Oxford University Hospital
Dr Kate Lankester,
[email protected]
Consultant Clinical Oncologist
Brighton & Sussex University Hospital
Dr Jaishree Bhosle,
[email protected]
Consultant Medical Oncologist
Royal Marsden Hospital
Consultant Clinical Oncologist
Maidstone &Tunbridge Wells NHS Trust
Consultant Clinical Oncologist
Royal Marsden Hospital
[email protected] Tel: 020 8661 3271 Gastro-intestinal
Dr John Bridgewater,
[email protected] Tel: 020 7380 9093 Dr Rebecca Muirhead
[email protected] Tel:
Gynaecological
Acute Oncology and Palliative Care (joint leads)
Tel: 020 8661 3278 Dr Rema Jyothirmayi,
[email protected] Tel: 01622 225 304
Sarcoma
Dr Aisha Miah,
[email protected]
Cancer Treatments 1 - Module Guide 2016/17
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Skin, Melanoma
Dr Susan Lalondrelle
[email protected]
Consultant Clinical Oncologist
Royal Marsden Hospital
Consultant Clinical Oncologist
Sussex Cancer Centre
tel:020 8661 3270/3662 HIV-related
Dr David Bloomfield
[email protected] Tel: 01273696955 ext:4602
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Royal Sussex County Hospital
CT1 Guide 2016-17
3
Urological Malignancy
Indicative syllabus content This core topic area covers Genito-Urinary cancers, including: Prostate cancer Urothelial and Bladder cancer Testicular tumours Renal cancer Penile cancer Learning resources (reading list) Core texts You are advised to read the following key papers Relevant chapters in Treatment of Cancer, Price, Sikora and Illidge, 5th edition, 2008 (Hodder and Arnold) Additional general reading Relevant chapters in Oxford Textbook of Oncology, Souhami, Tannock, Hohenberger and Horiot, 2nd edition, 2002 (Oxford University Press) Chemotherapy of Urological cancer. In The Royal Marsden Hospital Handbook of Cancer Chemotherapy ed: Brighton and Wood 2005 (Elsevier Churchill Livingstone). Relevant chapters in External Beam Therapy Edited by Peter Hoskin, Oxford University Press Prostate cancer BUG prostate cancer guidelines available at http://www.bug.uk.com/downloads/MDT%20GUIDANCE%20FOR%2 0MANAGING%20PROSTATE%20CANCER%20EVIDENCE%20BA SE%20SEPT%202013.pdf
Tree, AC, Alexander E, van As, NJ, Dearnaley DP, Khoo. Biological dose escalation: what is there to be gained and how is it best done? VS Clinical Oncology 2013 25 (8) 483-98
A round up of prostate radiotherapy, evidence and future directions
Yien Ning Sophia Wong, Roberta Ferraldeschi, Gerhardt Attard and Johann de Bono Evolution of androgen receptor targeted therapy
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for advanced prostate cancer. Nature Reviews Clinical Oncology Volume 11 2014 365-376 [A good review of the history of ADT in prostate cancer and current therapies. The second half of the paper is looking at new/experimental agents, so not needed for the MSc but interesting general knowledge.] Conventional versus hypofractionated high-dose intensitymodulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial. Dearnaley D, Syndikus I, Mossop H et al. Lancet Oncol. 2016 Jun 20. pii: S1470-2045(16)30102-4. doi: 10.1016/S14702045(16)30102-4. [Epub ahead of print]
Prostatectomy
Ficarra V1, Borghesi M, Suardi N, De Naeyer G, Novara G, Schatteman P, De Groote R, Carpentier P, Mottrie A. Long-term evaluation of survival, continence and potency (SCP) outcomes after robot-assisted radical prostatectomy (RARP). BJU Int. 2013 Aug;112(3):338-45. doi: 10.1111/bju.12001. Epub 2013 Mar 7. [An example of expected outcomes (functional and oncological) after prostatectomy]
Testicular cancer Horwich A, Shipley J, Huddart R Testicular germ-cell cancer. Lancet. 2006 Mar 4;367(9512):754-65.
EAU guidelines on testicular cancer: 2011 update. Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Fizazi K, Horwich A, Laguna MP; European Association of Urology. Eur Urol. 2011 Aug;60(2):304-19. doi: 10.1016/j.eururo.2011.05.038. Epub 2011 May 25. [Review.]
