1. CELL BIOLOGY AND CANCER

2. .01 Cancer types, incidence, pre-disposition, and risk factors

3. CANCER
WHERE DID IT GET ITS NAME?

4. Hippocrates observed 2300 years ago that the long, distended veins that radiate out from some breast tumors look like the limbs of a crab – from that observation came the term KARKINOMA in Greek, and later, CANCER in Latin.

5. A. Cancer facts
Group of 100 diseases that develop across time

6. 2. Can develop in virtually any of the body’s tissues

7. 3. Characterized by uncontrolled cell division

8. 4. Hereditary & environmental factors contribute to cancer development

9. 5. Second leading cause of death in U.S.

10. 6. Men have one in two lifetime risk, women one in three
ACTIVITY 1 – FACES OF CANCER

11. Type of Information FAMILY HISTORY
(write in the number of “yes” and “no” answers for all teams)
YES _____
NO ______

12. NUMBER OF PEOPLE DIAGNOSED WITH CANCER
TOTAL OF ALL TEAMS
0-19 YEARS _____
20-39 YEARS ______
40-59 YEARS ______
60 AND OLDER ______

13. TYPE OF CANCER WRITE IN THE NUMBER OF EACH
BLADDER __ LEUKEMIA __PROSTATE ___
BRAIN ___ LUNG ___ RETINOBLASTOMA ___
BREAST ___ ORAL CAVITY ___ SKIN ___
CERVICAL ___ OVARIAN ___ UTERINE ___
COLON ___ PANCREATIC __ OTHER ___

14. POSSIBLE RISK FACTORS
(LIST ANY POSSIBLE RISK FACTORS)

15. B. Types of cancer
Benign – not cancerous, does not invade nearby tissue or spread to other parts of the body (will grow & push organs out of way)
Malignant – cancerous; can invade nearby tissue and spread to other parts of the body (will invade organs by enzymes eating through tissue)

18. Metastatic – spread through body by hemogenic (blood) or lymphogenic (lymph)

19. 4. Type depends on cause & location
5. Each type has its own growth rate, prognosis, and treatability

20. C. Incidence increases with age
(old men have better chance of developing cancer)
Develops over time and could result from different causes
Can occur at any age and in any location

21. D. Inherited predisposition
Can inherit a cancer – susceptible mutation
Occurs in all the body’s cells

22. E. Risk Factors Increase a person’s risk for developing cancer
Cigarette smoking
Exposure to the sun
Exposure to carcinogens
Females – family history of breast cancer
Fair skin
Chemicals, radiation, & viruses

23. Risk Factors We Can Control
~Excessive exposure to UV radiation
especially for those with fair complexion
~Occupational exposure to substances like
coal tar, creosote, arsenic compounds &
radium
~Poor nutrition & improper body weight
~Risky sexual behavior
~Substance abuse
~Prolonged exposure to stress

24. Risk Factors We Cannot Control
~ Aging (Which is one of the biggest risk factor)
~ Males are more likely than females to develop cancer
~ Heredity (Inherited Predisposition)

25. F. Chance of surviving cancer increases with early detection & treatment
Incidence rate – number of new cases per year per 100,000 persons
Mortality rate – number of deaths per 100,000 persons per year
Survival rate – proportion of patients alive at some point after their diagnosis of cancer (chance of cure)
Morbidity - disease

26. .02 Causes & development of cancer
Many different agents can cause cancer
(Carcinogens)
sun
Radiation
Chemicals
smoking

27. Cancer involves the uncontrolled division of body cells.
B. Cancer represents a breakdown of the processes that regulate the growth of normal cells & tissues.
Cancer involves the uncontrolled division of body cells.
Cell division is normally precisely regulated
Cell cycle regulation is accomplished by two major types of genes

28. 4. Cancer causing agents often damage genes
5. When damage occurs to genes that regulate the cell cycle, signals that inhibit cell division can change leading the cell to divide more often that it normally would
(cancer cells multiply rapidly, taking up space and nutrients from the normal cells

29. C. Cancer develops from genetic damage to cells across time
Cigarette smoke can damage genes that regulate growth of normal cells

30. D. Cancer research leads to understanding normal cell cycle and new strategies for treating cancer

32. E. Stages of tumor development
tumor – mass of cancer cells
adenoma – noncancerous tumor
Ovarian mucinous cyst adenoma This tumor weighed 35 pounds.

