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About Introduction to the Biology of Cancer Course
Cancer is responsible for the deaths of over 500,000 people in the United States and over 8 million people throughout the world every single year. Cancer is becoming more common around the world since people are living longer, and it is anticipated that by the year 2030, the disease would affect more than 20 million individuals on a yearly basis. People who have an interest in learning more about cancer and the ways in which it can be prevented, diagnosed, and treated are the target audience for this online course.
Both the molecular biology of cancer (including oncogenes and genes that repress tumour growth) and the biological hallmarks of cancer are covered in this course. In addition, the course discusses the factors that increase one’s likelihood of developing the most common types of cancer, such as lung cancer, breast cancer, colon cancer, prostate cancer, liver cancer, and stomach cancer. We discuss how cancer is staged, the primary methods cancer can be diagnosed through imaging, and the treatments available for the most common types of cancer.
This course also includes two Honors sessions that are specifically devoted to malignancies of the liver and the prostate in addition to the standard materials.
You will be able to do the following once you have successfully completed this course:
- Determine which cancers are the most common in the world. (In the first lecture), explain how genes are involved in both the development of cancer and its risk. (In this part of the lecture, you will be responsible for listing and describing the ten cellular hallmarks of cancer. (This is the third lecture.) Describe what metastasis is, and list the primary stages of the metastatic process. During the fourth lecture, we will discuss the role that imaging plays in the screening, diagnosis, staging, and treatment of cancer. (Lecture 5): Please describe the process of treating cancer. (Lecture 6)
We hope that at the end of this course, you will have a fundamental understanding of the biology of cancer as well as therapeutic options. However, it can help you comprehend how cancer develops and gives a framework for understanding cancer diagnosis and therapy. Although the course is not designed for people seeking treatment recommendations, it can help you understand how cancer develops.
SKILLS YOU WILL GAIN
- Cancer
- Biology
- Cancer Biology
- Cancer Genetics
Course Apply Link – Introduction to the Biology of Cancer
Introduction to the Biology of Cancer Coursera Quiz Answers
Week 1
Quiz 1: Introduction Quiz
Q1. What is the major risk factor for developing lung cancer?
- Chronic obstructive pulmonary disease (COPD)
- Asbestos
- Smoking
- Chemical inhalation
Q2. What are the major risk factors for developing liver cancer?
- Infectious mononucleosis
- Hepatitis and cirrhosis
- Smoking and cirrhosis
- Hepatitis and poor diet
Q3. What are the major risk factors for developing breast cancer?
- Age, + family history, BRCA1 carrier
- Age, Chemical inhalation, BRCA1 carrier
- + family history, dense breast tissue, BRCA3 carrier
- Age, smoking, dense breast tissue
Q4. What are the major risk factors for developing prostate cancer?
- Age, + family history, African American race
- Age, + family history, Asian race
- Age, + family history, smoking
- Age, + family history, alcohol abuse
Q5. Not including all forms of cancer, what is the major cause of death wordwide?
- Heart disease
- Cancer
- Chronic obstructive pulmonary disease (COPD)
- Stroke
Q6. What is the major cause of death in the US?
- Heart disease
- Stroke
- Cancer
- Alzheimer’s disease
Q7. How is cancer best defined?
- Spreading growth
- Cells that move around the body
- The study of tumors
- Uncontrolled growth
Q8. Name the major types of cancer
- Mesothelioma, sarcoma, leukemia, lymphoma
- Carcinoma, sarcoma, leukemia, lymphoma
- Carcinoma, mesothelioma, leukemia, myeloma
- Carcinoma, glioblastoma, sarcoma, lymphoma
Q9. What are the four most common cancers in US?
- Liver cancer, stomach cancer, colon cancer, lung cancer
- Sarcoma, liver cancer, colon cancer, breast cancer
- Lung cancer, leukemia, stomach cancer, breast cancer
- Breast cancer, colon cancer, lung cancer, prostate cancer
Q10. What is the single most important risk factor for developing cancer worldwide?
- Salted foods
- Alcohol abuse
- Smoking
- Obesity
Week 2
Quiz 1: Genetics Quiz
Q1. How many copies of each gene do humans have?
- 2
- 1
- 4
- 8
Q2. What is a gene?
- a unit of heredity made up of DNA
- a double helix
- how DNA is replicated
- a type of pea plant
Q3. Who is the father of genetics?
- Charles Darwin
- Gregor Mendel
- Samuel Watson
- Christopher Venters
Q4. What type of BRCA1/2 mutation do women at increased risk for breast cancer have?
- Inactivating
- Benign
- Activating
Q5. An activating mutation occurs in:
- an unrelated gene
- a tumor suppressor
- an oncogene
- Q6. Most genetic variation is:
- Harmful
- Benign
Q7. Only one copy of a gene (“allele”) needs to be mutated to be cancer-inducing.
