GROUP 2 – N204

CELL CYCLE AND CHEMOTHERAPY

How are they related?

To keep the body in good health is a duty... otherwise we shall not be able to keep our mind strong and clear.  -

Buddha

Cancer Statistics 2011 as well as Cancer Facts and Figures 2011 published through A Cancer Journal for Clinicians  reported that

during 1990 to 2007 premature cancer deaths of 898,000 cases were actually prevented. Good news? Yeah,… but not

really. 

In May of 2011, World Health Organization released Causes of Death 2008 Summary Tables articulating that 13.6% of deaths

from the whole world are caused by malignant neoplasms; bronchus/ lung/

trachea garnering the largest percentage.

Cancer is the third leading cause of morbidity and mortality in the Philippines. Leading cancer sites/types are lung, breast, cervix, liver, colon and rectum, prostate, stomach, oral cavity, ovary and leukemia. There is at present a low cancer prevention consciousness and most cancer patients seek consultation only at advanced stages. Cancer survival rates are relatively low.

Going back to the investigation conducted by American Cancer Society, the latter part of the study said that the figures of averted deaths

could have been much higher if only everyone was able to gain advantage of the

development. 

The analysis claimed that “cancer death rates for individuals with the least education are

more than twice those of the most education”. Again, if only each one is well clued-up, 60,370 additional citizens diagnosed with cancer could

have survived. 

Education is always reiterated as a very important factor in premature cancer

death deterrence. We have premeditated during our BSN years about primary,

secondary and tertiary prevention; and as a nurse, it is our sole conscientiousness to update our knowledge not for ourselves

and our loved ones but for the community on the whole.

Questions as basic as: What is cancer? What causes it? How to prevent it? And, Is

there a cure? To multifaceted inquiries like: How is it pathologically developed?

Or, Why is the concept of cell cycle important in understanding the

mechanism of chemotherapy?; should on no account be taken for granted. 

Hopefully, facilitated by this digest created by group 2, we would be able to contribute in promoting the campaign of skyrocketing

everyone’s wisdom about cell, cancer and chemotherapy. This report includes non complex

definition of cells, its cycle, overview of chemotherapy, paradigm, supplementary articles and researches, and methods on how we can be

able to successfully disseminate these facts to our clients, the community and to the future nurses.

THE CELL CYCLE

CANCER

Cancer is a class of diseases characterized by out-of-control cell growth. There are over 100

different types of cancer, and each is classified by the type of cell that is initially affected.

Cancer harms the body when damaged cells divide

uncontrollably to form lumps or masses of tissue called tumors (except in the case of leukemia where cancer prohibits normal blood function by abnormal cell

division in the blood stream

http://en.wikipedia.org/wiki/File:Cancer_requires_multiple_mutations_from_NIHen.png

Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell

somewhat.

Cancer is fundamentally a disease of failure of regulation of

tissue growth. In order for a normal cell to transform into a cancer cell, the genes which

regulate cell growth and differentiation must be altered

WHAT CAUSES CANCER?

Genes - the DNA typeCells can experience

uncontrolled growth if there are damages or mutations to DNA, and therefore, damage to the genes involved in cell division.

Four key types of gene are responsible for the cell division process: oncogenes tell cells when to divide, tumor suppressor genes tell cells when not to divide, suicide genes control apoptosis and tell the cell to kill itself if something goes wrong, and DNA-repair genes instruct a cell to repair damaged DNA.

Cancer occurs when a cell's gene mutations make the cell unable to correct DNA damage and unable to commit suicide.

CarcinogensCarcinogens are a class of

substances that are directly responsible for damaging DNA, promoting or aiding cancer.

Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens.

Hormones Some hormones factor in the development of cancer by promoting cell proliferation.

Chemotherapy

is a general term for treatments that use

chemical agents (drugs) to kill cancer cells.

