9

Consumer
Chemistr
y
Quarter 4 – Module 4:
Anticancer Drugs

MANDAUE CITY COMPREHENSIVE

NATIONAL HIGH SCHOOL
Introductory Message
This Self-Learning Module (SLM) is prepared so that you, our dear learners,
can continue your studies and learn while at home. Activities, questions,
directions, exercises, and discussions are carefully stated for you to understand
each lesson.

Each SLM is composed of different parts. Each part shall guide you step-by-
step as you discover and understand the lesson prepared for you.

Pre-tests are provided to measure your prior knowledge on lessons in each

SLM. This will tell you if you need to proceed on completing this module or if you
need to ask your facilitator or your teacher’s assistance for better understanding of
the lesson. At the end of each module, you need to answer the post-test to self-
check your learning. Answer keys are provided for each activity and test. We trust
that you will be honest in using these.

In addition to the material in the main text, Notes to the Teacher are also
provided to our facilitators and parents for strategies and reminders on how they
can best help you on your home-based learning.

Please use this module with care. Do not put unnecessary marks on any
part of this SLM. Use a separate sheet of paper in answering the exercises and
tests. And read the instructions carefully before performing each task.

If you have any questions in using this SLM or any difficulty in answering
the tasks in this module, do not hesitate to consult your teacher or facilitator.

Thank you.
 What I Need to Know

This module was designed and written with you in mind. It is here to help
you master the properties, mode of action and effects of anticancer drugs. The
scope of this module permits it to be used in many different learning situations.
The language used recognizes the diverse vocabulary level of students. The lessons
are arranged to follow the standard sequence of the course. But the order in which
you read them can be changed to correspond with the textbook you are now using.
This learning module is aligned with the learning competency:
● describe the properties, mode of action and effects of anticancer drugs.
After going through this module, you are expected to:
1. describe the anticancer drug and its properties;
2. describe the mode of action and the effects of anticancer drug; and
3. explain the effects and side effects of anticancer drugs to cancer cells.

What I Know

Directions: Read each question carefully. Choose the letter of the correct answer.

1. What kind of drug could effectively reduce or kill cancer cells?

a. anticancer c. chemotherapy
b. antimetabolite d. doxorubicin
ha

2. What is chemotherapy?
a. It is a treatment for cancer using surgical process.
b. It is a radiation treatment to divide cancer cells.
c. It is the destruction of cancer cells through radiation therapy and
radiation.
d. It is a drug treatment that uses powerful chemicals to kill fast-growing
cells in your body.

1
3. What does the “total cell-kill” mean in chemotherapy?
a. It is the process of reducing cancer cells.
b. It is a surgical process and drug treatment for 5 years.
c. It is a treatment of the DNA of the cancer cell by eliminating the nitrogen
bases.
d. It is the removal of tumor by surgical process and destruction of cancer
cells through radiation therapy.

4. What happens to a patient’s body during chemotherapy?

a. It decreases the tumor mass by 100 mg.
b. It targets cells that grow and divide quickly.
c. It can reduce the tumor mass by 99.99% by surgical process.
d. It can identify the cancer cells and destroy the cell division process.

5. How do alkylating agents affect cancer cells?

a. It reduces the tumor mass by 99.99%
b. It reduces the damage of the cancer cells.
c. It keeps the cancer cell into one area and kills it.
d. It stops the cancer cell from reproducing by damaging its DNA.

6. Which anticancer drug is used to treat severe psoriasis and rheumatoid?

a. Bleomycin c. Doxorubicin
b. Daunorubicin d. Methotrexate

7. How does cyclophosphamide work to treat cancer?

a. It slows down the cell division of cancerous cells.
b. It strengthens the immune system of the patient.
c. It helps produce good cells and replace the damaged ones.
d. It scrambles the DNA of cancer cells and may damage the healthy cells.

