Cancer Education Lesson 1 : Cancer an overview

GENERAL NOTE FOR TEACHERS. THROUGHOUT THE COURSE THE KEY POINTS TO USE ARE IN BOLD AND ANY SUGGESTIONS FOR TEACHING POINTS ARE IN BLUE. Learning objectives Learning outcomes Introduction Cancer Education Lesson 1 : Cancer an overview How to keep healthy and what influences health, including the media To have an increased understanding of cancer Use a brainstorm activity with class in groups. General question What do you know about cancer? With class in groups suggest that they write their answers on a large sheet of paper. Suggested questions What people say Types of cancer? Causes How can we reduce the risk? Questions you want answered? etc. Main activities Ask them where their information came from, personal experience, media, friends, family, TV programmes and to rate in terms of reliability Full set of cards Card game provided. 1. Divide class into 5 groups and give each a set of cards. 2. Explain that they need to start with Card 1. Read the If required there is an additional set of cards for photocopying in the Reserve Sheets section at the end) question and answer either True or False. Depending upon the answer, the bottom of the card will tell them which card to go to next. 3. Repeat this with all the cards setting them out in a circle as they answer them. 4. To have answered them all correctly the last card will return them to Card 1 and complete the circle. 5. If they cannot complete the circle, or they complete the circle but have cards left, then they have gone wrong and will have to revisit their answers. When they have finished ask them if they are surprised at any answers. Read out the answers (provided at the END of this lesson plan) using the additional information and power point. 1

Plenary Lesson review link to objectives Where do we go next? Cancer is a generic name for over 200 diseases which all have one thing in common and that is the disease comes from cells beginning to divide in an uncontrolled manner What makes every cancer different is the person s genetic make up, the area of the body where it develops, and the cause. Every cancer is different, so every treatment will be different too. Statistics show that a cancer will affect 1 in 3 of us and 1 in 4 of those affected will die BUT despite producing cancer cells day in day out 2/3rds of us will never contract the disease and of those who do 75% will beat it! Dietary factors are estimated to account for approximately 30% of cancers in western countries, making diet second only to tobacco as a preventable cause of cancer. Therefore the next lessons explore what we know about cancer, what we can do to prevent it, and if we get it how to increase the odds for survival. Resources Interactive White Board, flipchart or white board, Cancer Teaching Pack which contains: Card Game and answer sheets and the CD disc (in the front of the file) A3 or A4 paper for group activity The card game gives general information on; what is cancer, treatments (conventional and complementary), causes and prevention. Answers to the Cancer Card Game Answer Sequence is: 1, 15, 3, 8, 6, 2, 7, 5, 14, 11, 12, 4, 10, 9, 13, 1 etc. Note: This depth of information is provided for occasional reference and/or advanced work. The most effective practice would be to use the slides and the information in BOLD only. The best approach is to flip through the slides quickly with most classes. 2

1. The body produces pre cancer cells everyday (3 types of cancer cell) SLIDES 1a,1b,1c Everyday your immune system deals with and removes 200 or so pre-cancer and developing cancer cells. Poor diet, toxins, infection and even poor mental state all contribute to a reduction of your immune system, to the point where one day a rogue cell beats the system and cancer will develop. The disease arises principally as a consequence of individual exposure to carcinogenic agents in what individuals inhale, eat and drink, or are exposed to in their personal or work environment. Personal habits, such as tobacco use, dietary and physical activity patterns - as well as occupational and environmental conditions - rather than genetic factors, play the major roles in the development of cancer. Therefore it is important to look after your immune system 15. Benign tumours grow at only a modest rate and do not spread TRUE A tumour is an unusual growth in the body. The organs and tissues of the body are made up of tiny building blocks called cells. Cells in different parts of the body may look and work differently but most reproduce themselves in the same way. Cells are constantly becoming old and dying, and new cells are produced to replace them. Most cells have a fixed number of divisions (approximately 50) before they die. Cancer cells do not have a limit. Normally, the division and growth of cells is orderly and controlled but if this process gets out of control for some reason, the cells will continue to divide and develop into a lump which is called a tumour. Tumours can either be benign or malignant. Cancer is the name given to a malignant tumour. Benign (non-cancerous) - these are tumours that don t have the ability to spread elsewhere in the body. They are often surrounded by an outer layer and they may grow more slowly. They only become a problem if they grow too big and press on surrounding organs or change how the organ works. Malignant (cancerous)- these tumours have the ability to spread to other parts of the body. They are usually not surrounded by an outer layer and invade into other tissue and they may grow faster. Cancer is the uncontrolled growth and spread of cells that may affect almost any tissue of the body. 3. There is only one type of cancer FALSE 3

