A 20/20 View of Cancer

About Mini Medical School

Mini Medical School offers a unique glimpse into the health sciences at the University of Minnesota. Community learners with a shared interest in health embark on a journey examining the scientific foundations of health and disease. Presented using common language for ease of understanding complex topics, your guides are internationally renowned experts who are shaping the way health care is delivered locally and globally.

Key Concepts in Cancer and Cancer

Cancer is an umbrella term that refers to hundreds of diseases.
Cancers are characterized by uncontrolled cell growth and spread (into local or distant tissues).
Cancers arise from the corruption or misuse of genetic information (encoded by DNA).
We get cancer because of bad luck, old age, and life-style choices.
The mission of the Masonic Cancer Center at the University of Minnesota is to reduce the burden of cancer on all Minnesotans.

Research and The Anatomy of a Tumor

Solid tumors are made up of many different cell types, including tumor cells and various types of non-tumor cells.
The term “tumor microenvironment” refers to the immediate environment within and surrounding a tumor that includes non-tumor cells and additional factors that provide structural support to the tumor.
Interactions between tumor cells and their “microenvironment” are critical for tumors to grow and metastasize to distant sites.
The tumor microenvironment can impact the ability of cancer therapies to effectively eliminate tumor cells.
Developing therapies that effectively target the tumor microenvironment may enhance the efficacy of cancer therapies.

Christopher Pennell, PhD

Associate Director, Community Engagement and Education Masonic Cancer Center; Associate Professor, Laboratory Medicine and Pathology

Kaylee Schwertfeger, PhD

Director, American Cancer Society Institutional Research Grant; Associate Professor, Laboratory Medicine and Pathology

Cancer Genetics

All cancers have a genetic cause – but that doesn’t (usually) mean the genes you’re born with cause cancer; instead cancer is primarily caused by mutations occurring in rare cells in your body.
For most people, their cancer risk is more determined by lifestyle choices than who their parents are. But some families do pass along high risk cancer-causing gene mutations from parent to child.
Cancer cells typically have many, many gene mutations and about 6 or more of these “drive” the abnormal behavior of the cancer cells, while the rest are merely “passengers.”
It is thought that the genes mutated in a cancer can produce abnormal proteins allowing the immune system to kill off the cancer cells. This is how “immunotherapies” like Keytruda can work for some cases of cancer.
The specific genes that are mutated in a tumor or leukemia may determine the prognosis of the patient and dictate the best therapy for the physician to choose.

When Good Cells Go Bad

All cells communicate or "signal" within and between each other in order to make appropriate cellular "decisions" based on hormonal cues.
Cancer cells are making inappropriate or abnormal decisions that cause them to grow and spread (into local or distant tissues - metastasize).
The wiring inside of cancer cells is altered due to corruption (mutations) or misuse (too much or too little) of critical genetic information.
The abnormal molecules (signaling proteins) in cancer cells that "pass" a signal can be inhibited by cancer therapies (drugs) to kill cancer cells.
Understanding how cancer cells send inappropriate "signals", and how this differs from normal cells, is essential to finding new and more effective cancer treatments and ultimately, cures.

David Largaespada, PhD

Associate Director, Basic Sciences, Masonic Cancer Center; American Cancer Society Research Professor; Professor, Department of Pediatrics

Carol Lange

Co-Director, Cellular Mechanisms of Cancer Program, Masonic Cancer Center; Director, Molecular, Genetic, and Cellular Targets of Cancer Training Program; Tickle Family Land Grant Chair of Breast Cancer Research; Professor, Medicine and Pharmacology

Diet and Lifestyle Factors in Cancer Risk

Lifestyle factors impact health (tobacco, alcohol, diet).
Some chemicals in the environment or diet, if present at sufficiently high levels, can increase cancer risk.
Eat a varied and well balanced diet containing antioxidants.
Many chemicals in the diet can mitigate health risks posed by environmental and dietary toxicants.
Not all naturally occuring herbs used as alternative medicines are safe.

E-cigarettes and Vaping: Chemistry and Toxicology Considerations

Both the e-cigarette devices and the liquids used with these devices contribute to the chemical complexity of e-cigarette aerosol.
Flavors and high nicotine content contribute to the popularity of some devices, such as JUUL, among youth.
Adult addicted smokers could potentially reduce some of their health risks by switching to e-cigarettes; however, complete switching is required to achieve this goal.
Research employing biomarkers of exposure and effect can provide key insights into the potential long-term health consequences of e-cigarette use.
Investigators in the Masonic Cancer Center at the University of Minnesota are nationally and internationally recognized leaders in the field of chemistry and toxicology of tobacco products.

