Cell Biology and Cancer

under a contract from the

National Institutes of Health
in collaboration with the
National Cancer Institute

Center for Curriculum Development

5415 Mark Dabling Boulevard
Colorado Springs, CO 80918
BSCS Development Team Design and Layout
Joseph D. McInerney, Co-Principal Investigator Angela Barnes, Finer Points Productions
Lynda B. Micikas, Co-Project Director
April L. Gardner, Visiting Scholar BSCS Administrative Staff
Diane Gionfriddo, Research Assistant Timothy H. Goldsmith, Chairman, Board of Directors
Joy L. Hainley, Research Assistant Joseph D. McInerney, Director
Judy L. Rasmussen, Senior Executive Assistant Michael J. Dougherty, Associate Director
Janie Mefford Shaklee, Evaluator
Lydia E. Walsh, Research Assistant Videodiscovery, Inc. Administrative Staff
D. Joseph Clark, President
Videodiscovery, Inc. Development Team Shaun Taylor, Vice President for Product Development
D. Joseph Clark, Co-Principal Investigator
Shaun Taylor, Co-Project Director National Institutes of Health
Michael Bade, Multimedia Producer Bruce Fuchs, Office of Science Education
Dave Christiansen, Animator John Finerty, National Cancer Institute
Greg Humes, Assistant Multimedia Producer Susan Garges, National Cancer Institute
Lucy Flynn Zucotti, Photo Researcher William Mowczko, Office of Science Education
Cherie Nichols, National Cancer Institute
Advisory Committee Gloria Seelman, Office of Science Education
Ken Andrews, Colorado College,
Colorado Springs, Colorado Field-Test Teachers
Kenneth Bingman, Shawnee Mission West High School, Christina Booth, Woodbine High School,
Shawnee Mission, Kansas Woodbine, Iowa
Julian Davies, University of British Columbia, Richard Borinsky, Broomfield High School,
Vancouver, BC, Canada Broomfield, Colorado
Lynn B. Jorde, Eccles Institute of Human Genetics, Patrick Ehrman, A.G. Davis Senior High School,
Salt Lake City, Utah Yakima, Washington
Elmer Kellmann, Parkway Central High School, Elizabeth Hellman, Wheaton High School,
Chesterfield, Missouri Wheaton, Maryland
Mark A. Rothstein, University of Houston Law Center, Jeffrey Sellers, Eastern High School, Washington, DC
Houston, Texas
Photo Credits
Carl W. Pierce, Consultant, Hermann, Missouri
Figures 1, 7, and 8: Corel Corporation
Kelly A. Weiler, Garfield Heights High School,
Garfield Heights, Ohio This material is based on work supported by the National
Raymond L. White, Huntsman Cancer Institute, Institutes of Health under Contract No. 263-97-C-0073.
Salt Lake City, Utah Any opinions, findings, conclusions, or recommendations
Aimee L. Wonderlick, Northwestern University expressed in this publication are those of the authors and
Medical School, Chicago, Illinois do not necessarily reflect the views of the funding agency.
Writing Team Copyright ©1999 by the BSCS and Videodiscovery, Inc.
Mary Ann Cutter, University of Colorado— All rights reserved. You have the permission of BSCS and
Colorado Springs Videodiscovery, Inc. to reproduce items in this module
Jenny Sigstedt, Consultant, Steamboat Springs, Colorado (including the software) for your classroom use. The
Vickie Venne, Huntsman Cancer Institute, copyright on this module, however, does not cover
Salt Lake City, Utah reproduction of these items for any other use. For
permissions and other rights under this copyright,
Artists
please contact the BSCS, 5415 Mark Dabling Blvd.,
Dan Anderson
Colorado Springs, CO 80918-3842.
Kevin Andrews
Revised September 2012
Cover Design
NIH Publication No. 10-4646
Karen Cook, NIH Medical Arts and Photography Branch

Cover Illustration
Salvador Bru, Illustrator Please contact NIH with questions
about this supplement at
Editing
[email protected].
Barbara C. Resch
Contents
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v

About the National Institutes of Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi

About the National Cancer Institute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii

About Biological Sciences Curriculum Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii

Introduction to Cell Biology and Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

What Are the Objectives of the Module? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Why Teach the Module? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
What’s in It for the Teacher? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Implementing the Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