There are over 200 different types of cancer that can occur in humans. They all may behave differently from each other and may have different causes, different symptoms and may require different types of treatment. Therefore there isn t one single cure, each cancer is individual and requires individual prescription It is important to remember that all of our cells have similar structures and share a majority of their functions. Cancers may be categorized based on the functions/locations of the cells from which they originate. The following terms are commonly used to distinguish tumours of different origin. Cancer types Slide 2 Carcinomas About 85% of cancers are carcinomas. They start in the epithelium, which is the covering (or lining) of organs and of the body (the skin). Sarcomas These form in the connective tissues of the body such as muscle, bone and fatty tissue (6% of cancers). Leukaemias/Lymphomas These occur in the tissues where white blood cells (which fight infection in the body) are formed, i.e. the bone marrow, and lymphatic system (5%). Others forms of cancer Brain tumours and other rare forms of cancer make up the other 4% of cancers. These are some cancers by organ site; Slide 3 Information on slide Lung cancer Breast cancer Stomach cancer Colorectal cancer Liver cancer Cancers of the female reproductive tract Cancers of the male reproductive tract Oesophageal cancer Bladder Head and Neck cancer Lymphoma Leukaemia Pancreatic cancer Melanoma Thyroid cancer Kidney cancer Tumours of the nervous system 8. There is no single factor that causes cancer TRUE Causes of Cancer Slide 4 The disease arises principally because individuals are exposed to cancer causing agents in what they: inhale eat and drink, come into contact with in their personal or work environment. 4

It is also caused by personal habits such as tobacco use physical activity patterns Cancer is a very complex disease. Scientific research has shown that there are a number of factors that increase or decrease a person s chances of getting cancer. Diet - Dietary factors account for about 30% of all cancers in Western Countries and approximately up to 20% in developing countries; diet is second only to tobacco as a preventable cause. Environment/toxins Viruses/Infections Hereditary genes 6-7% makes a minor contribution to the susceptibility of most kinds of cancers. 6. Cancer is contagious FALSE Cancer although a disease is not contagious. Definition of disease; It is a term of health status; when something is wrong with a bodily function. 2. Cancer cells need less oxygen than normal cells to live TRUE Cancer cells are able to survive at low oxygen levels, which is one reason why they may be more resistant to treatment than normal cells. Other differences - Normal cells commit suicide apoptosis - cancer cells do not. Apoptosis Is programmed cell suicide, it is clean and quick and involves a predictable sequence of structural changes that cause a cell to shrink and be rapidly digested by neighbouring cells. - Normal cells keep confined because as soon as they touch other cells they stop growing unlike cancer cells. 7. A cancer will affect 1 in 3 of us TRUE Slide 5 Information on slide A cancer will affect 1 in 3 of us and 1 in 4 of those affected will die Over 70% of cancers happen to people who are over the age of 60 The possibility of being diagnosed with cancer before the age of 15 is about 1 in 500 The most common cancer for men is lung cancer (19%), followed by prostate cancer (17%) The most common cancer for women is breast cancer (29%), followed by large bowel cancer (12%) 2/3rds of us will never contract the disease and of those who do 75% will beat it! Statistics show that a cancer will affect 1 in 3 of us, and 1 in 4 of those affected will die. This means that most people survive their cancers. 5