Most commonly, chemotherapy acts by killing cells that divide rapidly, one

of the main properties of most cancer cells. This means that it also harms cells that divide

rapidly under normal circumstances

Chemotherapy encompasses a wide variety of therapy treatments. Terms such as "adjuvant," "neoadjuvant," "consolidation," and "palliative" often add to the confusion surrounding chemotherapy if not properly defined and explained. The purpose of this page is to increase the level of understanding about various chemotherapy protocols currently used.

Adjuvant chemotherapy - Chemotherapy given to destroy left-over (microscopic) cells that may be present after the known tumor is removed by surgery. Adjuvant chemotherapy is given to prevent a possible cancer reoccurrence.

Neoadjuvant chemotherapy - Chemotherapy given prior to the surgical procedure. Neoadjuvant chemotherapy may be given to attempt to shrink the cancer so that the surgical procedure may not need to be as extensive.

Induction chemotherapy - Chemotherapy given to induce a remission. This term is commonly used in the treatment of acute leukemias.

Consolidation chemotherapy - Chemotherapy given once a remission is achieved. The goal of this therapy is to sustain a remission. Consolidation chemotherapy may also be called intensification therapy. This term is commonly used in the treatment of acute leukemias.

Maintenance chemotherapy - Chemotherapy given in lower doses to assist in prolonging a remission. Maintenance chemotherapy is used only for certain types of cancer, most commonly acute lymphocytic leukemias and acute promyelocytic leukemias.

First line chemotherapy - Chemotherapy that has, through research studies and clinical trials, been determined to have the best probability of treating a given cancer. This may also be called standard therapy.

Second line chemotherapy - Chemotherapy that is given if a disease has not responded or reoccurred after first line chemotherapy. Second line chemotherapy has, through research studies and clinical trials, been determined to be effective in treating a given cancer that has not responded or reoccurred after standard chemotherapy. In some cases, this may also be referred to as salvage therapy.

Palliative chemotherapy - Palliative is a type of chemotherapy that is given specifically to address symptom management without expecting to significantly reduce the cancer.

Why is it that the concept of cell cycle is important in understanding the mechanism of chemotherapy?(PARADIGM and TEXTUAL EXPLANATION)

Since the mechanism of chemotherapy is primarily demonstrated on a cellular level, it is relevant to understand the concept of cell cycle. All living tissues are made of cells. Cells grow and reproduce to replace worn out ones. By definition, cell cycle is composed of all steps in the process of reproduction, and that period extending from one mitosis to the next. In normal cell population, inhibitory control slows or stop reproduction (as in wound healing, contact inhibition causes fibrous tissue growth to cease at the point where the edges of the wound come together) whereas stimulating factors cause the process to move rapidly ( cellular responses to injury – inflammation and cellular repair). However, cancer cells go through the same cycle, uncontrollably.

The cell cycle has five phases. After a cell reproduces, the two new cells are identical. Each of the two cells made from the first cell can go through the same cycle again

when needed.

G0 phase : resting phase; The cell has not yet started to divide. Cells spend much of their lives in this phase. When cells get the signal to reproduce, it moves to the G1 Phase.

G1 phase: During this phase, RNA and protein synthesis occurs. The cell starts making more proteins and growing larger, so the new cells will be of normal size. Some key process occurs to signal its entrance into the S phase of

DNA synthesis.

S phase: DNA synthesis occurs. Replication of DNA begins resulting in two exact sets, which will occupy the nuclei of

the two daughter cells.

G2 phase: DNA synthesis ceases. RNA and protein synthesis continue in preparation for mitosis

M phase: In this phase, the cell actually splits into 2 new cells.

Most chemotherapy drugs act on cells that are actively replicating that’s why

having the knowledge about the cell cycle is important. Some of these drugs attack cells specifically on the cell cycle phase and some on all phases. Understanding how these drugs work helps oncologists

predict which drugs are likely to work well together. When chemotherapy drugs attack reproducing cells, they cannot differentiate normal cells from cancer

cells. Thus, the damage on normal cells results to a number of side effects.

Chemotherapeutic agents can be classified according to the phase of the cell cycle in which they are active. Agents that are cell-cycle nonspecific have a linear dose-response curve; that is, the greater the dose of the drug, the greater is the fraction of cell kill. However, cell-cycle-phase-specific drugs have a plateau with respect to cell killing ability, and cell kill will not increase with further increases in drug dosage (Page, R.).