Robert Turesky, BSc, PhD

Masonic Chair in Cancer Causation; Professor, Medicinal Chemistry

Irina Stepanov, PhD

Associate Professor, Environmental Health Sciences, School of Public Health

Tumor Immunology and Immunotherapy

The immune system has evolved to eradicate infections and abnormal (cancer) cells.
There are many mechanisms in place for the immune system to not target healthy tissues. This process is called “self tolerance”.
While some cancers are caused by infections, most cancers are derived from mutations in normal healthy cells. While cancers grow and acquire more mutations, some mutations in cancer cells can appear as foriegn to the immune system.
Cancers employ many mechanisms to promote self tolerance and avoid immune detection.
Harnessing the immune system for cancer therapy is producing remarkable results in some patients and in some cancer types.
Many immunotherapies in the clinic are drugs that “release the brakes” on the bodies’ own immune system so it is no longer “tolerant” to the cancer cells. However, this can also cause immune-mediated pathology in normal tissues.
Developing safe and effective immunotherapies is challenged by the complexity of cancer and the risk of “off-target” toxicity.
Cell engineering is a way to create “designer” and living cells for cancer therapy in those cancer patients where other therapies fail.

Precision Cancer Therapy

Not all individuals respond to cancer treatment and for some this is related genetics.
Genetic mutations used to select cancer treatments can be inherited or acquired.
Not all individuals with cancer have cancer genetic mutations that can be treated with precision medicine therapies.
For some cancers precision medicine therapy is life long.
Tumor resistance may develop to precision medicine treatments.

Ingunn Stromnes, PhD

Assistant Professor, Microbiology & Immunology, Center for Immunology, Center for Genome Engineering;Masonic Cancer Center Member

Pamala Jacobson, PharmD, FCCP

Professor and Director, Institute of Personalized Medicine, College of Pharmacy, Experimental and Clinical Pharmacology

Katherine Bensen

Young professional and mother of four living with stage IV lung cancer

Cancer in Minnesota

Cancer disparities particularly impact Somali immigrants in Minnesota.
There are a wide range of reasons for this, including social, cultural and religious influences.
There are also great opportunities to address these disparities through conducting community partnered research in collaboration with the Somali community.
We can also address these disparities by partnering with local clinics and health care providers.
Family based and strengths focused approaches, including incorporating messages from the Muslim faith in cancer prevention efforts, can make a positive difference on cancer disparities for Somali community members.

Clinical Trials and the Minnesota Clinical Cancer Trials Network

Population and laboratory studies identify potential new treatment strategies.
Clinical trials are necessary to develop new drugs and improve cancer outcomes.
Partnering with patients to enroll in clinical trials is necessary to defeat cancer.
Reducing disparities in cancer outcomes requires new strategies to include patients who do not live in metropolitan areas.

Rebekah Pratt

Assistant Professor, Program in Health Disparities Research, and Family Medicine and Community Health

Douglas Yee, MD

Director, Masonic Cancer Center, John H. Kersey Chair in Breast Cancer Research, and Professor, Medicine and Pharmacology

Cancer Survivorship

There are growing numbers of cancer survivors.
Cancer survivors have a unique set of needs.
Cancer survivors are at high risk for chronic diseases.
The care of cancer survivors requires a team approach, with multiple disciplines.

A Heroic Journey Mindset

Facing a diagnosis of cancer provides endless options - and opportunities - to react and respond. What does a “heroic journey” mindset mean?
How was a heroic journey mindset helpful for me when I received my diagnosis of throat cancer.
What are some tools and techniques I incorporated in my heroic journey mindset:
- Support - creating Team FIERCE
- Connections - authoring my Caring Bridge story
- Nature and animals
- Mindfulness x3!
- Gratitude
How can you help others, and yourself, travel a heroic journey pathway.

The Gray Zone: When Life Support No Longer Supports Life

Role confusion frequently exists between loved ones, caregivers and health care agents in medical events.
How does a non-medically trained individual determine when enough is enough?
There may be hidden impacts to health care agents responsible for making end of life decisions for their loved one.

From Surviving to Thriving

Being your own advocate to receive the best possible care
Biohacking to a better recovery
Staying resilient and tenacious with the bumpy roads ahead

Anne Blaes, MD

Associate Professor, Hematology/Oncology; Director of Cancer Survivorship Services and Translational Research; Section Head, Medical Oncology

Tanya Bailey, MSW, LICSW

Cancer Survivor; Co-ordinator, Animal-Assisted Interactions, PAWS Program

Deborah Day Laxson, PMP, CHTP

Founder, Health Care Agent Literacy Project, LLC; Author, The Gray Zone: When Life Support No Longer Supports Life; Vice Chair, Minnesota Palliative Care Advisory Council; Steering Committee Member, Minnesota Cancer Alliance

Scott Petinga

H!NK DIFFERENT Foundation Founder and Director; Center of Advocacy for Cancer of the Testes International Founder; Superhero; 10x Entrepreneur; 3x Philanthropist; Healthcare Advisor

A 20/20 View of Cancer

About Mini Medical School

Recent Courses

Mind Matters: the Brain and Mental Health

Food, Nutrition & the Effects of Substances on Health

Mini Medical School: Aging and Health