8. Which is the first approved chemotherapy drug in 1962?

a. Doxorubicin c. Fluorouracil
b. Daunorubicin d. Paclitaxel

9. What anticancer drug can be prescribed to a patient with a pancreatic

cancer that has spread or is inoperable?
a. Bleomycin c. Doxorubicin
b. Gemcitabine d. Methotrexate

10. Which of the following can be used as anticancer drug but could weaken the
heart of a patient?
a. Bleomycin c. Doxorubicin
b. Daunorubicin d. Methotrexate
Lesson
Anticancer Drugs
1
What’s In

Directions: Read the article and answer the questions

Sunshine may prevent cancer

Sunshine is back in the good books of medical practitioners and
dermatologists. New research suggests that fifteen minutes a day of direct exposure
to sunshine may be beneficial in the prevention and treatment of many forms of
cancer. Researchers point to the fact that there is a lower incidence of prostate,
colon and breast cancers in sunnier parts of the world.
Dr. Edward Giovannucci of Harvard University suggests that vitamin D, also
known as the “sunshine vitamin”, might help prevent 30 deaths for each one
caused by skin cancer. He said: "I would challenge anyone to find an area or
nutrient or any factor that has such consistent anti-cancer benefits as vitamin D."
Plastering our bodies in sunscreen to avoid skin cancers, such as
melanoma, may be more harmful than direct exposure to the sun. Sunscreen
blocks UV rays and therefore inhibits the vital production of vitamin D. Our skin
absorbs the rays and produces vitamin D. Melanoma, the deadliest kind of skin
cancer, accounts for just 1.4 per cent of all cancer deaths.
TRUE / FALSE

a. Scientists have told us for many years that sunshine is healthy. T/F
b. Researchers say there is a link between studying and cancer. T/F

c. Doctors and scientists have changed their minds about UV rays. T/F

d. Vitamin C is called the “sunshine vitamin”. T/F

e. Vitamin D may prevent 30 deaths for each one caused by skin cancer.T / F

f. Sunscreen might not be so necessary now. T/F

g. Our bodies need five hours a day in direct sunlight. T/F

h. There is less cancer in sunnier parts of the world. T/F
 What’s New

Naked mole rats can live for an incredibly long

time and have an exceptional resistance to
cancer thanks to unique conditions in their bodies that
stop cancer cells from multiplying.
Researchers at the University of Cambridge
suggests that what sets naked mole-rats apart is the
microenvironment - the complex system of cells and
molecules surrounding a cell, including the immune
system. The researchers believe interactions with this
microenvironment are what stop the initial stages of
cancer from developing into tumours, rather than a cancer resistance mechanism
within healthy cells as previously thought.
On the other hand, molecular and cell biologist Vera Gorbunova of the
University of Rochester in New York discovered that the secret to this rodent's
good health is a complex sugar called hyaluron that keeps cells from clumping
together and forming tumors. Hyaluron exists in all animals, helping lubricate joints
and serving as an essential component in skin and cartilage. It's been used in skin
lotions and anti-arthritis treatments, and some forms have even been proposed to
promote cancer. In addition, the researchers discovered that the enzyme that
breaks down this sugar is not very active in naked mole rats, allowing the
compound to accumulate to higher concentrations than it does in other animals.
The researchers think that this sugar evolved to make naked mole rat skin more
elastic and able to cope with the tight squeeze of the narrow underground tunnels.

Direction: Answer the following questions:

1. What happens to cancer cells in naked
mole rats?

2. What is hyaluron?
A B
3. How does hyaluron affect the naked
mole rat?

4. By using a Venn diagram, distinguish

the characteristics of naked mole rats
(A) from other rats (B)?
 What is It

Anticancer drug

Anticancer drug, also called antineoplastic

drug, is any drug that is effective in the treatment of
malignant, or cancerous, disease. There are several
major classes of anticancer drugs - alkylating
agents, antimetabolites and anthracycline antibiotics.
In addition, there are a number of drugs that do not
fall within those classes but that demonstrate
anticancer activity and thus are used in the treatment
of malignant disease.

Drug treatment for cancer is called chemotherapy. The job of chemotherapy

is to destroy cancer cells, including those that may have spread beyond the main
tumor. Unlike surgery or radiation, most types of chemotherapy, or "chemo," don't
target a particular tumor or a particular part of the body, although there are some
newer "designer drugs" being developed that seek out and destroy cancer cells
specifically. Most forms of chemotherapy attack all rapidly dividing cells, and cancer
cells fit that description.

