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What Science Knows about Cancer

What Science Knows about Cancer

Professor David Sadava Ph.D.
City of Hope Medical Center, Claremont Colleges
Course No.  1956
Course No.  1956
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Course Overview

About This Course

24 lectures  |  31 minutes per lecture

Few global challenges touch humanity with as much immediacy or ubiquity as cancer. Over the course of their lifetime, one in three people in North America, Europe, and Australia will develop a malignancy, and in the United States alone, the direct and indirect costs of cancer amount to billions of dollars a year. The sad truth is that almost every family in the Western world will be affected by cancer at some point in their lives.

The good news is that the landscape of cancer treatment and prevention is a vastly different place than it was even a decade ago. Thanks to a relatively new focus on molecular medicine, scientists have been on a highly encouraging trajectory of discovery. And with each passing day, researchers are gaining a deeper understanding of the mechanisms involved, poising them on the brink of tremendous breakthroughs.

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Few global challenges touch humanity with as much immediacy or ubiquity as cancer. Over the course of their lifetime, one in three people in North America, Europe, and Australia will develop a malignancy, and in the United States alone, the direct and indirect costs of cancer amount to billions of dollars a year. The sad truth is that almost every family in the Western world will be affected by cancer at some point in their lives.

The good news is that the landscape of cancer treatment and prevention is a vastly different place than it was even a decade ago. Thanks to a relatively new focus on molecular medicine, scientists have been on a highly encouraging trajectory of discovery. And with each passing day, researchers are gaining a deeper understanding of the mechanisms involved, poising them on the brink of tremendous breakthroughs.

With the wealth of findings in this field, it is not surprising to read contradictory reports about causes and treatments. It can be difficult to separate fact from fiction, but if we arm ourselves with a scientific understanding of cancer, we'll not only have the tools to evaluate emerging news, we'll be in a much better position to prevent and grapple with the disease.

What Science Knows about Cancer reports from the front lines of the war on cancer with a clear and scientifically precise—yet thoroughly accessible—guide to how the disease develops, thrives, and can potentially be conquered. Taught by David Sadava, a laboratory researcher at the City of Hope Medical Center and an award-winning professor of biology at The Claremont Colleges, this fascinating 24-lecture course leaves no stone unturned in explaining the amazing ways cancer works to subvert the body's normal functioning, and how therapies can reverse these insidious processes.

Using a highly visual, step-by-step approach that takes you deep inside the cancer cell, Professor Sadava answers your questions about cancer and debunks myths with a level of specificity, scientific rigor, and candor that is rare to find.

With his expert guidance, you'll explore

  • why cancer rates have risen over the last century;
  • what agents and conditions cause cancer, from tobacco and radiation to diet and female reproductive status;
  • how DNA changes underlie the development of cancer;
  • the specific genes involved in making cells progress, divide, and spread;
  • the methods physicians employ when battling cancer; and
  • how behavior modification, drugs, vaccines, and compounds found in natural substances may help prevent cancer.
Cancer from a Scientist's Perspective

Professor Sadava presents cancer at the macro and microscopic levels as he lays bare the crisis it creates for both humanity and the human body. You'll venture inside cells to learn the conditions that lead them to become specialized or cancerous, and how the mechanisms that facilitate tumor growth are analogous to the gas pedal and brakes in your car.

Methodically organized and delivered, What Science Knows about Cancer uses a six-part framework to investigate the multistage model of cancer.

  • Part one begins with an overview of the challenge cancer presents for society and an examination of the history of cancer dating back over 3,000 years.
  • Part two delves into how scientists use epidemiology to identify environmental agents of cancer, and introduces how spontaneous changes in the expression and duplication of DNA can go awry.
  • Part three looks at tumors—from how they grow and metastasize to how they're diagnosed, staged, and graded by physicians.
  • Part four reveals recent discoveries about genes and inherited cancers, cancer-causing viruses, and the molecular biology of cancer.
  • Part five describes how the three major methods of treatment—surgery, radiation, and chemotherapy—have evolved over time and are frequently used in combination.
  • Part six offers a frank analysis of the state of cancer screening and prevention.

While you'll touch on specific forms of the disease, these lectures aren't designed to examine the prognosis or therapies of individual cancers. Rather, they empower you to understand how the disease operates and how, through advances in science, it might be stopped.

