Old Dominion University/Biology 294=Genetics/Spring 2021/Rinehart-Kim
Book Project: The Immortal Life of Henrietta Lacks by Rebecca Skloot
As a group you should meet to discuss the book and answer these questions.
Numbered questions have a somewhat objective answer.
Questions with a letter (and in bold) are more subjective and should be discussed among the members of your group before submitting.
Submit the numbered questions and the questions with a letter separately.
QUESTIONS:
Chapter 1
Dr. Howard Jones was the gynecologist who examined Henrietta Lacks at Johns Hopkins.
1. Why is Dr. Howard Jones known, both worldwide, and in Norfolk?
Dr. Howard Jones was known worldwide for being a gynecologist and reproductive medicine expert. He was the gynecologist who first examined Henrietta Lacks when she was referred to John Hopkins from her physician. In Norfolk, he was associated with EVMS for years and founded the Jones Institute for Reproductive Medicine in Norfolk as well.
Chapter 2
Henrietta Lacks grew up in Clover, VA.
2. Looking at a Virginia map, what is the closest you’ve ever been to Clover, VA?
The closest I have been to Clover is Virginia Beach.
Henrietta Lack was part of the Great Migration when she moved to Baltimore.
3. Describe the Great Migration, and why it occurred.
The Great Migration is the mass exodus of the majority of the black population from the Southern states to the north during the early 20th century in hopes of pursuing jobs and establishing financial stability as the southern states were still locked in a state of economic stagnation and the overall prejudice and discrimination of the white population directed towards the blacks. In the case of the Lacks family, it was where they migrated to from the Maryland city of Baltimore, which was formerly a slave state, to migrate to Clover for work opportunity (Skloot 26).
Chapter 3
4. What did Dr. TeLinde think about carcinoma in situ?
The old widely accepted notion regarding carcinoma in situ (cancer in its original place) was that due to its inert state, doctors believed it was nowhere near deadly and concerning as the more active and fast-growing cancer, but Dr. TeLinde disagreed with the idea, thinking that carcinoma in situ was an early stage of cancer (Skloot 28).
5. How did Dr. TeLinde prove that he was correct?
Dr. TeLinde was only able to prove he was correct thanks to the Greek Researcher George Papanicolaou, who invented a test called the Pap Smear. It helped detect precancerous cells and when doctors could accurately interpret the results could save many lives.
6. Where did the name “Pap smear” come from?
The “Pap” in “Pap smear” is named after the Greek researcher, George Papanicolaou, who mentioned the method in his findings from 1941; the “smear” part of the phrase refers to how the method is usually conducted: by scraping a curved glass pipette against the cervix in order to gather cell samples, which would then be observed with a microscope (Skloot, 28).
7. What is a pathologist looking for in a Pap smear?
In a pap smear sample, the goal is to find any traces of precancerous or malignant changes in the cell in addition to any inflammation from infections (Skloot, 28).
8. Comment on the transport of radium used to treat cancer.
Radium, despite its apparent radioactive properties was transported at first by Kelly in his coat pockets and a taxi driver transported a bag of radium and dropped it off at clinics. Since he had no protection the taxi driver later died of cancer. No safety precautions were used when transporting this material because it was not thought of as a harmful substance.
Dr. Wharton took samples from Henrietta Lacks and gave them to Dr. George Gey.
9. For what was this the eventual source?
These samples were the source of HeLa cells, the first cells which would grow forever. These cells would be instrumental in the development of a polio vaccine and countless other medical breakthroughs.
10. Discuss the major ethical violation in taking the sample.
The major ethical violation in taking the sample, was that it was done without Henrietta’s knowledge or her family’s. She gave permission for the procedure but not the removal or the sale of her body tissues.
11. How has this ethical violation of sample collection been corrected? Connect this to the Lacks family’s main complaint about the use of Henrietta Lacks’ cells.
The Lacks family’s main complaint about the use of HeLa cells was not their use itself, but rather the commercialization of HeLa cells and lack of recognition for where they came from. The Lacks family struggled financially while HeLa cells were being sold for large amounts of money. It has been corrected by needing to have the informed consent of the patient when taking a sample of a patient’s DNA. Lacks family believed there was no informed consent, so they did not have permission to take her cells thus sell them later on for a profit.
