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Fatigue

I totally agree with the mention (by Marcelo1229 (talk · contribs)) of cancer-related fatigue. A recent supplement in Oncologist seems to have been devoted entirely to the subject, see PMID 17573456 and PMID 17573455. Perhaps these reviews could be used to support the information on fatigue. JFW | T@lk 23:43, 3 January 2008 (UTC)

I believe it would be useful for patients, and fair to the subject, to write something that psycho-stimulants can be useful for treatment of cancer-fatigue. An article by the National Cancer Institute (found in [1] states the following (among other things):
"Psychostimulants - Although fatigue is one of the most prevalent symptoms in cancer, to date few trials are published on the use of psychostimulants as a treatment for fatigue in people with cancer. The support for their use arises largely from clinical anecdotal experience. Psychostimulants (caffeine, methylphenidate, modafinil, and dextroamphetamine) given in low doses are useful for patients who are suffering from depressed mood, apathy, decreased energy, poor concentration, and weakness. Extensive clinical experience with cancer patients indicates that psychostimulants promote a sense of well-being, decreased fatigue, and increased appetite."
Another reputable source on cancer (cancer.org) has at least two links on Ritalin for cancer-fatigue:
regards, marcelo1229; Jan3, 08; 19:15 US-PST —Preceding unsigned comment added by Marcelo1229 (talk • contribs) 03:18, 4 January 2008 (UTC)

Could you please familiarise yourself with footnotes? Your recent addition relies on inline URL links, while the remainder of the article uses footnotes. Another editor will now have to mop up behind you. Also, have you considered the sources I have presented in my above post? JFW | T@lk 09:05, 6 January 2008 (UTC)

I have reviewed your addition. Your main source in an NCI PDQ page for health professionals, and you are lending disproportionate weight to pharmacology as opposed to exercise, CBT, management of anaemia, and other interventions listed there. I suspect many cancer patients would prefer not to use Ritalin etc. JFW | T@lk 09:15, 6 January 2008 (UTC)

Thanks much for the suggestion for me to look into the proper way to place footnotes in the article. However, I do not apologize for "lending disproportionate weight to pharmacology as opposed to exercise, CBT, management of anaemia, and other interventions listed..." I wonder how would patients who can barely get up from bed will start and continue an exercise program..., or how many cancer patients who do not have anemia will be served by treating their non-existing problem..... IMHO censoring/redacting additions that are not wrong, even if they might arguably may be incomplete, diminishes the value of Wikipedia as a collection of documents that evolve and improve over time...

I do not claim to know how many cancer patients would prefer to use Ritalin or not... My sense is that many/most cancer patients would prefer simply not to have fatigue, and my guess is they would not care much how this is taken care of... And Ritalin and similar drugs are currently in use for cancer-related fatigue, by some patients, with relatively good results (this, according to the American Cancer Society, among others...). But if editors choose to keep such information out of the Wikipedia piece on cancer, and keep patients who would read the piece ignorant, presumably because the information is not complete, so be it... I did not know that a written piece has to be absolutely perfect/comprehensive before it sees the light of day on Wikipedia.... Marcelo1229 (talk) 21:12, 7 January 2008 (UTC)


The following quote from the article is a hopeless generalisation:

Fatigue is a very common problem for cancer patients, and has only recently become important enough for oncologists to suggest treatment, even though it plays a significant role in many patients' quality of life

Oncology and palliative car have been concerned about fatigue for many years. Where did this factoid about fatigue being only recently recognised appear from? Is there a credible reference? Re psychostimulants. Methylphenidate is sometimes used to lift mood in terminally ill cancer patients, where the prognosis is too short to expect a meaningful response from standard antidepressants. It may ease fatigue in some of these patients, probably because fatigue is intimately related to low mood or depression in a proportion of cases. Steroids (which are used more commonly) possibly ease fatigue in a similar way but also work by reducing swelling(they also help to restore the appetite, but can stop patients from sleeping and cause mania in some people.) Cancer fatigue is caused by lots of things, and it is simplistic in the extreme to suppose that one class of drugs (eg psychostimulants) will have more than a superficial benefit in anything but a minority of cases. Causes of cancer-related fatigue include, off the top of my head:

1)Cancer. sounds obvious, but curing or controlling the cancer is the single best treatment.
2)Metabolic disturbance. Eg Jaundice, renal failure, hypoabulinaemia, hypercalcaemia, cancer cachexia.
3)Anaemia, bone marrow failure. whether due to the malignancy itself or as a side effect of treatment.
4)Organ failure. Liver failure, renal failure, respiratory or cardiac failure, obstructed bowels etc etc tend to make one feel a bit under the weather.
5)Treatment. Surgery, chemotherapy, and radiotherapy are all noted causes of fatigue.
6)Old age. Cancer happens a lot in older people who simply do not possess much physiological reserve.
7)Depression and worry. Common in cancer patients. Depression makes one feel tired and apathetic, also associated with insomnia.
8)Pain and nausea. Two of the commonest symptoms of cancer. Potent causes of fatigue.

Jellytussle (talk) 23:01, 7 January 2008 (UTC)

I am contacting you on behalf of www.ecancermedicalscience.com the open access cancer journal from the European Institute of Oncology in partnership with the European CanCer Organisation. I am interested in the possibility of our URL being added to your useful links section as we provide free access to cancer research across the globe, including those in the third world. Our aim is the open dissemination of research in an attempt to speed up the time from research discovery to patient benefit. Any advice you can provide on being added as Professional and research European link would be much appreciated as we are really keen to make people aware of our site as a valuable and free resource. ecancermedicalscience is free to publish, free to read and free to comment and is completely not for profit. —Preceding unsigned comment added by HannahRedmond (talk • contribs) 14:38, 5 February 2008 (UTC)

I'm really not sure what the need for such a link would be. This is an article for the general reader, and I think there is more to say for linking to the major international organisations rather than a fairly new low-impact factor journal. I presume it is a professional journal? JFW | T@lk 18:25, 5 February 2008 (UTC)
The journal is linked in the European Institute of Oncology page, this should suffice. I note, however, that this Institute is not linked in the Cancer article. Emmanuelm (talk) 18:35, 7 February 2008 (UTC)


Just to give you a bit more info about ecancermedicalscience, we are the journal of the European Institute of Oncology and also educational partner of the European Cancer Organisation - ECCO which represents over 50,000 members across Europe including pateint advocacy groups. Although our journal is new and relatively low impact it is entirely open access and completely free to read, publish research and comment which is something that none of the high impact larger journals can offer. The journal is a professioanl journal. If you would liek any further info, just let me know! Thanks Hannah —Preceding unsigned comment added by 82.109.122.211 (talk) 08:38, 1 April 2008 (UTC)

Why is this article not a Wikipedia:Featured articles?

... even Lung cancer, with its outdated classification, is on the list! So here comes the template :

removed incorrectly placed template to nom that was never submitted

Is this enough or do we also have to list it in Wikipedia:Featured article candidates? Emmanuelm (talk) 19:23, 12 February 2008 (UTC)

I removed the old, malformed fac template (that was never submitted), and highly recommend you first seek a peer review, announced at WP:MED. At minimum, the citations are going to need a lot of work before this article can succeed at WP:FAC. I suggest a review of autism, Asperger syndrome, influenza, tuberculosis or Tourette syndrome to understand the expectations at FAC. Lung cancer received very weak support at FAC, and is not the best article to compare to. This article would currently fail at least on citation level (1c) and citation formatting (2c) and there are WP:MOS issues as well. SandyGeorgia (Talk) 21:42, 15 February 2008 (UTC)
I will not spend hours reformatting references just to get a little star. This preoccupation with format over content is asinine. Fuhgetabutit. Emmanuelm (talk) 18:38, 16 February 2008 (UTC)
For the record, the reason references have to be properly formatted is to make it easier for others to see what sources you're using, and to verify those references. Nbauman (talk) 19:56, 16 February 2008 (UTC)

Suggested addition on Diet

I'd like to suggest that the section on diet should at least mention the theory that consumption of refined sugars and other simple carbohydrates play a role. This has been speculated for some time and recent research has confirmed the link, e.g.

I realize that the degree to which sugar/starch play a role is still a matter of controversy but I believe that it is at least generally accepted now that there is some link.

