Cancer Treatments. Cancer Education Project. Overview:

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1 Cancer Educatin Prject Cancer Treatments Overview: This series f activities is designed t increase students understanding f the variety f cancer treatments. Students als explre hw the txicity f a chemtherapy agent can be studied in a labratry setting, and the issues that shuld be cnsidered befre participating in clinical trials. Part 1: Cancer Treatment Center (80 minutes) Students investigate different types f cancer treatments. They develp, peer review, and revise brchures fr adult cancer patients n different cancer treatments. Part 2: Finding the Right Chemtherapy Dse (80 minutes) Students d a hands-n labratry simulatin t determine the highest dsage f chemtherapy drug that des nt interfere with nrmal liver cell functin. Part 3: Clinical Trials fr Cancer Treatments (40 minutes) Students explre the phases f clinical trials and the imprtance f infrmed cnsent when cnsidering participatin in cancer clinical trials. Teacher Instructins Part 1: Cancer Treatment Center Befre Class, prepare fr each student: One cpy f Cancer Treatment Center letter One cpy f Cancer Treatment Brchure Guidelines Fur cpies f Feedback Frm fr Cancer Treatment Brchure Arrange fr Internet access r print resurces fr student research. First Cmmittee Meeting (20 minutes): Distribute ne cpy f Cancer Treatment Center letter t each student. Read the letter t the class. Assign students t wrk in cmmittees f 4 students. Assign each team ne f the fllwing treatment methds: 1

2 Chemtherapy Radiatin therapy Surgery Angigenesis Inhibitrs Bilgic Therapy Targeted Therapy Bne Marrw Transplantatin Gene Therapy Hrmne Therapy Phtdynamic Therapy Allw 10 minutes fr the cmmittee meeting during which parts f the brchure are assigned t team members. Tell students that they are expected t d research and prepare their part f the brchure fr hmewrk (r during class). Answer questins cmmittee members may have abut the assignment. If yur students d nt have hme access t Internet, yu may chse t print and distribute the infrmatin btained by fllwing the links at: Nte: If ne r tw students in each cmmittee have hme Internet access, they may be willing t print cpies f resurces that they find fr students wh d nt have cmputer access. Secnd Cmmittee Meeting (40 minutes) Prvide each student with 4 cpies f Feedback Frm fr Cancer Treatment Brchure. Emphasize the imprtance f including key infrmatin and f creating a cnsistent apprach fr presenting the infrmatin in the parts the brchure. Allw 40 minutes fr students t share and peer review their draft parts f the brchure using the Feedback Frm fr Cancer Treatment Brchure. Fr hmewrk, students shuld use the feedback frm the peer review t make apprpriate revisins t their sectins f the brchure. Third Cmmittee Meeting (20 minutes) Allw 20 minutes fr students t cmbine the revised parts int a single team brchure. If time permits, allw an additinal class perid fr students t share their brchures with their classmates. 2

3 Part 1 Cancer Treatment Center University Medical Center Anytwn, New Yrk Dear Vlunteer: Thank yu fr adding yur name t a list f individuals wh wuld be willing t vlunteer their help t supprt cancer patients and their families. A significant number f ur cancer patients have difficulty reading and understanding the medical infrmatin n cancer treatments that is prvided n ur current website. T slve this prblem, we have established several cmmittees t design brchures that explain cancer treatments t these patients. Yu will wrk n a cmmittee that will create an engaging and infrmative brchure fr adult cancer patients r their family members. This cmmittee will meet fr three wrking sessins. In additin, each member f this cmmittee shuld expect t spend a significant amunt f time wrking independently t prepare fr cmmittee meetings. Meeting 1: Planning fr Cmmittee Wrk (10 minutes) Cmmittee members cllabrate t decide wh will be respnsible fr each tpic sectin f the brchure. See attached infrmatin n selected sectin tpics. Independent Wrk: Cmmittee members shuld: Review the infrmatin n cancer treatment n ur current web sites: and Select key infrmatin relevant fr their assigned sectin f the brchure Prduce a draft f their assigned brchure sectin Print cpies f web site materials that they used in develping their brchure Bring a flder t the next meeting that cntains: (1) their brchure sectin, (2) the ther related web site materials 3