What Are the Goals of the Module? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
What Are the Science Concepts and How Are They Organized? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
How Does the Module Correlate with the National Science Education Standards? . . . . . . . . . . . . . . . . . . . 6
How Does the BSCS 5E Instructional Model Promote Active, Collaborative, Inquiry-Based Learning? . 6
The BSCS 5E Instructional Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Engage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Explore/Explain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Elaborate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Evaluate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
What’s the Evidence for the Effectiveness of the BSCS 5E Model? . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
How Does the Module Support Ongoing Assessment? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
How Can Controversial Topics Be Handled in the Classroom? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Using the Student Lessons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Format of the Lessons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Timeline for Teaching the Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Using the Web Site . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Hardware and Software Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Getting the Most Out of the Web Site . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Collaborative Groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
State Standards Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Web Materials for People with Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Understanding Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Unraveling the Mystery of Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Cancer as a Multistep Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
The Human Face of Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
New Hope for Treating Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Cancer and Society . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

iii
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Additional Resources for Teachers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Student Lessons
Lesson 1—The Faces of Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Lesson 2—Cancer and the Cell Cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Lesson 3—Cancer as a Multistep Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Lesson 4—Evaluating Claims about Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Lesson 5—Acting on Information about Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99

Masters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109

iv
Foreword
This curriculum supplement, from the National Model (page 9), cutting-edge science content,
Institutes of Health (NIH) Curriculum and built-in assessment tools. Activities promote
Supplement Series, brings cutting-edge medical active and collaborative learning and are inquiry-
science and basic research discoveries from based to help students develop problem-solving
the laboratories of the NIH into classrooms. As strategies and critical-thinking skills.
the largest medical research institution in the
United States, NIH plays a vital role in the health Each of our curriculum supplements comes with
of all Americans and seeks to foster interest in a complete set of materials for teachers, including
research, science, and medicine-related careers extensive background and resource information,
for future generations. NIH’s Office of Science detailed lesson plans, masters for student worksheets,
Education (OSE) is dedicated to promoting and a Web site with videos, interactive activities,
science education and scientific literacy. updates, and corrections (as needed). The
supplements are distributed at no cost to educators
We designed this curriculum supplement to across the United States upon request. They may
complement existing life science curricula at be copied for classroom use but may not be sold.
both the state and local levels and to be consistent
with the National Science Education Standards We welcome your feedback. For a complete
(released by the National Academy of Sciences in list of curriculum supplements and ordering
1996). It was developed and tested by a team of information, or to submit feedback, please visit
teachers, scientists, medical experts, and other http://science.education.nih.gov.
professionals with relevant subject-area expertise
from institutes and medical schools across the We appreciate the valuable contributions of the
country, representatives from the National talented staff at Biological Sciences Curriculum
Cancer Institute, and curriculum design Study (BSCS) and Videodiscovery, Inc. We are
experts from Biological Sciences Curriculum also grateful to the NIH scientists, advisors, and
Study (BSCS) and Videodiscovery. The authors all other participating professionals for their work
incorporated real scientific data and actual case and dedication. Finally, we thank the teachers
studies into classroom activities. A three-year and students who participated in focus groups
development process included geographically and field tests to ensure that these materials are
dispersed field tests by teachers and students. For both engaging and effective.
the 2012 edition, key sections of the supplement
were updated, but the Student Lessons remain I hope you find our series a valuable addition
basically the same. to your classroom and wish you a productive
school year.
The structure of this module enables teachers to
facilitate learning and stimulate student interest by Bruce A. Fuchs, Ph.D.
applying scientific concepts to real-life scenarios. National Institutes of Health
Design elements include a conceptual flow of
lessons based on the BSCS 5E Instructional

v
About the National Institutes of Health

Founded in 1887, NIH is the federal focal point research and clinical investigators, as well as the
for health research in the United States. Today, myriad professionals in the many allied disciplines
NIH is one of the agencies within the Department who support the research enterprise. These efforts
of Health and Human Services. Its mission is also help educate people about scientific results so
science in pursuit of fundamental knowledge that they can make informed decisions about their
about the nature and behavior of living systems own—and the public’s—health.
and the application of that knowledge to extend
healthy life and reduce the burdens of illness and This curriculum supplement is one such education
disability. NIH works toward meeting the mission effort. It is a collaboration among the National
by providing leadership, direction, and grant Cancer Institute, the NIH Office of Science
support to programs designed to improve the Education, Biological Sciences Curriculum Study,
health of the nation through research. and Videodiscovery, Inc.

