Because learning changes everything.

Unit 01: Cancer

Connect Master 2.0

Why Biology?
Michael Windelspecht

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 Introduction: The Biology of Cancer

Why Do Cells Become

Cancerous?

How Does Cancer Affect My

Body?

How Is Cancer Treated?

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 The Biology of
Cancer 2
Why Do Cells Become
Cancerous?

Figure 1.4

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 What Is Cancer? 1

Cancer is a disease that is caused by the inability of the body

to control the division of cells.
Cancer can be caused by genetic or environmental factors.
Most cancers are named based on the type of cells or tissues
where they originate.

TABLE 1.1 Some Common Forms of Cancer

Cancer Type Origin
Melanoma Skin
Leukemia White blood cells in the bone marrow
Carcinoma Lining of the internal organs or skin
Sarcoma Connective tissue, such as bone
Lymphoma Cells and tissues of the immune system

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 What Is Cancer? 2

There is a misconception
that cancer is primarily is a
disease of the elderly.

Cancer is the fourth

leading cause of death in
young people.

Males have a one in two

chance of developing
cancer during lifetime; for
females it is a one in three
chance.
Figure 1.1

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 What Is Cancer? 3

Figure 1.2

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© McGraw Hill LLC Source: American Cancer Society, Cancer Facts & Figures, 2018 6
 What Is Cancer? 4

The body’s organ

systems have specific
physiological roles
that maintain
homeostasis.

As the number of
cancer cells grow,
physiological changes
occur in tissues or
organs, impacting
their role in
homeostasis.

Figure 1.3

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 The Biology of
Cancer 3
How Does a Cell Normally
Work?

Figure 1.5

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 How Does a Cell Normally Work?

Cells have the ability to:

• Acquire materials and
energy.
• Respond to their
environment.
• Reproduce.
• Maintain an internal
environment.
• Adapt to their environment.

Cells are either prokaryotic

(bacteria) or eukaryotic
Figure 1.6
(animal, plant, fungi).
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 Eukaryotic Cells Have
Membrane-Bound Organelles
TABLE 1.2 Function of Some Common Structures in a Human Cell
Organelle/
General Function Structure Description
Structure
Information Processing Nucleus Contains the genetic information of the cell.
Ribosomes Structure where the genetic information is used to
manufacture proteins.
A table summarizes the functions of organelles or
Energy structures Mitochondria
found in eukaryotic cells,
Converts the with
energytheir
found in nutrients to a form usable
by the cell.
descriptions. General functions are listed in column 1.
Transport andFirst function
Processing involves two structures,
Endoplasmic second,
Synthesis of proteins (roughfourth,
ER), lipids (smooth ER),
of Nutrients reticulum (ER) and carbohydrates (smooth ER).
and fifth functions involve one structure each, and third
function involves
Lysosomethree structures.
Digestion of incoming nutrients.
Golgi apparatus Processing center of the cell.
Isolation Plasma membrane Isolates the cell from its external environment and
selectively allows for the passage of materials.

Cell Division Centrioles Assist in dividing the genetic material and contents of
the cell during cellular reproduction.

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 Cells Are Specialized 1

During development, cells

receive genetic information
that allows them to become
specialized, meaning they
have a specific purpose in
the body.

Cancerous cells ignore the

genetic programming that
makes them specialized;
they lose their function.

Figure 1.7

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 Cells Are Specialized 2

Enzymes are (usually) protein catalysts

for chemical reactions.

The shape of the enzyme determines

how it will interact with molecules.

Enzymes have an active site where the

substrate binds; products are released
after the reaction has occurred.

Some cancer drugs work by binding to

the active site, preventing the substrate
from reacting with the enzyme.
Figure 1.8
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 Information Is Contained within DNA 1

DNA (deoxyribonucleic acid)

is a nucleic acid that stores
genetic information.
DNA consists of units called
nucleotides. Each nucleotide
contains:
• a 5-carbon deoxyribose sugar
(green pentagon ‘S’).
• a phosphate group (yellow
circle ‘P’).
• a nitrogen-containing base
(blue ‘C’).

Figure 1.9
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 Information Is Contained within DNA 2

Adenine (A) always pairs with

thymine (T); guanine (G) always
pairs with cytosine (C).

It is the order of the nitrogen

bases in DNA that stores the
genetic information for the cell.

The sum of all genetic

information in a cell is called the
genome.