--Mcorazao (talk) 20:01, 15 February 2008 (UTC)

P.S. Note that it is worth pointing out that cancer cells have a far more voracious appetite for sugar than normal cells and, in fact, are one of the few types of cells that cannot survive without sugar in the bloodstream. --Mcorazao (talk) 20:05, 15 February 2008 (UTC)

There is a well established link between obesity and certain cancers. Excess carohydrate intake is linked with obesity, as well with as lower socioeconomic groupings which have other cancer epidemiological asociations, such as increased smoking and alcohol use, industial exposure etc etc. These are all quite difficult to disentangle, and I am sceptical about the Mexican paper, which is quite underpowered from an epidemiological p.o.v. and which has a debateable study design. The Korean paper is interesting, and shows an association, but not necessarily a causal link. People with high serum glucose tend to be overweight. Jellytussle (talk) 22:53, 19 February 2008 (UTC)

True that the degree of causality is widely debated. However, from what I gather (bearing in mind I am not involved in the medical industry at all) the establishment has been quietly acknowledging that extreme consumption of simple carbohydrates is at least a poor idea for avoiding cancer.
Regarding serum glucose and sugar consumption I don't think there is anybody who seriously debates causality is there? I think this been well established, both empirically and theoretically. It is true that people who are overweight tend to have higher average serum glucose than others ("insulin resistance") but I believe it is well proven that in both groups restricting or eliminating simple carbs will drop serum glucose far more than these differences (although the patient might have to substantially drop simple carbs before the effect is seen).
I am not suggesting that the article should say that restricting sugar/starch is a "cure" or is considered a "therapy" but since these things are considered unhealthy anyway and some relationship has been demonstrated it seems worth mentioning.
--Mcorazao (talk) 03:38, 20 February 2008 (UTC)
P.S. Some other articles:

Proposal for Diet section

For the diet section, I propose that we present the public health goals and personal recommendations of the WCRF/AICR Expert Report, Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective. (http://www.dietandcancerreport.org/downloads/chapters/chapter_12.pdf):

  • FOODS AND DRINKS THAT PROMOTE WEIGHT GAIN

Limit consumption of energy-dense foods and avoid sugary drinks

  • PLANT FOODS

Eat mostly foods of plant origin

  • ANIMAL FOODS

Limit intake of red meat and avoid processed meat

  • ALCOHOLIC DRINKS

Limit alcoholic drinks

  • PRESERVATION, PROCESSING, PREPARATION

Limit consumption of salt and avoid mouldy cereals (grains) or pulses (legumes)

The evidence and specific sources supporting these recommendations could then be outlined as presented in the report:

"Judgements of ‘convincing’ or ‘probable’ generally justify goals and recommendations. These are proposed as the basis for public policies and for personal choices that, if effectively implemented, will be expected to reduce the incidence of cancer for people, families, and communities.

Eight general and two special goals and recommendations are specified. In each case a general recommendation is followed by public health goals and personal recommendations, together with footnotes when further explanation or clarification is required. These are all shown in boxed text. The accompanying text includes a summary of the evidence; justification of the goals and recommendations; and guidance on how to achieve them."

(http://www.dietandcancerreport.org/downloads/chapters/chapter_12.pdf)

--Phenylalanine (talk) 00:44, 17 March 2008 (UTC)

Inclusion of Electrochemotherapy paragraph?

Hi everyone, I have written an article about electrochemotherapy here: http://en.wikipedia.org/wiki/Electrochemotherapy and I am trying to introduce links in articles on related topics (following the message at the beginning on article "This article is orphaned as few or no other articles link to it.Please help introduce links in articles on related topics. (January 2008)").

I believe it would be fairly appropriate to include the short paragraph in the 'cancer page', as I can not find any other article as related as this one. You can read more about ECT at the http://en.wikipedia.org/wiki/Electrochemotherapy and help me with providing some feedback about what to include in the paragraph, or adress any issues with the article itself.

Thanks you, Matevz Leskovsek —Preceding unsigned comment added by Leskovsek (talk • contribs) 07:49, 22 March 2008 (UTC)

It is an esoteric and experimental treatment that has only been studied in a fairly small group of patients. It is not presently recommended in the treatment of any malignancies. As I have previously indicated, I don't think ECT (no, not electroconvulsive therapy) belongs on this page. JFW | T@lk 09:21, 25 March 2008 (UTC)
Agree with JFW.Jellytussle (talk) 22:44, 25 March 2008 (UTC)
This one is hitting pretty much all the red flags... MastCell Talk 03:34, 26 March 2008 (UTC)
I think this material does have a place in a more specialised article on cancer chemotherapy, as there are good sources that discuss this eg PMID 18041666 and PMID 17614247, but since this is still a very new and not particularly common technique, it isn't really appropriate for the general article on cancer. Tim Vickers (talk) 03:51, 26 March 2008 (UTC)

Question about Cure for Cancer

I just watched a segment on 60 minutes about a possible method of destorying targeted cancer cell, meaning a cure, to be developed in the next ten years. That's why I'm contemplating removing the sentence:

Because "cancer" refers to a class of diseases, it is unlikely that there will ever be a single "cure for cancer" any more than there will be a single treatment for all infectious diseases.

Could someone reevaluate this please? I also think its being very presumptuous in saying that cures for these diseases will never arise. Ekublai (talk) 15:49, 14 April 2008 (UTC)

Ekublai, no need to wait 10 years, this stuff already exists. For example, rituximab targets and kills B cell lymphoma, the tumor melts away, everyone is happy but a few months later the tumor is back and now it is resistant to the drug. Bottom line: cancer is hard to treat, there will never be a miracle cure. There will, however, be a multitude of different targeted therapies, each with its own properties. Emmanuelm (talk) 17:05, 14 April 2008 (UTC)

Picture

Why don't we add a photograph of a person who has cancer and that the sighs of cancer can be seen on him/her? This is not rude at all and helps people reading the article understand what happens once you have cancer. Anyone supports the idea?--71.190.95.63 (talk) 01:24, 15 April 2008 (UTC)

Prognosis and the mention of celebrities.

Currently Lance Armstrong and Tony Snow are mentioned as inspirational cases who have survived or carried on with cancer. Interesting, but is this suitable for the cancer page or should it be moved to another "celebs with cancer" page? The problem is that these people are culture-specific, and do not necessarily mean anything to a majority of Wiki readers. Lance Armstrong may be world-famous, but few people outside the US have heard of Tony Snow. What about Mr T, Kylie Minogue, Mo Mowlem, Roy Castle, John Diamond, or that kid from Vancouver? There are must be notable cases from S. America, Africa, Asia, that I am not aware of. Where do you stop?

I move to banish individual named cases from this page. Jellytussle (talk) 08:51, 15 April 2008 (UTC)

I was initially quite positive about mentioning Lance, but the list becomes rapidly unmanageable and has immediate verifiability problems. Leaving alone the endless "who's in, who's out" debate. Good on yer. JFW | T@lk 21:28, 11 May 2008 (UTC)

Wikipedia:Transcluded content/Let's get rid of the NHL

Technical note: this discussion is transcluded in Talk:lymphoma, Talk:Non-Hodgkin lymphoma, Talk:Cancer, Wikipedia talk:WikiProject Pathology. Comments posted here will be shown in all.

I don't object in principle to trimming the external links, but the last trimming deleted a lot of useful links.

For example, it deleted the American Society of Clinical Oncology. That's the major professional society in the U.S., if not the world. I've been to their meetings. The top researchers present their latest results on, for example, the newest treatments for breast cancer, and videos of their presentations are posted on ASCO's web site, free 90 days after the meeting. They're useful for further information, and for WP:RS to link to. That's a much better resource than, say, reports of the same studies in the BBC or Associated Press, or to medical journals behind a subscription wall.

The American Cancer Society is similar, except their material is more consumer-oriented.

If we want to trim that list, we should discuss it here in talk and go through it on a case-by-case basis. Yeah, it's a lot of work. Nbauman (talk) 01:01, 6 May 2008 (UTC)

Agreed. Links should be discussed. ASCO is an important link. There are many others that are less useful.Jellytussle (talk) 07:44, 6 May 2008 (UTC)

Followup

The section on Treatment needs a subsection, Followup or Surveillance or even Survivorship, to include discussion of watchful waiting. Watchful waiting, sometimes also called "observation only", increasingly is an important "treatment arm" of clinical trials. --Una Smith (talk) 15:52, 27 May 2008 (UTC)

Pathophysiology

The section on Pathophysiology needs a subsection about the "root and shoot" theory that some cancers are derived from "cancer stem cells" and treatment may eliminate the cancer but not the cancer stem cells. Such cancers are likely to recur despite "successful" treatment. See PMID 16150939 (free full text). --Una Smith (talk) 20:51, 28 May 2008 (UTC)

Melatonin

No discussion about melatonin!! --74.14.217.184 (talk) 11:01, 29 May 2008 (UTC)

Altmed

I've edited and shortened the CAM section, which was a bit rambling. It also cited examples incorrectly - paclitaxel was not an "alternative therapy" which gained mainstream acceptance. It was discovered, developed, and tested by the National Cancer Institute, which found it while screening naturally occuring substances. I'm not aware that the Pacific yew tree had any cancer-specific use before the NCI isolated paclitaxel. The introduction of ATRA for acute promyelocytic leukemia was an example of "conventional" evidence-based translational research, which identified retinoic acid receptors on APL cell lines, described the differentiation-inducing effect of ATRA on these cell lines, and was then pioneered for human use by the Chinese, who treated the first APL patient with ATRA in 1985. PMID 18299451 is a nice summary by people who were there. MastCell Talk 17:46, 2 June 2008 (UTC)

Chemoprevention

The first paragraph of this section reads as follows:

The concept that medications could be used to prevent cancer is an attractive one, and many high-quality clinical trials support the use of such chemoprevention in defined circumstances.

