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Awards & Recognition

Co Authors:

Nancy A. Rice
Department of Biology
Western Kentucky University

Bruno Borsari
Biology Department
Winona State University


We are a recipient of a 2004 National Dissemination grant from the National Science Foundation’s Division of Undergraduate Education and has been cited as a source for model case studies by the National Research Council and the American Association for the Advancement of Science



Keywords: 2004 National Dissemination grant, National Science Foundation Division of Undergraduate Education, NSF, National Science Digital Library, NSDL, American Association for the Advancement of Science, AAAS, National Research Council, NRC, Biology2010
Topical Area: web20
Educational Level: web20
Formats: web20
Type/Method: web20
Language: web20
Subject Headings: Biology (General)   Cell Biology   Medicine (General)   Genetics / Heredity  
Date Posted: 3/5/2010
Date Modified:
Copyright: Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.

Teaching Notes

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Teaching notes are intended to help teachers select and adopt a case. They typically include a summary of the case, teaching objectives, information about the intended audience, details about how the case may be taught, and a list of references and resources.

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1. Regarding the use of CA-125, it should be strongly emphasized that this “marker” measures inflammation, not cancer per se. There is no specific blood test for ovarian cancer like the PSA test for prostate cancer. This is important because students need to understand that many lives could be saved (perhaps 15,000/year) if there were a way to screen women for ovarian cancer. This would mean diagnosis at stages I or II when the cure rates are much higher than for stages III or IV when cure rates are dismal. Students could be asked to look up survival for these stages.

Students should be asked to explain why we don’t have a specific test. Are there biological reasons? There are also political/economic questions that students should consider since they may well affect their lives. What issues are involved with insurance companies having to pay for screening mammograms? What is the reason for the new idea that the PSA need not be done on men over the age of 70? Why is the CA-125 not used for screening, even if there are some false positives?

2. Why do we use the term "remission"? Who invented that word? Was it oncologists? Certainly they use it and so does every one else! What does it mean? To me it means that there’s no sign of that cancer, BUT we’re waiting for it to return, for the other shoe to drop, so to speak. If a person has a heart attack or a stroke, and they’ve recovered, there’s a reasonable probability of a repeat. Have students look these numbers up. BUT we don’t say that these patients are "in remission."

How does the term "remission" affect the patient? Does it instill a bit of unnecessary fear? (The doctor must think it’s coming back!) Does this term remove hope that the patient might be cured?

Victoria Finnerty, Ph.D.
Department of Biology
Emory University
Atlanta, GA 30322

I enjoyed the case presentation on ovarian cancer from the National Center for Case Study Teaching in Science. However, I would like to make a correction to a comment that was submitted by a reader on 08/21/2008 in response to this case.

The commenter wrote: “Regarding the use of CA-125, it should be strongly emphasized that this ‘marker’ measures inflammation, not cancer per se. There is no specific blood test for ovarian cancer like the PSA test for prostate cancer.”

I disagree. Inflammation can also elevate PSA levels in serum, such as prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (BPH) (enlargement of the prostate). (Ref - NCI website -

I think these cases are very instructive and well-done. My correction is only meant to preserve the great value they already contain.

Jose A Hernandez, MD
Mercy Hospital
Miami, FL

I am writing with a suggestion for this case. I have used this case for several years now in my Pathophysiology course. This is a course for health majors at a community college. I use the website to make the case a clicker case and my students enjoy seeing the “clicker” case come to life. Before the case study today, I used the following link: to discuss the New York Times bestseller, The Immortal Life of Henrietta Lacks. Henrietta Lacks died of ovarian cancer and her cells were collected and used in research without her knowledge. The HeLa cells have been used for 60 years and just recently the entire genome of the cells was originally published by a European lab but then retracted. This led to the most recent decision by the Lacks family and the NIH about who can have access to the genome of the HeLa cells. Raises some nice ethical issues and awareness of the issues around tissue donation, etc.

Alisa J. Petree, MHSM, MT(ASCP), Associate Professor & Clinical Coordinator
Medical Laboratory Technician Program
McLennan Community College
Waco, TX 76708

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