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Cancer casestudy

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Cancer case study.

Cancer case study.

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Cancer casestudy Presentation Transcript

  • 1. A Case Study of Ovarian Cancer by Nancy A. Rice, Department of Biology, Western Kentucky University, and Bruno Borsari, Biology Department, Winona State University 1
  • 2. Abby is Sick: Review of the Story So Far…• Abby has been having abdominal pain.• She has gone to see Dr. Allen.• An ultrasound has indicated a mass on her right ovary. 2
  • 3. Group Discussion• If you were Abby, what questions would you have? 3
  • 4. CQ1: What percentage of peoplewith cancer who die each year, dieof cancer related causes? A: less than 1% B: about 10% C: about 25% D: more than 25% 4
  • 5. CQ1: What percentage of peoplewith cancer who die each year, dieof cancer related causes? A: less than 1% B: about 10% C: about 25% D: more than 25% 5
  • 6. Overall CancerIncidence and MortalityTrends in U.S. 6
  • 7. Asnapshotof ovarian cancerFrom: A Snapshot of OvarianCancer, National CancerInstitute, updated 2007. 7
  • 8. CQ2: Abby wondered: what is thedifference between cancer andtumor? What do you think?A: The two terms can be used interchangeably as they are synonymous.B: Cancer is a disease that eventually disrupts body functions whereas a tumor is a mass of cells with no apparent function in the body.C: Cancer is contagious while a tumor is not.D: Cancer is genetic but tumors are not. 8
  • 9. CQ2: Abby wondered: what is thedifference between cancer andtumor? What do you think?A: The two terms can be used interchangeably as they are synonymous.B: Cancer is a disease that eventually disrupts body functions whereas a tumor is a mass of cells with no apparent function in the body.C: Cancer is contagious while a tumor is not.D: Cancer is genetic but tumors are not. 9
  • 10. What is Cancer?• Simplest definition From the American Cancer Society “ cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. If the spread is not controlled, it can result in death.”• Tumor – Two types: • Benign (non-cancerous) – this is not cancer! – Does not spread; it can eventually become malignant in some cases. • Malignant (cancerous) – this is cancer – Has the potential to spread to other parts of body. 10
  • 11. CQ2a: Abby asked: what is thedifference between a tumor that hasmetastasized and one that hasn’t?A: A metastasized tumor doesn’t invade surrounding tissue.B: If the tumor has metastasized then it is less dangerous than one that hasn’t.C: If the tumor has metastasized then the cancer may have spread to other parts of the body.D: A metastasized tumor is more easily treated with surgical removal. 11
  • 12. CQ2a: Abby asked: what is thedifference between a tumor that hasmetastasized and one that hasn’t?A: A metastasized tumor doesn’t invade surrounding tissue.B: If the tumor has metastasized then it is less dangerous than one that hasn’t.C: If the tumor has metastasized then the cancer may have spread to other parts of the body.D: A metastasized tumor is more easily treated with surgical removal. 12
  • 13. Role of Cell Division in Cancer Top = normal cell division Bottom = unregulated cell division and tumor formation Malignant If tumor invades surrounding tissue (cancerous) BenignIf tumor has no effect on surrounding tissue (non-cancerous) Metastatic If individual cells break away and start a new tumor elsewhere (cancerous) 13 Image from the National Cancer Institute
  • 14. Metastasis 14
  • 15. CQ3: Abby’s CA-125 levels taken at twodifferent times are indicated below. IsAbby likely to have a cyst or cancer? 700A. benign 600 500 tumor 400 300B. malignant 200 CA-125 level tumor 100 0 Normal Abby Abby-2 patient weeks later 15
  • 16. How can you diagnose ovarian cancer?• CA-125 is the name for a protein produced on the surface of ovarian cells and released into the blood.• Almost all healthy people have CA-125 levels below 35 U/ml 16
  • 17. Preparing for SurgeryBefore the surgery, Dr. Allen came in to talk to Abby abouther test results.“I am really sorry, but your CA125 level is high and it lookslike your ovary actually does not have a cyst, but insteadhas a tumor. It is best now to go ahead and remove both ofyour ovaries.”Dr. Allen explained she had consulted with a pathologist toverify the diagnosis. She pulled out a brochure titledOvarian Cancer and opened it to show Abby threephotographs. One showed normal ovarian tissue; the othertwo showed benign and malignant ovarian tissue. 17
  • 18. Normal ovarian epitheliumOvary Ovariancystoadenoma adenocarcinoma(benign) (malignant) 18
  • 19. end of part 1 19
  • 20. Abby, a 20 year old college student has just found outthat she has ovarian cancer start part 2 20
  • 21. The genetics of ovarian cancerAbby was surprised to learn she might have ovarian cancer.“I’m only 20 years old. How did I get ovarian cancer? Isn’t this adisease of older women?Discuss: What might be some of Abby’s concerns about havingovarian cancer at such an early age? 21
  • 22. Dr. Allen told Abby:“Typically ovarian cancer does affect older women. However,you may have a genetic predisposition for it. Cancer cells havemutations in specific genes that regulate cell division. Whenthey are mutated, cell division becomes uncontrollable,” thedoctor explained. “Exposure to certain things like smoking,radiation, or viruses can damage these genes or they mighthave mutated randomly.” 22
  • 23. CQ4: Why does cancer primarilyaffect older people rather than youngpeople?A:Because the immune system of older people is not as effective in distinguishing normal cells from cancer cells.B: Because the DNA of older people is more susceptible to mutations.C: Because cancer develops after multiple mutations have occurred which takes years to happen.D: None of the above. 23