This entire paragraph basically consists of opinions and contains no sources.

The word "attractive" for instance is highly subjective and should be removed.

The same problem exists with "high-quality"; what exactly constitutes high quality?

For these reasons, I think that the paragraph needs to be either deleted or completely rewritten.

Kst447 (talk) 05:53, 29 June 2008 (UTC)

To Jfdwolff: I have not "stuffed" the article with tags, I have inserted the appropriate tags into the appropriate sections.
Although it is easy to point out POV issues with descriptive words as I have done, it is not always easy to replace information, especially as this is not my area of expertise by any means. Someone with sufficient knowledge on the relevant body of research should take the matter in hand, but just because I can not do this does not mean the removal of tags is warranted.
Kst447 (talk) 19:42, 29 June 2008 (UTC)

Vitamins

There is a concept

At the beginning of this section, grammar seems to be taking a big hit. I haven't replaced anything however, as I am not sure how to define the body of research on vitamins. A "theory", "some scientific consensus"?

Kst447 (talk) 06:00, 29 June 2008 (UTC)

Cancer bacteria

I found this cancer bacteria article and it doesn't seem to be linked in this article, leaving it perhaps a little orphaned. Perhaps it could be integrated somewhere? I'm not sure how big of a deal bacteria really are in cancer research. Also, the lead to this article feels overwhelming, and perhaps a new "Background" section is appropriate, cutting the lead down to only two or three paragraphs. II | (t - c) 08:09, 15 July 2008 (UTC)

The lead is overwhelming, firstly because cancer is overwhelming, and secondly because people have over the months been trying to cover absolutely everything in the lead. If you think content needs to be removed, see WP:BOLD.
As for cancer bacteria, this is a subject that has been discussed in extenso in the past. Some editors insisted that we devote large amounts of space to Alan Cantwell's debunked theories on mycoplasma, but common sense prevailed. The very maximum that I think is acceptable is a link in "see also", but really no more than that because there are simply no reliable sources linking bacterial infection to cancer barring Helicobacter pylori. JFW | T@lk 09:46, 15 July 2008 (UTC)
I know Is there a better page than heritability for the whole "Complex interactions between carcinogens and the host genome may explain why only some develop cancer after exposure to a known carcinogen"? Also, a PubMed search for cancer AND bacteria turns up a whopping 11k reviews. Here is a recent review. There seems to be a somewhat stronger relationship. I think I found a better place for the wikilink. II | (t - c) 10:42, 15 July 2008 (UTC)
The only real "hypersensitivity to known carcinogen" mutations are in hereditary DNA repair disorders. I don't think we have a page on hereditary predisposition to cancer.
Regarding cancer bacteria: this has been discussed to the death (see this archived discussion). The review you are mentioning, apart from being in a low-prominence journal, only really concludes what we already know: that H. pylori is linked with upper digestive tract malignancies and a big question marks over all others. Nothing else to be done, methinks. JFW | T@lk 12:31, 15 July 2008 (UTC)
Oh no... as soon as I saw "cancer bacteria" on my watchlist, I had a serious flashback to the months of tendentiousness surrounding the topic way back when. I know that shouldn't prejudice me, but still... I don't think we need to push this too hard - it's an idea (one of literally hundreds) about cancer that has received some research interest, but not something we need to focus on in an overview article. MastCell Talk 20:55, 15 July 2008 (UTC)
PMID 17208515 is also a good review. H. pylori are worth mentioning in this article, but the relevance of other bacteria to human cancer in general is presently speculative. Tim Vickers (talk) 21:14, 15 July 2008 (UTC)
Tim, I'm not sure if we should be using the World J Gastroenterol citation you added. That journal hasn't got an impact factor because of unusual editorial practices. JFW | T@lk 05:52, 16 July 2008 (UTC)
OK, I'd chosen that since it was open-access. Substituted new ref. Tim Vickers (talk) 15:13, 16 July 2008 (UTC)

Error

Recurrance has a spelling mistake, it should be "at" —Preceding unsigned comment added by 122.109.34.68 (talk) 13:48, 17 July 2008 (UTC)

OK. JFW | T@lk 15:02, 17 July 2008 (UTC)

Vaccination

I'm surprised that other then a short research mention (and the HPV vac) nothing is mentioned about the Human Melanoma Vaccination and the Canine Melanoma Vaccination that is being administered (succesfully in about 40% of cases) to dogs. There should also be mention of the research on producing a vaccine for Tazmanian Devils and their aggresive and contagiouse cancer type. I would try and write something but I'm definitly not knowledgable enough. I do know that 'Considerable' needs to be expanded upon with examples and succeeses in order to not be considered a weasle word since there is considerable interest/interest/research in vaccinations for certain cancer types and subtypes. —Preceding unsigned comment added by 68.153.130.132 (talk) 13:54, 12 August 2008 (UTC)

Causes of death

I scanned this article and didn't find any information on how exactly cancer causes death. Is it always because a vital organ deteriorates and is unable to function properly? Or are there other causes too? I'd like to see the article clarified about this. -Rolypolyman (talk) 14:48, 18 August 2008 (UTC)

Because of the very explicit nature of the answer to your question, I chose to post it in my personal talk page. If you have a strong reaction when talking about death, please do not read it. Otherwise, here it is. I do not think that this list belongs in the Cancer article, usually read by patients at the beginning of the disease. Emmanuelm (talk) 18:32, 18 August 2008 (UTC)

In contrast to Emmanuelm, I think we might need to mention the actual mechanism of death in cancer. However, this may be very hard to source because all cancers are different it this regard. Perhaps we should clarify that infection and thrombosis are major systemic complications that may worsen prognosis etc. JFW | T@lk 19:35, 18 August 2008 (UTC)

In contrast to Emmanuelm, I also think we might need to mention the actual mechanisms of death. If we're writing for people at the beginning of the disease (which is one of the many legitimate audiences for WP), then we have an ethical obligation to give them information without WP:CENSOR. They must make decisions, involving adverse effects for example, so they need to understand their disease as thoroughly as possible.
People often tell me that patients "can't handle" the truth, but I don't know of any evidence to support that. Do you? If anything, I've seen articles in the English-language medical journals that doctors aren't forthright enough.
I did see a study of interviews with people with serious or terminal diseases. Some of them wanted more information, and others didn't. I assume that the people who don't want more information won't be looking it up on WP. Nbauman (talk) 21:09, 7 September 2008 (UTC)

Nbauman, are you aware of any reliable sources that address the mechanisms of death in cancer? It's a tricky topic, but I would imagine from experience that infection and thromboembolism are the most common causes of death, and that direct damage by the cancer (e.g. tracheal obstruction by lung cancer, tentorial herniation due to cerebral metastasis) is fairly uncommon. JFW | T@lk 21:37, 7 September 2008 (UTC)

I think that this can be discussed sensitively. Of course it will always upset someone. I discuss this with cancer patients on a weekly basis, and most of them take it OK, probably because they asked me in the first place. I think that opening the cancer page implies a search for cancer-related facts, and illness and death is likely to be part of that.

I think Emmanuelm has a reasonable point, so how about trying to get the passage into shape here before sticking it on the main page? how's this for an inadequate first shot: In the West, approximately 50% of patients diagnosed with cancer will die of the disease. Illness and mode of death from cancer can take many forms. Contrary to popular belief,the process is often painless. The effects of cancer can broadly devided into two groups: local and systemic. Local Effects a relatively small tumour can cause illness and death if it obstructs or perforates a critical structure. Common examples of this include:

obstructive jaundice and liver failure from metastases obstructing the biliary outflow.
renal failure due to an obstructing lesion in the kidney, ureter, bladdre, or prostate
Superior Vena Cava Obstruction due to a tumour in the superior mediastinum
Raised intracranial pressure, convulsions due to a tumour in the brain
Uncontrolled haemorrhage from directly from a tumour, or caused by tumour eroding a blood vessel in the lungs or neck.
Obstruction or perforation of the bowel from an obdominal or pelvic cancer.

Systemic Effects Cancers may cause illness and death from a general effect on the body. There are a number of well-recognised paraneoplastic syndromes associated with specific cancer types, most commonly Hypercalcaemia. A common finding in advanced cancer is carcinomatosis or cachexia, where the patient becomes weak, tired, and loses weight. When cachexia is very advanced, the patient is likely to become completely bedbound and very frail, with general organ failure. In this situation, the final cause of death is often pneumonia or another simple infection. Overall this is probably the most common ultimate cause of death from cancer. Jellytussle (talk) 20:15, 9 September 2008 (UTC)

Jellytussle, do you know of any research studies that have addressed this question of "what eventually kills the cancer patient"? I'm certain that we must not generalise, and therefore we could not extrapolate studies on lung cancer to breast cancer etc... JFW | T@lk 21:17, 9 September 2008 (UTC)

JFW, there must be a decent review somewhere. I am pretty tied up for the next 2 weeks but will have a look afterwards if no-one else has. There may be references in one of the textbooks eg Souhami and Tobias. Otherwise the causes are pretty heterogeneous. There are definitely papers on carotid blow-out, hypercalcaemia, SVCO, haemoptysis etc etc. The trick will be to tie it all up into something concise. I will have a think about what I wrote above and maybe do a second draft when I get back into town. Happy for someone else to have a go if they think it is worthwhile.Jellytussle (talk) 22:16, 9 September 2008 (UTC)

Cancer and Chinese Medicine

Chinese medicine contains a number of methods for dealing with cancer, including acupuncture and herbal medicine. There is no mention of Chinese medicine in this article. Chinese medicine can help to reduce pain suffered by cancer victims, and in some cases may help to prolong lives of cancer patients. Chinese medicine may further be used to help counteract the effects of radiation and chemotherapy.