Gilbert DC, Van As NJ, Huddart RA. Reducing treatment toxicities in the management of good prognosis testicular germ cell tumors. Expert Rev Anticancer Ther. 2009 Feb;9(2):223-33. Review. [discussion of impact of information on late effects on treatment strategies]
Van As NJ, et al. Evidence-based pragmatic guidelines for the follow-up of testicular cancer: optimising the detection of
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relapse. Br J Cancer. 2008 Jun 17;98(12):1894-902. [Evidence based approaches to follow up schedules] Bladder cancer
www.bladder-cancer-course.org [EAU site with good interactive review of superficial bladder cancer management] EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol. 2016 Jun 17 [Epub ahead of print] Babjuk M, Böhle A, Burger M, Capoun O, Cohen D, Compérat EM, Hernández V, Kaasinen E, Palou J, Rouprêt M, van Rhijn BW, Shariat SF, Soukup V, Sylvester RJ, Zigeuner R. [Good review of NMIBC] Kaufman, D.S., Shipley, W.U. and Feldman, A.S. (2009). Bladder Cancer. Lancet, 374, p.239-249. [short well-referenced review of all stages of bladder cancer] Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer. Alfred Witjes J, Lebret T, Compérat EM, Cowan NC, De Santis M, Bruins HM, Hernández V, Espinós EL, Dunn J, Rouanne M, Neuzillet Y, Veskimäe E, van der Heijden AG, Gakis G, Ribal MJ.Eur Urol. 2016 Jun 30. pii: S0302-2838(16)302901. doi: 10.1016/j.eururo.2016.06.020. [Epub ahead of print] PMID: 27375033 [Good overview but from a surgical perspective, hence radiotherapy not considered a standard option]
Lalondrelle S, Huddart. Improving radiotherapy for bladder cancer: an opportunity to integrate new technologies. R. Clin Oncol (R Coll Radiol). 2009 Jun;21(5):380-4. [up to date perspectives of new technologies in radiotherapy treatment of bladder cancer]
BUG bladder cancer guidance available at http://urologyuk.com/Documents/BAUS%20BUG%20MDT%20Guidli nes%20-%20bladder%20cancer.pdf
NICE guidance on bladder cancer 2015 available at http://www.nice.org.uk/guidance/ng2/evidence/evidence-review3744110
Role of chemo in localized disease – the two key papers
Advanced Bladder Cancer (ABC) Meta-analysis Collaboration.
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Adjuvant chemotherapy in invasive bladder cancer: a systematic review and meta-analysis of individual patient data Eur Urol. 2014 Jul;66(1):42-54. doi: 10.1016/j.eururo.2013.08.033. Epub 2013 Aug 28.
Leow JJ, Martin-Doyle W, Rajagopal PS, Patel CG, Anderson EM, Rothman AT, Cote RJ, Urun Y, Chang SL, Choueiri TK, Bellmunt J. Adjuvant chemotherapy for invasive bladder cancer: a 2013 updated systematic review and meta-analysis of randomized trials. Eur Urol. 2014 Jul;66(1):42-54. doi: 10.1016/j.eururo.2013.08.033. Epub 2013 Aug 28.
Renal cancer
Capitanio U, Montorsi F. Renal cancer Lancet. 2015 Aug 25. pii: S0140-6736(15)00046-X. doi: 10.1016/S0140-6736(15)00046-X. [Epub ahead of print - Nice review of all of renal cancer.]
Chowdhury S, Larkin JM, Gore ME. Recent advances in the treatment of renal cell carcinoma and the role of targeted therapies. Eur J Cancer. 2008 Oct;44(15):2152-61. Epub 2008 Sep 29. [Review]
Penile cancer
Hakenberg OW, Compérat EM, Minhas S, Necchi A, Protzel C, Watkin N; European Association of Urology. EAU guidelines on penile cancer: 2014 update. Eur Urol. 2015 Jan;67(1):142-50. doi: 10.1016/j.eururo.2014.10.017. Epub 2014 Nov 1. [note current controversial stance on radiotherapy!]
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4
Gastro-Intestinal Malignancy Indicative syllabus content This core topic area covers Gastro-Intestinal cancers, including: Oesophageal cancer Stomach cancer Pancreatic cancer Hepato-biliary cancer Colorectal cancer Anal cancer Learning resources (reading list) Core texts You are advised to read the following key material: Relevant chapters in Treatment of Cancer, Price, Sikora and Illidge, 5th edition, 2008 (Hodder and Arnold) Additional reading Relevant chapters in Oxford Textbook of Oncology, Souhami, Tannock, Hohenberger and Horiot, 2nd edition, 2002 (Oxford University Press) Details of further readings on specific sub-topics are expected to be identified during teaching on the module. Oesophageal cancer
Forshaw MJ, Gossage JA, Stephens J, Strauss D, Botha AJ, Atkinson S, et al. Centralisation of oesophagogastric cancer services: can specialist units deliver? Annals of The Royal College of Surgeons of England. 2006; 88(6): 566-70. [Surgical UK outcomes and centralisation]
Birkmeyer JD, Stukel TA, Siewers AE, Goodney PP,Wennberg DE, Lucas FL. Volume and Operative Mortality in the United States. Surgeon N Engl JMed. 2003; 349(22): 2117-27. [Importance of surgical centralisation]
Cunningham D, Starling N, Rao S, Iveson T, Nicolson M, Coxon F, et al. Capecitabine and Oxaliplatin for Advanced Esophagogastric
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Cancer. N Engl J Med. 2008; 358(1): 36-46. [Optimal systemic treatment for metastatic disease.]
