case study the lung cancer mystery

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Case Study: The Lung Cancer Mystery Mark as Favorite (35 Favorites)

ACTIVITY in Radiation , Alpha/Beta/Gamma Decay , Radioactive Isotopes . Last updated August 02, 2024.

In this activity, students will analyze a scenario about the sudden spike of lung cancer cases in a specific neighborhood. They will take on the role of an investigative reporter in order to examine important information related to the crisis. The activity will provide students the opportunity to learn about radon gas, radiation, and radioactive isotopes. The activity will culminate with the creation of a poster in the form of a public service announcement, where students will focus on the decay of radon and bring awareness to the hazardous radiation that is emitted.

Grade Level

High School

NGSS Alignment

This activity will help prepare your students to meet the performance expectations in the following standards:

• HS-PS1-8: Develop models to illustrate the changes in the composition of the nucleus of the atom and the energy released during the processes of fission, fusion, and radioactive decay.
• Asking Questions and Defining Problems
• Engaging in Argument from Evidence
• Obtaining, Evaluating, and Communicating Information

By the end of this activity, students should be able to:

• Describe one of the three main types of nuclear radiation, alpha radiation.
• Evaluate textual and graphic evidence to support that energy released in the process of nuclear decay may result in the incidence of cancer in human patients.
• Identify the composition of the nucleus before and after nuclear decay.
• Identify the emitted particles resulting from nuclear decay.

Chemistry Topics

This activity supports students’ understanding of:

• Nuclear Chemistry
• Radioactive Isotopes

Teacher Preparation : 10-20 minutes Lesson : 120 minutes

• A copy of student handouts (printed or digital)
• Poster Paper
• Poster-making materials like paper, pencils, coloring markers
• No special safety considerations are needed.

Teacher Notes

• Students should work in groups of 3-4 to answer the case study. Within the group, students will pick jobs: reader, ambassador, investigator and writer. The duties of each are outlined in the supplemental PowerPoint presentation.
• The timing for each task is suggested on the PowerPoint presentation. This is editable, and you can change the suggested times for tasks as you see fit.
• Students should be provided with part 1 of the case study first. It contains four links for the students to research the causes of lung cancer, so you may want to consider providing an electronic copy as well.
• Case study is based on the original case study for medical students found in: Environmental Medicine: Integrating a Missing Element into Medical Education, 1995 – Case #50 .
• When students are done with the tasks and work from part 1, they are provided with part 2. I suggest that while each student should have their own copy (this could be in electronic form), each group can turn in one completed case study by the end of a 60-minute class period.
• The public service announcement poster activity is important for students to make a model of the nuclear decay of radon. I suggest this is done individually, but you student can work in pairs as you see fit.
• The poster portion of the activity can be omitted if time does not allow for it.
• While not ideal, the case study could be used as a substitute lesson plan with some modification and assigned as an individual activity.

For The Student

It was 1982 when Mr. and Mrs. Jones moved into their new home. They had 2 children and lived a relatively healthy and active life, except that Mr. Jones had been an avid smoker for many years. He quit smoking after 20 years. They resided in California and lived through an earthquake in 1994 of a magnitude of 6.7. In 1999 Mrs. Jones was diagnosed with lung cancer and died in 2000. Mr. Jones decided to quit smoking when his wife was diagnosed. Neither of the children ever smoked. Mr. Jones went to the doctor because he had a cough for 3 months that would not go away, even after taking cough medicine. He also lost 20 pounds.

Mrs. Perez moved to the same neighborhood 3 years before. Around the time Mr. Jones went to the doctor, Mrs. Perez who never smoked, found that she was also losing weight and had a cough that would not go away. Both Mr. Jones and Mrs. Perez were eventually diagnosed with lung cancer. Over the next 2 years their neighborhood had 20 total cases of lung cancer. Is this a coincidence?