A Wealth of Eye-Opening Discoveries

This course will captivate you with descriptions of new targeted therapies coming from the realm of molecular medicine, such as drugs that attack DNA and other cell processes, and vaccines that harness a patient's own white blood cells, prompting the immune system to reject a tumor. And you'll be filled with a sense of optimism as you're introduced to treatments in the early stages of development, such as tumor-specific viruses that destroy tumor cells while leaving normal cells unharmed.

Here's a glimpse of some of the other surprising information you'll encounter:

  • About 10% of cancer is initiated by viruses, and a roughly similar percentage of cancer is inherited.
  • Things many people assume causes cancer—such as pollutants and food additives—may not be as significant as natural substances in foods and normal reproductive processes.
  • Public policies such as home radon testing may be based on false assumptions about the risks for cancer.
  • Tumors can recruit their own blood supply through the process of angiogenesis.
  • Some cancer occurs spontaneously, simply because of imperfections in our chemistry.
Prevention as the Best Medicine

In addition to highlighting carcinogens to avoid, What Science Knows about Cancer outlines the natural agents that leading researchers—Professor Sadava included—are investigating for their anti-cancer properties.

You'll consider thought-provoking information on the benefits and efficacy of various types of cancer screening, including genetic testing for the "breast cancer gene" (BRCA1), as well as breast self-exams, cervical screenings, colonoscopies, mammograms, and PSA screenings for prostate cancer. Along the way, you'll consider ethical and legal questions regarding the costs associated with these tests, their rates of false positives, what should be done with the information, and whether their routine use has a significant impact on rates of survival.

As a lab researcher at the forefront of this fight who works at the City of Hope Medical Center—and who also taught one of the first comprehensive courses on cancer to undergraduates—Professor Sadava is uniquely qualified to offer a straightforward explanation steeped in the latest science. Although he is presenting high-level findings, he never overwhelms with a barrage of data. Rather, he offers a nuanced interpretation that places research within its broader context—as only a scientist of his caliber is capable of doing.

An abundance of edifying charts, slides, and animations provide a rich visual reference for the information presented, while in-depth accounts of patient histories, clinical trials, and epidemiologic studies enrich your experience and aid comprehension.

Cancer isn't necessarily something any of us likes to think about, but knowledge truly is power. Forever change the way you view and cope with this all-too-common challenge with What Science Knows about Cancer.

These lectures are not designed for use as medical references to diagnose, treat, or prevent medical illnesses or trauma. Neither The Great Courses nor Professor Sadava is responsible for your use of this educational material or its consequences. If you have questions about the diagnosis, treatment, or prevention of a medical condition or illness, consult a qualified physician.

