Understanding Cancer Tutorial
Information for Teachers
Understanding Cancer Tutorial
• This tutorial was adapted from the
Understanding Cancer: Cancer Tutorial
available at
http://www.cancer.gov/cancertopics/understandi
ngcancer/cancer
• There are two forms for this PPT:
– Teacher Presentation version (with a script)
– Student Handout version (if printing, specify
black/white on print menu)
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Understanding Cancer Tutorial
Information for Teachers
• The National Cancer Institute has produced a
series of cancer related PowerPoint tutorials.
These are available as downloadable format at
http://www.cancer.gov/cancertopics/understandi
ngcancer.
• Each PowerPoint in this series includes a
teacher script. Once these have been
downloaded, you may modify the slide show and
print student handouts.
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Understanding Cancer
Teacher Information
Developed by:
Lewis J. Kleinsmith, Ph.D.
Donna Kerrigan, M.S.
Jeanne Kelly
Brian Hollen
Discusses and illustrates what
cancer is, explains the link
between genes and cancer,
and discusses what is known
about the causes, detection,
and diagnosis of the disease.
These PowerPoint slides are not locked files. You can mix and match slides from
different tutorials as you prepare your own lectures. In the Notes section, you will
find explanations of the graphics.
The art in this tutorial is copyrighted and may not be reused for commercial gain.
Please do not remove the NCI logo or the copyright mark from any slide.
These tutorials may be copied only if they are distributed free of charge for
educational purposes.
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Cancer
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Understanding Cancer
Developed by:
Lewis J. Kleinsmith, Ph.D.
Donna Kerrigan, M.S.
Jeanne Kelly
Brian Hollen
Discusses and illustrates what
cancer is, explains the link
between genes and cancer,
and discusses what is known
about the causes, detection,
and diagnosis of the disease.
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What are some different kinds of cancer?
Bloodstream
Lung
Lymph nodes
Breast (women)
Colon
Bladder
Prostate (men)
Fat
Bone
Muscle
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What are some different kinds of cancer?
Carcinomas:
Lung
Leukemias:
Bloodstream
Lymphomas:
Lymph nodes
Breast (women)
Colon
Bladder
Prostate (men)
Sarcomas:
Fat
Bone
Muscle
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What are some different kinds of cancer?
Cancer Prefixes Point to Location
Prefix
Meaning
adeno-
gland
chondro-
cartilage
erythro-
red blood cell
hemangio- blood vessels
hepato-
liver
lipo-
fat
lympho-
lymphocyte
melano-
pigment cell
myelo-
bone marrow
myo-
muscle
osteo-
bone
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How are Normal and Cancer Cell Division Different?
Normal
cell division
Cancer
cell division
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How are Normal and Cancer Cell Division Different?
Normal
cell division
Cell Suicide or Apoptosis
Cell damage—
no repair
Cancer
cell division
First
mutation
Second
mutation
Third
Fourth or
mutation later mutation
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Uncontrolled growth
How are normal and cancer growth different?
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How are normal and cancer growth different?
Normal Growth
Dead cells
shed from
outer surface
Epidermis
Dividing cells
in basal layer
Cell migration
Dermis
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How are normal and cancer growth different?
The Beginning
of Cancerous
Growth
Underlying tissue
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How are normal and cancer growth different?
Tumors
(Neoplasms)
Underlying tissue
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How are normal and cancer growth different?
Invasion
Cancer cells grow into
surrounding tissues
and blood vessels
Metastasis
Cancer cells are
transported by the
circulatory system
to distant sites
Cancer cells
reinvade and grow
at new location
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What is the difference between a
benign tumor and a malignant tumor?
Benign
Malignant
Time
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What is the difference between a
benign tumor and a malignant tumor?
Benign (not cancer)
tumor cells grow
only locally and cannot
spread by invasion or
metastasis
Malignant (cancer)
cells invade
neighboring tissues,
enter blood vessels,
and metastasize to
different sites
Time
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Why are malignant tumors dangerous?
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Why are malignant tumors dangerous?
Brain
Melanoma
cells travel
through
bloodstream
Liver
Melanoma
(initial tumor)
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What is cancer screening?
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Why is cancer screening important?
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Why is cancer screening important?
Early Cancer May Not
Have Any Symptoms
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What are some types of cancer screening?
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What are some types of cancer screening?
Cervical Cancer
Screening (Pap Smear)
Normal
Pap smear
Abnormal
Pap smear
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What are some types of cancer screening?
Breast Cancer
Screening
(Mammogram)
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What are some types of cancer screening?
Prostate and
Ovarian
Cancer
Screening
(Blood Tests)
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What are some types of cancer screening?
Colon Cancer Screening
Fecal Occult Blood Test and Colonoscopy
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How is cancer diagnosed?
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What is a biopsy?
How is the biopsy analyzed?
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What is a biopsy?