Chapter 4
12. How were HeLa cells named?
By using only the first two letters of the first and last names with “He” from Henrietta and “La” from Lacks. This naming method is also common practice in gathering cell lines from patients (Skloot, 37).
13. Comment on the growth comparison between Henrietta Lack’s cervical carcinoma cells and her normal cells.
Henrietta’s carcinoma cells were said to have grown twenty times faster than her normal cells. The normal cells also died a few days after being put in culture. With enough food and warmth, the carcinoma cells were immortal.
Chapter 7
14-15. Name at least two things that could be studied with HeLa cells.
With HeLa cells, immune suppression and cancer growth can be studied with such samples (Skloot, 58).
Chapter 8
16. Why couldn’t Henrietta Lacks cells be cultured after she was hospitalized for pain?
Henrietta’s body had become contaminated with toxins that normally would be flushed out in urine. However, due to the cancer she was unable to urinate properly. These cells with toxins in them died almost immediately in culture.
Chapter 13
17. Why is culturing cells, like HeLa cells, important for the field of virology?
Culturing cells is important in virology because it allows scientists to understand how a virus infects cells. HeLa cells assisted in the creation of the polio vaccine.
Chapter 14
In 1953, the Minneapolis Star “leaked” the name Henrietta Lacks, but it was not correct (although nearly so).
18. What name did they publish?
The Minneapolis Star incorrectly published the name, “Henrietta Lakes.” (Skloot, 105).
19. How did this mistake affect the Lacks family (i.e., what did it prevent them from knowing)?
Ultimately, the misspelling and publishing of the incorrect name never allowed for the Lack family to discover her inadvertent impact to cell culture and the overall field of medicine. The mistaken name also led to further misconception, further being interpreted as “Helen Lane” published from Collier’s magazine, and then there was “Helen Larson” from Rolling Stone magazine (Skloot, 105-109).
Chapter 17
20. What was the Nuremberg Code? A code that came about after the Nuremberg trials, where seven Nazis were sentenced to death by hanging due to their cruel experimentation to humans in WWII. The first line that the code states “The voluntary consent of the human subject is absolutely essential.” The code is a ten-point code of ethics when conducting trials/experiments on humans.
21. How did Dr. Southam violate it, and how did Dr. Mandel propose to violate it? Why was violation different from breaking the law? The code was not law, simply a set of recommendations not taught routinely in medical schools, many American researchers including Southam claimed not to know it existed, so violation is much different here. In 1954 when Southam began injecting people with HeLa cells there was no formal research oversight in the US clearly violating the code, withholding information for his benefit- patients might have refused to participate in the study if they’d known what he was injecting. Physicians and researchers protested the introduction of state and federal laws that hoped to regulate human experimentation. Mandel would have doctors on his staff inject 22 JCDH patients with cancer cells for Southam but his staff refused, knowing about the code.
22. How could the Nuremberg Code be enforced? In civil courts- “But taking a researcher to court required money, know-how, and the knowledge that you were being used for research in the first place.”
23. Why was the Nuremberg Code particularly “gray” for obtaining HeLa cells? It would be decades after informed consent was first mentioned in a court case in 1957 that it would finally be applied to Lack’s case, where scientists conduct research on tissues no longer attached to a person’s body.
Chapter 18
The second cells deposited in the America Type Culture Collection (ATCC) were HeLa cells.
24. Go to the ATCC web site and look for the information that corresponds to Henrietta Lack’s information.
You can buy her cells on the website, Qty of 1 vial cost $495.00 for-profit and $420.75 non-profit, the biosafety level is 2(the cells contain human papilloma virus) and the storage conditions are in the liquid nitrogen vapor phase.
Chapter 22
25. What is the difference between epidermoid and adenocarcinoma cancer? Why is it important to know this information? Epidermoid means originating from epithelial tissue and adenocarcinoma means originating from glandular tissue in the cervix. It explains why the cancer spread so much faster throughout her body than doctors expected and identifying it as the right type of cancer would help with treatment.