The following are some of the commonly used cell-cycle-dependent chemotherapy drugs and the specific stages of the cell cycle during which they exert their effects.

Anthracyclines are anti-tumor antibiotics that interfere with enzymes

involved in DNA Replication. These agents work in all phases of the cell-cycle. Thus, they are widely used in

variety of cancers. A major consideration when giving these drugs is that they can permanently damage

the heart if given in high doses. Examples: daunorubicin, doxorubicin,

epirubicin, and idarubicin.

Corticosteroids are natural hormones and hormone-like drugs that are useful in treating some types of cancer (lymphoma, leukemias, and multiple myeloma), as well as other illnesses. When these drugs are

used to kill cancer cells or slow their growth, they are considered chemotherapy drugs. Corticosteroids are also commonly

used as anti-emetics to help prevent nausea and vomiting caused by chemotherapy. Examples include

prednisone, methylprednisolone and dexamethasone.

Antimetabolites are a class of drugs that interfere with DNA and RNA growth by substituting for the normal building blocks of RNA and DNA. These agents damage cells during the S phase. They are commonly used to treat leukemia, tumors of the breast, ovary and the

intestinal tract, as well as other cancers. Examples include 5-fluorouracil, capecitabine, 6-mercaptopurine,

methotrexate, gemcitabine, cytarabine, fludarabine, and pemetrexed.

Bleomycin is an Antibiotic that

generates free radicals to destroy DNA. Thus, concurrent antioxidant supplementation may

reduce its efficacy.

These drugs are derived from Chinese ornamental Camptotheca acuminate;

they inhibit DNA topoisomerase I which interrupts the elongation phase

of DNA replication. Topoisomerase enzymes normally sepratae strands of

DNA so they can be copied. These drugs are used in the treatment of certain leukemias, as well as lung,

ovarian, GI, and other cancers.

These are often plant alkaloids and other compounds derived from

natural products. They inhibit mitosis or inhibit enzymes form making

proteins needed for cell replication. They work primarily in the M phase, but can damage cells in all phases.

They are used to treat many different cancers including breast cancer, lung cancer, myelomas, lymphomas, and

leukemias.

They are derived from the periwinkle plant (Vinca rosea) and

block polynerization of microtubules, resulting in impaired mitotic spindles.

Examples include vinblastine, vincristine, vinorelbine.

Podophyllotoxins inhibit DNA

topoisomerase II activity blocking DNA synthesis.

Taxanes are semi-syntehtic compounds from the yew plant.

They promote microtubular assembly and stability, blocking

cell cycle mitosis.

ACTION SITESOF CHEMOTHERAPY

DRUGS

G1 Phase, RNA & Protein Synthesis

S Phase, DNA Synthesis/duplication

G2 Phase, RNA & Protein Synthesis

M Phase, Mitosis cell

division

G0, resting stage

Antimetabolites

Asperg

inase &

Corti-

coste

roids

Alkylating & Anthra-cy-clines

Bleomycin,

Irenotecan,

Mitoxantrone

Vinca AlkaloidsPodophyllotoxins Tax-

anes

Action Sites of Cytotoxic Agents on a Cell Cycle level

Concepts tackled from modules 1-3* In Module 1: We learned about homeostasis and the steadiness of the internal environment as well as the values in certain measurements of the internal environment or the negative feedback loop. We were enlightened also in adaptive mechanism of the body and its response to stress. Also discussed here how a certain disease can start and how our body fight and adopt to it. In relation to the topic bout cancer studies have indicated an indirect relationship between stress and certain types of virus-related tumors. Evidence from both animal and human studies suggests that chronic stress weakens a person’s immune system, which in turn may affect the incidence of virus-associated cancers, such as Kaposi sarcoma and some lymphomas. 