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24 Lectures
  • 1
    Cancer Is an Ongoing Challenge
    Kick off the course with an overview of what you’ll learn and the history of cancer. Discover what has transpired in the war on cancer, from the earliest theories and treatments to medicine’s relatively recent transition from a focus on dividing cells to targeted therapy based on molecular biology. x
  • 2
    Cancer Is a Major Burden to Society
    As you investigate why cancer is a growing problem in the United States and across the globe, explore the burden cancer places on society as a whole—both to people and the economy—and look at some of the most common forms of the disease. See why, surprisingly, cancer doesn’t rank on the Global Burden of Disease Study. x
  • 3
    Discovering Causes of Cancer in Populations
    What do population studies tell us about the causes of cancer? Define the science of epidemiology and learn how it can be used to study cancer in both populations and individuals. Differentiate between case-control and cohort studies, and the categories of risk factors for cancer. x
  • 4
    Some Causes of Cancer in Populations
    Continue exploring epidemiology by delving into environmental causes of cancer that have emerged from studies, including tobacco, diet, a woman’s reproductive status, medications, pesticides, radiation, and even your personality. How does giving birth later in life make you more vulnerable to breast cancer? Is the average person’s exposure to pesticides really dangerous? Find out here. x
  • 5
    DNA Is the Key to Understanding Cancer
    Take the first steps in understanding the multistage model of cancer by learning how various agents initiate cancer at the genetic level. Explore the fundamentals of DNA as genetic material, the process by which DNA is expressed and duplicated, and the ways this process of duplication can go awry, causing cell mutations to accumulate. x
  • 6
    How Does DNA Change to Initiate Cancer?
    Two types of carcinogens mutate DNA: chemicals and radiation. Build on what you’ve learned about DNA by looking specifically at how these carcinogens produce cancer at the cellular level. Then, examine carcinogens that don’t damage DNA and how epigenetic changes in DNA can result in cancer. x
  • 7
    How Do We Know If Something Causes Cancer?
    Does hair dye cause cancer? What about saccharin? Familiarize yourself with the types of experiments scientists conduct to determine if something causes cancer, and consider whether a range of natural and manmade substances with carcinogenic properties have the potential to cause cancer in humans. Conclude this lecture by looking closely at the concept of risk analysis. x
  • 8
    How Do Normal Cells Function?
    Focus on cells as the basic structures of living things through an exploration of their internal composition, particularly the nucleus where the genome is retained. See how this discovery was proven in the cloning of Dolly the sheep and consider how this is relevant to cancer treatment. x
  • 9
    What Is Different about Cancer Cells?
    How do tumors start? Find out how cells divide without normal controls in place and the nine unusual properties shared by many cancerous cells—including the ability to recruit a blood supply. Then learn about the process of apoptosis, or programmed cell death, and the molecules being developed to block telomerase, a protein that lets cancer cells escape dying. x
  • 10
    How Do Tumors Grow?
    What is the difference between benign and malignant tumors? What signs of cancer do people typically experience? Turn to tumor development and growth with a discussion of the methods doctors use to diagnose, stage, and grade tumors—all of which inform how aggressive treatment should be—and an introduction to the distressing processes of metastasis and angiogenesis. x
  • 11
    How Tumors Spread and Thrive
    The body does everything it can to reject a tumor, but sometimes the immune system is not only too overburdened to succeed, it’s unable to even recognize that tumors exist. Find out why tumors can go undetected as you continue your investigation of metastasis and angiogenesis, and how these phenomena contribute to the growth and spread of tumors. x
  • 12
    What Are Tumor Viruses?
    Most of us will be infected with—and recover from—Epstein-Barr virus at some point in our lives. In some people, this infection contributes to the development of cancer. Understand what viruses are, how tumor viruses can be identified, and the way viruses such as Epstein-Barr, hepatitis B, and papilloma cause cancer if other conditions are present. x
  • 13
    How Do Tumor Viruses Cause Cancer?