Websites for research

• American Cancer Society:
• https://www.cancer.org/cancer/lung-cancer/causes-risks-prevention/what-causes.html
• Mayo Clinic:
• https://www.mayoclinic.org/diseases-conditions/lung-cancer/symptoms-causes/syc-20374620
• John Hopkins Medicine:
• https://www.hopkinsmedicine.org/health/conditions-and-diseases/lung-cancer/lung-cancer-risk-factors
• American Lung Association:
• https://www.lung.org/lung-health-diseases/lung-disease-lookup/lung-cancer/learn-about-lung-cancer/what-is-lung-cancer/what-causes-lung-cancer
• What are some causes of lung cancer? Mention at least 3 different causes.
• Imagine you are a reporter for the local newspaper. Write down 3 key details about this medical mystery that a reporter would need to investigate.
• Imagine you are a reporter for the local newspaper. Mr. Jones, his children and Mrs. Perez have all agreed to be interviewed by the media. Which patient will you interview, and why?
• Write down 3 questions you would ask the patient.

Mrs. Perez joined an online lung cancer support group. They had a lot of links that explain the many causes of lung cancer. She found an article about radon. With this new knowledge, she tested her house and found that the average amount of Radon in her home was above recommended levels. She started to urge neighbors and the community in general to be tested for Radon. The U.S. Environmental Protection Agency (EPA) recommends that homes need inspection and repair to lower the amount of radon if the measured level is 4 pCi/L or higher. pCi refers to picocuries . According to the EPA each year about 14,000 deaths in the United States are due to lung cancer caused by indoor radon exposure.

Background Information

Summary : Large quantities of isotope Radon-222 inside homes is the main cause of exposure to ionizing radiation in most of the world. This type of radiation is emitted by radioactive isotopes, like Rn-222, and has enough energy to remove electrons from atoms. The removal of electrons from atoms results in the production of ions. Ionizing radiation cannot be seen or smelled. However, it can be detected with specialized instruments like a Geiger counter or a film badge, usually worn by X-ray technicians. Exposure to radon gas does not cause immediate irritation and for this reason there are no obvious signs of discomfort in patients until symptoms appear. Symptoms include a cough that will not go away for months and weight loss. In addition, not everyone in a home is affected the same way by Radon-222 and some people may not develop symptoms, or may develop symptoms at different times. The only way to know if a home is contaminated with Rn-222 is to test and measure radon levels in homes.

What is Radon? Radon is a gas with no detectable color or smell. The main source of radon in homes is soil, but sometimes the source can be building materials or underground water. Radon can concentrate inside a home in a few different ways. It can diffuse into a home through cracks, dirt floors or cinder block walls. While in the open air, radon gas will cause little risk. But inside a home, radon gas can become concentrated because of how airflow is regulated when homes have temperature controlled systems, exhaust fans, dryers, fire places, and other appliances that affect how air moves.

Radon gas is the result of the radioactive decay of radium, an element that is often found in rock and soil. Radon’s half-life is 3.8 days. While this is a relatively short time, it is enough time for the gas particles to move through the soil and building materials and concentrate inside homes. The gas is then inhaled by people living inside the home. Radon-222 can undergo radioactive decay inside the respiratory system, expose the patients to alpha radiation and result in the incidence of lung cancer. The decay of radon produces four isotopes with half-lives of less than 30 minutes.

Alpha Radiation : Alpha radiation (⍺), is a type of radioactive emission characterized by a Helium nuclei. It contains two protons, two neutrons and a net positive charge of +2. When an alpha particle is released it can penetrate 0.05 mm into body tissue. With constant exposure this particle can eventually result in cellular damage. Here is an example of the emission of alpha radiation:

• Are other members in the homes of the patients at risk for lung cancer as a result of elevated radon levels?
• What are 4 main topics that you need to research to understand how Radon’s radioactive decay causes lung cancer?

