Focus: Students participate in a role play about people who develop cancer, assemble data about the people's experiences with cancer, then discuss the generalizations that can be drawn from these data.
Major Concepts: Cancer is a group of more than 100 diseases that develop across time. Cancer can develop in virtually any of the body's tissues, and both hereditary and environmental factors contribute to its development.
Objectives: After completing this activity, students will
Prerequisite Knowledge: None
Basic Science-Health Connection: This opening activity introduces cancer as a public health issue that can be systematically studied using the methods of science (for example, gathering and analyzing data).
As described in Understanding Cancer, cancer is a group of diseases that are characterized by uncontrolled cell division. This uncontrolled division can compromise the function of an organism and ultimately may cause its death.
Each of us has a chance of developing cancer sometime in our life. On average, in the United States, men have a 1 in 2 lifetime risk of developing cancer and women, a 1 in 3 risk. Many Americans, however, have a higher-than-average chance of developing particular forms of cancer. For example, smokers have a 10-fold higher risk of developing lung cancer compared with nonsmokers. Likewise, women who have a mother, sister, or daughter who has had breast cancer have about a 2-fold higher chance of developing breast cancer compared with women who do not have such a family history.
The National Cancer Institute estimates that approximately 8 million Americans alive today have a history of cancer. In 1998, more than 1 million new cases were diagnosed. In fact, cancer is the second leading cause of death in the United States, exceeded only by heart disease.
This activity introduces the module by reminding students that cancer is a public health issue in the United States. In the activity, students participate in a role play based on the relative incidence of various types of cancer in the U.S. population for a recent year. As part of the role play, each student receives information about one person who develops cancer. Students work in groups, discussing the relevant events of each person's life; as a class, they assemble data about the population as a whole. Students examine the data the class assembles and draw a set of important generalizations about cancer from them. These generalizations set the stage for subsequent activities in the module in which students learn how cancer develops and consider how claims about factors alleged to cause cancer are evaluated and acted upon.
You will need to prepare the following materials before conducting this activity:
To make a set of identity envelopes for your class, first make one complete copy of Master 1.1, The Faces of Cancer. Cut each page along the lines to create five separate pieces of paper. Paste the piece that names and describes each fictitious person onto the front of an envelope, then place the remaining four pieces (labeled "0-19 years," "20-39 years," "40-59 years," and "60+ years") inside the envelope, in order from the earliest period of life to the latest.
With 1 in 3 Americans developing cancer in their lifetimes, it would not be unusual if one or more of your students is personally involved with cancer. It may be that the child's parent, family member, or even the child has or has had cancer. For some of these students, the topic of cancer may be disturbing. Because of this, we suggest that you watch your students for signs of discomfort with the topic (for example, reluctance to begin the activity, unusual quietness or reticence) and provide appropriate support.
It may be useful to begin the activity by asking students to indicate with a show of hands whether they have had an experience with cancer and offer those who raise their hands the opportunity to share it with the class. Emphasize that students also may keep this information private, if they so choose. During the team work, you may want to approach those students who raised their hands and assure yourself that they are handling the activity well.
If you have a student who is having serious difficulty with the topic, you may want to offer him or her a learning alternative to completing the activities in the module.
1. Introduce the activity by asking students to count off in sets of 6 (that is, 1, 2, 3, 4, 5, 6, and so on) and to write down their numbers.
Counting off in this manner sets up the demonstration of statistics that occurs in Step 2 and also identifies the teams into which students will organize in Step 5.
2. Explain that the American public often is presented with statistics about various characteristics of the U.S. and world populations. Sometimes a good way to get a sense of what such statistics mean is to express them in terms of a group of real people. To illustrate this, conduct the following exercise.
. Ask all the students who are number 2, 3, 5, or 6 to stand. Explain that if the population in this class is representative of the American population, approximately 6 in 10 (or in this case, 4 in 6) of the people in the room will have children.
The proportion of U.S. citizens who have children is a rough estimate based on data from 1994 indicating that 42 percent of women aged 15 to 44 do not have children.