There are sufficient sources for these therapies, primarily from Bob Flaws at Blue Poppy Press, as well as many books published in China in English and in Chinese. A good number of these therapies have been researched in China, although the results of that research for the most part has not been translated into English.

Proposed Entry for Cancer and Chinese Medicine

Cancer and Chinese Medicine

Chinese medicine offers some hope and much relief to those who suffer from cancer of many different types. This may be news to many who live in the west.

A number of ancient herbal formulas may help to address pain caused by cancer, while new formulae may help to relieve the side - effects of chemotherapy and radiation treatments.

Acupuncture treatments may also help deal with cancer, especially stomach cancer. There are specific acupoints which focus in on stomach cancer.

Chinese medicine is well-suited to address the following types of cancer:

Lung cancer Mammary / Breast cancer Esophagal (throat) cancer Nasal cancer Stomach cancer Pancreatic cancer Prostate cancer Ovarian cancer, ovarian cysts, uterine cancer. Bladder cancer Liver cancer Leukemia Skin cancer Brain cancer

Although Chinese medicine does not "cure" cancer, Chinese medicine is capable of relieving pain related to cancer, reducing the side effects of chemotherapy and radiation and extending life expectancy for those diagnosed with cancer.

1. Development of Formulas of Chinese Medicine, ed. by Liu Gongwang, Huaxia Publishing House, 2002. ISBN 7-5080-2797-3/R.350 pp 374 - 408.

2. Blue Poppy Press, Free Articles, http://www.bluepoppy.com/press/download/press_articles.cfm

3. Illustration of Composed Acupoints in Acupuncture - Moxibustion Use, by Liu Yan, Shanghai Science and Technology Press, 2004. ISBN 7-5323-7136-0.


Mojave Cowboy at Yahoo 13:43, 26 August 2008 (UTC)

There are numerous other alternative modalities used in the treatment of cancer. I'm unconvinced that TCM needs any more mention than all the other modalities, given that at the moment there is no solid evidence that TCM improves mortality or response rates. JFW | T@lk 19:39, 26 August 2008 (UTC)
To be open-minded and fair about it -- if you can find a well-designed randomized, controlled trial in a major peer-reviewed journal, or at least a journal on PubMed, I'd leave it in. Otherwise, I'd delete it. That web site seems to be self-published, by someone who sells the products, not a WP:RS.
Is there anything on Chinese medicine for cancer on the Cochrane collaboration? Nbauman (talk) 05:13, 27 August 2008 (UTC)
Are you suggesting my response was not open-minded and fair? JFW | T@lk 22:33, 27 August 2008 (UTC)
You could substitute, "to be as generous as possible to traditional Chinese medicine." Nbauman (talk) 01:50, 28 August 2008 (UTC)

Diagnostic error

Caesarjbsquitti (talk · contribs) added a section suggesting that cancer diagnosis needs to be done with care and that errors in diagnostic testing could lead to the exposure of patients to harmful treatment. The source talks very specifically about an incident in Canada where errors were made in testing the hormone receptor status of breast cancer specimens.

With respect, I think this is soapboxing. Of course diagnostic tests need to be done properly, and this extends well beyond cancer diagnosis. One erroneous measurement in the INR of a thrombosis patient can lead to under- or overdosing of warfarin and exposure to risk of either recurrence of thrombosis or severe haemorrhage, both of which are unpleasand and potentially life-threatening. I see no difference between immunohistochemistry and any other diagnostic tests. The point about laboratory quality control is much broader; in the UK, NEQAS fulfills such a function, but I don't know if Health Canada has a similar facility. JFW | T@lk 05:31, 18 September 2008 (UTC)

I believe the expert involved in this particular incidentS suggested that 'this was a wake up call for the world'.... I would tend to think that many of the 'experts' on this subject are not willing to expose this, and cancer victims should know this. Soapboxing ? We are talking about people's lives here...!Its important. --Caesar J.B. Squitti: Son of Maryann Rosso and Arthur Natale Squitti (talk) 18:42, 18 September 2008 (UTC)

Yes, if I thought I had something important to say I would also use bombastic language. Unless you can provide a secondary source that supports the primary source, it will be hard to verify whether the world decided to get woken up by his call.

Cancer victims are entitled to know that the facility where their histology is performed is accredited and participates in quality control processes (I have mentioned NEQAS). It may not be particularly helpful if they are taught to distrust their pathologists, which may cause chaos. In any case, it is not Wikipedia's task to broadcast something that is not already generally known. JFW | T@lk 21:20, 18 September 2008 (UTC)

This person seem of little importance in the global scheme of things. If they are reported widely and start a notable international movement on cancer diagnosis then we might consider adding this to the general article on cancer, until then it's just one guy's opinions on a slow news day. Tim Vickers (talk) 22:21, 18 September 2008 (UTC)

Even if he's the world expert on immunohistochemistry, it remains a comment in reference of a particular incident. I'd be loathe to include this unless strong secondary sources available. JFW | T@lk 22:39, 18 September 2008 (UTC)

I agree with JFW, this discussion does not belong here. I would add that a general discussion of QA, QC and errors would be more appropriate in the Anatomical Pathology article.
Bye the way, I am familiar with the incident in Newfoundland and with another incident in my own Canadian province. Along with two other pathology error scandals in Canada over the past 12 months, they created a "perfect storm" that will lead to a tightening of error reduction measures for Anatomical Pathology in Canada. Emmanuelm (talk) 19:09, 21 September 2008 (UTC)

All animals?

I am surprised to read that "Cancers can affect all animals". I remember reading somewhere — I think it was in Maxim D. Frank-Kamenetskii, Unraveling DNA — that cancer affected only vertebrates, which are also the only animals to have an adaptive immune system (I don't know the relation between these two facts, if there is any). David Olivier (talk) 15:28, 10 October 2008 (UTC)

It does seem to be a bit different in invertebrates (I'd guess due to their short lifespan), PMID 10637629 does explain this a bit and although the phenotypes are a bit different flies do get cancer and similar mechanisms control cell proliferation and death. Tim Vickers (talk) 19:08, 10 October 2008 (UTC)

Nuclear facilities

The claim that children living near nuclear facilities face an increased risk of cancer is at best dubious and misleading. It would be correct to say that some studies found unexpectedly high numbers of leukemia cases in the vicinity of some nuclear facilities, although even formulated thus it might mislead the reader without statistical training into assuming there is good evidence for a causal relationship. —Preceding unsigned comment added by 24.14.32.122 (talk) 06:47, 21 November 2008 (UTC)

The immediate cause of death

Nowhere in the article is the immediate cause of death discussed. Is it typically organ shutdown caused by the cancer? Patient bleeding out when an invasive tumor compromises a vein? Percentage breakdown would be nice. Tempshill (talk) 17:48, 27 November 2008 (UTC)

I'm not sure if this data is available.
It is different for different forms of cancer too.
Once we have a source we could always implement this, but I think it's been discussed before and it is a perennial issue. JFW | T@lk 00:46, 28 November 2008 (UTC)

Cyberchondria

I would really like to see a cyberchondria warning somewhere at the beginning of this page. 189.180.37.172 (talk) 08:51, 8 January 2009 (UTC)

I'm sure you do, but not at the beginning (it is only a minor annoyance in the grand scheme of things) and only if there are reliable academic sources addressing the issue. JFW | T@lk 13:15, 8 January 2009 (UTC)

For those interested in a source that can be used where relevant:

Cancer epidemiology problems

The epidemiological statistics in this article were out of date (2005; the latest are 2008) and in some cases were summarized incorrectly:

  • The claim that cancer is responsible for about 25% of deaths in "other developed countries" was unsourced.
  • The claim "In a yearly basis, 0.5% of the population is diagnosed with cancer." is unsourced and is implausible from a global perspective.
  • A claim that leukemia is "the most common infant malignancy (30%)" seems to be referring to a source that is actually talking about children aged 1 through 14, so the claim was in the wrong section. Also, the claim is only about the U.S.
  • The claim "In some Western countries ... cancer is overtaking cardiovascular disease as the leading cause of death" wasn't sourced.