It can affect us at any age, but is most likely to happen when we are older. Over 70% of cancers happen to people who are over the age of 60. There are some cancers that are more likely to affect younger people than others, e.g. leukemia (a cancer of white blood cells), or osteosarcoma (a type of bone cancer). Around 1,500 new cases of childhood cancer are diagnosed each year in the UK. The risk for an individual child in Britain of being diagnosed with cancer before the age of 15 is about 1 in 500. In this country Cancer Research suggests that cancer rates increase annually by 2% but they have not included skin cancer (one of the fastest growing cancers). Therefore when skin cancer is included it is nearer to 4%. Some cancers are very common and others are very rare. The most recent statistics for the UK show that for men the most common cancer is lung cancer (19%), followed by prostate cancer (17%), large bowel cancer (14%), and bladder cancer (7%). For women the figures are breast cancer (29%), large bowel cancer (12%), lung cancer (11%), and cancer of the ovary (5%). We now know enough about the causes of cancer to prevent at least one-third of all cancers. Cancer is largely preventable: by stopping smoking, providing healthy food and avoiding the exposure to carcinogens. BUT despite producing cancer cells day in day out 2/3rds of us will never contract the disease and of those who do 75% will beat it! Many people with cancer can be cured but it is even better to prevent it and never to get it in the first instance. Even if a cancer cannot be cured, it can often be controlled with treatment for months or years. 5. The origin of one of the treatments we have today is linked to the battlefields of the 1 st World War TRUE This was the historical origin of chemotherapy. One of the treatments we have today exploits the fact that cancer cells multiply more rapidly than normal cells. The origin of this treatment goes back to the soldiers on the battlefields of the First World War, who were dying from a deadly silent weapon of chemical warfare, poisonous nitrogen mustard gas. Doctors examining the bodies of dead soldiers noticed a lot of damage to cells in their bone marrow. They also had very few white blood cells. No one thought much about this until after the Second World War when scientists working on chemical weapons wondered if the nitrogen mustard gas might have killed the bone marrow cells because these cells multiplied rapidly. If this was true, they reasoned, similar chemicals might kill cancer cells. They made some trial drugs and gave them to mice who had the white blood cell cancer, leukaemia. It was extremely successful, the mice were cured. This was the beginning of cancer chemotherapy. Scientists and doctors screened tens of thousands of natural and laboratory-made chemicals looking for anything that would kill multiplying cells, but there were drawbacks to this approach. 6

The drugs that were discovered usually killed all rapidly multiplying cells in the body. This meant that they killed some of the normal cells that lined the stomach and small intestines, cells that made hair, and cells in the bone marrow. Another problem was that only about 5% of the cells in a tumour are multiplying at any one time. Cells that are not multiplying cannot be killed by this treatment. As well as all these drawbacks, it was soon clear that chemotherapy would only work against some types of cancer. In spite of these problems there have been some important successes. As well as chemotherapy there are two other areas of orthodox treatment namely, surgery and radiotherapy. Radiotherapy uses high speed ionising radiation similar to x-rays, to hit the DNA in cancerous cells, if it hits the DNA when it is dividing a nonsensical code sequence will be produced and the body s natural defence system will throw the rogue cells out. In addition there are also complementary therapies which can work alongside the orthodox treatments which consist of for example, lifestyle changes, vitamin, mineral and other supplements, reflexology, reiki, yoga/meditation, etc. Some of these treatments have been shown to improve the quality of life of patients with cancer. Note: More on this in a later lesson List of Treatments Slide 6 Surgery An operation is done to remove the tumour. Surgery is often used if the cancer is only in one area of the body and has not spread. It may be used to remove lymph nodes if these are also affected by the cancer. It can sometimes be used to remove a cancer that has spread to another area of the body, but this is not common. The type of operation will depend on the area of the body affected by the cancer, and on the size and position of the tumour. Radiotherapy This is the use of high energy x-rays to destroy cancer cells, but cause as little harm as possible to normal cells. The radiotherapy is aimed at the affected area of the body and is very carefully planned. It can cause side effects and the most common is tiredness. The side effects will depend on the part of the body that is being treated. Chemotherapy Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. There are more than 50 different chemotherapy drugs. Some are given as tablets or capsules but most are given by drip (infusion) into a vein. The drugs go into the bloodstream and travel throughout the body to treat the cancer cells wherever they are. Sometimes just one chemotherapy drug is used, but often a combination of two, three or more drugs is given. Chemotherapy can cause side effects. The side effects will depend on which drug (or combination of drugs) is used. There are now very good ways of preventing or reducing the side effects of chemotherapy. 7