    Learn about molecular biology and how gene expression is controlled before turning to an investigation of the way tumor viruses use these gene control mechanisms to initiate cell division, and, ultimately, cancer. Wrap up by looking at how cancer develops in 90% of cases—from normal cells that aren't infected by viruses. x
  • 14
    How Do Cancer-Causing Genes Work?
    In almost all cancer, genes that stimulate cell division called oncogenes are mutated. But can one such mutation cause cancer on its own? Examine an experiment that answers this question, then look closely at proto-oncogenes and oncogenes to discover how they function and what they do in the cell to turn on cancers, including neuroblastoma tumors in children. x
  • 15
    Can Cancer Be Inherited?
    Why do cancers sometimes run in families? Explore the “two-hit” hypothesis for how cancers are inherited along with the criteria for defining cancer as hereditary with a discussion of several forms—including retinoblastoma, colon cancer, and breast cancer—that are known to be passed on this way. Explore inherited susceptibilities to cancer that make some people more prone to developing this disease. x
  • 16
    How Do Normal Genes Suppress Tumors?
    Now that you understand oncogenes, focus on tumor suppressor genes for a more complete view of cancer. Start by learning how the BRCA1 gene mutation in inherited breast cancer was discovered—and its implications—before turning to strategies for identifying and isolating suppressor genes to be used in therapy. Explore the genes’ functions, from repairing DNA damage to acting as brakes in the cell division cycle. x
  • 17
    How Do Genetic Changes Result in Cancer?
    All tumors are not created equal. Trace how cancer develops as a series of molecular changes, then learn how the worldwide Cancer Genome Project is working toward individualized therapies. Conclude by looking at genetic testing and considering its ethical and legal ramifications. x
  • 18
    Treating Cancer with Surgery
    From research to clinical trials to approval, cancer therapies face a long road before they become viable treatment options. As you turn to the science behind surgical cancer therapy, explore this developmental process. Using breast cancer as an example, learn the scientific principles of surgical therapy and how it has evolved. Weigh the pros and cons of using surgery to diagnose cancer, remove localized tumors, and prevent metastasis. x
  • 19
    Treating Cancer with Radiation
    Continue your investigation of ways to treat cancer by learning how radiation treatments, including proton therapy, brachytherapy, and radiosurgery, are often used to kill cancer cells. Next, explore the use of stem cell transplantation to restore the bone marrow of patients who’ve experienced high doses of radiation or chemotherapy. x
  • 20
    Treating Cancer with Drugs
    Turn to the last of the three methods of treatment with this lecture that traces the origins of chemotherapy to mustard gas attacks in World War II. Learn about the path taken by a drug on its way to a tumor, the combinations of chemotherapy used by oncologists, and how drugs are often derived from plants and other natural sources. x
  • 21
    How Do Drugs Attack Cancer?
    Some cancer drugs go to work on DNA while others target processes inside the cell. Get an introduction to both categories and learn the science behind how widely used drugs such as methotrexate, tamoxifen, and cisplatin operate. Consider the side effects patients commonly experience when undergoing chemotherapy and the reasons cells become resistant to treatment. Then, using kidney cancer as an example, look at how science has led to new treatments with the potential to target specific tumors. x
  • 22
    Frontiers of Cancer Treatment
    Explore avenues of treatment at the frontiers of science, starting with how a patient’s own immune system can be harnessed in cancer therapy. Take an in-depth look at antibodies and gene therapy as options for treatment and consider the amazing potential of viruses that target tumors only and leave normal cells undamaged. x
  • 23
    Can Screening for Cancer Be Useful?
    Why are monthly breast self-examinations no longer recommended in some countries? Do PSA screenings for prostate cancer have any impact on survival rates for men with the disease? Examine the science of screening and the success rates of current screening methods for cancers of the breast, cervix, colon, and prostate, and consider whether getting screened is worthwhile given the risks and costs associated with each. x
  • 24
    Can Cancer Be Prevented?
    Conclude the course with a discussion of prevention, from carcinogens to avoid to substances that studies indicate could offer chemoprevention in a wide variety of cancers. Learn why identifying carcinogens and preventive agents is so challenging for researchers, and look toward the promising future of treatment and prevention. x