I made this change to try to address these issues. Eubulides (talk) 20:45, 4 February 2009 (UTC)

I noticed that a lot of the epidemiological material was put in Cancer #Classification, where it didn't fit well. I moved it to Cancer #Epidemiology. One of the subsections was mislabeled Adult cancers but it discussed cancers of all ages, not just adult cancers, so I renamed it to Incidence and mortality. This removed the need for the Nomenclature subsection header so I removed the header. Also, epidemiology is broader than merely studying incidence, so I removed a claim that that's what it is. More work needs to be done to clean up the epidemiological discussion; this is just a first cut to fix the glaring organization problem. Eubulides (talk) 20:59, 4 February 2009 (UTC)

Pictures of removed tumors

Wow, those are really rather explicit. Does there need to be so many examples? 202.89.189.114 (talk) 22:24, 3 August 2008 (UTC)

why not? there not explicit, that's like saying no one should ever look at their own body --208.71.219.60 (talk) 06:49, 15 August 2008 (UTC)

Actually, it's not like that at all. In the future, before you make a comparison, do a mental check: 'does this make any sense at all?' If the answer is no, hit the Back button on your browser. 62.63.184.74 (talk) 19:53, 7 September 2008 (UTC)

What did you expect, it's about cancer, and the images display varies kinds of tumours. Drawn images of tumours still on the person would be preferable, if anyone has any. Feyre (talk) 22:31, 26 August 2008 (UTC)

Still, I find those pictures to be really disgusting. I think they should be on the lower part of the article and in a expandable gallery. Seriously, they are really disgusting. --190.43.167.142 (talk) 18:48, 5 October 2008 (UTC)

I agree. The pictures are quite graphic -- an amputated female breast with a huge cancerous tumor as the first image on the page? Come on, that's a bit much. MaxVeers (talk) 05:29, 30 October 2008 (UTC)

It is a human body. The only reason it is gross to you because it is not normal. Sheepeh (talk) 04:13, 28 November 2008 (UTC)

I agree they should be on an expandable gallery. Then it doesn't matter, instead of forcing people to view it they have the choice. —Preceding unsigned comment added by 99.237.78.107 (talk) 16:04, 25 January 2009 (UTC)

There are no such photos under articles for abortion or STDs. Those are human bodies in various "abnormal" shapes and forms as well. And there is a reason for this. These images, as they currently are, make this article difficult to read for many people who would otherwise need it's contents. I agree with many of the previous comments and suggest one, not numerous photos be left in, and that one be moved down the page. —Preceding unsigned comment added by 84.50.6.73 (talk) 14:39, 6 January 2009 (UTC)

I'm studying medicine, and I like that there are so many pitures. I feel it is not unreasonable for a person to expect to see pictures of cancers when they look up cancer on a website known to include photos for illistrative purposes. However, cancer is an emotional subject for many people, and seeing so many photos of the most graphic cancers is obviously upseting some users. It would be easy to have one or two photos of lower grade tumors, with a link in the article to see more pictures. Alternatively, other pages have galleries at the bottom, maybe that would be a more acceptable way to display these photos? —Preceding unsigned comment added by 71.38.168.42 (talk) 04:55, 6 February 2009 (UTC)

Discussion Sequential treatment/Odds algorithm

Dear jdfwolff: Dr. Y. Swan has informed me of your repeated deletion of the entry with request of discussion. The Odds algorithm is no longer OR (developped 1998/9, published 2000), but you are right in the sense that it is less known in medical circles and may therefore be seen as OR. However, serious diseases, and hence in particular Cancer, raise probably the most serious questions for which it should be consulted. What would you think of the following entry? "Think of a sequence of n patients requesting (with signed confirmation) a compassionate-use non-standard treatment, about which little is known. (Sequential observations are thus the only way to collect information about the success probability). Somewhat simplified,the problem is that the responsible physician would like to obtain all possible successes by minimizing the "unsuccessful suffering". Since the physician has no prophetical capacities, his/her ethical objective turns into the problem of stopping with largest possible probability on the last "success" in the sequence of length n. This problem is solved by the Odds algorithm. Its advantages are that it is (mathematically) easy to apply and, in particular, proved to be optimal under certain conditions and almost optimal under weaker conditions." The Odds algorithm cannot solve all problems in this context, of course. However, there is no alternative solution to this problem. Given the seriousness of the (ethical) objective it should therefore, to our opinion, enter the Cancer Article in Wikipedia.(F.T.Bruss) —Preceding unsigned comment added by 164.15.127.79 (talk) 17:19, 21 January 2009 (UTC)

Which source supports this statement? I'd like to see in particular a general review of cancer treatment that discusses this method, so I can see that it is of sufficient general importance and notability to be included in this overview article. Tim Vickers (talk) 17:32, 21 January 2009 (UTC)
It is exactly my point that the Odds algorhythm has not been disseminated in clinical oncology. Therefore, to suggest that it is even relevant in this context is original research. However ethical your objective, an encyclopedia can only document that which is already known, not personal views or hypotheses unpublished elsewhere. PubMed yields no references under either your own name or Dr Swan's suggesting that neither of you have published on this topic in the medical literature. JFW | T@lk 23:43, 21 January 2009 (UTC)

You are probably right, nothing on this seems to have been published on this topic in the medical literature.(I am a Prof. of Mathematics, not of Medicine or medical sciences.) Besides my articles in Annals of Probability (2000 and 2003) it has been published in terms of the most important example for applications of the odds algorithm in "The art of a right decision" which appeared in three national editions of the Scientific American ("Spektrum der Wissenschaft" (2005, June-Vol., pp 78-84, in German), "Pour la Science" (in French, Sept.-Vol. 2005, pp 56-62), and in "Al Aloom, in Arabic), and then in E n g l i s h in the "Newsletter of the European Math. Society." I hope doctors will think it over more deeply because it is important. Having said this you have convinced me that Wikipaedia is not the place to attract attention. - Thank you, F.T. Bruss. —Preceding unsigned comment added by 81.241.17.43 (talk) 12:22, 1 February 2009 (UTC)

There is little doubt that mathematical decision support in fields such as oncology would be very beneficial. Once the subject has received attention in secondary sources the whole matter can be reconsidered. JFW | T@lk 16:05, 1 February 2009 (UTC)
This might be interesting on a page on medical statistics, or medical decision making, or even medical ethics. does not really belong on the cancer page (which does not include a lot of every day statistical-based oncology management) even though it may be relevant.Jellytussle (talk) 12:48, 6 February 2009 (UTC)

As per #Improvement suggestions and WP:LINKFARM I replaced the contents of this section with a DMOZ link and an invocation of {{NoMoreLinks}}. For reference, here is the previous contents of the section, in case there's something useful there. Eubulides (talk) 08:27, 7 February 2009 (UTC)

Look up archive 4 in Wiktionary, the free dictionary.
Wikimedia Commons has media related to Cancer (illness).
  • {{dmoz|Health/Conditions_and_Diseases/Cancer/}}

Professional and research

Global
North America
South America
Europe
  • EORTC European Organization for Research and Treatment of Cancer. A European non-profit organization that sets up and executes clinical trials.
  • Cancerbackup UK cancer information charity.
  • The Institute of Cancer Research One of the world's foremost independent cancer research organisations, based in the United Kingdom.

Support and advocacy

(end of previous version of external links section) Eubulides (talk) 08:27, 7 February 2009 (UTC)

Moved Epidemiology to subarticle

I moved most of Cancer #Epidemiology to a new subarticle Epidemiology of cancer, leaving behind a summary. This is one of the sorts of changes suggested in #Improvement suggestions above. Something similar appears to be needed for the sections on treatment, prevention, and pathophysiology, but I figured I do the easiest one first and see how well it fared. Eubulides (talk) 00:51, 12 February 2009 (UTC)

Inflammation

SteveChervitzTrutane (talk · contribs) has now twice inserted a broad-sweeping statement that lifestyle-related cancer is predominantly related to inflammation. The source for this is PMID 18626751 (Pharm Res 2008). Grand theories of cancer need a much stronger source than presently provided - basically along the lines of Knudson or Hanahan & Weinberg. Before adding this again I need better evidence that this is indeed a major trend in cancer research. JFW | T@lk 10:51, 9 November 2008 (UTC)

Looking at Nature:
  • Cancer-related inflammation 23Jul08 doi: 10.1038/nature07205
  • Inflammation and cancer 19Dec02 doi: 10.1038/nature01322
  • NF-?B functions as a tumour promoter in inflammation-associated cancer 25Aug04 doi: 10.1038/nature02924
(contains "chronic inflammation...accounting for approximately 20% of human cancer")
  • Cancer Inflammation by remote control 08Jun05 doi: 10.1038/435752a
  • Nuclear factor-?B in cancer development and progression 24May06 doi: 10.1038/nature04870
  • Cancer An inflammatory link 22Sep04 doi: 10.1038/431405a
That kind of research? I can send copies, send me an email. Franamax (talk) 18:57, 9 November 2008 (UTC)

Whoa, thanks for blinding me with science. Of course there is a role for inflammation (or at least the inflammasome) in cancer, and I don't even oppose its mention, but the source provided is inadequate. There is a significant gap between "20% of cancer is inflammation-related" and "the lifestyle factors of cancer cause cancer by causing inflammation". I don't think the second point can be demonstrated with the above references. JFW | T@lk 19:29, 9 November 2008 (UTC)