Instructions

In your group, assign one topic (from question 2 above) to each group member. Set a timer for 10 minutes. Each member must research their own topic and find 2-3 important/noteworthy details. Record the information from each group member in the table below.

Radon Mystery Poster

You will create a public health announcement that must include a model of the decay of Radon.

• Using an 8x10 sheet of paper create a poster to serve as a public health service announcement.
• Radon’s half-life and decay reaction
• Explain all parts of the decay reaction
• What type of radiation is emitted from radon decay
• Ways we can identify radon contamination in our homes
• The consequences of radon contamination in a home
• Symptoms of lung cancer

• Biomarker-Driven Lung Cancer
• HER2 Breast Cancer
• Chronic Lymphocytic Leukemia
• Small Cell Lung Cancer
• Renal Cell Carcinoma

• CONFERENCES
• PUBLICATIONS
• CASE-BASED ROUNDTABLE

Case 1: 72-Year-Old Woman With Small Cell Lung Cancer

EP: 1 . Case 1: 72-Year-Old Woman With Small Cell Lung Cancer

Ep: 2 . case 1: extensive-stage small cell lung cancer background, ep: 3 . case 1: impower133 trial in small cell lung cancer, ep: 4 . case 1: caspian trial in extensive-stage small cell lung cancer, ep: 5 . case 1: biomarkers in small cell lung cancer, ep: 6 . case 1: small cell lung cancer in the era of immunotherapy.

EP: 7 . Case 2: 67-Year-Old Woman With EGFR+ Non–Small Cell Lung Cancer

Ep: 8 . case 2: biomarker testing for non–small cell lung cancer, ep: 9 . case 2: egfr-positive non–small cell lung cancer, ep: 10 . case 2: flaura study for egfr+ metastatic nsclc, ep: 11 . case 2: egfr+ nsclc combination therapies.

EP: 12 . Case 2: Treatment After Progression of EGFR+ NSCLC

EP: 13 . Case 3: 63-Year-Old Man With Unresectable Stage IIIA NSCLC

Ep: 14 . case 3: molecular testing in stage iii nsclc, ep: 15 . case 3: chemoradiation for stage iii nsclc, ep: 16 . case 3: pacific trial in unresectable stage iii nsclc, ep: 17 . case 3: standard of care in unresectable stage iii nsclc, ep: 18 . case 3: management of immune-related toxicities in stage iii nsclc.

Mark Socinski, MD: Thank you for joining us for this Targeted Oncology ™ Virtual Tumor Board ® focused on advanced lung cancer. In today’s presentations my colleagues and I will review three clinical cases. We will discuss an individualized approach to treatment for each patient, and we’ll review key clinical trial data that impact our decisions. I’m Dr. Mark Socinski from the AdventHealth cancer institute in Orlando, Florida. Today I’m joined by Dr Ed Kim, a medical oncologist from the Levine Cancer Institute in Charlotte, North Carolina; Dr Brendon Stiles, who is a thoracic surgeon from the Weill Cornell Medical Center in New York ; and Dr Tim Kruser, radiation oncologist from Northwestern Medicine Feinberg School of Medicine in Chicago. Thank you all for joining me today. We’re going to move to the first case, which is a case of small cell lung cancer. I’m going to ask Dr Kim to do the presentation.

Edward Kim, MD: Thanks, Mark. It’s my pleasure to walk us through the first case, which is small cell lung cancer. This is a case with a 72-year-old woman who presents with shortness of breath, a productive cough, chest pain, some fatigue, anorexia, a recent 18-pound weight loss, and a history of hypertension. She is a schoolteacher and has a 45-pack-a-year smoking history; she is currently a smoker. She is married, has 2 kids, and has a grandchild on the way. On physical exam she had some dullness to percussion with some decreased-breath sounds, and the chest x-ray shows a left hilar mass and a 5.4-cm left upper-lobe mass. CT scan reveals a hilar mass with a bilateral mediastinal extension. Negative for distant metastatic disease. PET scan shows activity in the left upper-lobe mass with supraclavicular nodal areas and liver lesions, and there are no metastases in the brain on MRI. The interventional radiographic test biopsy for liver reveals small cell, and her PS is 1. Right now we do have a patient who has extensive-stage small cell lung cancer. Unfortunately, it’s what we found. It’s very common to see this with liver metastases.

