1. Medical Interventions Unit 3 Review

2. Lesson 3.1 Detecting Cancer
Activity Who is Affected by Cancer?
Activity Diagnostic Imaging Career Activity
Activity When Cells Lose Control
Activity DNA Microarray
Activity Unlocking the Secrets in Our Genes (math activity)
Lesson 3.2 Reducing Cancer Risk
Activity Am I at Risk?
Activity Skin Cancer Prevention
Activity Breast Cancer Screening and Prevention
Activity Virology Career Activity
Activity Routine Screenings
Lesson 3.3 Treating Cancer
Activity Diary of a Cancer Patient
Project Biofeedback Therapy
Project Design of a Prosthetic Arm
Project Occupational and Physical Therapy Careers

3. Lesson 3.1 Detecting Cancer
Activity Who is Affected by Cancer?
Activity Diagnostic Imaging Career Activity
Activity When Cells Lose Control
Activity DNA Microarray
Activity Unlocking the Secrets in Our Genes

4. What fundamental characteristics do all cancers have in common?
Genetic component
Environmental component – Smoking, radiation, diet/health
If caught early and removed before it spreads the cancer may not cause problems
If it spreads/metastasizes there could be potential problems
Incidence of cancer increases with age
Cancer can affect any organ or tissue in the body

5. What fundamental characteristics do all cancers have in common?
Proto-oncogenes – Normally control cell division by telling the cell to divide. Cancer can be caused by these genes being turned on too much
Mutation can cause them to be oncogenes, which lead to uncontrolled division
Translocation of a promoter can cause the oncogenes to be turned on more than they are supposed to be
A mutation can cause multiple proto-oncogenes, which will cause it to be overexpressed and uncontrolled cell division

6. What fundamental characteristics do all cancers have in common?
Tumor-Suppressor Genes– Normally control cell division by telling the cell to stop dividing. Cancer can be caused by these genes being turned off
Example is the p53 gene
Triggers apoptosis (programmed cell death) if there is a mutation
Activates DNA repair enzymes to repair any mutations
Halts the cell cycle so no copies of the cell are made with the mutation
Mutations in these genes can lead to cancer

7. What fundamental characteristics do all cancers have in common?
Cancer cells can proliferate indefinitely in culture.
Cancer cells do not exhibit contact inhibition. Once cancer cells cover the surface of the dish, the cells will continue dividing and pile up on top of each other.
Cancer cells undergo morphological changes and will exhibit various shapes.
Cancer cells can grow under less stringent conditions, and can usually grow on simple culture medium.
Cancer cells often have an abnormal number of chromosomes and the chromosomes often have an abnormal structure.

8. In what ways are diagnostic imaging technologies used to diagnose and treat disorders?
X-Ray – uses radiation to view broken bones bones, lung diseases, and digestive system
CT scan – uses multiple X-rays in a tube to produce cross-sectional views of bone and soft tissue, like organs.
MRI – uses magnets to produce detailed cross-sectional views of soft body tissue to identify diseases.
Bone Scan – Add radioactive tracers that are soaked up by the bone to produce full skeletal view to identify abnormal bone growth

9. What do DNA microarrays measure?
DNA microarrays measure the number and amount of genes turned on and off in cancer cells vs. normal cells
We can do this by collecting mRNA from the cells, which will only be made if the genes are turned on
We can also determine if there is a correlation between genes interacting with each other

10. How is DNA microarray technology used to determine the differences in gene expression between different tissue samples?
Red – The genes are only on in cancer cells
Yellow – The genes are on in cancer and normal cells
Black – The genes are not on in either cells
Green – The genes are only on in normal cells

11. How is DNA microarray technology used to determine the differences in gene expression between different tissue samples?
Microarrays can also tell us the relative intensity of the gene expression because there will be varying shades of the colors.
The bright red would be a high expression of the gene in cancer cells, where as the dark red would be a low expression.
The same would be true for the yellow and the green

12. How is DNA microarray technology used to determine the differences in gene expression between different tissue samples?
We can superimpose the colors from the cancer gene and the normal gene over each other to get one single color.
We assign this color a number (ratio)
A number over 1 the gene is expressed more in cancer cells
A number under 1 the gene is less expressed in cancer cells
A number equal to 1 the gene is expressed the same in both cells
0 means the gene is not expressed in either cell

