What Science Knows about Cancer

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

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.

Disclaimer:
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
 |  Average 31 minutes each
  • 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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Your professor

David Sadava

About Your Professor

David Sadava, Ph.D.
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...
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Reviews

What Science Knows about Cancer is rated 4.6 out of 5 by 45.
Rated 4 out of 5 by from excellent content but tends to go too fast The professor knows his stuff. I learned a great deal from the course and now have much respect for the complexity and, yes, "beauty" of the biology of the general entity called cancer. I am a cancer survivor myself and thank Prof. Sadava for his help to me by this course. Often, however, when he gets into complex material, he seems to forget that some in his audience are not scientists and proceeds at lightning speed. He also tends to drop his voice at the end of a sentence or topic; as well, when he refers to complex terms or concepts which he has previously covered, he repeats them very rapidly, almost dismissively, as if his whole audience recognized them and thoroughly understood them.
Date published: 2013-06-02
Rated 5 out of 5 by from MOST EXCELLENT, INDEED! In this fascinating course Dr. David Sadava gives us the latest updated understandings of the War on Cancer. Professor Sadava is an excellent and knowledgeable lecturer who has spent his career researching and teaching about this dreaded disease. The course is divided into six parts each dealing with a specific topic. PART I – CHALLENGE OF CANCER 1 in 3 people will get malignant cancer and 1 in 4 will die from it which is why cancer is the second-leading cause of death (heart disease is number one). PART II – CAUSES OF CANCER Population observations and the science of epidemiology in looking for causes are explained. Cancer is mostly a disease of changes in DNA. The major things that cause cancer are tobacco and diet as well as some reproductive factors and he makes the point that many of the things that cause cancer are natural rather than artificial. PART III – CANCER AS A DISEASE The multiple changes a cell goes through in order to change from a normal cell to a cancer cell are discussed. It’s the accumulation of damage in multiple steps over many years which causes the problem. Sadava explains how the new science of stem cells relates to cancer, the fact there is great heterogeneity in tumor cells and all cancers cells are not alike, science now knows much more about the steps of metastasis (how cancer spreads), and angiogenesis (how a tumor recruits its blood supply). PART IV – GENES AND VIRUSES Peering deeply inside cells and looking into genes, viruses, and molecular biology led to the discovery that 10% of cancers are caused by tumor viruses which led to the discovery of oncogenes and proto-oncogenes in cells. Additionally it was found 10% of cancers are inherited which led to the discovery of suppressor genes. It was then found you can do a molecular biography of cancer and look at all the specific changes in genes as a cancer develops which led to the ability to use targeted therapy. PART V – TREATMENT The study of how cancer spreads led to changes in surgery. Surgery gives a patient the best chance to be cured. New forms of radiation therapy cause less damage to good cells and if surgery is not possible, radiation therapy gives a patient the next best chance to survive. Chemotherapy has evolved from natural products to isolated molecules to targeted therapy. If the cancer has spread and chemotherapy is necessary, the patient cannot be cured but may still achieve many years of quality life. PART VI – SCREENING AND PREVENTION Screening is done on a population basis and the use of cancer screening depends on knowledge and once we know the cause, it leads to prevention. Dr. Sadava concludes this highly informational course by giving his best estimates of what the future holds in cancer research and treatment. In the struggle to find the causes of cancer, he thinks epidemiology will identify nutritional causes and preventative agents. Better screening methods for carcinogenic agents in the environment will be developed. Studying cancer as a molecular disease will lead to the cancer genome being used to identify genes important in cancer development. Molecular biographies of cancer will result in a clearer understanding and prognosis. In the area of cancer treatment he predicts surgery will become less invasive and new methods will be developed to deliver therapy directly to cancer cells. Knowledge of the molecular biographies of cancers will lead to targeted chemotherapies. Screening and prevention will improve the ability to identify tumor cells and blood markers for earlier detection, treatment, and screening. Finally he sees the acceptance of cancer as a chronic disease creating better chemo-preventative agents and a further decline in smoking will lead to a comparable decline in cancer. This course is highly recommended due to the information imparted about cancer, Dr. Sadava’s superb presentation, and because knowledge is power.
Date published: 2013-05-29
Rated 5 out of 5 by from 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!
Date published: 2013-05-09
Rated 5 out of 5 by from Wise words from a great man following his purpose David Sadava is a true outlier amongst professors, to whom countless students credit their career trajectories in science and medicine, due to his unique ability to convey the "So what?" of complex and rapidly advancing medical research concepts to give traction to the power of modern science. If you ever wondered what the relevance of all those complex cycles you had to memorize in Biochemistry, Organic Chemistry, and Cell Biology is to you and your loved ones, watch this series. Sadava speaks, not only from his years of experience in the trenches of research medicine, but also from the humanity of one who has loved and lost dearly to a disease that has affected so many of us and our loved ones and is still one of the most medically challenging diseases to treat--cancer. His artful ability to convey the hope that his field is bringing to so many is not only the "So what?" that has inspired countless future doctors and research scientists, it is also his purpose--which he shares with elegance, wit, and passion. Thank you, Dr. Sadva, for all your contributions to education and science! We owe you a debt of gratitude for all you have shared. Respect, Doc Forever
Date published: 2013-05-04
Rated 5 out of 5 by from 'The Great Courses' Has Really Outdone Itself . .
Date published: 2013-05-03
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