Not only that, I've actually read some of them :) What would be the "lifestyle factors"? Smoking, alcohol and obesity? Diet? Some of the above are review articles, I can read through them and look for specific yea/nay's on each factor. I agree that a sweeping statement goes much too far, Franamax (talk) 20:05, 9 November 2008 (UTC)

Sorry, I should have started a discussion topic rather than re-adding the Pharm Res citation back into the article. I don't have any axe to grind here and agree that any statement about cancer and inflammation should stress that this is still an area of active research. The inflammation-cancer connection is certainly something that is not well-understood, but there is a rapidly accumulating body of knowledge here and I feel it deserves some mention given the amount of interest in this area, if only to state that investigation is ongoing and opinions on this topic can range from minor to sweeping. Inflammation is itself a complex phenomenon and it's clearly involved in many diseases but the cause-effect relationship can sometimes be hard to discern. I've noticed that the cancer-inflammation link appears in other places within Wikipedia:

Such pages could be noted in a 'Cancer > Inflammation' section, and might even warrant creating a separate 'Cancer and inflammation' page eventually. Here are a few other citations worth checking out:

Cheers. SteveChervitzTrutane (talk) 09:55, 16 November 2008 (UTC)

Steve, I don't think anyone disputes the fact that chronic inflammation plays a role in carcinogenesis. You, like Franamax, are just blasting me with papers that happen to have "cancer" and "inflammation" in their keywords. What I'm not seeing (and as a cancer researcher you will understand this) is a grand theory that fits in the mould of Knudson and similar. The reference you added doesn't do the trick.
I don't really care what other Wikipedia articles might say about inflammation and cancer. What I would have liked is a recent review by leaders in cancer research summarising recent research and outlining the current state of play. You admit that this field is in rather a state of flux, so it might still be a tad too early. JFW | T@lk 22:00, 17 November 2008 (UTC)
If I'd just been blasting you with papers, I would have noted all 407 in the search. :) In fact, the first two I posted are major review articles citing 174 references between them. The first one (doi:10.1038/nature07205) is a recent review in a major journal by (presumably major, since it's a paper in Nature) cancer researchers which seems to be summarising recent research and outlining the current state of play. Like I say, I do actually read the stuff. Currently, our article doesn't even mention the word "inflammation". Could you have a look at that Nature review? Franamax (talk) 00:03, 18 November 2008 (UTC)

As you may have guessed, I have no fulltext access to Nature and am therefore unable to read the paper. Feel free to cite the conclusions of Mantovani et al in the article, if you think that will enhance it. Judging from the abstract, it is likely to be more useful than Coussens et al or any other one from the rest of the list. JFW | T@lk 00:31, 18 November 2008 (UTC)

I'm hesitant on the wording as I'm not a topic expert, although I think the Mantovani ref would directly support Steve's version (not the "vast majority" bit, rather, the uncertain but definite role that inflammation plays). I'll use this space for a gratuitous plug for the Resource Exchange, where you can get the full text of pretty much anything you want, or give it if you got it! Franamax (talk) 10:40, 18 November 2008 (UTC)
I'm no topic expert either, but am eager to get something posted on the cancer-inflammation connection in the article, the lack of which I view as a gaping hole. I agree that Mantovani et al. would be a good reference to cite. Also perhaps the NCI's 'Executive summary' page I noted above (though it is devoid of primary citations). I'll try and get a hold of Montovani et al. and take a stab in the next week or two and will post it here for feedback before editing the main article. Thanks for the tip about the Resource Exchange! SteveChervitzTrutane (talk) 10:19, 14 February 2009 (UTC)

Fungus

I would like to add that there is this guy that is stating that cancer is a fungi infestation, I watched his video and came her to see if there is any discussion about the subject and found out that it was not even mentioned, should it not be at least in an contested information area along with the inflammation theory? For reference, here is his address: http://www.cancerfungus.com/

Notivago (talk) 23:39, 28 November 2008 (UTC)

Sounds like a fringe theory to me. Unless it is a notable theory that has been published in reliable sources it does not belong in a serious article on cancer. Tim Vickers (talk) 17:39, 29 November 2008 (UTC)
Fungus is very easy to see under the microscope using old (100 year old!) techniques. I have looked at thousands of cancers and hundreds of fungal infections under the microscope. Cancer is not caused by fungi. Emmanuelm (talk) 20:39, 6 January 2009 (UTC)

Lead image

This recent edit removed Image:Renal cell carcinoma.jpg with the comment "Image removed from top panel for two reasons - 1) It doesn't reflect all types of cancer accurately 2) It's terrifying to an irresponsible degree." I disagree on both points.

  • First, there's no requirement that the lead image "reflect all types of cancer accurately"; the lead image is merely supposed to illustrate the topic in an interesting way,. Requiring the lead image to summarize all aspects of the topic accurately would be too much: it would mean, for example, that we'd have to remove Image:Autism-stacking-cans_2nd_edit.jpg as the lead image from Autism as it doesn't summarize all of autism.
  • Second, I don't find the image at all terrifying, any more than the lead image in Stomach is terrifying. In both cases the image is showing part of a human body that's cut out of the body, which I suppose is "terrifying" in some sense; but this is standard on medical topics and what is unusual about illustrating a medical topic that way? If we really wanted a "terrifying" image, we would use something like Image:RecurrentbreastCA.gif: that is indeed terrifying to the average reader. In contrast, Image:Renal cell carcinoma.jpg is not anything like that, and (except to the reader who knows anatomy) doesn't look any more or less terrifying than most medical photographs.
  • Third, this article should have some lead image; if not Image:Renal cell carcinoma.jpg; then what?

Eubulides (talk) 18:37, 24 February 2009 (UTC)

Since my preferred option of somebody smoking a cigarette is a non-starter, I'm fine with the renal cancer image. Tim Vickers (talk) 18:42, 24 February 2009 (UTC)
  • Something like the image found lower down on the page, which shows how cancer develops is surely more appropriate. Neither of the images you show above are 'terrifying' to someone used to dissection or versed in anatomy; I merely feel that, given the page's high density of traffic (the page is the one which is listed first on a google search for 'cancer'), and the likelihood that much of that traffic will be generated by those with cyberchondria and other, worried individuals, it would be more responsible to display a less immediately shocking image. I am willing to defer to a more experienced editor, but think that encyclopaedias have a duty to respect the sensitivities of their readership; the articles on fasciculation and ALS do, for example, begin by stressing that symptoms of both are usually non-fatal (something sufferers are wont to assume).

CharlieRCD (talk) 18:55, 24 February 2009 (UTC)

Wikipedia is WP:NOTCENSORED, but I agree that the gross pathology image was exactly that. There are probably more abstract images that could be chosen, such as microscopy slides. I don't think the image in the infobox is meant to be anything more than a pretty picture. If an image has bearing on article content then surely it should be in the relevant section. JFW | T@lk 21:50, 24 February 2009 (UTC)
I dunno, I'd rather have the image actually lead into the topic, rather than be just a thing of beauty. Autism{'}s lead image does that. How about Image:Tumor Mesothelioma2 legend.jpg instead? It's about lung cancer, which is all too common, but it's more abstract. Eubulides (talk) 21:59, 24 February 2009 (UTC)
I certainly think this is an important issue. I note the part of the last page that reads: "Words and images that would be considered offensive, profane, or obscene by typical Wikipedia readers should be used if and only if their omission would cause the article to be less informative, relevant, or accurate, and no equally suitable alternatives are available ". I suggest the best course of action is to find something explanatory and non-shocking. I appreciate it's a horrible disease, but there's no need to make it shocking to the casual (quite possibly already distressed) reader. Perhaps this is a flawed, overly-emotional argument, but I think the above passage can be used to defend its logic. CharlieRCD (talk) 01:30, 25 February 2009 (UTC)
The image Tumor_Mesothelioma2_legend.jpg has been added to the page; it definitely needs a lead image of some kind. CharlieRCD (talk) 21:52, 25 February 2009 (UTC)

Improvement suggestions

I'm following up on Why is this article not a Wikipedia:Featured articles?, a thread of about a year ago. Cancer is quite good but it's not yet up to featured article quality. Here are some suggestions to improve it.