  • 24. CQ4: Why does cancer primarilyaffect older people rather than youngpeople?A:Because the immune system of older people is not as effective in distinguishing normal cells from cancer cells.B: Because the DNA of older people is more susceptible to mutations.C: Because cancer develops after multiple mutations have occurred which takes years to happen.D: None of the above. 24
  • 25. Cancer is a genetic disease• Cancer arises from the accumulation of genetic changes (mutations).• Most cancers have a minimum of 6-9 different genes mutated.• Many genes that are mutated in cancer are involved in regulating the cell cycle. 25
  • 26. CQ4a: Does someone with cancerrisk passing the disease on to his orher offspring?A: yesB: no 26
  • 27. CQ4a: Does someone with cancerrisk passing the disease on to his orher offspring?A: yesB: no Technically “B” is correct, however while someone with cancer does not pass the disease on to offspring directly we can pass on a susceptibility or predisposition to it in our genes. 27
  • 28. Remember: The cell cycle has four phases and controls cell division• Two gap or growth phases (G1 Interphase and G2)• S phase - DNA synthesis• M phase - Mitosis 28
  • 29. Cell Cycle Checkpoints• Checkpoints are where conditions within the cell might move the cycle along or might stop it.• For example, when the cell’s DNA is damaged, a protein called p53 can stop the cell cycle and cause the cell to die which prevents a damaged cell from being copied. 29
  • 30. CQ5: What would you expect cells to be like ifthe DNA that codes for proteins like p53 weremutated or absent?A: The absence of p53 inside cells would cause them to divide more rapidly.B: The absence of p53 could cause cells to replicate with damaged DNA that could ultimately lead to cancer.C: The absence of p53 could cause cells to skip mitosis (M phase) and stay in S phase of the cell cycle.D: The absence of p53 would have no effect on the cells. 30
  • 31. CQ5: What would you expect cells to be like ifthe DNA that codes for proteins like p53 weremutated or absent?A: The absence of p53 inside cells would cause them to divide more rapidly.B: The absence of p53 could cause cells to replicate with damaged DNA that could ultimately lead to cancer.C: The absence of p53 could cause cells to skip mitosis (M phase) and stay in S phase of the cell cycle.D: The absence of p53 would have no effect on the cells. 31
  • 32. Abby’s treatment optionsDr. Allen came to see Abby after her surgery.“Everything went really well. Now we need to thinkabout preventing this from ever coming back.Typically we use a combination of various types oftherapy, which includes radiation andchemotherapy.”– Radiation - Uses high-energy rays to kill cancer cells. A large machine directs radiation at the body.– Chemotherapy - Uses anticancer drugs to kill cancer cells. 32
  • 33. Typical Ovarian Cancer Treatments One common chemotherapy for ovarian cancer is Taxol, which was first isolated from the bark of a Yew tree in 1962 by the National Cancer Institutes (NCI). Taxol blocks a cells ability to break down the mitotic spindle during mitosis and interferes with the completion of cytokinesis. Taxus Brevifolia 33
  • 34. CQ8: Can surgery alone successfullycure a cancer that has metastasized? A. No, all body cells are dividing uncontrollably B. Yes, it could remove all cells with defective cell-cycle regulation C. No, cancer cells are no longer localized in one spot D. Yes, if the tumor is benign 34
  • 35. CQ8: Can surgery alone successfullycure a cancer that has metastasized? A. No, all body cells are dividing uncontrollably B. Yes, it could remove all cells with defective cell-cycle regulation C. No, cancer cells are no longer localized in one spot D. Yes, if the tumor is benign 35
  • 36. Two years after her treatment for ovarian cancer, Abbygraduated from college with a BA in Anthropology. Threeyears later she married, and today she is living happily withher husband Charles and their four-year-old adopteddaughter. 36
  • 37. PQ1: Which is true of all cancers? A. They’re caused by viruses. B. They’re caused by exposure to carcinogens. C. They’re caused by changes in DNA. D. They’re inherited. E. all of these are correct 37
  • 38. PQ1: Which is true of all cancers? A. They’re caused by viruses. B. They’re caused by exposure to carcinogens. C. They’re caused by changes in DNA. D. They’re inherited. E. all of these are correct 38
  • 39. PQ2: For a cell, a mutation in a genelike the one that produces the p53protein is most like: A. a stuck accelerator B. broken brakes C. a bad mechanic D. I don’t know 39
  • 40. PQ2: For a cell, a mutation in a genelike the one that produces the p53protein is most like: A. a stuck accelerator B. broken brakes C. a bad mechanic D. I don’t know 40
  • 41. PQ3: In 1971, Dr. Judah Folkman suggested that atumor cannot grow beyond 1-2 mm without new bloodvessels to provide nutrients to the tumor. In the 1990sit was discovered that a growth factor called VEGFstimulates the formation of new blood vessels. Andnow we know that many cancer cells secrete highlevels of VEGF. From this information, one mightpredict: A. small tumors secrete more VEGF than large tumors B. preventing VEGF production or action can stop tumors from growing C. normal cells do not secrete VEGF D. Dr. Folkman won the Nobel Prize in Physiology and Medicine 41
  • 42. PQ3: In 1971, Dr. Judah Folkman suggested that atumor cannot grow beyond 1-2 mm without new bloodvessels to provide nutrients to the tumor. In the 1990sit was discovered that a growth factor called VEGFstimulates the formation of new blood vessels. Andnow we know that many cancer cells secrete highlevels of VEGF. From this information, one mightpredict: A. small tumors secrete more VEGF than large tumors B. preventing VEGF production or action can stop tumors from growing C. normal cells do not secrete VEGF D. Dr. Folkman won the Nobel Prize in Physiology and Medicine 42
  • 43. the end 43