More recent research with animal models (animals with a disease that is similar to or the same as a disease in humans) suggests that the body’s neuroendocrine response (release of hormones into the blood in response to stimulation of the nervous system) can directly alter important processes in cells that help protect against the formation of cancer, such as DNA repair and the regulation of cell growth. (www.cancer.gov)

Stress reduction can improve the immune response and possibly slow cancer progression.

* In Module 2 : In this module its more about the basic unit of life:

cell. In this module it explained how the cells are organized, the different cell parts and it’s remarkable functions, the stages of cell cycle and the cellular vicissitudes that affects body aging.

In relation of this module to Chemotherapy that Chemotherapy works by bringing it to a halt or slowing the growth of cancer cells, which grow and divide rapidly. But it can also damage healthy cells that divide quickly, such as those that line your mouth and intestines or cause your hair not to grow. Damage to healthy cells may cause side effects. Often, side effects get better or go away after chemotherapy is over. Chemotherapy acts mainly on replicating cells during the cell cycle by interfering at different levels from DNA synthesis to protein function. They can work at any point of the cell cycle (cell-cycle specific- phase non-specific) but some works only in specific phase of the cycle (phase specific). Other chemotherapeutics act on cells whether they are in the cell cycle or resting and are named cell-cycle nonspecific drugs.

There are many different types of chemotherapy agents each acting on a different part of the cell cycle. Some are cell cycle specific meaning that they only work on specific parts of the cell cycle while others work at any part of the cell cycle. This is the name given to the sequence of events that a cell goes through when it grows and divides into two. The cell consists of 4 stages: G1 a resting stage prior to DNA replication; S the stage in which DNA is copied; G2 a gap stage and M where cell division takes place. (http://www.chomotherapy.com)

 * In Module 3 :

We were educated about the response of cells when there’s an injury and inflammations, how our body response to infectious agents and alterations in wound healing. In relation to this module on Current treatment strategies, such as chemotherapy, radiotherapy, stem cell transplantation, or a combination of them, are mostly effective but may induce serious side effects to normal tissues. In addition, tumors are developing resistance against most of these conventional therapies. Tumors "hybrid" cell lines can induce immune responses against tumors cells in the lab, as opposed to directly attacking them. As a result, the patients' tumors cells, as well as related cell lines, were killed, his findings reveal. The response of the immune system to cancerous cells is often inadequate because tumor cells use a variety of mechanisms to avoid detection.

SCENARIOTo further explain the

relationship of the cell cycle and chemotherapy, we incorporated the idea in a fantasy story.

Individuals, Communities and Students can easily understand Cancer, the cell cycle and chemotherapy with the use of this story.

We hope you would enjoy reading.

Once upon a time in a far away kingdom,

cells were living happily with their well-ordered lives.

The inhabitants were happy and

contented, and everything seemed working well and good. While the empire has vast

supply of resources, the whole kingdom

was in return maintained and protected by the

loyal and hardworking working

cells.

Day in and day out, the kingdom was nourished by the Royal Cell Workers. The Royal Cell Workers were considered the

primary unit of society because they give the kingdom its special structure,

energizes and protects it from harm and handle almost all sorts of tasks

necessary to sustain life inside the kingdom. They were endowed with

certain “magical powers’ that they use in carrying out their daily duties.

The kingdom needs them, all of them. This was the reason why they keep on reproducing themselves (exact copies

of themselves!) so they could carry their huge task of running the kingdom well and good. But some workers stop

reproducing themselves once the kingdom has stopped growing. They just replace those Royal Cell Workers who suffered damage or unfortunate

death in line of their duties. Also, most of them become matured and had

specialised for their particular jobs in the kingdom.

All their lives, the Royal Cell Workers knew their purposes from the start. They are

aware of their important role in sustaining the life in the kingdom. In their hearts and minds, they knew the need to reproduce

themselves (up to 50-60 time maximum) and to increase their numbers when the

kingdom needs more workers. Then, they need to cooperate and observe harmony among them so they could stay and work together in their right places. They were

programmed to be in this way (deep within them) such that when their code of conduct is broken (e.g detached in their right places, reproduced themselves more than 60 times

or became badly damaged), they self-destruct.