MRC working party for oesophageal cancer. Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. The Lancet. 2002; 359(9319) 1727-33. [Neoadjuvant chemotherapy for oesophageal cancer is better than surgery alone]
Pancreas
Campbell PJ, Yachida S, Mudie LJ, Stephens PJ, Pleasance ED, Stebbings LA, et al. The patterns and dynamics of genomic instability in metastatic pancreatic cancer. Nature. 2010; 467(7319): 1109-13. [Pancreas cancer is a genetic mess.]
Neoptolemos JP, Stocken DD, Friess H, Bassi C, Dunn JA, Hickey H, et al. A Randomized Trial of Chemoradiotherapy and Chemotherapy after Resection of Pancreatic Cancer. N Engl J Med. 2004; 350(12): 1200-10. [Adjuvant 5FU.]
Mukherjee S, Hurt CN, Bridgewater J, Falk S, Cummins S, Wasan H, et al. Gemcitabine-based or capecitabine-based chemoradiotherapy for locally advanced pancreatic cancer (SCALOP): a multicentre, randomised, phase 2 trial. The Lancet Oncology. 2013; (0): http://dx.doi.org/10.1016/S470-2045(13)700214. [Chemoradiation for localised pancreas cancer.].
Conroy T, Desseigne F, Ychou M, Bouché O, Guimbaud R, Bécouarn Y, et al. FOLFIRINOX versus Gemcitabine for Metastatic Pancreatic Cancer. New England Journal of Medicine. 2011; 364(19): 1817-25. [FOLFIRINOX for advanced disease.]
Biliary
Andersen JB, Spee B, Blechacz BR, Avital I, Komuta M, Barbour A, et al. Genomic and Genetic Characterization of Cholangiocarcinoma Identifies Therapeutic Targets for Tyrosine Kinase Inhibitors. Gastroenterology. 2012; 142(4): 1021-31.e15. [Biliary tract cancer is genetically targetable.]
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Madariaga JR, Iwatsuki S, Todo S, Lee RG, IrishW, Starzl TE. Liver resection for hilar and peripheral cholangiocarcinomas: a study of 62 cases. Ann Surg. 1998; 227(1): 70-9. [Surgery is difficult.]
Valle J, Wasan H, Palmer DH, Cunningham D, Anthoney A, Maraveyas A, et al. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010; 362(14): 1273-81. [Cisplatin and Gemcitabine for advanced disease.]
Hepatocellular carcinoma
Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc J-F, et al. Sorafenib in Advanced Hepatocellular Carcinoma. New England Journal of Medicine. 2008; 359(4): 378-90.
Llovet JM, Real MI, Montaña X, Planas R, Coll S, Aponte J, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. The Lancet. 2002; 359(9319): 1734-9. [TACE for liver only disease.]
Colon cancer
Sadanandam A, Lyssiotis CA, Homicsko K, Collisson EA, Gibb WJ,Wullschleger S, et al. A colorectal cancer classification system that associates cellular phenotype and responses to therapy. Nature medicine. 2013; 19(5): 619-25. [Molecular subtypes of colorectal cancer.]
Andre T, Boni C, Mounedji-Boudiaf L, Navarro M, Tabernero J, Hickish T, et al. Oxaliplatin, Fluorouracil, and Leucovorin as Adjuvant Treatment for Colon Cancer. N Engl JMed. 2004; 350(23): 2343-51. [Adjuvant FOLFOX.]
Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Goodman PJ, et al. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl JMed. 1990; 322(6): 352- 8. [Adjuvant 5FU for colon cancer.]
Sauer R, Becker H, Hohenberger W, Rödel C,Wittekind C, Fietkau R, et al. Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer. New England Journal of Medicine. 2004; 351(17): 1731-40. [Neoadjuvant chemoradiation for T3-4 rectal cancer.]