4 Meeting 2: Cmmittee Review f Drafts (40 minutes) Cmmittee members shuld exchange their flders with at least tw ther cmmittee members wh will evaluate their draft sectin. T peer review these draft sectins, cmmittee members shuld review the web site infrmatin in the flder and then cmplete the feedback frm prvided by the cancer center staff. Make specific suggestins fr revisins, additins, r deletins t the cntent f each sectin f the brchure. Prvide specific suggestins n hw t make the brchure mre engaging and understandable fr cancer patients. Prvide specific suggestins n changes that culd be made t imprve the cnsistency between different sectins f the brchure. Independent Wrk: Cmmittee members wuld use feedback frm the peer review t imprve their draft prtin f the brchure. Meeting 3: Cancer Center Staff Review f Drafts (20 minutes) Cmmittee members meet t assemble the parts f the brchure int a cmplete brchure. Our gal is t have brchures ready fr ur patients by n later than. (date) Thank yu fr agreeing t assist the cancer center by wrking n these cmmittees. If yu have any questins, please cntact me by calling xxx-xxx-xxxx. I wuld be happy t answer any questins that yu have. N Directr f Patient Services Cancer Treatment Center 4

5 Part 1 Sectin Tpics fr the Cancer Treatment Brchure Develped by the Cancer Treatment Center Staff Subject fr Cancer Treatment Brchure Type f Cancer Treatment: Each brchure shuld include the fllwing sectins: Sectin Tpics Name f Respnsible Cmmittee Member 1. What is? 2. Hw Des Wrk? 3. What Shuld I Expect During 4. What Are The Side Effects f? 5. What Are The Risks f? 6. What Are The Benefits f? 7. Hw Can I Cpe With The Side Effects f? 8. What Supprt Is Available During? Our current infrmatin n cancer treatment is prvided thrugh these tw web pages: Be sure t fllw the relevant links n these websites. Als d a web search t find additinal infrmatin. 5

6 Part 1 Feedback Frm fr Cancer Treatment Brchure Type f Cancer Treatment: Sectin Tpics: Name f Authr: Name f Reviewer: 1. Three specific suggestins fr revisins, additins, r deletins t ensure that the cntent f the sectin prvides accurate and essential infrmatin fr the patient. 2. Tw specific suggestins t make the sectin mre engaging and understandable by the patient. 3. One specific suggestin t imprve the cnsistency between different parts f the brchure? 6

7 Teacher Instructins Part 2: Finding the Right Chemtherapy Dse (80 minutes) Citatin: This activity was mdified frm Cancer Warrir: What s the Right Dse?, a lab activity prduced by PBS at Befre class: Prepare ne cpy the lab handut ( Finding the Right Chemtherapy Dse ) per student. Cpy and cut apart the Drug and Dse Assignment Slips n the next page. Each team shuld receive ONE f these slips. Depending n the number f teams, yu shuld select dsage slips that include at least: 0 drps, 1 drp, 5 drps, and 10 drps. Prepare a kit f the fllwing materials fr each student team f tw r three students. 1 Drug and Dse Assignment Slip see next page 1 plastic well plate 1 plastic drpper labeled Liver Cells 1 plastic drpper labeled Chem Drug 3 tthpicks 1 small (at least 20 ml) cup labeled Liver Cell Hmgenate 1 small (at least 10 ml) cup labeled Chemtherapy Drug - Curl 3 clean test tubes (apprx 25 ml) 1 bttle f 3% hydrgen perxide (purchase at drug r grcery stre) 1 drpper labeled Glycerl filled with glycerl 1 stirring rd r cffee stirrer 1 metric ruler 1 pair f gggles 1 small Pst-it nte Immediately befre lab class: Use a blender t prepare liver (fresh r frzen/defrsted) hmgenate. Chp apprximately ne half (1/2) pund f liver int small pieces. Put the chpped liver and 100 ml f distilled water int a blender. Blend fr three minutes. Strain thrugh a sieve t remve large pieces that may clg pipets. Dispense abut 20 ml int cups labeled Liver Cells. Leftver liver hmgenate may be frzen in a ice cube tray fr ther labratry classes. Prepare simulated chemtherapy drug ( Curl ) by making a 200 ml f a 2% NaCl slutin. Add ne r tw drps f yellw fd clring t the NaCl slutin. Prvide each team f students with abut 10 ml f the simulated chemtherapy drug. Dispense in small plastic cups labeled Chemtherapy Drug Curl. Fill Glycerl labeled drppers with abut 1 ml f glycerl. Pst a large class graph n the bard r n pster paper. See sample graph n page 9. 7