. Invite the students who are standing to sit, then ask all the students who are number 3 or 6 to stand. Explain that if the class population is representative, approximately 3 in 10 (or in this case, 2 in 6) of the people in the room will be involved in an alcohol-related automobile accident sometime in their lifetimes.
|In March 1998, the National Cancer Institute, American Cancer Society, and Centers for Disease Control and Prevention announced that cancer incidence and death rates for all cancers combined and for most of the top 10 sites declined between 1990 and 1995, reversing an almost 20-year trend of increasing cancer cases and death rates in the United States. Point out that this provides evidence that cancer research has paid off in thousands of human lives saved. Suggest that some students may want to consider a career in cancer research.|
A fact sheet published by the National Highway Traffic Safety Administration in 1997 (Traffic Safety Facts 1997, National Highway Traffic Safety Administration, http://www.nhtsa.dot.gov/) estimated that about 3 in every 10 Americans would be involved in an alcohol-related motor vehicle accident at some time in their lives.
. Invite the students who are standing to sit, then ask all the students who are number 1 or 4 to stand. Explain again that if the class population is representative, approximately 1 in 3 (or in this case, 2 in 6) of the people in the room will develop cancer sometime during their lifetimes. Ask students if this statistic surprises them.
Answers will vary.
. Finally, ask about one fourth of the students who are standing to sit (for example, if 10 students are standing, ask 2 or 3 to sit). Explain that the number of students left standing represents the approximate percentage of the U.S. population who will die of cancer (about 25 percent). Note that the work of scientists and health care professionals across many years has increased the gap between the number of people who develop cancer and the number of people who die from it, and ask your students what factors they think are contributing to this increased gap.
Students likely will answer that it is the result of increased prevention, earlier detection, and improved treatment.
3. Invite the students who are still standing to sit, then ask the class whether there is any way to know who will develop cancer and when.
Students may answer that there is no way to know for sure, but, in general, old people, people who smoke, and people exposed to excessive radiation develop cancer. Accept allreasonable answers without comment; the purpose of this questioning is to encourage students to express what they already know about cancer and to highlight the fact that there is no definitive way to know who will develop cancer. If students make questionable claims about risk factors or other aspects of cancer, you may wish to respond that many claims are made about cancer and then ask students how they could investigate such claims. You may also wish to point out that Activity 4, Evaluating Claims About Cancer, addresses this question.
4. Explain that in this activity, students will learn more about who develops cancer, when, and why, by assuming the identities of 30 [insert the number of students in your class] fictitious people who develop cancer and building a profile of some of the key events in these people's lives.
Current statistics reveal that only 1 in 3 Americans will develop cancer during their lifetimes. In this activity, however, each of the 30 fictitious people develops cancer. The activity is structured in this way to offer all students similar experiences and to provide maximum richness and variety to the stories of cancer the students encounter. Students will be reminded of the 1 in 3 risk of developing cancer when they complete the questions on the bottom of Drawing Conclusions (see Step 18).
5. Direct the students to organize into teams based on the number they received during the count-off (all students with number 1 should form one team and so on).
Students will work in teams of four to five throughout the activities in the module. To ensure that students working together as members of one team have a common foundation of experience and understanding, we recommend that you keep students in the same teams for all of the activities.
6. Distribute one identity envelope to each student and explain that the outside of the envelope contains a description of the person that student is to become. Ask students to read the descriptions on the envelopes they receive and share who they are with the other members of their teams. Ask students not to open their envelopes at this time.
We suggest that you do not try to match male students with male names and female students with female names. Instead, distribute the envelopes randomly throughout the class. This strategy simplifies the process of distributing the envelopes and avoids the problem that your class may contain a different number of males and females than the identity envelopes do.
To make the activity fun, encourage students to read the description of the person they have "become" to themselves, then introduce themselves (in first person) to the other members of their team. As students move through the activity, encourage them to "tell" their stories to the rest of the team, using first-person language and representing the person they have become as realistically as they can.
Tip from the field test. Before distributing the envelopes, you may wish to explain that some students will be asked to assume the identities of people quite different from themselves (for example, a different sex or ethnic or cultural group). Explain that this is an inevitable consequence of the activity's structure and ask all students to do the best job they can representing the people whose identities they have assumed.
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