- False
- True
Q8. Cancer cells have __ rate of mutation compared to normal cells.
- an identical
- a lower
- a higher
Q9. The central dogma describes _.
- How children inherit DNA from their parents
- How genotype is expressed as a phenotype
- Transcription of DNA to RNA, translation of RNA to protein, and synthesis of protein
Q10. DNA damage and replication error arise by
- both environmental carcinogens and chance errors during replication
- environmental carcinogens
- chance errors during replication
- neither environmental carcinogens or chance errors during replication
Week 3
Quiz 1: Hallmarks Quiz
Q1. One way cancer cells differ from normal cells is metabolism. What effect is this phenomena known as?
- None of these options
- Telomerase Effect
- Warburg Effect
- Watson Effect
Q2. Typically, cancer cells produce __ via this process
- Glucose
- Hydrochloric
- Lactate
Q3. Cancer cells differ from normal cells as they are able to up-regulate signals to attenuate CD-8+ T Cell proliferation. What ligand do tumor cells up-regulate?
- CP L2.
- Both of these.
- PD L1.
Q4. Immune cells promote inflammation by secreting _____.
- cytokines
- water
- cytokines and chemokines
- chemokines
Q5. Typically, cancer cells are able to evade which type of cells?
- B cells and T cells
- Macrophages
- B cells, T cells, and macrophages
- Other cancer cells
Q6. One way cancer cells differ from normal cells is that cancer cells can become immortal. Which enzyme do cancer cells use to elongate telomeres?
- None of these options
- Ribosomes
- DNA
- Telomerase
Q7. Typically, a normal cell will stop dividing once the cell reaches __
- Dunn’s limit
- Hayflick’s Limit.
- Rivers limit organs
Q8. Cancer cells can typically have mutations and deletions in which of the following?
- Both
- p53
- Rb.
Q9. Other ways cancer cells differ from normal cells is that cancer cells can :
- Sustain proliferation
- Evade growth suppression
- Harbor an unstable genome
- All of these options
- Avoid cell death
Q10. Typically, a cancer cell can over-express a gene that contributes to tumor cell proliferation and tumor formation. This gene is known as __
- a blue gene
- a tumor suppressor
- an oncogene
Q11. Normal eukaryotic cells detect DNA damage and can do what?
- Continue the cell cycle
- Pause the cell cycle, repair the damage, re-enter the cell cycle
- None of these
Q12. Cancer cells form new blood vessels by inducing ___
- Angiogenesis
- Primary tumor growth
- Intravasation
- EMT
Q13. Cancer cells initiate this process in order to obtain which of the following. Check all that apply.
- EMT
- oxygen
- nutrients
Q14. Which of the following are key steps in metastasis?
- Intravasation
- Extravasation
- Invasion
Q15. Which hallmark entails immortality of the cancer cells?
- Hallmark #10 Activation of metastasis
- Hallmark #1 Replicative Immortality
- Hallmark # 9 Angiogenesis
- EMT
Q16. Genes that are found to be deleted or mutationally inactivated in cancers and allow them to grow are called __ .
- Nutrients and Tumor Suppressor Genes
- Nutrients
- Tumor Suppressor Genes and Oncogene
- Oncogenes
- Tumor Suppressor Genes
Q17. What anti-apoptotic protein was discussed that is seen up-regulated in cancer cells that allows them to resist cellular death?
- XL-B
- None of these
- Both of these
- Bcl-xL and other Bcl-2 family members
Q18. For cancer cells to evade the immune system, they possess the ability up-regulate __ , which suppresses T Cell proliferation.
- EMT
- VEGF
- Telomerase
- Programmed Death Ligand 1 (PD L1)
Week 4
Quiz 1: Metastasis Quiz
Q1. Which Hallmark of Cancer does NOT promote metastasis?
- Angiogenesis
- Evading growth suppression
- Genome instability
- None of these options
Q2. Metastasis is…
- The growth of a benign tumor.
- The spread of cancer to other organs.
- Prostate cancer growing in the prostate.
- Cancer cells that die in the circulation.
Q3. True or false: The prognosis of metastatic cancer is generally more favorable than non-metastatic cancer.
- False
- True
Q4. Identify the correct nomenclature for the TNM staging system:
- Teratome, Neural degradation, Mucus membrane
- Tumor size, lymph Node involvement, Malleability
- Tumor size, lymph Node involvement, Metastasis
- Thyroid involvement, Nuclear instability, Matrix
degradation
Q5. Which is the most advanced cancer?
- T2N1M1
- T3N1M1
- T1N0M0
- T2N1M0
Q6. Identify the correct order of steps of metastasis.