Hormonal Therapy Hormonal therapies work by altering the levels of particular hormones in the body. Some cancers depend on certain hormones in order to divide and grow. By altering the level of hormones in the body, or blocking the hormones from attaching to the cancer cells, the cancer can be controlled. As well as; Biological therapies e.g vaccines, Angiogenesis inhibitors (stops cell getting a blood supply), Cancer growth inhibitors, Gene therapy etc Stem cell & bone marrow transplants Supportive therapies, Bisphosphonates, Blood transfusion, Plasma exchange and Steroids etc Other treatments - Hyperbaric oxygen therapy, Hyperthermia treatment, and Photodynamic therapy. Complementary therapies - Counselling, Relaxation, Visualisation (mental imagery), Hypnotherapy, Self-help groups and Healing etc 14. Coffee enemas are used in cancer treatments FALSE Coffee with the caffeine was used years ago. They are used by some beauty centres as a way of detoxing - some centres recommend up to 4 enemas a day! 11. 20% of the monies spent on cancer is used for prevention - False 20p in every 100 = 0.2% In USA 11 billion dollars spent by government and drug companies, prevention less than 1%. 12. When a tumour gets to the size of about one centimetre it needs a blood supply TRUE Cancer cells release growth factors that cause nearby blood vessels to produce branches that grow into the cancerous tissue and therefore the cancer cell can get the nutrients it needs to grow. This is when the tumour begins to grow unchecked. This is one of the areas that scientists look at in controlling the cancer. If they can stop the blood supply the cancer cannot grow and spread. 4. Some viruses are directly linked to cancer - TRUE Infections from viruses, bacteria and trematodes (which are flukes: parasitic flatworms having external suckers for attaching to a host) account for 30% of all cancers worldwide (NOT in Europe). There are 6 viruses that have a direct link to cancers and HIV an indirect as this lowers the immune system allowing cancers to happen. But it also depends on genetic make up and how a person responds to a virus as to whether it will have an adverse effect. A vaccine for cervical cancer has been produced which they say will reduce this particular cancer by 75%. Lesson 5 will look more closely at viruses and bacteria and their link to cancer. 10. Skin moisturisers contain a chemical that is the sister product to commercial anti freeze - TRUE 8

Note: These products are not dangerous when used in moderation! The product is propylene glycol, workers handling it in factories must use protective clothing and gloves because it burns the skin in high concentrations! In many lipsticks are substances such as isopropyl alcohol which damages DNA, titanium or aluminium (linked to Alzheimer s). Quantities are very small and they are not considered to be a risk. Many toxins are linked to cancers. Lesson 4 looks at how to reduce the effects of toxins. 9. 30% of cancers are caused by poor diet TRUE The World Health Organisation also reported that dietary factors are estimated to account for approximately 30% of cancers in western countries, making diet second only to tobacco as a preventable cause of cancer. In the year 2000 the World Health Organisation reported that 10 million (5.3 million men and 4.7 million women) worldwide developed a malignant tumour of which 6.2 million died. (3.8 million survived!) In 2003, 7.1 million died world wide accounting for 12.6 of the global death total. They have also reported that at least 1/3 rd of all cancer cases are preventable! 13. Broccoli forms cyanide in cancer cells and causes them to die TRUE Broccoli forms a chemical in the body which is able to kill cancer cells. Cancer cells use an enzyme called glycosidase to help burn their fuel, glucose. Glycosidase converts B17 which is found in broccoli into benzaldehyde (an analgesic) and hydrogen cyanide (a poison) and thus kills the cell. Normal cells produce energy using oxygen and an enzyme, rhodinase. Rhodinase neutralises B17 and benzaldehyde in the presence of oxygen is immediately oxidized to benzoic acid which is non-toxic. However cancer cells have an outer protein shield and for B17 to be effective the shield has to be de-masked. Two protein digestive enzymes; one from Pineapple (bromelain) and one from Papaya (papain) help to de-mask the shield. B17 is also present in the seeds of apples, apricots, cherries, peaches, plums and nectarines, strawberries, watercress, cranberries, almonds and millet. So fruit is good for you! 9

SUMMARY SLIDE 7 The body produces pre cancer cells everyday Tumours that spread are cancerous Over 200 different types of cancer No single factor that causes it and no single cure therefore many different treatments Cancer cells differ from normal cells in that they do not burn oxygen and carbohydrates 2/3rds will not get cancer and of the 1/3 rd that do 75% will beat it Change in lifestyle could prevent over 30% of cancers! Viruses and bacteria responsible for 30% of cancers Toxins have links with cellular damage and links with cancer 10