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Fakih.M.G. Metastatic Colorectal Cancer: Current State and Future Directions. JCO, June 1, 2015, 1717-1720
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5
Gynaecological Malignancy Indicative syllabus content This core topic area covers Gynaecological cancers, including: Principles of screening (for Cervical and Ovarian cancer) Ovarian cancer Cervical cancer Vulval cancer Uterine malignancies Gestastional Trophoblastic disease Learning resources (reading list) Core texts You are advised to read the following key material:
Relevant chapters in Oxford Textbook of Oncology, Souhami, Tannock, Hohenberger & Horiot, 2nd edition, 2002 (Oxford University Press)
Relevant chapters in Treatment of Cancer, Price, Sikora and Illidge, 5th edition, 2008 (Hodder and Arnold)
Diseases of the Breast, Harris, Lippman, Morrow & Osborne, 3rd edition, 2004 (Lippincott, Williams and Wilkins)
Relevant chapters in Cancer: Principles and Practice of Oncology, DeVita, Hellman & Rosenberg, 2004, (Lippincott, Williams and Wilkins)
Additional reading
Radiotherapy in Practice: Brachytherapy, Ed Peter Hoskins & Catherine Coyle, 2005 (OUP)
E-learning for Health Care / Royal College of Radiologists Gynaecological Brachytherapy online material – available at http://portal.e-lfh.org.uk/ and /www.e-lfh.org.uk/programmes/ [Students need to register on-line and then can access Advanced Radiotherapy programme]
Details of further readings on specific sub-topics may be identified during teaching on the module.
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6
Acute Oncology
Indicative syllabus content This specialist topic area covers: Acute oncological emergencies Radiotherapy in oncological emergencies Malignancy of undefined origin The role of Acute Oncology in clinical practice Learning resources (reading list) Core texts You are advised to read the following key material:
Relevant chapters in Clinical Problems in Oncology: A Practical Guide to Management, Moorcraft S-Y, Lee D, and Cunningham D, 2014 (John Wiley & Sons).
Cancer patients in crisis: Responding to Urgent Needs, Royal College of Physicians (2012), available at https://www.rcplondon.ac.uk/resources/cancer-patients-crisisresponding-urgent-needs [RCP article with Working Party report and further documentation]
Relevant chapters in Treatment of Cancer, Price, Sikora and Illidge, 5th edition, 2008 (Hodder and Arnold)
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7
Palliative Care
Indicative syllabus content This specialist topic area covers: Management of pain Multi-disciplinary management of the dying patient Management of other cancer symptoms Role of palliative radiotherapy and interventional radiology Learning resources (reading list) Core texts You are advised to read the following key material:
Relevant chapters in Clinical Problems in Oncology: A Practical Guide to Management, Moorcraft S-Y, Lee D, and Cunningham D, 2014 (John Wiley and Sons).
Relevant chapters in Treatment of Cancer, Price, Sikora and Illidge, 5th edition, 2008 (Hodder and Arnold)
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8
Sarcoma
Indicative syllabus content This specialist topic area covers: Soft Tissue Sarcoma Bone Sarcoma Learning resources (reading list) Core texts You are advised to read the following key material:
Relevant chapters/sections in Oxford Textbook of Oncology, Souhami, Tannock, Hohenberger and Horiot, 2nd edition, 2002 (Oxford University Press)
Relevant chapters/sections in Treatment of Cancer, Price, Sikora and Illidge, 5th edition, 2008 (Hodder and Arnold)
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9
Skin and Melanoma
Indicative syllabus content This specialist topic area covers: Non-melanomatous skin cancer Melanoma Merkel cell cancer Learning resources (reading list) Core texts You are advised to read the following key material:
Relevant chapters/sections in Oxford Textbook of Oncology, Souhami, Tannock, Hohenberger and Horiot, 2nd edition, 2002 (Oxford University Press)
Relevant chapters/sections in Treatment of Cancer, Price, Sikora and Illidge, 5th edition, 2008 (Hodder and Arnold)
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10
HIV-related Malignancy Indicative syllabus content This specialist topic area covers the specific specialist topic of cancer associated with HIV/AIDS. Learning resources (reading list) Core texts You are advised to read the following key material:
Relevant chapters/sections in Oxford Textbook of Oncology, Souhami, Tannock, Hohenberger and Horiot, 2nd edition, 2002 (Oxford University Press)
Relevant chapters/sections in Treatment of Cancer, Price, Sikora and Illidge, 5th edition, 2008 (Hodder and Arnold)
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11
Appendix Timetable 2016/17 The dates on which module teaching is scheduled to take place are as below, with major sections of the module indicated. Please note that this draft is as published at the start of the academic year and may be subject to change; any changes will be communicated to registered students by the MSc Course Administration team. A detailed session timetable will be distributed separately to this Module Guide, and made available on Canvas.
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