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Student Cancer Journals- Personal Reflections and Research
on Life and Death Issues

By Andrea Cobb



Type of activity:

  • Simulation
  • Community outreach
  • Review and reinforcement
  • Research
  • Utilization of research
  • Utilization of research tools

Target audience:

  • Biology
  • AP biology
  • Biotechnology
  • Genetics
  • Life science

Questions posed:

  • How do concepts learned in the study of mitosis, biochemistry and cell biology help me make a potentially life or death decision?


Background Information:

Teacher notes:

This was presented during our study of the cell cycle and mitosis. The learning objectives of this unit were to:

  • Reinforce concepts related to mitosis, the cell cycle and cellular differentiation

  • Investigate and understand proposed causes of cancer at the molecular level

  • Research medical treatments, their mechanisms of action, and side-effects

  • Reflect on real-life (or death) applications and implications of biology.

There were several parts to this activity. Students were given a general overview of the topic of cancer and were told that statistically, 5 of the 25 students in the room will develop cancer and that 1 or 2 of them may die of cancer. Many of them volunteered information about cancer occurring in their families. Students were given an alternative if they did not feel comfortable with this activity -- we have had students who have lost family or friends to cancer.

Student requirements:

Students will compile a notebook or portfolio of work related to the project. This will include research, personal letters/e-mail, records of personal interviews, reflections and decisions made.

Preparation time needed:

The teacher will need to compile a list of symptoms, a list of diagnoses, a list of possible treatments and possible side-effects and a list of prognoses. For my class of 26 students, I compiled lists of 8 different types of cancers, so that students which have the same type may interact with each other. I selected cancers which I felt would greatly impact my students (for example, cancers of the breast, lip, femur, prostate, leukemia, etc.). For such information, I called the American Cancer Society (1-800-4-CANCER).

Class time required:

One class period for introduction, background, assignment of symptoms and explanation of upcoming activities and grading expectations. Days 2-5 may require as little as 10 minutes or as much as a period, depending on the extent of in-class research and discussion. Note: The "days 1-5" may be spread out over an extended time period - once per week, for example.


Activity:

Abstract:

In this activity, students were "given" symptoms of particular cancers, were given diagnoses, treatments, and prognoses. They were asked to research their particular symptoms, type of cancer, treatment regimens from a variety of sources, including journal articles, textbooks, personal interview with doctors, scientists, related agencies, and cancer patients. They were asked to make decisions about whether they would accept treatment, whether their own insurance would cover such treatment and then they "flipped a coin" to determine the efficacy of their treatments (if they accepted them) and also the final cure/mortality outcome. Students maintained journals of their activity and were graded for accuracy of research and completion of objectives.

Materials needed: Research materials appropriate for the age and academic ability of the student

Description of the activity:

Day 1:

Students were given a list of symptoms (there were 8 different types) and were asked to research them and answer the following questions:

  • What were some possible causes of these symptoms?

  • How did they feel about the different possibilities?

  • Who would they tell about their symptoms?

  • Was there a link between anything they had done recently and the symptoms?

  • What was their insurance status, etc.

They then volunteered to share these with the class.

Day 2:

Students were given a diagnosis, prognosis, and treatment options. They may have used a variety of research materials to understand the terminology and predict the probability of a successful treatment. Such resources include CD-ROM based data (Mayo health book), accessing databases through the library, and the usual variety of medical dictionaries, current events, journals, etc. They were asked to record their feelings and to list pros and cons used in the decision-making process. We obtained reprints from the American Cancer Society. I had also hoped that they would discuss these ideas with several resource people who have had cancer -- however, they were hesitant to do so. Perhaps next year, we will invite these people in for an open forum for questions and answers.

Day 3:

Students were asked to describe their treatments, how the treatments "fought" cancer and any side-effects they may feel. They were asked to describe their emotional state and how they could cope with such stressors. This led to a great discussion about support groups for many types of situations, and how one goes about finding such a group.

Day 4:

Students were asked to flip a coin to determine whether their treatment was effective or not. By this time, they were involved enough in the activity to actually care a great deal about the outcome! They wanted to keep flipping the coin, but we had to discuss the fact that some treatments are ineffective. We discussed terms like metastasis and factors that inhibit cellular proliferation (contact inhibition, growth factors, etc.). They also investigated current events with new research into experimental treatments, fraudulent treatments, etc. They were then asked whether they would continue/discontinue treatment, whether their insurance would pay for experimental treatments, etc.

Day 5:

Students were to flip a coin to determine their final prognosis. We discussed how physicians determine whether one is "cured". They recorded their feelings and their plans for the immediate future. They also responded to this exercise -- they all remarked that it was involving, interesting and rather frightening.

Finally, we closed with an overview about causes of cancer, possible genetic links, environmental and behavioral triggers.


Evaluation:

Journals were graded for accuracy, thoroughness, and variety of research tools utilized and completion of the objectives (personal reflections, etc.)

Extension/Reinforcement:

The experience with this activity provides an excellent basis for discussing current events in the life sciences which are published throughout the remainder of the school year. One may bring in many related topics, such as environmental issues, bioengineering and oncogene research, immunology, homeostasis, etc.


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