How is the biopsy analyzed?
Pathology
Proteomic profile
Patient’s
tissue sample or
blood sample
Genomic profile
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What does a pathologist look for
examining biopsy tissue?
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What does a pathologist look for
examining biopsy tissue?
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What does a pathologist look for when he
examines biopsy tissue with a microscope?
Hyperplasia
Mild
dysplasia
Carcinoma in
situ (severe
dysplasia)
Cancer
(invasive)
Normal
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What does a pathologist look for when he/she
examines biopsy tissue with a microscope?
Normal
Hyperplasia
Mild
dysplasia
Carcinoma in
situ (severe
dysplasia)
Cancer
(invasive)
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What is the relationship between
tumor grade and patient survival?
General Relationship Between
Tumor Grade and Prognosis
100%
Low grade
I or II
Patient
Survival
Rate
High grade
III or IV
1
2
3
4
5
Years
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What is the relationship between
tumor grade and patient prognosis?
Low grade
I or II
Patient
Survival
Rate
High grade
III or IV
Years
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What does Stage III cancer mean?
Five-Year Survival Rates for
Patients with Melanoma (by stage)
100%
50%
I
II
III
Stage at Time of Initial Diagnosis
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What does Stage III cancer mean?
Five-Year Survival Rates for
Patients with Melanoma (by stage)
Stage III Cancer
100%
50%
I
II
III
Stage at Time of Initial Diagnosis
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What Causes Cancer?
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What Causes Cancer?
Some viruses or bacteria
Some chemicals
Radiation
Heredity
Diet
Hormones
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How could you explain the differences in the
cancer incidence in different countries?
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Population-Based Studies
Regions of Highest Incidence
U.K.:
Lung
cancer
JAPAN:
Stomach
cancer
CHINA:
Liver
cancer
AUSTRALIA:
Skin
cancer
CANADA:
Leukemia
U.S.:
Colon
cancer
BRAZIL:
Cervical
cancer
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Is the incidence of these cancers due to
genes, behavior, or environmental risk?
100
Colon Cancer
100
Stomach Cancer
70
50
5
0
7
0
Japan Japanese
families
in U.S.
U.S.
Japan Japanese
families
in U.S.
U.S.
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Is the incidence of these cancers due to
genes behavior, or environmental risk?
Colon Cancer
Stomach Cancer
(Number of new cases
per 100,000 people)
(Number of new cases
per 100,000 people)
100
100
70
50
5
0
7
0
Japan Japanese
families
in U.S.
U.S.
Japan Japanese
families
in U.S.
U.S.
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What increases peoples’ risk of cancer?
Sunshine
X-ray
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What increases peoples’ risk of cancer?
Some Carcinogenic Chemicals
in Tobacco Smoke
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What increases peoples’ risk of cancer?
20-Year Lag Time Between
Smoking and Lung Cancer
4000
Cigarettes
Smoked
per Person
per Year
3000
Cigarette
consumption
(men)
Lung
cancer
(men)
150
100
2000
Lung Cancer
Deaths (per
100,000 people)
50
1000
1900 1920 1940 1960 1980
Year
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What increases peoples’ risk of cancer?
Low Strength (Ultraviolet) Radiation
High
Dallas
Skin
Cancer
Incidence
Pittsburgh
Detroit
Low
Least
Most
Annual Sunshine
(UV radiation)
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What increases peoples’ risk of cancer?
High-Strength (Atomic) Radiation
High
Leukemia
Incidence
Low
Least
Most
X-ray Dose
(atomic radiation)
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What increases peoples’ risk of cancer?
Viruses
Virus inserts
and changes
genes for
cell growth
Cancer-linked virus
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What increases peoples’ risk of cancer?
Some Viruses Associated with Human Cancers
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What increases peoples’ risk of cancer?
Without
disease
HIV infection
Depressed
immune
system
KSHV infection
Kaposi’s
sarcoma
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What increases peoples’ risk of cancer?
Bacteria and Stomach Cancer
Patient’s
tissue sample
H. pylori
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What increases peoples’ risk of cancer?
All Breast Cancer Patients
Inherited factor(s)
Other factor(s)
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What increases peoples’ risk of cancer?
Inherited Conditions That Increase Risk for Cancer
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How do you know if you have genes that
make getting cancer more likely?
Genetic Testing
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How do you know if you have genes that
make getting cancer more likely?
Genetic Testing
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What happens to genes to cause cancer?
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What happens to genes to cause cancer?
Viruses
Chemicals
Radiation
Heredity
Chromosomes
are DNA
molecules
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What happens to genes to cause cancer?
Chemical
bases
A
C
T
G
DNA molecule
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What happens to genes to cause cancer?
DNA
DNA
Mutations
CA AG C T A A C T
Normal gene
CA AG C G A A C T
Single base change
CA A G G CG C T A A C T
Additions
C
T
CA A G A A C T
Deletions
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How do mutations in oncogenes
lead to cancer?