26. What kind did Henrietta Lacks have? Adenocarcinoma
27. Why might it be easier for someone with cancer to be infected with syphilis? Syphilis can suppress the immune system and allow cancer to spread faster than normal.
Chapter 23
28. Why did Dr. McKusick’s lab obtain blood from the Lacks family? They could solve the HeLa cells contamination problem and study Henrietta’s cells in entirely new ways.
29. Why did the Lacks family think they were drawing blood? Quoted from Day Lacks “They said they been doin experiments on her and they wanted to come test my children see if they got cancer killed their mother.” Quoted from Hsu “They probably heard people talking about HeLa back then. They are a very nice family, so they very nicely let us draw blood.”
Chapter 25
30. Do you think that a biological entity should be patented? (Do not just say yes or no; offer an explanation for your answer. There is no right or wrong answer!)
I do believe that biological entities should be patented as it would offer more protection and strict guidelines to those involved. For example, if Henrietta’s stem cells had been patented, rules would have to be set into place in order to protect her as also many people and lawyers would review the case, and nobody would be allowed to manufacture them unless they had the authority to do so. Lines though would have to be drawn and laws put into place as you cannot have people trying to patent things which would be considered unethical, like babies whose DNA have been genetically altered. Etc. This poses problems as although the method used to alter the DNA could be patented, the ethical issues would come into play when we start talking about putting a price tag on the lives of humans and who owns them.
Chapter 27
31. What infection probably caused Henrietta’s cervical carcinoma?
Her cervical cancer was most likely caused by HPV (Human Papillomavirus). It is transmitted through sexual activity. People who have long lasting infections are likely to develop cervical cancer.
32. What vaccine is currently being used to prevent this infection, and thus cervical carcinoma?
Today we are fortunate enough to have a vaccine against HPV called Gardasil, for both girls and boys. It can prevent cervical cancer before being exposed to the HPV virus.
33. Describe the molecular basis of how this infection caused Henrietta’s cervical carcinoma.
HPV caused Henrietta’s cervical carcinoma most likely because it survived for years without treatment, , causing the normal cells to become cancerous. First the cells develop into a precancerous change, called cervical intraepithelial neoplasia before becoming cancerous. It is also thought that HPV does not induce an immune system response for most of its life cycle, making the progression to cancer more successful.
34. What does telomerase do?
It’s an enzyme that is responsible for maintenance of the length of telomeres, basically preventing telomere shortening . It’s involved in cell cycle regulation. It also plays an important part in tumorigenesis, where the cell gains the ability of indefinite proliferation and gains the ability to live forever.
35. Comment on the presence of telomerase in HeLa cells.
Immortal HeLa cells are immortal and continue to divide due to an overactive telomerase that rebuilds telomeres after each division. This then prevents the cells from aging and allows the cells to continue dividing indefinitely.
Chapter 32
36.
Is Christoph Lengauer still a professor at Johns Hopkins?
No, he is not currently a professor. He was an adjunct professor for 15 years but no longer teaches. He is currently working Global Head of Oncology Drug discovery at Sanofi-avertis.
When Deborah and Zakariyya were looking at their mother’s cells, one of them was dividing.
37. Was it undergoing mitosis or meiosis?
It was undergoing Mitosis because the cell divided into two new cells which both contained her mother’s DNA.
Chapter 33
38. What was the Crownsville Hospital Center called in the 1950’s?
Hospital for the Negro Insane of Maryland
39. What type of research was done on patients at Crownsville during the 1950’s?
Pneumoencephalographic and skull x-rays were conducted on 100 epileptics. This involved drilling holes in the patient’s brain to drain the fluid around their brains in order to take a crisper image with x-ray. Another study they did was using deep temporal leads in the study of psychomotor epilepsy.
Photo Section (if your copy of the book has one)
I hope it has become obvious to you how different the laws governing the use of patient materials and privacy are between the time that Henrietta Lacks’ cells were first sampled, and today.
Look at the picture of Margaret Gey in the Gey lab at Hopkins, circa 1951. Remember that this picture was taken in a lab. Look at what is on the table.
What do you find on the table that you should not find in a lab (today)?