One fateful day, Royal Cell Workers noticed something strange with the way some of their comrades behave. No one knew what awaits them and

their Kingdom.

Royal Cell Worker 1: Hey dude, I saw some of our comrades acting very strange and different the past few months. They have reproduced entirely different copies of themselves!

Royal Cell Worker 2: Really, what do you mean dude?

Royal Cell Worker 1: Yeah, I swear I saw it! They continued reproducing beyond our limits but the strange thing is, they did not die! Now, they were looking different from us. They look gross!

Royal Cell Worker 3: OMG! I heard what you are saying dude! Yeah, that’s true and aside from their strange looks and behavior, they are no longer responding from us. I’m sending signals and tried communicating with them to no avail!

Royal Cell Worker 2: That’s scary…

Royal Cell Worker 1: That’s not all dude, they look unfriendly and they did not stick together with us. They seemed very snobbish at the surface levels, and instead of sticking together with us, they had detached themselves!

Royal Cell Worker 3: Most of all, they were working and functioning very differently from our tasks. They failed to specialize in our tasks and they stayed immature and I wonder a lot what is really happening with them. They keep on growing and keep on invading large areas in our place!

Royal Cell Worker 2: I haven’t heard this one in my entire life, we should do something about these strangers.

Royal Cell Worker 1: You’re right dude. We need to find out more about them.The Royal Cell Workers were left in the cold as to why it happened. Meanwhile, a cataclysmic danger is lurking for the entire kingdom.

Where they saw the event unfolded, the bizarre-looking Royal Cell Workers were

full of activities. With dangerous intents, they keep on reproducing and growing at a very fast pace. But this time, it was different from the rest of

the cells. Something deep inside caused them to behave in a more aggressive manner. They could not tell but they

knew that a deep and profound change happened to them.

Now, they have different magical powers and felt stronger and more powerful from the rest of the Royal Cell Workers in the kingdom. They

felt the urge to become special, to be different from the rest of them.

Hence;

Bizarre-looking Royal Cell Worker 1: I know, I know what lies in your minds my fellows! Something unexpected happened within all of us during our creation process, but come to think of it, we became different creatures among the rest of the kingdom. We have strange magical powers never seen before! I could feel the power within me.

Bizarre-looking Royal Cell Worker 2: Bwahaha, indeed, my comrade! We are now more aggressive, more powerful and stronger than most of the poor Royal Cell Workers. We are now Immortals, Independent and brutal Invaders out to show them our ferocious capacity to jeopardize this kingdom!

Bizarre-looking Royal Cell Worker 3: What are we waiting for Comrades! Let us establish our superiority in this place and rightfully claim what we belong to us. We are indestructible, we should prove to them what we can do! We should now be called, the Super Cancer Cells! Hail thou Super Cancer Cells!

Rest of the Bizarre-looking Royal Cell Workers: Hail thou Super Cancer Cells! Go forth and multiply!

And so the inevitable happened, the Super Cancer Cells unleashed their might and fury

in the said place (Colon part) within the kingdom. Armed with the power of indefinite reproduction of their own kind, there have been no more limits to their growth. They have developed atypical source of growth signal from inside of them and they could

now build a different supply system for the Super Cancer Cells. Now they don’t need

those help from their neighbor cells!

They are now looking down to the normal Royal Cell Workers since unlike them, Super Cancer Cells ignores “time to die” signals

and other signals which limits their reproduction. Moreover, the Super Cancer Cells have the power to migrate to another

site in the kingdom and further continue their conquest of more colonies!!

Meanwhile…Royal Cell Worker 1: OMG, these bizaare-looking creatures are now all over us. They have grown so fast and they are now very big..

Royal Cell Worker 2: Uhg,they have been taking away all our supply of oxygen and we are becoming weaker and weaker each day!

Royal Cell Worker 3: They got awesome powers too, they are building their own independent supply of everything that they need. And no one really knows for sure how they do it!