  • The lead is almost entirely unsourced, and large chunks of the body are unsourced. My little (and incomplete) review of the epidemiology material (see #Cancer epidemiology problems) found several serious sourcing problems; in many cases the claims were undoubtedly correct, but in at least two cases the claims appeared to be wrong. This stuff needs sourcing.
  • There are too many images running down the right side of the page at the start of the article. The lead images should be cut down to the diagram plus one photo of a cancer. The other images can be moved elsewhere as appropriate.
  • The article is way too long. I suggest cutting it down by (say) a factor of two.
  • The lead is way too long, perhaps even by a factor of three, and should be trimmed.
  • The section headers should be redone a bit, to follow the guidelines in WP:MEDMOS #Diseases/disorders/syndromes. I suggest the following order:
  • Classification
  • Signs and symptoms
  • Causes
  • Mechanism (renamed from Pathophysiology)
  • Prevention
  • Screening
  • Diagnosis
  • Treatment
  • Prognosis
  • Epidemiology
  • History
  • Research directions (renamed from Research)
  • In other animals (new material; should be brief)
  • References
  • Further reading
  • The See also section should be removed. Its wikilinks should be either moved into the main body of the text, or removed.
  • The External links section should be removed, or trimmed down to one link, namely the Open Directory Project link. The current external links section is waaayy too large and is a WP:LINKFARM.
  • In some cases the material is written too much from the U.S. perspective. It's understandable why this would be, but we should strive harder to use global data where available.

Comments? Eubulides (talk) 22:20, 4 February 2009 (UTC)

I just spent a day adding significant high-level information about the causes of cancer. The concern that the Causes section "needs trimming" must be counterbalanced with the fact that cancer has extremely complicated clauses, and the cause of cancer is one of the main topics of interest with regard to cancer. Granted, I agree that it could be "trimmed", but I would NOT suggest removing any useful information. Instead if you feel it is too long, you can make a Causes of Cancer article and keep the high-level overview in this article as well as short summaries of each subsection in Causes, then link via "Main article: Causes of cancer", without throwing away information. That might be useful. Ninjagecko (talk) 12:30, 25 March 2009 (UTC)

--

I'm unable to edit this article but there seems to be a typo: "the virus genome is inserts near a proto-oncogene" in the Viral or bacterial infection section might better read "the virus genome is inserted near a proto-oncogene" —Preceding unsigned comment added by Erickreid (talk • contribs) 16:54, 25 February 2009 (UTC)

Causes of cancer

I too have noticed the lack of referenced material in the introduction, and have therefore added a citation required to "..Nearly all cancers are caused by abnormalities in the genetic material of the transformed cells.." The sentence is worded poorly, as the cause of cancer for example, may be exposure to radiation, which then creates abnormalities in the genetic material. Therefore the cause of cancer in this case was radiation. MrAnderson7 (talk) 05:11, 5 February 2009 (UTC)
The semantics here are tricky. On a molecular level, the cancer is always due to genetic mutation. This is precipitated by a number of things such as radiation, tobacco, industrial carcinogens, etc etc. This is slightly different from the (equally valid) lay concept of saying "the cancer was caused by cigarettes/radon/shistosomiasis etc etc. Not sure that there is a single correct answer here in the context of this page. Bottom line however is that without the right mutations there will be no cancer.Jellytussle (talk) 12:55, 6 February 2009 (UTC)

Isn't this the difference between causation (radiation, say; or it could be inherited of course) and mechanism (genetic abnormalities)? We could simply reword it that way. However, we need a source regardless of how it's worded. Eubulides (talk) 16:01, 6 February 2009 (UTC)

Acutely-transforming oncoviruses can transform cells without somatic mutation, but for this to progress to clinical disease I think you would need further mutations. Tim Vickers (talk) 16:04, 6 February 2009 (UTC)
Hmmm. Even with transormation due to viral infection, one could argue that abnormal DNA is responsible, even if it is exogenous viral DNA (which may or may not be integrated into the host cell genome.)Jellytussle (talk) 11:22, 9 February 2009 (UTC)
For the introduction, I think that instead of trying to parse a precise definition, we should try to give the reader a few important points. Cancer is very complicated, and people can get lost in the details; it helps if you can say, "These are the important things you have to understand about cancer, and this entry will explain them in more detail, so as you read it, be alert for these points."
I think the important points in the introduction are (1) Uncontrolled growth (2) invasion and (3) metastasis, although other sources would include other steps. What else?
One way to organize it is to list the important points you want to make, and then explain each point as simply as possible.
Wikipedia is supposed to be written for the ordinary reader, not the specialist. I think the writing in this entry is a bit too difficult for the ordinary reader. A lot of scientists don't realize how ordinary people don't have the vocabulary that they use every day. It's quite a cognitive load for most people to read words like "benign" or "abnormalities", which have a precise meaning in science but not in everyday life. I ran the introduction through MS Word, and it had a Flesch-Kincaid Grade Level of 12, which means that it's readable by high school seniors (but not students below that level).
I've seen complaints in JAMA that a level of 12 was too high for most readers. Doctors who explain things to patients every day have a pretty good sense of what ordinary people understand.
Mind you, I don't think the entire entry has to be written on the 12th grade level. WP should also be written for scientists, medical doctors and other specialists who want advanced material and references to the professional literature. I think we should bend the rules. But not in the introduction. Nbauman (talk) 18:33, 9 February 2009 (UTC)

I've looked over the concerns of this section, that they largely seem to have been addressed by my significant rewrite of the Causes section introduction a week ago, which packaged most high-level concepts in the form that was easily consumable by most people. If people have things to add, please do so, there is still much work to be done probably. Someone above was thinking about a reorganization, but you all talk about it amongst yourselves. (sidenote: I also thought the sentence folks above were discussing was a bit inaccurate for the exact reasons Jellytussle summarized, but left it in.) Regarding "(1) Uncontrolled growth (2) invasion and (3) metastasis", I mentioned uncontrolled growth but not invasion and metastasis; does invasion and metastasis really belong in the "Causes" section? I guess putting it there is reasonable, but I personally would put it in a section about common progressions--please add it wherever you think it should go, if it isn't already somewhere in the article already. Ninjagecko (talk) 12:41, 25 March 2009 (UTC)

Self-amplifying, sources, etc.

A recent set of edits had some improvements, but there are some problems with it as well:

  • The newly-added sources are weak. Please try to find sources in peer-reviewed medical journals, as per WP:MEDRS. Web sites, even when high-quality, are not nearly as authoritative.
  • Inappropriate use of boldface, e.g., "self-amplifying". See MOS:BOLD.
  • There's no need to say "self-amplifying" more than once.
  • Overemphasis of cancer due to organ transplant. The article already talked about this rare form of cancer; why add even more?

Eubulides (talk) 16:57, 25 March 2009 (UTC)

Thank you for the feedback. I have not had time to find better sources, but I have fixed the issues with boldface, the issues with verbiage ('self-amplifying' -- though it is very difficult to find a similar phrase, e.g "errors which cause errors" is more verbose and is inaccurate -- but I think I found something that works -- though the original double-use was on purpose and for emphasis), and issues with organ transplantation (I missed the fact it had been mentioned in the article, since I just moved the text next to where it was mentioned -- now the information is combined into a single paragraph). Also made a few minor improvements. Ninjagecko (talk) 17:35, 25 March 2009 (UTC)

Now well

Is this or is this not a good article? It has this {{Refimprove|date=March 2009}} on it. --62.216.127.31 (talk) 01:23, 7 April 2009 (UTC)

Prevention of cancer page?

Seems like we could use a page on cancer prevention, where the mushroom info which was recently inserted/removed could go. Should it be titled cancer prevention or prevention of cancer? II | (t - c) 00:52, 31 March 2009 (UTC)

The usual phrase is "Cancer prevention", so that's a better name. However, no matter where that material goes, it has to be balanced with the mainstream opinion that there's no scientific basis for using mushrooms to prevent cancer. See, for example:
Eubulides (talk) 02:08, 31 March 2009 (UTC)

Assuming good faith... I agree. But isn't there someway we can display that information? It is more current than the paper you are using for evidence...It seems like there are very similar sentences in this article. Are those misplaced as well?Jatlas (talk) 05:06, 14 April 2009 (UTC)

As per WP:MEDRS, the article should use reviews (such as Borchers et al.) instead of primary sources. Also, WP:MEDRS suggests that we should not succumb to WP:RECENTISM and list the latest primary sources, as such sources tend to be more biased and dubious, especially when we get into areas such as "X prevents cancer!" (or "X causes cancer!", for that matter). There must be hundreds of papers published in the last year touting X (for some value of X) as a cancer preventative; why should Cancer emphasize mushrooms at the expense of all the other X's? That's why reviews are crucial. Even Borchers et al. is a dubious source here, since it doesn't place mushrooms in context with all other potential cancer prevention agents or cures. Eubulides (talk) 05:10, 14 April 2009 (UTC)

Broken link: Reference #73 (CARET Study) —Preceding unsigned comment added by 119.92.189.159 (talk) 00:59, 23 April 2009 (UTC)

Thanks, fixed. Eubulides (talk) 01:12, 23 April 2009 (UTC)

Awesome Show Great Job?