8 Drug and Dse Assignment Slips Drug Dsage = 0 drps (cntrl) Drug Dsage = 1 drp Drug Dsage = 2 drps Drug Dsage = 3 drps Drug Dsage = 4 drps Drug Dsage = 5 drps Drug Dsage = 6 drps Drug Dsage = 7 drps Drug Dsage = 8 drps Drug Dsage = 9 drps Drug Dsage = 10 drps 8

9 Sample Class Graph fr Part Height f Fam (mm) Chemtherapy Drug Dsage (Drps) During lab class: Distribute ne cpy f lab handut ( Balancing Act: Finding the Right Chemtherapy Dse ) t each student. Distribute ne kit f labratry materials t each team f students. Pint ut t students that they shuld refer t the Drug and Dse assignment slips in their materials kit. This prvides infrmatin n the dsage f chemtherapy drug that they will be respnsible fr testing. Ask students t fllw the labratry instructins. They shuld be careful t use the apprpriate dsage f chemtherapy drug they are assigned t test. 9

10 Part 2 Balancing Act: Finding the Right Chemtherapy Dse When testing a new drug fr use as a chemtherapy drug, scientists must first determine hw txic the drug is ver a range f dse levels. It is imprtant t determine what dsage (cncentratin in the bdy) will kill cancer cells while minimizing harmful effects n nrmal cells. Befre testing chemtherapy drugs n humans, scientists cnduct in vitr (in a test tube) labratry tests t determine what dsage f the drug will nt dangerusly interfere with nrmal cell prcesses. Scientists test the drug n healthy cells t determine what dsage f a new chemtherapy drug culd be used t kill cancer cells and still allw healthy cells t functin nrmally. Liver cells are ften used fr these tests because the liver is imprtant in deactivating and eliminating a wide range f txic mlecules that can damage cells. One such txic material is hydrgen perxide, a waste chemical prduced by nrmal cell metablism. The liver and many ther cells in yur bdy break dwn txic hydrgen perxide int harmless water and xygen. If liver cells are unable t deactivate and eliminate hydrgen perxide, they may be unable t carry ut essential cell prcesses. A drug research center has develped a ptential chemtherapy drug that they wuld like t test further. Our class has been asked cllabrate with the drug research center t determine the highest dsage f the drug that still allws liver cells t functin nrmally. Each team f students will be assigned t test the effect f ne cncentratin f this chemtherapy drug. Once each team has cllected data fr its part f the experiment, class data will be cmpiled t create dse-respnse curves fr this ptential chemtherapy agent. The Drug and Dsage assignment slip in yur materials kit indicates the name f the drug and the cncentratin yur team will be testing. Recrd the dsage f the drug that yur team is respnsible fr testing in each bx in the third clumn f Table 1. 10

11 Table 1: The Effects f Curl n the Activity f Liver Cells Trial # Drps f Liver Cell Hmgenate Dsage f Drug (drps) Height f Fam (mm) Student Team Prcedure: 1. Add 20 drps f the liver cell hmgenate (grund liver) t three different wells n the well plate. 2. Add the prescribed dse (number f drps) f the drug that has been assigned by yur teacher. Stir using clean tthpick. 3. Wait fur minutes fr the drug t act n the cells. While yu wait, prepare three test tubes with 10 ml f 3% hydrgen perxide. Draw a line n the utside f each test tube t indicate the tp f the hydrgen perxide. 4. Begin Trial # 1. Use a pipette t add 3 drps f the cells/drug mixture frm ne well n the spt plate directly t the hydrgen perxide in the test tube. Recrd the height f the fam (bubbles) in the tube (distance in millimeters frm the line n the test tube t the tp f the fam). 5. Repeat the abve prcedure fr tw mre trials (Trail #2 and Trial # 3). Make sure yu use cell/drug mixtures frm the ther wells n the spt plate. Fr example, use the cells/drug mixture frm the secnd well fr Trial #2 and use the cells/drug mixture frm the third well fr Trial #3. 6. Calculate the average height f fam fr the drug dsage yu are testing. Write yur initials, the cncentratin f the drug, and the average height f fam (in mm) n the Pst-it nte prvided in yur materials kit. 11