NIH’s education programs contribute to ensuring For more about NIH, visit http://www.nih.gov.
the continued supply of well-trained basic

vi
About the National Cancer Institute

The National Cancer Institute (NCI), a component • conducting research in its own laboratories
of the NIH, is the federal government’s principal and clinics;
agency for cancer research and training. The NCI • supporting education and training in all
coordinates the National Cancer Program, which areas of cancer research through training
conducts and supports research, training, health grants, fellowships, and “career awards”
information dissemination, and other programs for long-time researchers;
with respect to the cause, diagnosis, prevention • supporting a national network of Cancer
and treatment of cancer, rehabilitation from Centers, which are hubs of cutting-edge
cancer, and the continuing care of cancer patients research, high quality cancer care, and
and the families of cancer patients. outreach and education for both healthcare
professionals and the general public;
The NCI was established under the National • collaborating with voluntary organizations and
Cancer Act of 1937. The National Cancer Act of other national and foreign institutions engaged
1971 broadened the scope and responsibilities in cancer research and training activities;
of the NCI and created the National Cancer • collaborating with partners in industry in a
Program. Over the years, the NCI’s mandate has number of areas, including the development
come to include dissemination of current cancer of technologies that are revolutionizing
information and assessment of the incorporation cancer research; and
of state-of-the-art cancer treatments into clinical • collecting and disseminating information
practice. Today, the NCI’s activities include about cancer.
• supporting and coordinating research projects
conducted by universities, hospitals, research For more information about the National Cancer
foundations, and businesses throughout this Institute, visit its Web site at http://www.cancer.gov.
country and abroad through research grants
and cooperative agreements;

vii
About Biological Sciences
Curriculum Study
Headquartered in Colorado Springs, Colorado, The BSCS mission is to transform science teaching
BSCS was founded in 1958 as a curriculum study and learning through research and development
committed to an evidence- and inquiry-based that strengthens learning environments and
approach to science education. BSCS instructional inspires a global community of scientifically
materials and professional development services literate citizens. BSCS is a 501(c)3 nonprofit
are based on current research about teaching and organization. For more information, please visit
learning for all science classrooms, kindergarten http://www.bscs.org.
through college.

BSCS’s materials are extensively field-tested

in diverse settings across the country and
evaluated for proven effectiveness. The BSCS 5E
Instructional Model and inquiry are hallmarks
of its materials, placing students at the center of
their learning.

viii
Introduction to
Cell Biology and Cancer
“Tumors destroy man in a unique and appalling type of tumor (bone, cartilage, blood vessel) when
way, as flesh of his own flesh which has somehow injected into healthy animals.
been rendered proliferative, rampant, predatory,
and ungovernable. . . . Yet, despite more than Unfortunately, the full significance of these data
70 years of experimental study, they remain the was not to be realized for many decades. One
least understood. . . . What can be the why for reason was the difficulty of reproducing these
these happenings?” results in mammals. But another reason was that
scientists could not place Rous’ discovery in a
—Peyton Rous, in his acceptance lecture for the proper context. So many different things seemed
Nobel Prize in Physiology or Medicine (1966) to be associated with cancer that no one was able
to make sense of it all. For example,
Late in 1910, a young scientist at Rockefeller • In 1700, the Italian physician Bernardino
University was preparing to conduct a most Ramazzini wrote about the high rate of breast
improbable experiment. He wanted to know whether cancer among nuns and speculated that it was
one chicken could “catch” cancer from another. related to their celibacy and childlessness. This
At that time, the concept that every cell in the was the first indication that how one lived
body is derived from another cell was new, and might affect the development of cancer.
the idea that cancer might involve a disruption • In 1775, Percivall Pott, a London physician,
of normal cell growth was just taking hold. suggested that the very high rate of scrotal
and nasal cancers among chimney sweeps was
Thirty years had passed since Louis Pasteur’s a result of their exposure to soot. This was
influential paper on germ theory dislodged the the first indication that exposure to certain
humoral theory of disease that had prevailed chemicals in the environment could be an
for more than 2,000 years, and the prevailing important factor in cancer.
scientific view of cancer emphasized the role of • In 1886, Hilario de Gouvea, a professor at
chemical and physical agents, not infectious ones, the Medical School in Rio de Janeiro, Brazil,
as potential causes. reported the case of a family with an increased
susceptibility to retinoblastoma, a form of
Nevertheless, the 30-year-old Peyton Rous was able cancer that normally occurs in only 1 out of
to show that cell-free extracts from one chicken about 20,000 children. This suggested that
were able to cause the formation of the same type certain cancers have a hereditary basis.
of tumor when injected into a second chicken. • The discovery of X-rays in 1895 led to their
Rous’ tumor extracts had been passed through association with the skin cancer on the hand
a filter with pores so small that even bacteria of a lab technician by 1902. Within a decade,
were excluded. This result strongly implicated many more physicians and scientists, unaware
the newly discovered “filterable agents” known of the dangers of radiation, developed a variety
as viruses. Rous was later able to demonstrate of cancers.
that other types of chicken tumors could also be • In 1907, an epidemiological study found that
spread by their own, unique “filterable agents,” the meat-eating people from Germany, Ireland,
and that each would faithfully produce its original and Scandinavia living in Chicago had higher

1
Cell Biology and Cancer

rates of cancer than did their Italian and Figure 1. For people touched by cancer in any body
Chinese neighbors, who ate considerably system, modern science offers better treatment and
less meat. brighter prospects than ever before.