13. How are the similarities of gene expression patterns between different individuals calculated?
Using statistical analyses we look at gene expression of several genes in several patients that have the same disease.
We use correlation coefficients to determine if there is a pattern between what genes are turned on and what genes are turned off
If there is a positive correlation then both of the genes are behaving in the same way
If there is a negative correlation then the genes are behaving in opposite ways (one is on and the other is off)
Correlation of 1 means that gene expression is identical
Correlation of 0 means there is no correlation
A number further from 0 and closer to 1 means that there is a stronger correlation
REVIEW ACTIVITY (MATH ACTIVITY)

14. Lesson 3.2 Reducing Cancer Risk
Activity Am I at Risk?
Activity Skin Cancer Prevention
Activity Breast Cancer Screening and Prevention
Activity Virology Career Activity
Activity Routine Screenings

15. In what ways do different risk factors increase the chance that a person will develop cancer? How can lifestyle changes reduce the risk for developing cancer?
Biological
Age – the risk for all cancers increase
Infections – Some viral and bacterial infections can cause an increase risk of cancer
Reduce these risks by being screened often and getting vaccinations
Genetic
Sometimes a gene can be inherited from parents that increases the risk of cancer, because you already one step (mutation) towards cancer.
Hereditary cancer and familial cancer would be genetic. Sporadic cancer (most cancers) are not genetic.

16. In what ways do different risk factors increase the chance that a person will develop cancer? How can lifestyle changes reduce the risk for developing cancer?
Environmental
Pollution – Smoke and chemicals, like asbestos, can damage DNA
UV Radiation - More on this later
Radiation – Excessive radiation from sources, like Xrays
Behavioral
Red meat and other foods have been shown to increase risks of cancer (other foods, like antioxidants have been shown to lower cancer)
Smoking increases risk of lung cancer (same with smokeless tobacco and mouth cancer)
Not taking preventative measures, like staying out of the sun

17. Skin Cancer
Types
Basal/Squamous – most common and least dangerous form that can be found anywhere on the body
Melonoma – most common on face, chest, and legs, and are more likely to metastize
ABCDE
Asymmetry
Border irregularity
Color changes
Diameter greater than 1/4 inch
Evolving

18. Skin Cancer Diameter (1/4 in) Border irregular Color changes
Asymmetric
Evolving

19. Skin Cancer Treatment pyrimidine antagonists
(5-Fluorouracil or 5-FU) inhibit the enzyme that makes pyrimidines (thymine, uracil, cytosine), which stops production of DNA and RNA.
While this works in some patients it has a variety of side effects including burning and sun sensitivity

20. How can molecular tests be used to detect inherited genetic mutations associated with certain cancers?
Genetic Marker Analysis – Easier and cheaper genetic analysis than DNA Sequencing.
Markers are located directly in front of the gene in question (therefore, often passed on with the gene)
Markers are Short Tandem Repeats (non-coding DNA that are repetitive sequences of DNA)
STRs are highly variable by length (sequence can repeat any number of times making them different lengths)
Easy to identify STRs using gel electrophoresis because they are simply different lengths

22. How can molecular tests be used to detect inherited genetic mutations associated with certain cancers?
Genetic markers used in conjunction with pedigrees
Identify people with gene for cancer
Conduct a marker analysis on family members and unknown family member using gel electrophoresis
Identify STR sizes using standard curve
Compare STRs and identify alleles possessed by each family member
Analyze allele to see if there is a correlation between alleles and family members with cancer

23. Breast Cancer Genetic Component
BRCA 1 and BRCA 2 are tumor suppressor genes
Mutations in these may lead to tumors
5-10% of breast cancers are related to these genes
BRCA 2 genes are linked to male breast cancer
Preventative measures
Prophylactic mastectomy – reduces breast cancer risk by 90%
Get it test positive for BRCA 1 or 2 genes, calcium deposits, radiation therapy, or previous breast cancer
Hormonal therapy – medicines or removal of the ovaries in order to reduce estrogen
Nutrition
Physical Activity

24. How can viruses lead to cancer?
Viruses can cause cancer by injecting DNA into cells and thereby causing a mutation
HPV – linked strongly to cervical cancer, vaccines may help, but will not guard against every strain
EBV – may lead to lymphomas
Hepatitis B – Vaccine
Hepatitis C – No vaccine both may lead to liver cancer

25. Human Papilloma Viruses (HPVs)
HPV is a sexually transmitted infection
HPV causes abnormal cells to start growing and eventually can turn into cancer cells
HPV is the main cause of cervical cancer
HPS is linked to mouth and throat cancer
There is a vaccine available that protects against 4 types of the HPV virus.