- Growth of secondary tumor
- Intravasation
- Angiogenesis
- Primary tumor growth
- Extravasation
- EMT
- Angiogenesis
- Extravasation
- Intravasation
- Primary tumor growth
- EMT
- Survival in circulation
Q7. Cancer cells initiate this process in order to obtain nutrients and oxygen:
- Extravasation
- Intravasation
- EMT
- Angiogenesis
Q8. What does the word “homing” mean in the context of metastasis?
- Cancer cells migrate back to the tumor of origin.
- The immune system kills cancer cells to defend their home.
- Cancer cells growing in a tumor create a home in their organ of origin.
- Cancer cells tend to metastasize to certain organs.
Q9. Movement of an organism (or cancer cells) from its native habitat is…
- Easy
- Low risk
- High risk
- Random
Q10. Cancer cell proliferation and tumor formation causes an autoeutrophic…
- Swamp
- Cloud
- Pond
- Garden
Week 5
Quiz 1: Imaging Quiz
Q1. A 25 year old has had a plain film chest x-ray as part of a work-up for his 1-month history of coughing up blood. The chest x-ray showed a mass in the middle right lung. A chest CT scan is ordered. What additional information will the CT scan provide?
- The length and width (2 dimensional measurements) of the mass.
- The density of the mass in relation to other nearby structures.
- The location of the mass in relation to the other nearby structures.
Q2. 3-dimensional imaging is most commonly performed based on the anatomic planes of the human body. An image from the axial view, which is along the transverse plane of the body, separates what areas of the body?
- Head from feet
- Front from back
- Right from left
- Left from right
Q3. A student is learning about medical imaging. What would be a logical way (which was discussed in the lecture) to categorize the many types of imaging tests?
- By the type of color scale used in the image. (Examples: grey scale and color enhanced scale)
- By the type of energy used to produce the image. (Examples: magnetic field and sound waves)
- By the type of imaging device to be used. (Examples: CT scanner and tube)
- By the anatomical part of the body to be imaged. (Examples: head imaging and body imaging)
Q4. X-rays are included on the electromagnetic spectrum. What characteristics do they have that allow them to penetrate tissue in the human body to create an image?
- Short wavelength and high energy
- Short wavelength and low energy
- Long wavelength and low energy
- Long wavelength and high energy
Q5. A 70 year old has smoked tobacco since he was 15 years old. He is healthy. What cancer management technique would be appropriate for him?
- Monitor after therapy
- Cancer staging
- Cancer diagnosis
- Screening
Q6. A 50 year old has newly diagnosed colon cancer. CT scans of the chest, abdomen and pelvis have been obtained. Why were these particular staging scans obtained?
- They were obtained based on the treatment that is planned- treatment directed staging.
- They are based on findings in the diagnostic imaging test.
- They were obtained based on the anatomic areas closest to the colon – anatomic proximity
- They were obtained based on where colon cancer typically likes to go, also known as tropism.
Q7. A 25 year old with brain cancer has been treated with surgery, radiation, and chemotherapy. Then he had a brain MRI that showed the brain tumor had decreased in size- a partial response (PR). What was the purpose of the brain scan imaging assessment?
- Measure baseline disease and guide treatment initiation
- Measure effect of treatment response on nearby structures and guide future imaging
- Measure treatment response and guide treatment
Q8. A 60 year old was diagnosed with colon cancer. Staging showed the disease was limited to the colon and to one metastatic lesion in the liver. He was successfully treated with surgery to remove the cancer in the colon and chemotherapy to kill the cancer outside of the colon. Since then he has had monitoring imaging every 6 months, with a CT scan. How does the cancer hallmark “angiogenesis” explain why these scans can be used to monitor him for a possible recurrence of the cancer?
- Viable cancer forms new vessels which take up by the imaging contrast; once the cancer is dead those areas will no longer “light up” on the imaging.
- Viable cancer has altered metabolic processes and will metabolize sugars at a higher rate; once the cancer is dead those areas will no longer “light up” on imaging.
- Viable cancer has genomic instability, which promotes increased density on imaging scans; once the cancer is dead its genomic profile stabilizes and the cancer density is similar to that of surrounding tissues.
Q9. A 55 year old has been diagnosed with prostate cancer and the staging imaging showed one additional site of metastasis- in a rib. He has been deemed as having oligometastatic prostate cancer. He is asking why his oligometastasis is different from his friend’s widespread metastasis which was spread in many places throughout his ribs, spine and lymph nodes. Which of the proposed mechanisms of the biology of oligometastasis is NOT TRUE?
- Organs where the cancer cells attempted to spread to were not hospitable.
- Cancer cells that spread to outside organs facilitated angiogenesis and altered cellular metabolism.