When fighting cancer, the entire population of neoplastic cells - abnormal

growth of cells must be eradicated in order to obtain desired results. The concept of
"total cell-kill" applies to chemotherapy as it does to other means of treatment: total
excision of the tumor is necessary for surgical care, and complete eradication of all
cancer cells is required for a cure with radiation therapy. By investigation of a model
tumor system, the L1210 leukemia of mice, a number of important principles have
been established as follows:

1. A single clonogenic malignant cell can give rise to sufficient progeny to

kill the host; to achieve cure it is thus necessary to destroy every such cell. Since
the doubling-time of most tumors is relatively constant during logarithmic growth,
the life-span of the host is inversely related to the number of malignant cells that
are inoculated or that survive therapeutic measures.

2. The cell-kill caused by antineoplastic agents follows first-order kinetics,

that is, a constant percentage, rather than a constant number, of cells is killed by a
given therapeutic maneuver, this finding has had a profound impact on clinical
cancer chemotherapy. For example, a patient with advanced acute lymphocytic
leukemia might harbor 1012 or about 1 kg of malignant cells. A drug killing 99.99%
of these cells would reduce the tumor mass to about 100mg, and this would be
apparent as a complete clinical remission. However, 108malignant cells would
remain, any of which could cause a relapse in the disease.

Major classes of anticancer drugs

1. Alkylating agents are compounds that work by adding an alkyl group to the
guanine base of the DNA molecule, preventing the strands of the double helix
from linking as they should. This causes breakage of the DNA
strands, affecting the ability of the cancer cell to multiply. Eventually,
the cancer cell dies. The primary mode of action for most alkylating drugs is
via cross-linking of DNA strands. They can be classified as either
monofunctional alkylating agents, implying reactions with only one strand of
DNA, or bifunctional alkylating agents, which cross-link two strands of DNA.
Replication of DNA and transcription of RNA are prevented by these cross-
links. All alkylating agents depress bone marrow function and cause
gastrointestinal disturbances such as nausea and vomiting. As bone marrow
is responsible for the production of red blood cells, white blood cells and
platelets when it is weakened symptoms of anemia, infection and bleeding
respectively, may occur. In rare cases, this can lead to leukemia. The risk
of leukemia from alkylating agents is “dose-dependent,” meaning that the risk
is small with lower doses, but goes up as the total amount of the drug used
gets higher. The risk of leukemia after getting alkylating agents is highest
about 5 to 10 years after treatment.

Alkylating agents play a significant role in the treatment

of lymphoma, Hodgkin's disease, breast cancer, multiple myeloma, and other
malignancies. Anticancer drugs that contain alkylating agents
are cyclophosphamide, ifosfamide, melphalan, and chlorambucil.

2. Antimetabolites are called a “cytotoxic” type of drug because they kill cells.
They work by mimicking the molecules that a cell needs to grow. Cells are
tricked into taking in the drugs and then using the antimetabolites instead of
their normal building blocks of genetic material: RNA and DNA. With the
drugs on board, the cells can no longer copy their DNA, so they can’t divide
into new cells. Because antimetabolites target cells only as they are dividing,
these medications are most effective against tumors that are growing quickly.
The benefit of taking antimetabolite drugs to treat cancer is that the drugs
kill cancer cells, which can help you live longer and make your tumor stop
growing or shrink. But antimetabolites don’t work for everyone, and it can be
hard for doctors to predict whose tumors will respond to these drugs. Even
when antimetabolites first work well, tumors often become resistant to this
drug, which means they eventually don’t work anymore.

Hypomethylating agents represent a class of drugs that may restore normal

gene function to genes responsible for cell division and differentiation.
 Hypomethylating agents may function as biological response modifiers by
affecting cytokine cell signaling. These agents may be identified as
antimetabolites and they include 5-azacytidine and Decitabine.

Methotrexate is used to treat certain types of cancer of the breast, skin, head
and neck, or lung. Methotrexate is also used to treat severe psoriasis and
rheumatoid arthritis. Other examples include 5-Fluorouracil and Cytosine
Arabinoside.

3. Anthracyclines or anthracycline antibiotics are a class of drugs used in

cancer chemotherapy derived from Streptomyces bacteria (more specifically,
Streptomyces peucetius var. caesius). These compounds are used to treat a
wide range of cancers, including leukemias, lymphomas, and breast, uterine,
ovarian, and lung cancers. Examples include Bleomycin, Daunorubicin, and
Doxorubicin.

Anthracycline has three mechanisms of action:

1. inhibits DNA and RNA synthesis by intercalating between base

pairs of the DNA/RNA strand, thus preventing the replication of
rapidly-growing cancer cells,

2. inhibits topoisomerase II enzyme, preventing the relaxing of

supercoiled DNA and thus blocking DNA transcription and
replication,

3. Creates iron-mediated free oxygen radicals that damage

the DNA and cell membranes.