At the time Peyton Rous accepted his Nobel

Prize, it was not clear how these, and many other
observations, would ever be reconciled. By the
early 1970s, however, scientists armed with the
new tools of molecular biology were about to
revolutionize our understanding of cancer. In
fact, just over three decades later, Rous would
be astounded to learn of the progress made in
answering his question of “why?”

What Are the Objectives of the Module?

Cell Biology and Cancer has two objectives. The
first is to introduce students to major concepts
related to the development and impact of cancer. show significant declines in death rates for
Today, we have a picture of cancer that, while colorectal, lung, prostate, and female breast cancer.
still incomplete, is remarkably coherent and
precise. Cancer develops when mutations occur Cancer incidence rates show a more varied
in genes that normally operate to control the picture: the overall trend for 1999 to 2008 was
cell’s life cycle of growth, proliferation, and steady. The major cancers (colorectal, male lung,
death. These mutations prompt the cell to divide and prostate cancer) showed significant declines
inappropriately. Cancer-causing mutations can be during this period, while female lung cancer rates
induced by a wide variety of environmental agents decreased between 2004 and 2008 and female
and even several known viruses. Such mutations breast cancer rates declined between 1999 and
can also be inherited—thus the observation that 2004 but were stable between 2004 and 2008.
some families have a higher risk for developing
cancer than others. We still have much to learn It is notable that the combined cancer incidence
about cancer, to be sure. However, the clarity rates for both sexes had very different trends.
and detail of our understanding today speak For men the rate decreased steadily from 1994 to
powerfully of the enormous gains scientists have 2008. For women the rate declined between 1998
made since the War on Cancer was launched in and 2006 but remained stable from 2006 to 2008.
1971. We hope this module will help students Recently, incidence rates have actually increased
catch a bit of the excitement of these gains. for several cancers, including pancreas and
kidney, which are associated with excess weight.
A second objective is to convey to students the
relationship between basic biomedical research Death rates from all cancers combined have
and the improvement of personal and public decreased significantly in men and women; from
health. Cancer-related research has yielded 2004 through 2008, cancer death rates declined
many benefits for humankind. Most directly, about 1.6 percent per year. These decreases, which
it has guided the development of public health began in the early 1990s, are driven by declines
policies and medical interventions that today are in the three most common cancers in men (lung,
helping us prevent, treat, and even cure cancer. colorectal, and prostate), and declines in the three
As illustrations of the progress created by cancer leading cancers in women (lung, breast, and
research, note that cancer mortality decreased at colorectal). Prostate and breast cancers are the
a rate of 1.4 percent per year from 1999 to 2008. most frequently diagnosed cancers in the United
For the major cancers, the most recent trends States, but lung cancer accounts for the largest
number of cancer deaths.