Genes are units of genetic

information that provide
instructions for making proteins.
Figure 1.9
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 Using the Information Found in DNA 1

Gene expression occurs in 2 stages:

transcription and translation.
During transcription:
• Within the nucleus, RNA polymerase
exposes the nucleotide bases of the
DNA to be transcribed.
• A copy of mRNA is made from the DNA
strand. Uracil (U) is used instead of
thymine (T).
• mRNA is edited and leaves the
nucleus.

Figure 1.11
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 Using the Information Found in DNA 2

During translation:
• Within the cytoplasm, mRNA moves to
a ribosome.
• tRNA reads codons (3 nucleotides) of
the mRNA.
• For each codon, the corresponding
amino acid is brought to the ribosome
by tRNA and assembled.
• The polypeptide is released and the
ribosome and mRNA may be used
again.

Figure 1.11
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 Protein Structure Is Important
for Function
There are four levels of protein
structure:
• Primary structure: the linear sequence of
amino acids.

• Secondary structure: Amino acids interact

based on weak chemical interactions.

• Tertiary structure: 3-D molecule, functional.

• Quaternary structure: Multiple protein

chains interact to form larger molecules with
more complex functions.

Figure 1.13
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 How Do Cells Divide? 1

The cell cycle describes the

organized series of events required
for cell division.
The cell cycle consists of:
• Interphase (orange) – The
majority of the cell’s time;
normal functions occur.
Consists of G1 (growth),S
(synthesis), and G2 (growth)
phases
• M phase (blue) – the portion
where cell division occurs;
consists of mitosis and
cytokinesis.
Figure 1.16

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 How Do Cells Divide? 2

Checkpoints function to:

• Regulate the speed at which the
cell moves through the cell cycle.
• Ensure the cell is ready for cell
division.

If a cell is not ready for cell

division, it will be put into G0
phase to attempt to repair its
DNA.
If that is not possible, the cell
may undergo apoptosis
Figure 1.17
(programmed cell death).
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 Chromosomes
DNA is compacted and organized into chromosomes that are found in the
nucleus of cells.
Telomeres are repeating sections of nucleotides found at the end of
chromosomes. They shorten with each cell cycle. When they are too
short for replication, the cell undergoes apoptosis.
Humans have 23 pairs of chromosomes. Of each pair, one comes from
the mother and one comes from the father.
Pairs of chromosomes are homologous, meaning they code for similar
traits, even though they may have different alleles.
During the S phase, DNA replication occurs.
Each homologous chromosome is copied,
forming a sister chromatid.
Sister chromatids are held in place by a
centromere until the M phase.
Figure 1.19
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 The Process of Mitosis 1

Figure 1.20

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 The Process of Mitosis 2

Figure 1.20

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 Quick Check 3

Question 5:
At which of the following checkpoints is a cell’s DNA checked for damage, and
if found, the cell is sent to the G0 phase?
a. G1
b. G2
c. M
d. None of the above are correct.

Question 6:
The replication of the genetic material occurs following a successful passage
of which checkpoint?
a. M
b. G1
c. G2
Question 5 answer: a
d. G0 Question 6 answer: b

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 The Biology of
Cancer 4
Why Do Cells Stop Dividing
Correctly?

Figure 1.22

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 Mutations

Mutations are any changes

to the nucleotide sequence
of DNA.
Mutations can be caused by
chemicals (called
carcinogens), radiation
exposure, or viruses.
Mutations may or may not
impact protein structure.

Figure 1.23

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 Tumor-Suppressor Genes

Tumor-suppressor genes
prevent unregulated cell
growth by slowing down
the progression of the cell
through the cell cycle.
Most code for proteins that
survey DNA for damage
during the G1 checkpoint.
Examples associated with
breast cancer include p53
and BRCA1.
Figure 1.24

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 Proto-Oncogenes

Proto-oncogenes speed up the cell

cycle.
Associated with signaling pathways:
growth hormones interact with target
cell receptors, proto-oncogenes are
activated, and cell division is
promoted.
Proto-oncogenes become oncogenes
when mutations cause them to be
“stuck”.
Figure 1.26 Only a single mutation is required for
this.
Examples associated with breast
cancer include ERBB2.
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 The Biology of
Cancer 5
What Are the Characteristics
of Cancer?

Figure 2.2c

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 Characteristics of Cancer Cells

Cancer cells are different

from typical cells as they:
• look different (irregular
shape, larger nuclei with
more genetic material).
• are immortal (because of the
telomerase enzyme that
repairs telomeres).
• lose the ability to specialize.
Masses of unspecialized
cells are called tumors.
They can be benign or
malignant.
Figure 1.7

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 Angiogenesis

As tumor cells grow, they require

oxygen and nutrients.
Angiogenesis occurs as growth
factors are released and
capillaries grow toward the
tumor.