Patients treated with doxorubicin have been described in acute and chronic
cardiovascular effects. The first, which can develop within a few minutes after
administration and include hypotension and rhythm disturbances are usually
reversible and easily treatable. However, doxorubicin is also able to induce chronic
myocardial damage, depending on the cumulative dose of drug administered and
clinically characterized by hypotension, tachycardia, ventricular dilation and
congestive heart failure. It has been calculated that, from 27 to 60% of patients who
undergo this event by doxorubicin die because of it.

SOME COMMON CHEMOTHERAPY DRUGS:

● Doxorubicin (Adriamycin) is one of the most powerful chemotherapy drugs

ever invented. It can kill cancer cells at every point in their life cycle, and it's
used to treat a wide variety of cancers. Unfortunately, the drug can also
damage heart cells, so a patient can't take it indefinitely.
● Cyclophosphamide (Cytotoxan) is a drug that can treat many different
cancers. Like many other chemotherapy drugs, it scrambles the DNA of
cancer cells. Because it damages healthy DNA too, it can also cause long-
term injury to the bone marrow, which, in a few rare cases, can lead to a new
case of leukemia (cancer of certain white blood cells).

● Paclitaxel (Taxol) is an effective drug used for treating some cases of breast
cancer and ovarian cancer, but it can damage nerves over time, leaving some
people with decreased sensation in their hands and feet. The anticancer
compound in this drug was first discovered in the bark of Pacific yew trees.

● Fluorouracil (Adrucil) was first approved as a chemotherapy drug in 1962

and is one of the oldest chemotherapy drugs still prescribed today. It's
primarily used to treat gastrointestinal cancers (including colon, rectal,
stomach) and certain types of breast cancer.

● Gemcitabine (Gemzar) is a relatively new chemotherapy drug that is effective

at slowing the growth of several types of cancer. Used alone, it's a first-line
treatment for pancreatic cancer that has spread or is inoperable. It's also
used in combination to treat certain types of breast, ovarian, and lung
cancers.
 What’s More

Activity 1

Directions: Complete the concept map below by writing terms and definitions to
satisfy the idea inside the box and relationship to another box.

, also known as
drug that could kill cancer cells during chemotherapy.

6.
Antimetabolites drugpreventsthe strandsofthedouble Anthracyclinesused
work by 3..
to stop 9..
helixfromlinkingby adding an alkyl group.

Examples are Examples are Examples are

4. 7. 10.

5. 8. 11.

Guide questions

1. What is an anticancer drug?

2. What are the three (3) classifications of anticancer drugs?
3. What is the organic compound present in alkylating agents?
4. What will happen to cancer cells if the patient takes antimetabolite medicine?
5. How do anthracyclines stop the replication of DNA in cancer cells?
6. What are the other uses of anticancer drugs?
Activity 2

Directions: Show the effects and side effects of anticancer drugs. The arrow going
up represents the benefits of anticancer drugs during treatment process while the
arrow going down represents the side effects during cancer treatment.

A. Alkylating agents

Choices :

- Drugs that
prevent
replication of
cancer cell by
introducing an
alkylating agent.

- Drugs that
damage heart
B. Antimetabolite cells.

- Drugs that
prevent
replication of the
cancer cell by
inserting a base
pair to DNA and
RNA.

- Drugs that stop

the cell division
of the cancer cell
by mimicking a
C. Anthracyclines molecule of DNA
and RNA.

- Drugs that are

effective in
certain amount
of time.

- Drugs that
could affect bone
marrow leading
to anaemia.
Activity 3

Direction: Read the story and answer the question.

Hodgkin lymphoma survivor adjusts to life after cancer

BY MD ANDERSON STAFF
After a cancer diagnosis, many patients wait anxiously to hear the words “no
evidence of disease.” But as Kimberly Hill has learned, the start of this new chapter
– life after cancer – is where the real journey begins.

Kimberly, now 47, thought the hardest part of her lymphocyte predominate
Hodgkin lymphoma diagnosis was behind her when she learned she showed no
evidence of disease in May 2015.

“I think I had unrealistic expectations that this journey was over,” says
Kimberly of learning she had no evidence of disease.