2
Research is also pointing the way to new Cancer research has yielded other benefits as
therapies that scientists hope will combat the well. In particular, it has vastly improved our
disease without as many of the devastating side understanding of many of the body’s most critical
effects of current treatments. For example, much cellular and molecular processes. The need to
of the current drug development to prevent or understand cancer has spurred research into
fight cancer focuses on targeting specific genes, the normal cell cycle (the sequence of events
pro­teins, and pathways unique to or altered in by which cells enlarge and divide), mutation,
cancer cells. Although many of these types of DNA repair, growth factors, cell signaling, and
drugs are still in various stages of testing and cell aging and death. Research has also led to
development, several are already approved for use, an improved understanding of cell adhesion
and enthusiasm about the prospects of controlling and anchorage (the “address” system that keeps
cancer at the molecular level continues. Gleevec®, normal cells from establishing themselves in
for example, is a small-molecule drug approved inappropriate parts of the body), angiogenesis (the
by the U.S. Food and Drug Administration (FDA) formation of blood vessels), and the role of the
to treat gastrointestinal stromal tumor (a rare immune system in protecting the body from harm
cancer of the gastrointestinal tract) and certain caused by abnormal cells as well as from invading
kinds of chronic myeloid leukemia. Gleevec® microbes and viruses.
is also approved for certain kinds of acute
lymphoblastic leukemia, chronic eosinophilic This module addresses our progress in
leukemia, dermatofibrosarcoma protuberans, understanding the cellular and molecular bases of
myelodysplastic/myeloproliferative disorders, and cancer and considers the impact of what we have
systemic mastocytosis. It is also being studied in learned for individuals and society. We could have
the treatment of other types of cancer. addressed many concepts, but with the help of
a wide variety of experts in this field, we chose
An enormous amount of progress is also being these for your students to explore:
made in the field of cancer vaccines, which stimulate • Cancer is a group of more than 100 diseases
the immune system to kill existing cancer cells that develop across time. It can occur in
or to recognize and attack pathogens before they virtually any of the body’s tissues, and
can cause disease. Cancer vaccines, which are both hereditary and environmental factors
still largely experimental, are either preventive— contribute to its development.
intended to prevent cancer from developing in • The growth and differentiation of cells in
healthy people—or therapeutic—intended to the body are normally precisely regulated;
treat existing cancers by strengthening the body’s this regulation is fundamental to the orderly
natural defenses against the disease. The FDA has process of development that we observe across
already approved two cancer preventive vaccines. the life spans of multicellular organisms.
The first is a vaccine against the hepatitis B virus Cancer develops due to the loss of growth
(HBV). Chronic HBV infections can lead to liver control in cells. Loss of control can occur as a
cancer. The second vaccine, which is known result of mutations in genes that are involved in
as Gardasil®, is highly effective in preventing cell-cycle control.
infections by two types of human papilloma • No single event is enough to turn a cell into
virus (HPV) that cause most (70 percent of) a cancerous cell. Instead, it seems that the
cervical cancers in the United States and Western accumulation of damage to a number of genes
Europe. Cervarix is also approved to prevent (“multiple hits”) across time leads to cancer.
infections with the two types of HPV that cause • Scientists use systematic and rigorous criteria
most cervical cancers and some oropharyngeal to evaluate claims about factors that may
cancers. The FDA has also approved sipuleucel-T contribute to cancer development. Consumers
(Provenge®) for the treatment of some men with can evaluate such claims by applying
metastatic prostate cancer. criteria related to the source, certainty, and
reasonableness of the supporting information.

3
Introduction to Cell Biology and Cancer
Cell Biology and Cancer

• We can use our understanding of the science of What’s in It for the Teacher?
cancer to improve personal and public health. Cell Biology and Cancer meets many of the criteria
Translating our understanding of science into by which teachers and their programs are assessed.
public policy can raise a variety of issues, such • The module is standards based and meets
as the degree to which society should govern science content, teaching, and assessment
the health practices of individuals. Such issues standards as expressed in the National Science
often involve a tension between the values of Education Standards. It pays particular attention
preserving personal and public health and to the standards that describe what students
preserving individual freedom and autonomy. should know and be able to do with respect to
scientific inquiry.
We hope the module’s five lessons will carry these • It is an integrated module, drawing most
concepts to your students effectively. Although heavily from the subjects of science, social
the lessons contain much interesting information science, mathematics, and health.
about various types of cancer, we suggest that • It has a Web-based technology component.
you focus your students’ attention on the major • It includes built-in assessment tools, which are
concepts the module was designed to convey. The noted in each lesson with an assessment icon.
concluding steps in each lesson are intended to
remind students of those concepts. In addition, the module provides a means for
professional development. Teachers can
Why Teach the Module? engage in new and different teaching practices
High school biology classes offer an ideal setting like those described in this module without
for integrating many areas of student interest. completely overhauling their entire program. In
In this module, students participate in activities Designing Professional Development for Teachers of
that integrate inquiry science, human health, Science and Mathematics, the authors wrote that
mathematics, and the interweaving of science, replacement modules such as this one “offer a
technology, and society. The real-life context window through which teachers get a glimpse of
of the module’s classroom lessons is engaging what new teaching strategies look like in action”
for students, and the knowledge gained can be (Loucks-Horsley et al., 1998). By experiencing
applied immediately to students’ lives. a short-term unit, teachers can “change how
they think about teaching and embrace new
approaches that stimulate students to problem
solve, reason, investigate, and construct their
own meaning for the content.” The use of a
supplemental unit such as this one can encourage
reflection and discussion and stimulate teachers
to improve their practices by focusing on student
learning through inquiry.