Royal Cell Worker 2: I’ve see them growing their own blood vessels which could explain why they are growing at the fast pace and siphoning off all nutrients and oxygen away from us! I beg your pardon but I’m feeling weak and sick now.. I think my time has come….(darkness)

As the Super Cancer Cells grow in size and power, they have squeeze and blocked small blood vessels in their area. Due to low blood and oxygen levels, some of the Royal Cell Workers began to die off. This made them easier for the Super Cancer Cells to continue to push their way through.

Super Cancer Cell 1: We have magnificently affirmed our presence in this area in the kingdom. The poor Royal Cell Workers are slowly dying due to our magical powers. They cannot beat us in our reproduction capacity, and we have lots of enzymes that we can use to break down tissues so that we can make our way through.

Super Cancer Cell 2: Aside from that, we can directly move into another place and spread easily our mighty Super Cancer Cell forces. That, my comrade, they cannot do. Hahaha!

Super Cancer Cell 3: We have invaded most of this particular area successfully and now, we must look to other places within the kingdom! Cheers!

With their newly found powers, Super Cancer Cells continued their invasion to other parts of the kingdom.

They have successfully spreaded their forces

through the circulatory system of the kingdom (blood and lymphatic

systems). They immediately established their presence

in the other invaded territory and carried on

their vicious cycles in their new territory.

On the other hand, the Royal Cell Workers from the Immune System Unit stood their grounds and put up a brave fight against the Super Cancer Cells. They

coordinated their discovery of the strange and bizarre-looking forces to their fellow Royal Cell

Workers working in lymphnodes to try to intercept the spreading forces of Super Cancer Cells. They

even called the help of their comrades in the Spleen to fight the destructive forces of their enemy.

Some of the Royal Cell Workers of the Immune System Unit recognized Super Cancer Cells as

abnormal cells and killed them. Unfortunately, this is not enough to get rid of them altogether; they are

quite a established force to contend with. They accepted that they can no longer cope with the advancing machinery of the established Super

Cancer Cells.

Royal Cell Worker 1: We are now facing perilous and uncertain times, my fellow cells. The Super Cancer Cells have invaded successfully the Colon part of the kingdom and now, we are seeing them establishing another position in the Liver territory. We need to stop this Crisis before the Kingdom falls.

Royal Cell Worker 3: In the memory of our fallen comrades and my friend Royal Cell Worker 2, I think we should now ask for help from outside and from other alternative methods to defeat the advancement of these dreaded Super Cancer Cells.

Royal Cell Worker 4 and 5: The kingdom is growing weaker and sicker each day, and soon the entire kingdom will fall to its own extinction!

Royal Cell Worker 1: We must welcome all help from the outside so we can bring down together the forces of Super Cancer Cells.

The Royal Cell Workers fought a gallant fight against the Super Cell Workers. However, it was not enough to win the war. Something needs to

be called to intervene, because they believe that drastic events call for drastic actions. They ought

to win to sustain the life of the Kingdom and they just have limited time to prepare.

Shortly after, the kingdom was prepared for the arrival of the outside forces. The forces were called to lead the fight against the marching

forces of Super Cancer Cells. They are extremely specialized force, merciless and with same level of ferocious power seen among the Super Cancer Cells. The forces were not native inhabitants in

the kingdom but they were assumed to have been trained to run after suspicious looking cells. The arrival was coupled with hope that

with the help of The “Chemo Commandos”, the Super Cancer Cells will see it own demise.

Chemo Commando 1: We are here to kill those wayward elements of Super Cancer Cells. Anything that looks suspicious to us shall not bear

any right to live in this Kingdom. Any suspicious fast growing cells, either from both sides, shall be exterminated. With this mission, we

will be heartless, and we can tell that a huge amount of casualties and collateral damage will not touch any nerve of emotion from us. We will

operate under the principle of “Scorched Earth” and in this way, we hope to win this War.

Chemo Commando 2: We would employ different styles in fighting. Since the kingdom is now attacked and they have spread their

conquest from the Colon part to the Liver, we are the right solution to your problems. We will track down all the Super Cancer Cells who

could have spreaded to other parts of the Kingdom. We will leave no stone unturned and we can reach the Super Cancer Cells anywhere

they can hide.

