How do we treat cancer?
The previous unit placed hyperproliferating tumor cells into a tissue context and focused on the important role of metastasis in the transition from a benign tumor to a malignant tumor. It introduced the concept that tumors associated with the same organ may have very different characteristics. This unit puts everything that has been learned about tumors into the context of treatment, emphasizing the problems that arise when treating cancers as an organ-based rather than a cell-based disease. It discusses the current diagnostic techniques and treatments, and also looks forward to how breakthroughs in DNA sequencing technology can provide us with new information to design more specific cancer drugs for better treatments in the future.
Lesson 1
How do we detect cancer?
This lesson will distinguish between preventative screening done on healthy people and diagnosis of symptoms, and introduces the common diagnostic techniques including physical examinations, imaging and biopsy/blood tests. As an activity, students work in small groups with clinical case studies to develop an effective diagnostic approach that is minimally physically or emotionally burdensome to the patient as well as cost effective.
| Objectives | – Differentiate between a preventative screen and a diagnostic test, and explain why this difference is important. – Describe the different options available for detecting and diagnosing tumors. – Explain why different detection methods are employed. |
| Activities | Jigsaw of patient case studies and determine appropriate diagnostic tests. |
| Materials | Printed Materials: – Lesson worksheet – HW worksheet |
| Homework | Worksheet: Read the Boston Globe article on the changing guidelines for mammograms and answer questions.This is a very important homework as it lays the foundation for upcoming discus-sions on the rationale for screenings and treatment guidelines. Students will be tested on this in the final exam. |
Lesson 2
What do cancer screens really tell us?
This lesson will examine the effectiveness of preventative screens. The diagnostic tools used, walk a fine line between being too sensitive and diagnosing healthy people as sick (false positives); or too specific so that they miss people who are actually sick (false negatives). Preventative screens that do identify early stage cancer but provide no information about prognosis may lead to overtreatment of a tumor that poses minimal risk. As an activity, students work in small group with case studies to evaluate the effectiveness of different types of screens for certain cancers.
| Objectives | – Explain the terms ‘sensitivity’ and ‘specificity’ with respect to cancer detection. – Explain the terms ‘false positive’ and ‘false negative’ with respect to cancer diagnosis. – Explain the limitations of mammograms with respect to cancer diagnosis. – Explain the limitations of the PSA test with respect to cancer diagnosis. – Explain the challenges of making individual decisions based upon population-wide evidence. |
| Activities | Evaluation of new screens for liver cancer and sarcoma. |
| Materials | Printed Materials: – Lesson worksheet – HW information sheet |
| Homework | Worksheet: Read about one of three specialties to prepare for tomorrow’s lesson. |
Lesson 3
How can we treat cancer?
This lesson will outline the various methods available for treating cancer: surgery, radiation, and chemotherapy. The different treatment approaches are compared and contrasted, and their strengths/weaknesses in treating primary and secondary tumors evaluated. As an activity, students work in small groups, emulating a tumor board to evaluate treatment plans for patients with different types of cancers.
| Objectives | – Describe the strengths and weaknesses of surgery as a cancer treatment. – Describe the strengths and weaknesses of radiation therapy as a cancer treatment. – Describe the strengths and weaknesses of chemotherapy as a cancer treatment. |
| Activities | Jigsaw: From the perspective of different cancer specialities, design a treatment plan for patients. |
| Materials | Printed Materials: – Lesson worksheet – HW worksheet Other Materials: – HW video (Optional) |
| Homework | Worksheet: Read article “The Treatment” and answer questions, or Video: Watch the 60 Minutes episode on using viruses to target brain cancers. |
Lesson 4
What happens once cancer has been treated?
This lesson is a continuation of Lesson 5.3. Students will follow up on the patients they devised treatments for 1, 5, and 10 years down the road, and evaluate whether the therapy they prescribed was effective. Based on their findings, students will discuss the difficulties in designing effective cancer treatments. They will also explore which palliative treatments and alternative therapies are valid care options.
| Objectives | – Define the terms “remission” and “relapse” and explain how the potential for relapse influences the choice of treatment. Explain why different cancers respond to similar treatments differently. – Explain the purpose of palliative and alternative therapies, and when they are appropriate. |
| Activities | Jigsaw: Follow up on patients from 5.3, to examine what happens after cancer treatment. |
| Materials | Printed Materials: – Lesson worksheet – HW worksheet Other Materials: – HW video |
| Homework | Worksheet & Video: Watch 60 minutes piece “The Cost of Living” and answer questions on worksheet. |
Lesson 5
How will cancer be treated in the 21st century?
This lesson will evaluate how the limitations of our available therapies could be improved on. Students will learn about how the Cancer Genome Atlas has provided significant tools that allows us to study cancer as a disease of specific gene mutations rather than as diseases of particular tissues or organs. Based on this, the lesson will introduce the concept of how personal information about cancer predisposition could give rise to personalized treatment plans. As an activity, students will identify optimal chemotherapy treatments against a variety of different cancers, based on data collected by the Broad Institute.
| Objectives | – Explain the concept of driver mutations in terms of cancer progression. – Explain how personalized medicine designs drugs to target driver mutations. – Explain how genetic sequencing is used to identify driver mutations. – Explain the concept of prevalence and penetrance of mutations. |
| Activities | Using data on different tumors from the Broad Institute, develop a personalized treatment plan. |
| Materials | Printed Materials: – Lesson handout – Lesson worksheet – HW worksheet |
| Homework | Worksheet: Read about Cancer Genome Atlas and answer questions. |
Lesson 6
So what about the “war” on cancer?
The final lesson of this module will examine research on cancer prevention, diagnosis, and treatment through a societal lens. In 1971, the US government declared a “War on Cancer” with the goal that cancer would be eradicated as a disease within a short period of time. Students will use their knowledge to assess the challenges that have prevented this goal from being achieved, and will evaluate the role they can play as citizens to help win this ‘war’ on cancer.
| Objectives | – Explain why the war on cancer has turned out to be more of a challenge than anticipated. – Identify one aspect of government policy, scientific research, or medical treatment of cancer that could be targeted in order to make the war on cancer more effective. |
| Activities | Watch Pink Ribbons Inc. video and discuss the role of corporations in fund raising for cancer. |
| Materials | Printed Materials: – Lesson worksheet |
| Homework | Prepare for final project. |
Teacher Prep: Unit 5 Lesson Overview Videos
In the YouTube embed below, click the order listing in the upper right to toggle the display for the full playlist.