Although she’s cancer-free, she still struggles daily with side effects of her
treatment -- neuropathy, weight gain, chemobrain, pain and the fear of recurrence.

The Knoxville, Tennessee, resident copes with these changes in the best way
she knows how, which is to continue moving forward despite the pain.

“I can’t take pain medication because I have an active lifestyle,” says

Kimberly. “Pain medications slow me down and add to the mental fogginess that I’m
already dealing with.”

She traded her stilettos for Converse because of pain and inflammation that
won’t go away. Walking across campus at the University of Tennessee where she
works and keeping up with her busy 9-year-old daughter require a lot of time on her
feet.
The toughest adjustment has been managing memory problems. Kimberly
admits she didn’t think chemobrain was real – until she experienced symptoms like
leaving her keys in the door, not turning off the stove and even forgetting to pick up
her daughter from school. Her inability to recall information has made completing
her Ph.D. and serving as an adjunct professor especially difficult.

Yet, she’s found ways to lessen the cognitive challenges.

“I use sticky notes. I carry a notepad around and use the record feature on
my phone. I set reminders -- and reminders to set reminders,” she jokes.

Perhaps the biggest adjustment has been Kimberly’s constant fear of her
cancer returning.
 “It’s a nagging feeling that’s always there. Even in your joy. Even when you
have happiness,” says the mother of three. “Every ache, every pain is always
accompanied by ‘What if?’”

Kimberly utilizes services at MD Anderson’s Integrative Medicine Center to

help with some of these side effects. She credits the center for treating the whole
person, by first acknowledging that her symptoms are real, and then providing
meditations and memory exercises to help.

“I practice mindfulness and self-care. I can’t help what was. I can’t help a lot
of what will be. But I can be very present in what’s now,” she says.

She’s learning how to be patient and adjust to her new way of life, one step at
a time. Despite all she’s been through, Kimberly is grateful for the most precious gift
of time.

“Try to appreciate all of the good things. You can get so bogged down on the
negatives you experience that you forget to be thankful that you’re here to
experience them.”

Guide questions

1. What is Hodgkin lymphoma?

2. What is the expectation of Kimberly after the chemotherapy?
3. What are the effects and side effects observed to Kimberly from his experience
after treatment?
4. What is the response of Kimberly to pain medication?
5. How did Kimberly cope with cognitive challenges after chemotherapy?
 What I Have Learned

Let us see how much you learned from this module. Complete the
paragraph below by filling out the blanks.

Anticancer drugs are Choices:

medications used to - kill cancer cells
1) . These drugs are
also called 2) . Drug - Antineoplastic
treatment for cancer is called 3) -chemotherapy
. The job of
chemotherapy is to 4) -destroy the cancer cell beyond
. tumor

-alkylating agents
There are several major classes of
anticancer drugs 5) , -antimetabolite
6) , and 7)
-anthracycline
.
Alkylating agents are compounds that - Drugs that prevent replication of
work by cancer cell by introducing an
8) . alkylating agent
Antimetabolites are also called a 9)
- cross-linking of DNA strands
, a type of drug
10) . It - cytotoxic
has a side effect of
- Drugs that stop the cell division of
11) .
the cancer cell by mimicking a
Anthracycline is a 12) .
molecule of DNA and RNA

- weakened heart cells

- Drugs that prevent replication of

the cancer cell by inserting a base
pair to DNA and RNA
 What I Can Do

Chemotherapy drugs have side effects and some have even more serious
effects. It is important to keep track of any side-effects while treating cancer. This
worksheet will help a cancer patient to monitor and observe the side effects of his
medications. Choose 1 of the 4 options to accomplish this worksheet.

Options:

1. By a vlog or blog, using any online social media platform, search for a cancer sur-
vive who has shared his battles against his illness via his blogs.

2. By an interview to a patient in the community, look for a relative or an

acquaintance that has undergone chemotherapy.

3. By an interview with the relative of a patient, look for a person who became a
companion to a cancer patient that has undergone chemotherapy.

4. By an interview to medical personnel in the rural health unit of the barangay.

PRECAUTION:

The teacher should consider the safety of the locality. Activities could be
modified and be used with professional judgment.