Chemo Commando 3: We can be called to bomb and shrink the tumor caused by the Super Cancer Cells before the tumor can be

exterminated. We will leave no survivors and anything that will be fast growing, will just consider themselves dead.

And so the War between Super Cancer Cells and Chemo Commandos began. The Chemo Commandos initiated Shock and Awe strategy with their sheer

force. The Chemo Commandos directly attacked the primary headquarters of the Super Cancer Cells. The

superior force of the Chemo Commandos were no match to the Super Cancer Cells. After destroying the Primary base of Super Cancer Cells, they initiated the

“Search and Destroy” approach to get those who managed to escape the bombardment.

However, the kingdom is paying a heavy price for this war. Because the Chemo Commandos operate under

the principle of “scorched earth policy” even the Royal Cell Workers were targeted. Unfortunately as in any war, Chemo Commandos cannot tell the difference

between elements of Super Cancer Cells and normal Royal Worker Cells, therefore it also kills large

numbers of healthy Royal Worker Cells producing undesirable, long-term and dangerous side effects in the process. They have quite weakened the kingdom

but it showed somewhat relative success in destroying the Super Cancer Cells.

Royal Cell Worker 1: I may be weak after this war, but I was very happy to see the destruction

of the Primar Chemo Commy Base invaded by the Super Cancer Cells. Now, the Chemo

Commandos are very busy tracking some of their elements who might have escaped from the

attacks of theandos.

Royal Cell Worker 3: Yeah, but I was not that much elated because many of our friendly forces were

destroyed also in the midst of this war. And it would take time for the kingdom to replace them and renew

itself. Much destruction has been witnessed among Hair cells, Stomach cells, and cells in the finger nails since

they were mistaken also as enemies of the Chemo Commandos.

Royal Cell Worker 4: At least, from my point of view, we have achieved our primary goal to stop the advance of

these Super Cancer Cells. It bought us more time to renew ourselves and strengthen the kingdom from

further attacks in the future. No one knows when the splinter groups of Super Cancer Cells would attack, but this temporary victory is enough for me to be happy at

the present time.

Royal Cell Worker 5: Hope springs eternal dude. No matter how bad things have been, they can always get

better.

END

MEMBERS: group 2 N204BABARAN, MA. MAGDALENA DECIALBANZUELA, CHRISTOPHER DUNGONGBARASI, DANICA MAE MERINBATACAN, JOCELYN ZAMORABAYONA, ANNA LIZA GONZALESBELTRAN, ANGELA BETSAIDA AGASBERONIA, MAYNADINE PADILLABETACHE, RAYDENE GRACE LLAVANBRILLANTES, JEFFREY MACADAANBROWN, LADY ANNE MARGOTTE EROTBULAONG, ANJELA DOMINGUEZCAABAY, JHON IVAN FABRIGASCABALAGNAN, KIM BERNARD VILLANUEVACABANES, RIA VALERIE DULIGCABANILLA, CHRISTOPHER PACTANACCABANOS, JAIME JR. DEUSCAJIGAL, PAULA MARIE NAZCALIBUSO, MAUREEN PAGADUAN

REFERENCES:References:Ocampo-Balabagno, A.V., et.al.: Pathophysiology: 3-54, 2006Porth, C.M.: Pathophysiology, Concepts of Altered Health Stateshttp://www.cancer.orghttp://www.slideshare.net/frankbonilla/principles-of-chemotherapyhttp://www.dynamicchiropractic.ca/mpacms/dc_ca/article.php?id=54916http://www.news-medical.net/news/20110618/Cancer-Statistics-2011-report-finds-progress-has-not-benefitted-all-segments-of-the-population-equally.aspxhttp://www.cancer.gov/cancertopics/cancerlibrary/what-is-cancer(http://www.curesearch.org/for_parents_and_families/intreatment/medical/article.aspx?StageId=3&TopicId=70&ArticleId=3126%20