12 7. Place yur Pst-it nte in the apprpriate lcatin n the class graph. While ther student teams finish their experiment, clean yur team s test tubes, spt plates, and wrk area. Call yur teacher ver t check yur lab clean-up. 8. Use the infrmatin n the class Pst-it graph t cmplete the Graph 1 belw. Be certain t include an apprpriate title that includes bth the independent variable and the dependent variable. Graph 1 Title: Height f Fam (mm) Chemtherapy Drug Dsage (Drps) 12

13 Questins fr Analysis 1. Why is it imprtant t cnduct mre than ne trial at each dsage? 2. What is the independent variable in this experiment? 3. What is the dependent variable in this experiment? 4. Accrding t the class graph, hw des increasing the dsage f the drug affect the liver cells? Explain yur reasning. 5. State ne advantage f using high dses, rather than lw dses, f the chemtherapy drug t treat cancer? 6. State ne disadvantage f using high dses, rather than lw dses, f the chemtherapy drug t treat cancer? 7. Often it is impssible t find a dsage f chemtherapy drug that kills all cancer cells withut having harmful affects n nrmal cells. The trick with chemtherapy is t find a drug dsage that is high enugh t kill cancer cells, but lw enugh t harm relatively few nrmal cells. Use yur graph t determine the highest dsage (drps) f the chemtherapy drug that will reduce nrmal liver cell functin by 10%. Explain hw yu arrived at yur answer. 8. What might happen t the ther cells and tissues f the bdy if the liver is unable t eliminate hydrgen perxide? 9. What are tw pssible surces f errr in this experiment? What actins culd be taken t avid, r reduce, each f these surces f ptential errr? 13

14 Teacher Instructins Part 3: Clinical Trials fr Cancer Treatment (10 minutes + hmewrk + 20 minutes) Befre class: Plan fr cmputer access r make print cpies f the resurces suggested in the student handut Clinical Trials fr Chemtherapy Treatments. Make ne cpy f Clinical Trials fr Chemtherapy Treatments fr each student. Make ne cpy f Clinical Trials - Venn Diagram fr each student. During first class (10 minutes + hmewrk): Distribute a cpy f Clinical Trials fr Chemtherapy Treatments t each student. Assign students t wrk in teams f 3. Assign ne student in each team t d research n ne phase f clinical trials - Phase I, Phase II, r Phase III. Allw hmewrk r time fr individual students t read abut clinical trials and answer the questins based n their assigned clinical trial phase. During secnd class (20 minutes): Draw the sample Venn diagram belw n the bard. Explain hw t d a Venn diagram, if students have nt used this type f graphic rganizer befre. Distribute ne cpy f Clinical Trials - Venn Diagram t each team. Ask student teams t wrk tgether t prepare a Venn diagram that summarizes the similarities and differences between the three different phases f clinical trials. Allw time fr students t share the results f their research with ther students in their team and t wrk tgether t prduce the Venn diagram. 14

15 Clinical Trials fr Cancer Treatments Phase I Phase II Differences Similarities Similarities Similar in ALL Similarities Differences Differences Phase III 15

16 Part 3 Clinical Trials fr Chemtherapy Treatments Once scientists have dne labratry tests n ptential chemtherapy treatments, the scientists need t test the treatments n human subjects. Tests n human subjects are called clinical trials. Patients must sign an infrmed cnsent frm befre they participate in clinical trials. Befre patients agree t participate in clinical trials, dctrs r scientists shuld explain bth the benefits and risks f the clinical trials t the ptential clinical trial participants. Patient s shuld understand and carefully weigh bth the benefits and the risks invlved in the clinical trials. Imagine that yu are a cancer patient wh had been asked t give his/her infrmed cnsent fr participatin in a PHASE clinical trial fr a new chemtherapy treatment. Use the infrmatin at and t answer the fllwing questins: 1. What types f peple participate in Phase clinical trial? 2. Hw many peple typically participate in Phase clinical trials? 3. What are the risks f participating in Phase clinical trials? 4. What are the benefits f participating in Phase clinical trials? 16

17 5. What questins wuld yu want yur dctr t answer befre yu agreed t participate in Phase clinical trials? 6. Wuld yu be willing t participate in Phase clinical trials? Explain why r why nt? Be ready t share the answers t these questins with ther members f yur team. 17

18 Clinical Trials - Venn Diagram Team Members Names,, Wrk as a team t prepare a Venn diagram t cmpare (shw similarities) and cntrast (shw differences) amng the Phase I, II, and III clinical trials. Phase I Phase II Clinical Trials Phase III 18

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