Transcript edited for clarity.

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FDA Grants Zongertinib Breakthrough Therapy Designation in HER2-Mutant NSCLC

New data on zongertinib for HER2-positive non–small cell lung cancer will be presented at the IASLC 2024 World Conference on Lung Cancer, shedding light on its potential as a novel treatment option for this patient population.

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Watch CBS News

Lung cancer mystery: Why are healthy, non-smoking, Asian women contracting the disease?

By Elizabeth Cook

Updated on: May 13, 2024 / 2:40 PM PDT / CBS San Francisco

A Bay Area-based study finds that 80% of Asian American women with lung cancer never smoked and researchers are trying to figure out why.

Five years ago, Vicky Ni got a call from her doctor. She had just gone in for an X-ray for what she thought was a pinched nerve. The next thing she knew, she was sitting in an oncologist's office.

"I was there by myself and, you know, the word "cancer" comes out of the doctor's mouth, so that's kind of not good," said Ni.

She had never smoked a day in her life, but the 48-year-old mother of two was diagnosed with stage IV lung cancer, the second most common cancer in both men and women in the United States. 

"I was asking them, I'm like, okay, so how long is treatment? And, you know, when are we done with this?" said Ni. "No one had told me up until then it was stage four. So, it was incurable. I would basically have to live with this condition for the rest of my life."

Ni is now 53. The treatments have been brutal;.they've given her high blood pressure and cholesterol. The cancer has now spread to her abdomen. But it's not the physical side effects that hurt the most. Ni has two daughters who were 13 and 15 when she was first diagnosed.

A few years ago, Vicky was asked to participate in a research program at the University of California, San Francisco called FANS, which stands for Female, Asian, Non-Smokers . Launched 15 years ago by Dr. Scarlett Gomez and Dr. Iona Cheng, it's a first-of-its-kind study in the U.S. on why lung cancer rates were rising among Asian females who never smoked.

"Lung cancer rates actually have been declining over the past several decades," said Gomez. "The exception to that trend was among Asian American females where the rates and the trend of the rates have been slightly increasing and edging upwards over the past several decades."

The doctors hope the FANS study not only leads to the development of more preventative measures and screening but also grabs the attention of folks with deep pockets. Right now, less than 1% of funding from the National Institutes of Health goes to diseases that impact the Asian American community.

"There is this perception that Asians don't get sick," said Gomez. 

Ni isn't spending her energy wondering how or why she got lung cancer. Instead, she is turning her pain into purpose, by reaching out to other women like 34-year-old Kit Ho who Ni recruited to also be part of the FANS study .

"I just feel like anything from me, if my tissue, if my saliva can help the researchers to find more medicine or find more ways to identify people early, then I want to be a part of it," said Ho.

Ho was diagnosed with cancer on Thanksgiving 2023. Doctors discovered four tumors in her brain they believe were linked to lung cancer. Just like Ni, she never smoked. She's also a mom to two kids who are 2 and 4 years old.

Ni is focusing on the things that bring her joy: family, friends and helping others know that even in their hardest moments, they are not alone.

"I want to do everything I can to make this diagnosis sort of meaningful to the world," said Ni.

• UCSF Health
• University of California
• Lung Cancer

Less than a month after arriving at KPIX 5 as the 5pm co-anchor and night-side reporter, Elizabeth Cook was in San Francisco's Mission District covering a chaotic Occupy march when a protester shoved her and her cameraman. With only moments to spare, the team got to safety and filed their report for the 11 pm news.

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