Name of cancer survivor/ patient (optional) :

Type of Cancer :
 Chemotherapy Side Effects Worksheet

Date / / / / / /
Day of Chemotherapy Cycle Day Day Day
Fever/Chills: Max Temp: Max Temp: Max Temp:
Write down your highest °C °C °C
temperature for the day. None None None
Temperature Mild Mild Mild
None – 37°C Moderate Moderate Moderate
Mild Fever – 37.1°C to 38°C Severe Severe Severe
Moderate Fever – 38.1°C to 40°C
Severe Fever – greater than
40.1°C
Write any medicines taken for this
here —>
Fatigue (Feeling Weak):
None ◻ None ◻ None ◻ None
Mild – Able to do normal activities ◻ Mild ◻ Mild ◻ Mild
with some effort Moderate – In bed ◻ Moderate ◻ Moderate ◻ Moderate
less than half of the day ◻ Severe ◻ Severe ◻ Severe
Severe – In bed more than half the
day*
Nausea:
None ◻ None ◻ None ◻ None
Mild – Can eat ◻ Mild ◻ Mild ◻ Mild
Moderate – Eating/drinking less ◻ Moderate ◻ Moderate ◻ Moderate
than normal Severe – Can’t eat or ◻ Severe ◻ Severe ◻ Severe
drink*
Write any medicines taken for this
here —>
Vomiting:
None ◻ None ◻ None ◻ None
Mild – Vomited once during the day ◻ Mild ◻ Mild ◻ Mild
Moderate – Vomited 2 to 5 times ◻ Moderate ◻ Moderate ◻ Moderate
during the day* Severe – Vomited 6 ◻ Severe ◻ Severe ◻ Severe
or more times during the day*

Write any medicines taken for this

here —>

Sore Mouth:
None ◻ None ◻ None ◻ None
Mild – Soreness or painless ulcer ◻ Mild ◻ Mild ◻ Mild
Moderate – Soreness or painful ◻ Moderate ◻ Moderate ◻ Moderate
ulcer but can eat* Severe – Painful ◻ Severe ◻ Severe ◻ Severe
ulcer and cannot eat*
 Assessment

Directions: Read each question carefully. Choose the letter of the correct answer.

1. What is the drug that could effectively reduce or kill the cancer cell?
a. anticancer c. chemotherapy
b. antimetabolite d. doxorubicin
ha

2. What is chemotherapy?
a. treatment for cancer using surgical process
b. radiation treatment to divide cancer cells
c. destruction of cancer cell through radiation therapy and radiation
d. drug treatment that uses powerful chemicals to kill fast-growing cells in
your body

3. What does the “total cell-kill” mean in chemotherapy?

a. It is the process of reducing cancer cells.
b. It is a surgical process and drug treatment for 5 years.
c. It is a treatment of the DNA of the cancer cell by eliminating the nitrogen
bases.
d. It is the removal of tumor by surgical process and destruction of cancer
cells through radiation therapy.

4. What happens to a patient’s body during chemotherapy?

a. It decreases the tumor mass by 100 mg.
b. It targets cells that grow and divide quickly.
c. It can reduce the tumor mass by 99.99% by surgical process.
d. It can identify the cancer cells and destroy the cell division process.

5. How do alkylating agents affect cancer cells?

a. It reduces the tumor mass by 99.99%
b. It reduces the damage of the cancer cells.
c. It keeps the cancer cell in to one area and kills it.
d. It keeps the cancer cell from reproducing by damaging its DNA.

6. Which anticancer drug is used to treat severe psoriasis and rheumatoid?

c. Bleomycin c. Doxorubicin
d. Daunorubicin d. Methotrexate
 7. What is cyclophosphamide used for?
a. It is used to treat leukemia.
b. It slows down the cell division of cancerous cell.
c. It strengthens the immune system of the patient.
d. It scrambles the DNA of cancer cells and damages the healthy cell.

8. Which is the first approved chemotherapy drug in 1962?

a. Doxorubicin c. Fluorouracil
b. Daunorubicin d. Paclitaxel

9. What anticancer drug can be prescribed to a patient with a pancreatic

cancer that has spread or is inoperable?
a. Bleomycin c. Doxorubicin
b. Gemcitabine d. Methotrexate

10. Which of the following can be used as an anticancer drug but could weaken
the heart of a patient?
a. Bleomycin c. Doxorubicin
b. Daunorubicin d. Methotrexate

Additional Activities

Create a profile of anticancer drugs. Include their prices and stores where
these could be purchased and how they can be purchased.