- The environment inside his prostate cancer primary tumor may not have been harsh, and the cancer cells that broke off and began to spread, were not aggressive
- Few of the cancer cells that spread outside of the primary prostate cancer survived circulation throughout the body.
Q10. The 55 year old who was diagnosed with oligometastatic prostate cancer will have a treatment plan with a goal to:
- Cure the cancer
- Stabilize the cancer
- Slow the cancer progression
- Control the cancer symptoms
Week 6
Quiz 1: Treatment Quiz
Q1. Adjuvant therapy:
- Occurs prior to surgery to treat a primary tumor
- Is the first line therapy for metastatic cancer
- Occurs after surgery or radiation to treat a primary tumor
- Usually includes an immunotherapy
Q2. The first line therapy for metastatic prostate cancer is:
- Chemotherapy
- Surgery
- Targeted therapy
- Hormone therapy
Q3. Bevacizumab (Avastin®) inhibits:
- EGFR
- VEGF
- DNA replication
- HER2
Q4. An otherwise healthy man has a small tumor in his lower lung. Correct first line therapy is most likely:
- Hormone therapy
- Targeted therapy
- Surgery
- Chemotherapy
Q5. The two main ways that chemotherapy attack cancer cells are:
- Stopping DNA replication and RNA transcription
- Stopping cancer cells from metastasizing
- Stopping cell mitosis and RNA transcription
- Stopping DNA replication and cell mitosis
Q6. Docetaxel (Taxotere®) inhibits cancer cell division by:
- Binding to topisomerase II
- Blocking mitosis
- Binding to T-cells
- Binding to DNA
Q7. The two checkpoints currently targeted by immunotherapy are:
- PD-1 and PD-2
- PD-1 and CTLA-4
- BH7 and PD-1
- CTLA-4 and CTLA-6
Q8. The main effector cells targeted by the checkpoint inhibitors is:
- The B-cell
- The cancer cells
- Neutrophils
- T-cells
Q9. A phase III clinical trial:
- Determines if the new therapy has any activity against a cancer
- Compares the new drug to the standard of care
- Tests a new therapy in monkeys
- Is done to find out how toxic the new therapy is
Q10. A phase I clinical trial:
- Compares the new drug to the standard of care
- Finds the maximally tolerated dose of a new agent
- \=]-p0[9o8ijuy67defgrwaqwxedciko9p0-[;
+}|=]-]adeqrwQAswxehjnu78p0-[ - termines how efficacious the agent is against a cancer
- Tests the new agent in mice
Quiz 2: Liver Cancer Quiz
Q1. What are the risk factors for liver cancer?
- Asbestos
- Smoking
- Family history of hemochromatosis, Hepatitis B, Hepatitis C
- Eating a diet high in fruits and vegetables
Q2. Liver cancer is most likely to be discovered in:
- A 80 year old man with heart disease
- A 60 year old man chronic Hepatitis B and cirrhosis
- A 20 year old man who smokes daily
- A 30 year old woman
Q3. When staging liver cancer, T stage refers to:
- The presence of metastases
- The
number of lymph nodes involved - The size of the liver tumor(s)
- The histologic type of liver cancer
Q4. The Child-Pugh system assesses:
- Prothrombin time, blood albumin level, blood bilirubin level
- Hepatitis B viral load
- White blood count, red blood count, bilirubin level
- The size of the primary liver tumor
Q5. Radiofrequency ablation for liver cancer may be curative when:
- There is liver cancer that has invaded tissue around the liver
- There are 3 tumors present, each greater than 3 cm in diameter
- There is a single tumor that is 6 cm in diameter
- There is a single tumor, less than 3 cm in diameter
Q6. Sorafenib is safest to use in patients with:
- Child-Pugh Class C
- Child-Pugh Class B
- Child-Pugh Class A
- Child-Pugh Class A, B, or C
Q7. Patients with cirrhosis:
- Have a higher risk of developing liver cancer
- Have a lower risk of developing liver cancer
- Often have a history of Hepatitis B or Hepatitis C infection
- Have a higher risk of developing liver cancer and often have a history of Hepatitis B or Hepatitis C infection
Q8. Types of locoregional therapy include:
- Radiofrequency ablation
- All of these options
- Microwave ablation
- Cyroablation
Q9. The liver:
- Is not necessary for life and can
be removed easily - Makes urine to eliminate waste
- Helps people breathe
- Is unique because it has arterial and portal circulations
Q10. Liver transplant as a treatment for liver cancer:
- Is the treatment of choice in a Child-Pugh Class B patient with three 5 cm tumors.
- Is the treatment of choice for metastatic liver cancer
- Could be the treatment of choice in Child-Pugh Class A patients with a single 3 cm tumor
- Is the treatment of choice in Child-Pugh Class C patients
Conclusion
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