4
Implementing the Module
The five lessons in this module are designed to be • to recognize the role of science in society and
taught either in sequence, as a supplement to your the relationship between basic science and
standard curriculum, or as individual lessons that personal and public health.
support or enhance your treatment of specific
concepts in biology. The following pages offer What Are the Science Concepts and
general suggestions about using these materials in How Are They Organized?
the classroom; you will find specific suggestions We have organized the lessons to form a conceptual
in the support material provided for each lesson. whole that moves students from an introduction
to cancer (The Faces of Cancer), to an investigation
What Are the Goals of the Module? of its biological basis (Cancer and the Cell Cycle
Cell Biology and Cancer is designed to help students and Cancer as a Multistep Process ), to a discussion
reach the following major goals associated with of how people evaluate claims about cancer
biological literacy: (Evaluating Claims About Cancer), and, finally, to
• to understand a set of basic scientific principles a consideration of how understanding cancer can
related to cancer as a cellular phenomenon, help people make decisions about issues related to
• to experience the process of inquiry and personal and public health (Acting on Information
develop an enhanced understanding of the About Cancer). Table 1 displays the sequence of
nature and methods of science, and major concepts addressed by the five lessons.

Table 1. Conceptual flow of the lessons.

Activity Learning Stage* Major Concepts
Lesson 1 Engage Cancer is a group of more than 100 diseases that develop across
The Faces of time in virtually any of the body’s tissues. Both hereditary and
Cancer environmental factors contribute to its development.
Lesson 2 Explore/Explain The growth and differentiation of cells in the body normally
Cancer and the are precisely regulated; this regulation is fundamental to the
Cell Cycle orderly process of development that we observe across the life
spans of multicellular organisms. Cancer develops due to the loss
of growth control in cells. Loss of control occurs as a result of
mutations in genes that are involved in cell-cycle control.
Lesson 3 Explore/Explain No single event is enough to turn a cell into a cancerous cell.
Cancer as a Instead, it seems that the accumulation of damage to a number
Multistep Process of genes (“multiple hits”) across time leads to cancer.
Lesson 4 Elaborate Scientists use systematic and rigorous criteria to evaluate claims
Evaluating Claims about factors associated with cancer. Consumers can evaluate
About Cancer such claims by applying criteria related to the source, certainty,
and reasonableness of the supporting information.
Lesson 5 Evaluate We can use our understanding of the science of cancer
Acting on to improve personal and public health. Translating our
Information understanding of science into public policy can raise a variety
About Cancer of issues, such as the degree to which society should govern
the health practices of individuals. Such issues often involve a
tension between the values of preserving personal and public
health and preserving individual freedom and autonomy.

5
Cell Biology and Cancer

Table 2. Correlation between lessons and high school biology topics.

High School Biology Topic Lesson 1 Lesson 2 Lesson 3 Lesson 4 Lesson 5
Biology of Cancer Yes Yes Yes No No
Cell Cycle and Regulation of Cell Division No Yes Yes No No
Mutation No Yes Yes No No
Cancer and Personal and Public Health No No No Yes Yes

Although we encourage you to use the lessons • Instructors place less emphasis on
in the sequence outlined in Table 1, many of the transmitting information and more
lessons can be taught individually, to replace emphasis on developing students’ skills.
or enhance a more traditional approach to • Students are involved in higher-order
the same or related content. Table 2 provides thinking (for example, analysis, synthesis,
recommendations for inserting the lessons into a and evaluation).
standard high school curriculum in biology. • Students are engaged in activities
(for example, reading, discussing,
How Does the Module Correlate with and writing).
the National Science Education Standards? • Instructors encourage students’ exploration
Cell Biology and Cancer supports teachers in their of their own understandings, attitudes,
efforts to reform science education in the spirit and values.
of the National Research Council’s 1996 National
Science Education Standards (NSES). Table 3 lists Most teachers endorse the use of active learning.
the content and teaching standards that this We know intuitively, if not experientially and
module primarily addresses. explicitly, that learning does not occur through
a process of passive absorption. But often, we do
How Does the BSCS 5E Instructional not realize how active students must be for real
Model Promote Active, Collaborative, learning to occur. Typically, the answer to this
Inquiry-Based Learning? question is more active than we might expect.
The activities in this module are designed to
offer students the opportunity to participate in The lessons in this module were designed with
active, collaborative, and inquiry-based learning the following assumptions about active learning
in biology. But what do these terms mean? (BSCS, 1999):
Despite their current popularity, many teachers 1. An activity promotes active learning to the
think of active, collaborative, and inquiry-based degree to which all students, not simply a
learning rather generically. Defining these three vocal few, are involved in mental processing
key terms specifically will provide a foundation related to the content.
on which we can build a detailed description of 2. An activity promotes active learning to the
the instructional approach that the five lessons in degree that it offers extended opportunities
this module advocate and implement. for students to become personally engaged
with the content.
Conceptually the broadest of the three, active 3. An activity promotes active learning to the
learning, means that students are involved “in degree that it involves students in thinking
doing things and thinking about the things deeply about content.
they are doing” (Bonwell and Eison, 1991, p. 2).
These authors elaborate by listing the following The activities also make extensive use of
characteristics typically associated with strategies collaborative learning. Collaborative and
that deserve to be labeled “active”: cooperative learning currently enjoy “favorite
• Students are involved in more than listening. child” status among the many strategies available
to teachers. Teachers are using group approaches

