This unit has been designated as a "Quality Example of NGSS Design" by the NextGenScience Peer Review Panel in Spring 2023. The Intro to Cancer EQuIP review report can found on the nextgenscience website.
Intro to Cancer: Leukemia & Hina's Story
A Cellular Look at Cancer and Treatments
Overview
This is a cancer unit, intended for high school biology classes, focused on cell growth, cell cycle, and mutations. Over ten lessons, students investigate the case of Hina Marsey, an eleven-year old girl, who is diagnosed with a rare form of leukemia. As the unit unfolds, students develop conceptual models on cell growth, cancer, and treatments for leukemia. The unit builds toward a wet lab in which students conduct a gel electrophoresis lab to understand what it means to look for a "match" for transplantation.
The unit is organized into two conceptual bends:
Bend #1: How is Hina's illness affecting her body? unfolds over five lessons that are focused on understanding Hina’s story and how her doctors are able to diagnose her blood cancer. Students develop an understanding of cell growth, the cell cycle, and differentiation of blood cells.
Bend #2: How can Hina’s cancer be cured?, students are introduced to different forms of cancer treatments, before diving deeper into how chemotherapy and bone marrow transplants (including the process of matching donors with recipients) help patients, like Hina, who have leukemia.
This unit also contains a three-dimensional summative assessment that is modular, customizable, and includes options for differentiation. This assessment is storyline-based and involves the use of similar-but-different phenomena. It is located in the final lesson of the unit. The teacher key is available upon request (see details within the Lesson 10 Teacher Guide).
"This is the second year that I am using the 'Intro to Cancer: Leukemia & Hina’s Story' curriculum. I love the storyline approach, and have been very impressed with the payout of this curriculum."
- Biomedical Tech Teacher at Londonderry, NH
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Bend 1: How is Hina's illness affecting her body? (Lessons 1-5)
Intro to Hina's Story
To launch the unit, students draw on their own experiences and prior knowledge. They document ideas and experiences that they have around cancer and are introduced to Hina’s story. To track progress and record questions, the students create an initial conceptual model to help them understand Hina’s symptoms. They also fill out an incremental model tracking worksheet.
Cancer in the Blood
In this activity, students engage with productive uncertainty as they examine data, develop claims, and engage in scientific argumentation using a data-based seminar discussion format. Students examine two types of data from blood samples: complete blood count test results and blood smear microscope slide images. Students then participate in a seminar. Through collaborative discourse, they discuss the data, their interpretations, and how it applies to Hina’s story.
Cell Division & Cell Cycle
In this lesson, students learn about cell division and the process of mitosis as a way of understanding what caused Hina to have blast cells in her blood. In Part I, students explore why cells divide and learn that different cells divide at different rates based on what the body needs. Students watch several videos that show the process of mitosis. They then sequence the order of images in a cell cycle cartoon that shows the steps in cell division.
Cell Differentiation
In this lesson, students explore the process of cell differentiation. Students will work through a hands-on model using modeling clay that shows normal cell differentiation in the bone marrow beginning with undifferentiated stem cells and ending with mature blood cells of various types. This process, called hematopoiesis, is driven by the activation of specific genes triggered by environmental cues.
Cell Cycle Activity & Model of Hina's Disease
In this lesson, the classroom is transformed into a “board game” and the students into “game pieces” to model the cell cycle. In this role-playing game, students act as cells (healthy and cancerous) and go through the cell cycle, while some students play the roles of checkpoint proteins. This experience deepens their learning of the cell cycle, checkpoints, genetic mutations, and the effects of cancer on the cell cycle. Students complete the lesson by returning to their initial model’s of Hina’s disease.
Bend 2: How can Hina's cancer be cured? (Lessons 6-10)
Cancer Treatment & Patient Stories
After receiving an update on Hina's case, students explore the different treatments for cancer, with a focus on chemotherapy and bone marrow transplants. Students explore different patient stories from the Fred Hutch Cancer Center to learn more about cancer treatments to better understand Hina’s treatments. Students also have an opportunity to research different cancer-related careers.
Hina's Treatment
Students learn about human leukocyte antigens (HLAs) and the science behind finding bone marrow donor matches. Students also explore the diversity of the HLA genes and why matching bone marrow donors and cancer patients can be so difficult. This lesson also contains an optional lab activity in which students use DNA technology to find Hina a match.
Disparities in Leukemia
This series of two activities helps students explain why finding a bone marrow transplant match might be difficult for Hina. In the first activity, students explore the insufficient diversity of HLA alleles in the bone marrow database to support patients of non-European descent. Students read about the experiences of individuals with cancer who identify as Black as well as the work of Community Health Educators and researchers and share their ideas in a seminar discussion.
Cord Blood Donation & Model for Hina's Treatment
Students explore three sources of stem cells (bone marrow, peripheral blood, and cord blood) for those that need transplantation. They learn about the pros/cons, process, and obstacles for each source of stem cells before moving on to discussing the bioethics of one source: cord blood donation. Finally, students build on their previous conceptual models to show how Hina’s chemotherapy treatment affects her body and how the new donor stem cells replace her cancerous cells.
Conclusion
This lesson provides three ways for students to conclude their learning around Hina and her cancer treatment. The first activity is a public service announcement (PSA) project that allows students to apply their understanding of leukemia, stem cell transplantation, and HLA matching. The second activity is a three-dimensional summative assessment. This exam is modular, customizable, and includes options for differentiation. The assessment is storyline-based and involves the use of similar-but-different phenomena. A teacher key is provided upon request. In the third activity, students create luminaria to honor those who are struggling with cancer or have struggled with cancer in the past. This is an opportunity to bring emotional closure to the unit.
Careers in Cancer Research & Patient Care
Explore career profiles written specifically for high school students featuring real people working in fields related to cancer research, cancer treatment, and patient care. These profiles have been developed to accompany the Frontiers in Cancer Research curriculum units. These profiles represent a variety of career and educational pathways, diverse backgrounds, and various career stages. The featured professionals work for Fred Hutch Cancer Center, the University of Washington, Seattle Children's Hospital, and other organizations based in Washington State. Some work with adult patients, others work with pediatric patients and their families.
For many of the featured professionals, their work is related to leukemia and other blood cancers and the topics featured in these curriculum units. Students can explore the profiles on the site, read a variety of career stories, and access links to external resources. In addition, a Becoming the Next Cancer Researcher or Clinician section provides college and career information for students planning for a career in STEM, healthcare, or medicine. Teachers can use the Supplementary Info: College & Career Connections document to plan how to incorporate the study of careers in the science classroom.