There is a can of Pepsi, Coffee Mate, and coffee cups. In modern times we know we are not supposed to eat or drink while in the lab.
Note: I highly encourage you to read “Where They Are Now” and the “Afterword”. Both sections are at the end of the book. “Where They Are Now” will help you answer some of the questions.
A. Does your group think that the Great Migration was necessary? Is there a way it could have been prevented? Explain your answer.
We believe it was necessary for the blacks to separate from their previous lives of slavery and to start fresh. They were able to create their own culture, industry, and prosper, which was not possible in the South at the time. It could have been prevented if the United States had passed better laws against racism and slavery and underwent major reform, so they would not have needed to move to find their economic and civil freedoms.
B. Have you read a book (even a child’s book) which discusses a family returning to its roots after that family has participated in the Great Migration?
I have not read or heard any story of anyone who decides to move to the southern states when their family before them has moved during the Great Migration. Nicole- I believe the book the Butler is an example of an African American family that moves from the South to Washington DC in search for a better life.
C. Question #11 asks how this ethical violation of sample collection has been corrected? Do you think it has been corrected?
Yes and no. I believe it has been corrected. Today we have to sign so many forms giving implicit consent for everything that is either done to us or anything they take. Extra consent even has to be given when genetic information is involved because it involves your family. My question is do people really read those forms and what can hospitals do with all those samples when you give it to them for sampling. Are they allowed to test it then make money off it later? Or do they have to destroy it right after?
D. What are types of cells are used for cell culture? Do any other types of cells used for cell culture pose ethical issues?
Aside from HeLa cells, which can be classified as immortalized cell lines, other cellular sources for cell culture include recently extracted living tissue cells called primary cell lines, and stem cell lines gathered from umbilical cords and bone marrow. There are, of course, many issues regarding the methods and sources associated with gathering samples, mainly from how extraction is determined by whether or not the patient had given consent to have their cells extracted, which is not only evident when Henrietta’s husband, Dave (or Day), conceded to allow an autopsy to be performed on Henrietta (Skloot, 90), but also when John Moore found out that his spleen cells were being sold after being pressured by his doctor, Dr. David Golde, to sign a legal document permitting to use his cell line; Moore later filed a lawsuit against Golde (Skloot, 201). Even more so are the methods in gathering stem cells, which can also be found from extremely young embryos called blastocysts, bringing up an ethical question of whether or not such accumulation of cells counts as a human life.
E. Comment on the ethics in #29. Informed consent was never implemented. NIH guidelines stipulated that all human subject research funded by NIH (as this one was) required both informed consent and approval from a Hopkins review board. Scientists literally wanted the blood of children to further their researcher and were deceitful in its acquisition. They did not adhere to mandatory and specific humane guidelines, violating integrity for knowledge, completely disregarding human ethics in the process.
(Chapter 24) Dr. George Gey probably didn’t make any money from HeLa cells, but much money has been made since they were cultured. Yet, the Lacks family was very impoverished.
F. Comment on this dichotomy. This chapter is titled “Least They Can Do” as not only do the Lackses not receive any money from the HeLa cells, but journalists and scientists refer to the cells as “Helen Lane”. The least they can do is to give Henrietta credit. In the book it stated a tiny vial of her cells first went for $25. The ATCC has been selling HeLa cells since the sixties, when this book went to press they were selling for $256 per vial. As previously stated in #24, it currently costs around $450 to buy 1 vial of Henrietta’s cells from The American Type Culture Club today. They do not reveal how much money they take in from the cells, nor do they give any profit to the Lacks family. Dr. Gey was never in it for the money, he could have patented designs like the roller drum and made a fortune, he lived in a modest house that he spent years fixing up and making payments on. On his 30th wedding anniversary he gave his wife a $100 check that read on the back “Next 30 years not as rough. Love, George.” (she never cashed it). He would drain their bank account to buy lab equipment, so she opened up a new account just for that, to stop him from overspending. When the story of the HeLa cells was published in Rolling Stone Magazine in 1976 people were astounded, it read as a black woman fleeing slavery who got cancer and had her body sold by white people. The story blew up, that was the first time the true story of Henrietta Lacks was widely known by the public.
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