Growth factor
Receptor
Signaling enzymes
Transcription
factors
Cell nucleus
DNA
Cell proliferation
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How do mutations in oncogenes
lead to cancer?
Normal cell
Cancer cell
Mutated/damaged oncogene
Normal
genes
regulate
cell growth
Oncogenes
accelerate
cell growth
and division
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How do mutations in oncogenes
lead to cancer?
Normal Growth-Control Pathway
Growth factor
Receptor
Signaling enzymes
Transcription
factors
Cell nucleus
DNA
Cell proliferation
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How do mutations in oncogenes
lead to cancer?
Inactive growth factor receptor
Inactive intracellular
signaling protein
Signaling protein from active oncogene
Activated gene
regulatory protein
Transcription
Cell proliferation driven by
internal oncogene signaling
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How do mutations in tumor suppressor
genes lead to cancer?
Tumor Suppressor
Gene Proteins
Signaling
enzymes
Transcription
factors
DNA
Cell proliferation
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How do mutations in tumor suppressor genes
lead to cancer?
Normal
genes
prevent
cancer
Normal cell
Remove or inactivate
tumor suppressor genes
Cancer cell
Damage to
both genes
leads to
cancer
Mutated/inactivated
tumor suppressor genes
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How do mutations in tumor suppressor
genes lead to cancer?
Tumor Suppressor
Gene Proteins
Growth factor
Receptor
Signaling
enzymes
Cell nucleus
Transcription
factors
DNA
Cell proliferation
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How do mutations in the p53 gene lead to
cancer?
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How do mutations in the p53 gene lead to
cancer?
p53 Tumor Suppressor Protein
Triggers Cell Suicide
p53 protein
Normal cell
Excessive DNA damage
Cell suicide
(Apoptosis)
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How do mutations in DNA Repair Genes cause
cancer?
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How do mutations in DNA Repair Genes cause
cancer?
Normal DNA repair
T C GA C
Base pair
mismatch
No cancer
TC T AC
AG C T G
TC TAC
TCT AC
AG C T G
Cancer
AG
TG
AG A T G
No DNA repair
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What other kinds of mutations can lead
to cancer?
Genes Implicated in Cancer
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What other kinds of mutations can lead
to cancer?
Genes Implicated in Cancer
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Why does cancer risk increase with age?
Colon
Breast
Risk
Age
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Why does cancer risk increase with age?
Cancer Risk and Aging
400
Colon
300
Breast
Number of
Cancer Cases 200
(per 100,000
people)
100
0
20
40
60
80
Age of Person (in years)
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Cancer Tends to Involve Multiple Mutations
Benign tumor cells
grow only locally and
cannot spread by
invasion or metastasis
Malignant cells invade
neighboring tissues, enter
blood vessels, and
metastasize to different sites
Time
Mutation
Cells
inactivates proliferate
suppressor
gene
Mutations
inactivate
DNA repair
genes
Proto-oncogenes
mutate to
oncogenes
More mutations,
more genetic
instability,
metastatic
disease
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Cancer Tends to
Corrupt Surrounding Environment
Growth factors = proliferation
Invasive
Matrix
Proteases
Fibroblasts,
adipocytes
Blood vessel
Cytokines
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Cytokines, proteases = migration & invasion
What can people do to prevent cancer?
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What can people do to prevent cancer?
Carcinogenic
chemicals
Carcinogenic
radiation
Cancer viruses
or bacteria
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What can people do to prevent cancer?
Lung Cancer Risk Increases
with Cigarette Consumption
15x
10x
Lung
Cancer
Risk
5x
0
Non-smoker
15
Cigarettes Smoked per Day
30
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What can people do to prevent cancer?
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What can people do to prevent cancer?
Combination of Alcohol and Cigarettes
Increases Risk for Cancer of the Esophagus
40x
30x
Risk
Increase
20x
10x
Alcoholic Drinks
Consumed per Day
AND
Packs of Cigarettes
Consumed per Day
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What can people do to prevent cancer?
Correlation Between Meat Consumption and
Colon Cancer Rates in Different Countries
40
Number of Cases
(per 100,000
people)
30
20
10
0
80
100
200
300
Grams (per person per day)
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What can people do to prevent cancer?
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What can people do to prevent cancer?
High
HPV Infection Increases
Risk for Cervical Cancer
Cervical
Cancer
Risk
Low
Noninfected
women
Women
infected
with HPV
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What can people do to prevent cancer?
Some Carcinogens in the Home and Workplace
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Does industrial pollution cause cancer?
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Does industrial pollution cause cancer?
Incidence of
Most Cancers
1930
1950
1970
1990
Year
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Is There a Cancer "Epidemic"?
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Is There a Cancer "Epidemic"?
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Write a paragraph to answer
each of these questions.
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