Figure 2.4
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 Cancer Cells May Move to Other
Parts of the Body
Capillaries (red) and lymphatic
vessels (green) may carry
tumor cells to other parts of
the body where angiogenesis
may occur.
This spread of cancer to other
parts of the body is called
metastasis.

Figure 2.5
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 Quick Check 5

Question 9:
Angiogenesis is:
a. the movement of cancer from one location to another in the body
b. the despecialization of cancer cells
c. the growth of blood vessels in response to a growing tumor
d. None of the above are correct.

Question 10:
Which of the following are correct regarding malignant tumors? Select all that
apply.
a. They may undergo metastasis.
b. They invade surrounding tissues.
c. Their cells closely resemble other cells in the tissue.
d. They are masses of unspecialized cells.

Question 9 answer: c
Question 10 answer: a, b, and d
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 The Biology of
Cancer 6
What Do the Stages of
Cancer Mean?

Figure 2.12

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 Stages of Cancer

Most doctors use a number

system to grade cancers based
on:
• Size of tumor.
• Has tumor spread to nearby
tissues.
• Has cancer spread to nearby
lymph nodes.
• Has cancer moved to other
organs.

Figure 2.7
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 Stages of Cancer (Breast Cancer)

Stages 0–1 cancer: Tumor is limited

to a very small area and only nearby
lymph nodes, if any, are involved.
Stage 2: Tumor has become
invasive and has grown, but is still
located entirely within the breast,
lymph nodes may be involved.
Stage 3: Tumor has moved out of
the breast tissue, but has not spread
to distant organs, lymph nodes are
involved.
Stage 4: Cancer has fully
metastasized and spread to organs
outside the breast, the cancer is
incurable.
Figure 2.7
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 Quick Check 6

Question 11:
Which of the following are used to determine the stage of cancer?
a. The size of the tumor
b. The presence of cancer in nearby lymph nodes
c. Whether the cancer has moved to other organs of the body
d. All of the above are correct.

Question 12:
A breast cancer tumor is detected that is about 2 cm in size and has only
moved into lymph nodes associated in the breast? What stage would this
cancer be assigned to?
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4 Question 11 answer: d
Question 12 answer: b

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 Homeostasis

Homeostasis is the body’s ability to

maintain a constant internal
environment, including pH,
temperature, and blood chemistry.
Homeostasis is often regulated by
negative feedback loops.
Cancer disrupts homeostasis by
interfering with the body’s ability to
maintain homeostasis.
• Tumors take up space in organs
and block blood and lymphatic
vessels and ducts, so organs
cannot function.
• Tumors require oxygen and
nutrients, depriving nearby tissues.
Figure 2.13
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 Quick Check 7

Question 13:
Which of the following terms means the ability of the body to operate under
a set of defined internal conditions?
a. Angiogenesis
b. Carcinogenesis
c. Mutagenesis
d. Homeostasis

Question 13 answer: d

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 The Biology of
Cancer 7
How Is Cancer Treated?

Figure 3.1

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 Genetic Testing – PCR
Mutations in cancer-causing
genes can be tested for.
After blood is drawn, DNA is
isolated from white blood
cells and subjected to a
polymerase chain reaction
(PCR) in order to make
copies of the gene of
interest.

Figure 3.2

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 Genetic Testing – DNA Sequencing
Once copies of a gene have been made, the exact sequence of
nucleotides is determined through DNA sequencing.
Fluorescent tags are added to nucleotides in a DNA molecule and
chemical reactions remove one nucleotide at a time. A laser identifies
the nucleotide based on its fluorescent tag and a computerized output
is created.
Once sequenced, the nucleotide order can be compared with known
sequences to determine if mutations are present.

Figure 3.3b
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 Microarrays
DNA microarrays, or gene chips, can screen genetic information,
allowing doctors to look for specific mutations or differences in
gene expression between normal cells and cancer cells.

Synthetic DNA that corresponds to known cancer-related

mutations is placed on a chip. mRNA is isolated from cells and
used to create fluorescently labeled complementary DNA
(cDNA). Once hybridized with the synthetic DNA on the chip, the
cDNA will bind to its complementary match, indicating that those
cancer-related genes are being expressed.

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 Testing the Blood for Cancer
Blood tests called complete blood counts (CBCs) look at the presence
of normal blood cells and basic blood chemistry.
Cancers may elevate the number of white blood cells and tumor cells
may even be present in the blood.
Changes in blood calcium, enzymes, or ion concentrations may also
indicate that cancer is interrupting the function of an organ.
Specific proteins associated with cancer can be tested for in blood,
including CA 15-3 and CA 125.