26. Epstein-Barr Virus (EBV)
EBV is a type of herpes virus known for causing infectious mononucleosis (commonly known as “mono”)
EBV infects and stays in B lymphocytes
EBV infection increases a person’s risk of developing nasopharyngeal cancer and Burkitt lymphoma
EBV is also linked to Hodgkin diseases and stomach cancer
No vaccine or medications are available

27. Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV)
Both viruses are known to cause liver infection
The long-term infection caused by these viruses increases a person’s chance of developing liver cancer
There is a vaccine available to prevent HBV infection
There are a few medications available that are effective in treating HBV and HCV infections

28. What is the importance of routine cancer screenings?
You should get routine screenings for:
Prostate
Colon
Cervical
Breast
Skin, Testicular, and lung
Early detection of cancers is crucial to stop the metastases process before the cancer spreads and cause problems elsewhere.
It is easier to treat and cure cancer when caught early

29. Lesson 3.3 Treating Cancer
Activity Diary of a Cancer Patient
Project Biofeedback Therapy
Project Design of a Prosthetic Arm
Project Occupational and Physical Therapy Careers

30. What can a cancer patient receiving chemotherapy and/or radiation therapy expect during treatment?
Chemotherapy is the use of drugs to kill, prevent the spreading, slow growth, and treat symptoms of cancer.
The side effects are different for everyone, but typical side effects are hair loss, anemia and symptoms that occur with anemia, increased infections, bleeding, and bruising, and nausea
Most of these symptoms are due to the fact that chemo affects fast growing cells, like blood forming cells in the bone marrow. Therefore, not as much blood is being formed.

31. What can a cancer patient receiving chemotherapy and/or radiation therapy expect during treatment?
Radiation is more of local treatment that focuses radiation onto cancer cells to destroy DNA, causing cells to stop dividing.
Radiation can be given externally or internally through an implant
Most side effects are localized skin and hair changes along with fatigue
This may lead to anger, depression, and helplessness

32. How is biofeedback therapy used to help patients improve their health or manage pain?
Biofeedback changes the mental state of the patient, which allows them to calm down.
The patient learns to use their mind to control involuntary actions of the body, like heart rate, muscle tension, and respiration rate.
They can overcome pain by relaxing specific muscle groups to relieve certain chronic pain and migraines
This can also help lower blood pressure, anxiety attacks, asthma attacks, or urination problems

33. In what ways do artificial limbs allow patients who suffered the loss of a limb regain lost function?
Other limbs can offer simple movements, like hooks or pinchers to allow the person to pick objects up
Prosthetics can be hooked to other functional parts of the body that are used to move the prosthetic.
A patient can use switches and toggles to control the prosthetic
Myoelectrics can you muscle impulses to control the movement of the prosthetic.

34. How do advances in technology allow for the development of artificial limbs that look and move like actual human limbs?
Special dyes can be used to make the prosthetic the same color, with freckles, fingerprints and a life like appearance
Myoelectrics can use muscle contractions and EMG signals to control the prosthetic
Current research is ongoing into the use of brain signals connected to the motor cortex to move robotic arms, which could be the new wave of prosthetics.

35. How do physical and occupational therapists help patients with disabilities or patients recovering from surgery or injury?
PT focus on range of motion, movement, and ability to regain proper movement
OT work with patients to practice normal, routine practices that they have to do everyday, like driving, cooking, and using the restroom
They design appropriate exercises for the patients to practice the intended movement
They use electric shock, stretching, and massage therapy to relax and test muscles
They assign appropriate tools and rehab equipment for the patients to use and guide the patient in proper use

36. END