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David Sadava
Ph.D. David Sadava
City of Hope Medical Center, Claremont Colleges

Dr. David Sadava is Adjunct Professor of Cancer Cell Biology at the City of Hope Medical Center in Duarte, CA, and the Pritzker Family Foundation Professor of Biology, Emeritus, at The Claremont Colleges. Professor Sadava graduated from Carleton University as the science medalist with a B.S. with first-class honors in biology and chemistry. A Woodrow Wilson Fellow, he earned a Ph.D. in Biology from the University of California, San Diego. Following postdoctoral research at the Scripps Institution of Oceanography, he joined the faculty at Claremont, where he twice won the Huntoon Award for Superior Teaching and received numerous other faculty honors. He has been a visiting professor at the University of Colorado and at the California Institute of Technology. Professor Sadava has held numerous research grants and written more than 55 peer-reviewed scientific research papers, many with his undergraduate students as coauthors. His research concerns resistance to chemotherapy in human lung cancer, with a view to developing new, plant-based medicines to treat this disease. He is the author or coauthor of five books, including the recently published 10th edition of a leading biology textbook, Life: The Science of Biology, as well as a new biology textbook, Principles of Life.

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Rated 4.5 out of 5 by 18 reviewers.
Rated 5 out of 5 by What Science Knows about cancer I was just diagnosed with stage 1 esophageal cancer in April. After the initial shock wore off, I had many questions, but the reading material was so complex that I really did not find any answers. I found Dr Sadava's course extremely helpful! I have learned so much in just the first lessons. He gives information in a way that you do not need a medical degree to understand. He includes a lot of graphs that are easy to read and enhance the subject even more. If you have cancer, have a loved one with cancer or just enjoy science courses, I highly recommend this course! May 9, 2013
Rated 5 out of 5 by An Excellent Course I am a lawyer, and a cancer survivor, but I never understood what cancer was, or how the medical approaches to it work, prior to watching this course. So much has been learned since I was in college. and it is wonderful to have it clearly and concisely presented. I am just finishing my second viewing of it, watchiing one lecture per day so that the amazing amount of information packed into each one has a chance to sink in. The material is covered in a thorough way, and the graphics are a major help in illustrating what the Professor is saying. The presentation is entertaining, instructive, and very clear. I am in absolute awe of the Professor's ability to take a complex subject and make it comprehensible. I enjoy many of the Great Courses, but this one is easily the best so far. July 21, 2014
Rated 5 out of 5 by Great course Takes what could be very complicated and makes it easily digestible. Great organization of material. Made it into a fascinating series of lectures with excellent presentation skills. In fact I liked him so much I got his other course December 17, 2013
Rated 1 out of 5 by Incomplete and Misleading Professor Sadava makes a convincing case for the cancer industry party line but barely mentions the turmoil, descent and conflicts of interest that taint the field. The cancer research, detection and treatment industry has been over-promising, over-diagnosing, over-treating and under-delivering good results for decades. The party line in this course is the same as it has been for decades – this time is different we are so close to a cure we just need a little more… Scandals abound in cancer research, detection and treatment and are regularly reported in the print media. But the coverage does not do justice to the battles occurring behind the scenes in professional medical and biochemistry journals. Just enough of the scandals are presented here to give you the impression they are being adequately covered. Many doctors and researchers have concluded (some of them long ago) that there is a fundamental error in the reductionist approach but you will not find their arguments here. For example when Professor Sadava mentions the beta-carotene vs. lung cancer debacle but he does not give the full story as the complete story does not fit in with the industry’s reductionist approach. There is a rising chorus of researchers and doctors that want to present the public with accurate information. However they are shouted down by well-heeled commercial interests that can and do punish doctors and researchers who do not follow the party line. So this information remains buried in the literature unless one knows where to find it, read it and understand it. There are doctors and researchers presenting this information especially the nutrition facts. Professor Sadava is not in their ranks. For example Professor Sadava gives the impression there is no actionable dietary and nutrition information available. Actually there are over 3,000 English language Clinical Nutrition Studies published every year. Many of them are on cancer and are available to the general public but you need to know how to find them and read them (not to mention the time). Good clinical nutrition facts are available but are drowned out by the accompanying nonsense promoted everywhere. In this regard the Nurses Study and EPIC study cited by Professor Sadava are considered flawed and of limited value by many experts in cancer and nutrition research. And he leaves out the massive China Study although he does attack it without actually mentioning it. (For example, there is more to the fat vs. cancer country chart than Professor Sadava lets on.) Professor Sadava never states anything false that I heard rather he just presents half the science. For example carrots may contain trace amounts of aniline and aniline may be worse for you than the nitrosamines that are found in bacon. But the implication that bacon is healthier than carrots is the type of nonsense you see on the nightly news. Hint: there is more to carrots than aniline. Or to state the fact that the fruit peels contain toxins harmful to insects is true. The implication that they are harmful to humans would be true if it were not for the studies that show their toxicity is preferential to cancer cells. These and numerous other instances are examples of the cancer industries obsession with reductionist “silver bullet” solutions. The formula is simple concentrate on one fact to the exclusion of others. But my favorite is Professor Sadava’s attack on vegetables because (paraphrasing) “what you grow in your back yard will be different than what you grow in your front yard.” That is true but it is also true if you do not over load them with pesticides both are good for you. In a number of instances Professor Sadava lets on that he knows of the controversy and opposing views but refrains from details. And his recommended reading also does not tell the story. (A better recommended reading list would have earned a second star.) A better place to start is Dr. Goodman’s “The Human Body: How We Fail, How We Heal". Dr. Goodman’s unconventional definition of cancer is trending in the literature and will likely be adopted in the future. The following comment from James D. Watson, winner of the Nobel Prize for his co-discovery of the structure of DNA "The American public is being sold a nasty bill of goods... about cancer cures.” Those words spoken in congressional testimony in 1975 still ring true today. A few procedures have been shown to be life preserving but many have had the Hippocratic Oath repealed with little positive objective results to show for it. For example some insurance companies are refusing to pay for the expensive Prostate Proton Therapy presented as the new breakthrough because it has the same results as the old therapy and still leaves many grown men in diapers. Studies have shown that most men with prostate cancer will die of other causes first. That is the reason for the controversy mentioned briefly in the course. November 1, 2013
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