6
Table 3. Correlation to the National Science Education Standards.
A. The Content Standards
Standard A: As a result of activities in grades 9–12, Correlation to Cell
all students should develop abilities necessary to do scientific inquiry Biology and Cancer
and understandings about scientific inquiry
• Identify questions and concepts that guide scientific investigations. Lessons 2, 3, and 4
• Design and conduct scientific investigations. Lesson 4
• Use technology and mathematics to improve investigations and Lesson 3
communications.
• Formulate and revise scientific explanations and models using logic Lessons 2, 3, and 4
and evidence.
• Recognize and analyze alternative explanations and models. Lessons 3
• Communicate and defend a scientific argument. Lessons 4
• Understanding scientific inquiry. Lessons 2, 3, and 4
Standard C: As a result of their activities in grades 9–12, Correlation to Cell
all students Biology and Cancer
should develop understanding of the cell:
• Cells store and use information to guide their functions. Lesson 2 and 3
• Cell functions are regulated.
should develop understanding of the molecular basis of heredity:
• In all organisms, the instructions for specifying the characteristics of the Lesson 2 and 3
organism are carried in the DNA.
• Changes in DNA occur spontaneously at low rates.
should develop understanding of the interdependence of organisms:
• Human beings live within the world’s ecosystems. Lesson 5
Standard E: As a result of activities in grades 9–12, Correlation to Cell
all students Biology and Cancer
should develop abilities of technological design and understandings about
science and technology:
• Science often advances with the introduction of new technologies. Lesson 2
• Creativity, imagination, and a good knowledge base are all required in the Lessons 1–5
work of science and engineering.
Standard F: As a result of activities in grades 9–12, Correlation to Cell
all students should develop understanding of Biology and Cancer
should develop understanding of:
• personal and community health Lessons 1, 4, and 5
• natural and human-induced hazards Lessons 1, 4, and 5
• science and technology in local, national, and global challenges Lesson 5
Standard G: As a result of activities in grades 9–12, Correlation to Cell
all students Biology and Cancer
should develop understanding of:
• science as a human endeavor Lessons 2 and 4
• nature of scientific knowledge Lessons 2, 3, and 4
• historical perspectives Lesson 2

7
Implementing the Module
Cell Biology and Cancer

Table 3. Correlation to the National Science Education Standards.

B. The Teaching Standards
Standard A: Teachers of science plan an inquiry-based Correlation to Cell Biology and Cancer
science program for their students. In doing this, teachers
• develop a framework of yearlong and short-term goals for Each lesson provides short-term objectives
students. for students. Table 1, Conceptual Flow of the
Activities and Table 7, Timeline for Teaching
the Module, also help teachers plan.
• select science content and adapt and design curriculum to Using the module helps teachers update their
meet the interests, knowledge, understanding, abilities, and curriculum in response to their students’
experiences of students. interest in this topic.
• select teaching and assessment strategies that support The focus on active, collaborative, and
the development of student understanding and nurture a inquiry-based learning in the activities helps
community of science learners. teachers meet this standard.
Standard B: Teachers of science guide and facilitate learning. Correlation to Cell Biology and Cancer
In doing this, teachers
• focus and support inquiries while interacting with students. All of the activities in the module encourage
and support student inquiry.
• orchestrate discourse among students about scientific ideas. All of the activities in the module promote
discourse among students.
• challenge students to accept and share responsibility for their All of the activities in the module challenge
own learning. students to accept and share responsibility for
their learning.
• recognize and respond to student diversity and encourage all Combining the BSCS 5E Instructional Model
students to participate fully in science learning. with active, collaborative learning is an
effective way of responding to the diversity of
stu­dent backgrounds and learning styles.
• encourage and model the skills of scientific inquiry, as well as Annotations for the teacher that occur
the curiosity, openness to new ideas and data, and skepticism throughout the lessons provide many
that characterize science. suggestions for how teachers can model these
attributes.
Standard C: Teachers of science engage in ongoing Correlation to Cell Biology and Cancer
assessment of their teaching and of student learning.
In doing this, teachers
• use multiple methods and systematically gather data about Each lesson has a variety of assessment
student understanding and ability components embedded within its structure.
Annotations draw teachers’ attention to these
opportunities for assessment.
• analyze assessment data to guide teaching Annotations provide answers to questions
that can help teachers analyze student
feedback. The annotations also suggest ways
for teachers to change their approach to
students, based on that feedback.
Standard E: Teachers of science develop communities of Correlation to Cell Biology and Cancer
science learners that reflect the intellectual rigor of scientific
inquiry and the attitudes and social values conducive to
science learning. In doing this, teachers
• display and demand respect for the diverse ideas, skills, and The answers provided in the annotations for
experiences of all students teachers model these qualities.
• nurture collaboration among students All the lessons are designed to be completed
by students working in collaborative groups.
• structure and facilitate ongoing formal and informal discussion All the discussions in the lessons model the
based on a shared understanding of rules of scientific discourse rules of scientific discourse.
• model and emphasize the skills, attitudes, and values of The annotations for teachers provide many
scientific inquiry suggestions about how to model these skills,
attitudes, and values.