Figure 3.4
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 Scanning the Body for Cancer
Screening mammogram: X-ray of breast and surrounding tissues
that looks for abnormalities associated with cancer
Diagnostic mammogram: X-ray of breast and surrounding
tissues, used after finding a lump or suspicious blood work
Computerized tomography (CT) scans: X-ray of organs with
pictures from multiple angles that are used to generate a 3D
image, can involve dye for contrast
Positron Emission Tomography (PET) scan: uses radioactive
tracers to measure the metabolism of cells, cancer cells are more
active and stand out.
Magnetic Resonance Imaging (MRI): uses radio waves and
magnets to generate detailed images of the body.

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 Quick Check 8

Question 14:
Which of the following is the end result of a PCR process?
a. Sister chromatids
b. New cells
c. Multiple copies of a gene of interest
d. None of the above are correct.

Question 15:
Which of the following procedures use X-rays to detect the presence of
cancer? Select all that apply.
a. PET scan
b. CT scan
c. MRI scan
d. Mammogram Question 14 answer - c

Question 15 answer: b and d

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 The Biology of
Cancer 8
What Is Chemotherapy?

Figure 3.8

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 What Is Chemotherapy?
Chemotherapy is the use of drugs to treat disease. In the case of
cancer, chemotherapy works by targeting the cell cycle to prevent
cell division in rapidly dividing cells.
Chemotherapy affects all cells of the body, so it can be effective
in treating and preventing metastasis, but also has many
negative side effects.

Figure 3.9

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 Chemotherapeutic Drugs
Alkylating agents: chemicals that integrate into the DNA, causing
it to break at specific points; general and so can cause long-term
side effects including other cancers
Alkaloids: chemicals naturally produced by some plants; prevent
cells from forming spindle fibers, thus preventing cell division
Taxanes: naturally produced by yew trees; prevent microtubule
breakdown during cell division so cell division doesn’t continue
Antimetabolites: chemicals that mimic nucleotides and are
integrated into DNA, but interfere with DNA replication, preventing
cell division
Topoisomerase inhibitors: chemicals that disable topoisomerase
enzyme, preventing DNA replication

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 The Biology of
Cancer 9
How Is Radiation Used to
Treat Cancer?

Figure 3.12

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 What Is Radiation?
Radiation is the movement of energy in waves or particles.
The shorter the wavelength, the more energy is present.
Radiation therapy uses high-energy gamma rays and X-rays or
particles, including alpha and beta particles.

Figure 3.13

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 Radiation Therapy
Radiation therapy damages the DNA within a cell, slowing down or stopping
cell division. It can target specific areas but isn’t as effective at metastasized
cancer cells.
External radiation therapy: uses X-rays or gamma rays to target a specific
area of the body.
Internal radiation therapy: Small deposits of radioactive material are placed in
the body.
• Interstitial brachytherapy – seeds placed in direct contact with the tumor.
• Intracavitary brachytherapy – seeds placed in nearby body cavities.
• Low-dose treatments – Seeds are left inside a patient after treatment.
• High-dose treatment – Seeds are removed after treatment.
Systemic radiation treatment: Radioactive substances are injected into the
blood or ingested in the body.

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 Quick Check 10

Question 18:
Which of the following forms of radiation has the shortest wavelength and
highest amount of energy?
a. Gamma waves
b. Visible light
c. Microwaves
d. Infrared radiation

Question 18 answer: a

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 The Biology of
Cancer 10
What Is the Future of
Cancer Treatments?

Figure 3.15

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 Immunotherapy 1

The immune system functions to identify “self” vs. “nonself” and then
target any “nonself” cells for destruction.
Immunotherapy involves convincing the body’s immune system to
identify and eliminate cancer cells as “nonself” instead of “self.”
• Involves identifying antigen differences between “self” and cancer cells.
• Cancer vaccines use modified viruses to initiate an immune response
against cancer cells.
• Monoclonal antibodies can be created to target specific cancer
antigens.

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 Genome Editing 1

Genome editing targets specific sequences in DNA for editing.

Clustered regularly interspaced short palindromic repeats
(CRISPR) are most commonly used.
• Enzyme Cas9 uses an RNA molecule to identify and bind to specific
complementary sequences of DNA.
• PAM regulatory regions help make sure Cas9 has the correct
sequence.
• CRISPR can remove nucleotides, inactivate the gene, or insert new
nucleotides, changing the function of the gene.

CRISPR has been used in cancer treatments.

CRISPR explained.
https://www.youtube.com/watch?v=UKbrwPL3wXE

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