33. 1. Mutation – damage to genes causing cells to alter (1st stage of tumor development) 2. Hyperplasia – altered cells & its descendents grow & divide too often

35. 3. Dysplasia – one of these cells experiences another mutation that further increases its tendency to divide. This cell’s descendents divide excessively & look abnormal

36. 4. In situ (tumor) – Tumor formed from these mutated, rapidly dividing cells stays contained within its tissue of origin

37. 5. Invasive cancer (malignant) – if some cells experience additional mutations that allow the tumor to invade neighboring tissues & shed cells into the blood or lymph, the tumor is malignant.

38. 6. Metastases – escaped cells may establish new tumors at other locations in body

39. Cancer has been described as a single disease and a hundred diseases
Single disease – all cancers display uncontrolled growth, the ability to expand without limit.
Hundred diseases – cancer can appear as a result of different causes, in a variety of sites within the body, and that each type of cancer displays its own growth rate, prognosis, and treatability.

40. The discovery that all cancer involves a fundamental disruption in the growth of cells and tissues suggests that to understand cancer, we need to understand the events and processes that occur as both normal and abnormal cells grow and divide.

41. In fact, much cancer research across the past two decades has focused on this challenge. This research has revealed a complex picture of how two classes of genes, called proto-oncogenes and tumor suppressor genes, normally regulate the intricate sequence of cell cycle events.

42. And it also has revealed how the accumulation of mutations in these genes can contribute to the development of an altered cell, a cell that has lost the normal controls on cell division.
Activity 2

43. .03 Genetic damage & mutation
Cancer results from the accumulation of genetic damage to cells across time
multiple exposure over time
Mutation causes change in the way the cell functions or develops

44. B. Cancer cells differ from normal cells
Shape changes (appearance changes)
Changes in their dependence on growth factors
Multitude of biochemical differences

45. Know the ABCDs of early detection
Learn your ABCDs, the changes in a mole or skin growth
that are warning signs of melanoma:
Asymmetry: One half doesn't match the other half.
Border Irregularity: The edges are ragged, notched, or blurred.
Color: The pigmentation is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance. Color may spread from the edge of a mole into the surrounding skin.
Diameter: The size of the mole is greater than 6 mm (0.2 in.), or about the size of a pencil eraser.

47. C. Cancer is a multi-step process, which explains:
Increased incidence of cancer with age
Development of cancer decades after exposure to carcinogens (severe sunburns as a child)
Increased incidence of cancer among people with inherited dispositions (they are more likely to develop cancer than the general population)
Activity 3

48. .04 Improve personal and public health
A. Good choices can reduce an individual’s risk of developing cancer
1. Levels of cancer prevention
A. Individual behavior changes – develop healthy behavior habits
B. Health care providers – perform counseling & routine screening

49. c. National level – government regulations to minimize public exposure to known carcinogens
d. International level – actions of developed countries bring cancer worldwide

50. 2. Attention to ethical & public policy issues
Children wear protective headwear & clothing during peak hours of UV exposure would prevent most skin cancers

51. B. Risk factors for skin cancer
Excessive exposure to UV (ultraviolet) radiation – damages skin cells
Fair complexion
Occupational exposure to substances
Known carcinogens:
a. coal tar
b. Creosate
c. Arsenic Compounds
d. Radium

52. C. Good choices can improve an individual’s chance of survival if he/she develops cancer
Improved detection
Improved treatment
Activity 4

53. Early Detection Cancer remains the 2nd leading cause of
death in the United States.
Cancer is a multi-stage disease.
The earlier stages of the disease are now
more manageable and curable.

