Learning Matrix

Educational revision: 2026-09-10. This matrix precedes chapter expansion and keeps the scope at 20 topics.

Scope: the existing 20 chapters. This matrix records gaps in the short edition and the learning outcomes guiding expansion. The gaps below describe the starting point, not a claim that expanded chapters still omit these concepts.

Chapter	After reading, the learner should be able to	Gaps in the short edition
1. What cancer is, and is not	Distinguish a mass, neoplasm and cancer; explain why cancer is a family of diseases.	Tissue regulation; cancer without a mass; heterogeneity.
2. Cancer vocabulary without panic	Interpret terms with organ, method, negation and time while preserving uncertainty.	Contextual report reading; suspicion versus confirmation.
3. Cells, DNA, and tissues	Explain DNA, RNA and protein and connect gene regulation to tissue function.	Transcription, translation, expression and cell identity.
4. Benign, precancer, malignant	Distinguish cell quantity, atypia and invasion without assuming inevitable progression.	Basement membrane; in situ; limits of a linear sequence.
5. Why tumors grow	Explain net growth and subclone selection without assigning intention to cells.	Division/death balance; selection; limits of exponential growth.
6. Invasion and metastasis	Distinguish local invasion, transit and colonization; separate origin from biopsy site.	Colonization barriers; dormancy; primary versus specimen site.
7. Cancer types and tissue origins	Classify by site, histology and subtype without treating organ as a complete diagnosis.	Multiple classification axes; lineage; molecular identity.
8. Screening, diagnosis, monitoring	Calculate predictive value in an example and distinguish screening from confirmation.	Prevalence; 2×2 table; overdiagnosis and lead time.
9. Biopsy and pathology	Reconstruct the specimen-to-report pathway and explain sampling limits.	Fixation; sampling; morphology versus immunohistochemistry.
10. Imaging tests in plain language	Compare modality measurements and explain why a signal is not tumor identity.	CT/MRI/US/PET; resolution; acquisition and comparability.
11. Stage, grade, and risk	Separate anatomical extent, microscopic appearance and probabilistic estimates.	Clinical/pathologic stage; system version; time.
12. Biomarkers and mutations	Distinguish prognosis, prediction and unknown variant significance.	Analytical/clinical validity; utility; uncertain variants.
13. The cancer treatment map	Explain modality, objective and sequence as separate treatment dimensions.	Neoadjuvant/adjuvant use; supportive care; maturity and access.
14. Surgery, radiation, and local therapies	Connect anatomical target, margins and treatment volume to local therapy limits.	Margins; fractionation; toxicity; microscopic disease.
15. Chemo, targeted therapy, immunotherapy	Compare mechanisms and explain why selectivity does not eliminate toxicity.	Exposure; normal-tissue effects; resistance; contextual selection.
16. Remission, recurrence, resistance	Read a timeline without confusing absent detection with biological absence.	Detection limit; response versus duration; resistance.
17. Clinical trials and evidence levels	Analyze question, comparator, randomization and endpoint in a treatment claim.	Control; confounding; effect size; protocol versus result.
18. Survival, risk, and study endpoints	Calculate absolute/relative risk and explain censoring and OS/PFS events.	Denominators; percentage points; censoring; death as a PFS event.
19. Risk, prevention, and heredity	Explain predisposition and distinguish association, causation and absolute risk.	Somatic/germline; penetrance; confounding; prevention.
20. Cancer data, AI, and hype detection	Identify leakage, population shift and missing evidence of utility.	Split unit; calibration; external validation; prospective benefit.

Completeness Criterion

Each chapter must explain its core mechanism or distinction, work through an example, include a captioned figure and let readers justify an answer. References and a successful build do not demonstrate learning. Content review and reader testing remain separate steps. This introductory track does not cover every tumor, protocol, laboratory method or clinical decision.

What Remains Outside This Edition

The gaps in the table are addressed within the existing chapters, not by adding new topics. Tumor-specific classifications, detailed molecular pathways, laboratory protocols, treatment schedules, and implementation of statistical models remain in deeper material or outside this introductory scope. The learning outcomes are curriculum objectives, not measured learning results.

Supporting-reading source check for this expansion: 2026-09-10. Official NCI, NHGRI and FDA material and the cited literature inform the explanations. Worked examples and schematics are original educational constructions, not patient data, diagnostic images, validated models, or clinical thresholds. Existing references are retained; this date does not certify a new systematic review of every linked page. Testing the chapters with novice readers and independent specialist review remain pending.