8
across disciplines, for in- and out-of-class or her initial understandings through interactions
assignments, with large and small classes, and with phenomena, the environment, and other
with beginning and advanced students. In fact, individuals. In short, the student interprets
you will often find that collaborative activities go objects and phenomena and then internalizes this
hand-in-hand with active learning. interpretation in terms of previous experiences.

Collaborative and cooperative learning, which A constructivist view of learning recognizes that
have long theoretical and empirical histories, come the development of ideas and the acquisition of
out of different academic traditions, operate on lasting understandings take time and experience
different premises, and use different strategies. (Saunders, 1992). In the typical classroom, this
But both approaches share a fundamental means that fewer concepts and subjects can be
commitment to the notion that students learn from covered during the school year or, in this case,
and with each other—“learning through joint in five days of instruction. Nevertheless, research
intellectual effort,” according to one expert (Brody, suggests that students who are given time and
1995, p. 134). In the interest of brevity, we will opportunity to thoroughly grasp a small number
leave undiscussed the finer distinctions between of important concepts do better on traditional
the two, offering in this curriculum a mix of tests than students who are exposed briefly to a
strategies that put students together and engage large number of ideas (Sizer, 1992; Knapp et al.,
them in tasks that encourage learning together. 1995). In fact, the intensive thinking involved
in constructing a thorough understanding of a
Finally, the activities in the module use inquiry- few major ideas appears to benefit all students,
based strategies. All truly inquiry-based activities regardless of ability.
share the characteristics of active learning. In
addition, inquiry-based strategies emphasize Tables 4 and 5 illustrate the key components
discovery: the process of observation, followed by of the BSCS 5E Instructional Model, so-called
analysis, that leads to explanation, to conclusion, because it takes students through five phases of
or to the next question. Note that an activity need learning that are easily described using five words
not involve students in active experimentation to that begin with the letter “E”: Engage, Explore,
be fundamentally an inquiry experience. Explain, Elaborate, and Evaluate.

More than active or collaborative learning, inquiry- This instructional model allows students to share
based strategies attempt to teach students how common experiences related to cancer, to use and
biologists see the world, how they think about build on prior knowledge, to construct meaning,
what they see, and how they draw conclusions and to assess continually their understanding
that are consistent with observations and current of a major concept. It avoids excessive use of
knowledge. Such strategies say to the student, in lecture because research shows that 10 minutes
effect, “This is science as a way of knowing.” is near the upper limit of comfortable attention
that students give to lecture material, whereas
The BSCS 5E Instructional Model the attention span in an investigative activity is
The lessons in the module were designed using far longer (Project Kaleidoscope, 1991). In the 5E
an instructional model to organize and sequence Model, the teacher acts as facilitator and coach
the experiences offered to students. This model, much more frequently than he or she acts as the
called the BSCS 5E Instructional Model, is based disseminator of information.
on constructivism, a term that expresses a view
of the student as an active agent who “constructs” The following paragraphs illustrate how the
meaning out of his or her interactions with events 5Es are implemented across the lessons in this
(Perkins, 1992). According to this view, rather module. They also provide suggestions about
than passively absorbing information, the student effective teaching behaviors that help students
redefines, reorganizes, elaborates, and changes his experience each phase of the learning cycle.

9
Implementing the Module
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