54. Breast cancer screening
The type and frequency of breast cancer
screening that is best for you changes as you
age.
Ages 18 to 39: You should have a clinical breast exam every 3 years. If you have a high risk for developing breast cancer, talk to your health professional about when to begin having annual mammograms.
Ages 40 to 69: Annual clinical breast exams are recommended by all experts for women in this age group.

55. Cervical cancer screening
The Pap test is the most effective screening test for cervical
cancer and is often part of a pelvic exam.
Testing should start within 3 years of a
woman beginning sexual intercourse,
whatever age that may be, but no later than
21 years of age.
Women older than 30 should have different
screening recommendations based on their risk
factors.

56. Testicular and Prostate cancer screening
The American Cancer Society (ACS) recommends that all men between the ages of 15 and 40 have a testicular exam as part of a regular physical exam by their health
professionals.
Prostate exams are part of regular physical exams which
should be done annually.
A blood test called PSA (Prostate Specific Antigen) is available now and can detect the presence of prostate cancer earlier than physical exam. It is generally recommended for men over age 50 or those with risk factors for the disease.

57. Skin cancer screening
Screening guidelines from the American Cancer Society and other expert groups recommend that adults older than 40 have their skin checked by a health professional at least once a year, as well as during any other health exam.

58. Colon and rectal cancer screening
After age 50 the recommendations include
annual screening of stool for occult blood.
Colonoscopy, sigmoidoscopy and/or barium enema once every 5 years or as
recommended by your health professionall.

59. Look for any abnormal skin growth or any change in the color, shape, size, or appearance of a skin growth. Check for any area of injured skin (lesion) that does not heal.
Have your spouse or someone such as a close friend help you monitor your skin, especially places that are hard to see such as your scalp and back.

60. People People of all ages should get to know their skin
People People of all ages should get to know their skin. of all ages should get to know their skin.
Skin self-exam is a good way to detect early
skin changes that may indicate melanoma,
because most primary melanomas are
easily seen on the surface of the skin.
Skin cancer often appears on the trunk of
men and on the legs of women.

61. Awareness of Treatment Options
Seek education and stay current about new
research and discoveries on your own by
reading, listening and asking questions.

62. Ethics is a process of rational inquiry
D. Ethical values sometimes conflict in public policy debated about strategies for reducing the risk of cancer
Ethics is a process of rational inquiry
Ethics requires a solid foundation of information & careful interpretation of that information

63. Public policy may invade an individual’s freedom and autonomy
3. There are often competing, well-reasoned answers to what is right & wrong, or good or bad
Ex:
Public policy may invade an individual’s freedom and autonomy
Banning smoking in public places
Activity 5

64. A PROPOSED STATUTE
MANDATORY USE OF SKIN PROTECTION FOR ALL INDIVIDUALS UNDER THE AGE OF 18
Whereas it is well documented that only 15 percent of Americans regularly wear a sunscreen when they are outside, and 25 percent never wear sunscreen.

65. Whereas there is a direct link between the sun’s ultraviolet (UV) rays and melanoma, the deadliest form of skin cancer.
Whereas there were more than 42,000 new cases of malignant melanoma diagnosed in 1999.
Whereas more than 7,000 Americans die each year from melanoma.

66. Whereas disruption of the earth’s ozone layer by atmospheric chemical pollution may lead to rising levels of UV radiation.
Whereas 80 percent of a person’s UV exposure occurs prior to age 18.
Be it enacted by the Federal Statues that:

67. All individuals under the age of 18 are required to wear headgear and clothing that covers 90 percent of the extremities while outside during peak hours of UV exposure. This covering shall occur in all public locations that are currently under federal jurisdiction, including public school property, recreation sites, federal buildings, and work sites supervised by employers that are overseen by OSHA regulations.