For some reason, "Awesome Show Great Job" redirects here. That seems less than appropriate. However, I'm not sure what to do about that. —Preceding unsigned comment added by 71.56.131.213 (talk) 08:06, 29 April 2009 (UTC)

Thanks, I fixed it. Eubulides (talk) 09:08, 29 April 2009 (UTC)

Cancer photos

I find that the cancer photos make it difficult to read the information nearby. You just do not want to look too long onto a page that has those images. I propose to put the photos all together within the article, instead of inserting each one throughout the text. —Preceding unsigned comment added by 217.95.60.113 (talk) 02:56, 24 May 2009 (UTC)

Comparison to non-biological organisms

The section entitled "Comparison to non-biological organisms" isn't supported by in-line citations and contains dubious assertions which may be OR. I've acted boldly and removed it. Please feel free to discuss if you feel otherwise. Cheers, Majoreditor (talk) 00:55, 11 June 2009 (UTC)

Cancer in plants

The article says this "Any organism, even plants, can acquire cancer.". I find this very interesting, but the entire article apart from this line seems to be about humans and animals. Could we have some information or at least links about plant cancer? -OOPSIE- (talk) 04:37, 13 June 2009 (UTC)

Can think of examples, although "cancer" is not really the word. Tobacco mosaic virus causes neoplasia in plants. JFW | T@lk 12:37, 14 June 2009 (UTC)

Additional Treatment

Photodynamic Therapy should be added under treatment options as this becoming a new approach for various cancers.

Photodynamic detection is becoming widely used for detection of cancerous tissue Brain, Lung, Stomach, Bladder, Skin, Oral, Head and Neck, Colon, Penile, are just the begining.

Tomkerber (talk) 03:34, 3 July 2009 (UTC)tomkerber

{{sofixit}} - I would recommend finding a good reference that covers all those uses of PDT in one fell swoop, ideally a review article (see WP:MEDRS for guidance). JFW | T@lk 10:53, 5 July 2009 (UTC)

fact?

Because "cancer" refers to a class of diseases, it is unlikely that there will ever be a single "cure for cancer" any more than there will be a single treatment for all infectious diseases.

i've read somewhere stress is a cause of more than 70% of illnesses. so if stress is eliminated, won't these be too? in other words, please add a reference for above statement. 79.101.91.32 (talk) 08:04, 16 July 2009 (UTC)

I added some citations in support of the no-single-cure-for-cancer claim in the article. I'm not satisfied that I found the best reference in support of the link between the multifaceted nature of cancer and the difficulty for a single cure. This connection relies on the known vast variety of cancers and the failed attempts at finding a single cure to date. The long quest for an anti-angiogenesis-based treatment I think serves as good case demonstrating the difficulty of finding such a silver bullet cure for cancer. I included a recent reference that discusses this. SteveChervitzTrutane (talk) 08:39, 17 August 2009 (UTC)

Proposal: to add the information, that infection with XMRV virus is associated with prostate cancer, into the section Viral or bacterial infection

Please can anyone do it, I do not know how to unprotect the page References: http://www.ncbi.nlm.nih.gov/pubmed/19403677?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum http://www.ncbi.nlm.nih.gov/pubmed/19403664?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum http://www.ncbi.nlm.nih.gov/pubmed/18823818?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum http://www.ncbi.nlm.nih.gov/pubmed/16609730?ordinalpos=11&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum —Preceding unsigned comment added by Jsekal (talk • contribs) 19:56, 5 September 2009 (UTC)

plant-based diet and anti-cancer phytochemicals

I'd like to add more info on plant-based diets and cancer. What's the best way to propose an addition to this article? --Thomas.vandenbroeck (talk) 02:19, 14 September 2009 (UTC)

I'd just put the proposed text here, in this section. See Talk:Water fluoridation #Dietary Reference Intake for an example of proposing a change to an article. Eubulides (talk) 03:14, 14 September 2009 (UTC)

Contradiction

These two sentences seem to contradict eachother. Can someone who knows how this is supposed to read make it more clear?

"Substances that cause DNA mutations are known as mutagens, and mutagens that cause cancers are known as carcinogens."

"Many mutagens are also carcinogens, but some carcinogens are not mutagens."


Talk for above

For To Avoid the Contradiction, you must Deny that cancer is mutation cell. but most scientists believe that cancer is mutation cell. But straight evidence is not revealed. anyway some cancer cell have mutated position.


DNA mutations some times mean just changed DNA base pair. But some times mutations mean to mutate with evolution and certain function. The former mutations are simple but the latter mutations have huge mystery that is hard to explain.

"Substances that cause DNA mutations are known as mutagens, and mutagens that cause cancers are known as carcinogens."

In above sentence, I also have a doubt in statistics. There are too many cancer patients to say cancer cell is mutation cell.

Some cancer is virus based cancer. But other cancer is spontaneous cancer. And spontaneous cancer have short telomere(1) at last in this article and HeLa(HPV-18 positive cell line, virus based cancer) have long telomere(another virus based cancer have short telomere, it means that virus based cancer have no relation to the lenght of telomere).

"These two sentences seem to contradict eachother."

In above sentence, I agree your opinion. Some cancer cell have detectable mutation part. It means that some other cancer have not detectable mutation part. This is just guess but perhaps spontaneous cancer is not mutation cell.

Following is not proved and It is just a doubtful guess. But it's not swindle from a dishonest motive

Spontaneous cancers without any virus positive are maybe Programed Life Death(PLD) for generation shift. Human gene programed senescence and death as the process of generation shift. But some old man(The meaning of short telomere is old) doesn't concede his right to the next generations. So gene let him surrender his right to the next generations and die with induced tumor. In the wild, old animal get hunger so easily because of its weak power. But human's hunger doesn't depend on his or her physical power. Above tells about the ingestion of enough calories and the cancer formation

Short telomere have strong relation to spontaneous cancers at last in this article(1, full text of this article is free. Before read this article, you have to know that HeLa is HPV-18 positive cell line in other word virus based cancer) Above tells about the short telomere and the cancer formation

So perhaps the short telomere and the ingestion of enough calories are the key to cancer rise as a PLD. Cancer formation may be induced when somatic cells which have short telomere are exposed to urge to divide themselves. And virus negative cancer cell may divides itself without any lost of telomere length.

P.s

"Most cancer cells starve(die) and 4% of survived cells induce KRAS Pathway Mutations in 9mg/dl glucose(In To Maintaining Low Blood Sugar as a New Cancer Treatment, this writing exists just above in this pase)"

In above sentence, "KRAS Pathway Mutations" means the evolution for more intake of sugar and survival

some threat of life causes corresponding mutations(evolution) rarely. In other word, "KRAS Pathway Mutations" mean 0.5mM(9mg/dl) glucose is pretty strong threat for cancer cells.


REFERENCES


1.de Lange T, L Shiue, R M myers, et al: Structure and variability of human chromosome ends. Molecular and Cellular Biology 10:518-527, 1990

Evilstriver (talk) 04:19, 25 September 2009 (UTC)

Proposed update to prostate cancer study

The following text currently exists under "Prevention" > "Diet":

A 2005 secondary prevention study showed that consumption of a plant-based diet and lifestyle changes resulted in a reduction in cancer markers in a group of men with prostate cancer who were using no conventional treatments at the time.[53]

I would like to replace with the following text:

A 2005 secondary prevention study published in the Journal of Urology by Dr. Dean Ornish, showed that a year long "intensive lifestyle change" consisting of a vegan diet, aerobic exercise, stress management and weekly group therapy resulted in a 4% reduction in PSA levels with no patients having to leave the study for conventional treatment due to disease progression. In contrast, the control group for this study experienced a 6% increase in PSA levels with 6 patients having to leave the study for conventional treatment due to disease progression. [53]

--Thomas.vandenbroeck (talk) 03:53, 29 September 2009 (UTC)

I have an update to my original proposal text, here it is...

A 2005 secondary prevention study on prostate cancer published by Dr. Dean Ornish, showed that a year long "intensive lifestyle change" consisting of a vegan diet, aerobic exercise, stress management and weekly group therapy resulted in a 4% reduction in PSA levels with no patients having to leave the study due to disease progression. In contrast, the control group for this study experienced a 6% increase in PSA levels with 6 patients having to leave the study for conventional treatment due to disease progression.(footnote)

--Thomas.vandenbroeck (talk) 15:10, 1 October 2009 (UTC)

This is a single study, not a reliable source. Not currently. JFW | T@lk 19:40, 1 October 2009 (UTC)

Yes it is a single study, from a very reliable source: "The Journal of Urology" http://www.jurology.com/
--Thomas.vandenbroeck (talk) 23:42, 1 October 2009 (UTC)

http://it.wikipedia.org/wiki/Tumore--Baboz (talk) 09:07, 1 October 2009 (UTC)

Nope, different concept. JFW | T@lk 19:40, 1 October 2009 (UTC)

Proposal to include involuntary exposure to chemical contaminants in the Causes of Cancer section and in the Prevention Section

Cancer is predominately an environmental rather than a genetic disease. The geneticists interpretation of the environment includes lifestyle factors. However, there is a growing body of scientific opinion that postulates involuntary (non-lifestyle)exposure to environmental contaminants such as persistent organic pollutants, xenoestogens and other endocrine disrupting chemicals, may be implicated in the increased incidence of cancer over the past half century. It seems the evidence of involuntary exposure to these chemicals is a neglected topic in this article. So are the internal links to NGOs and Charities, that are concerned with primary prevention by promoting reduction of human exposure to these chemicals. The new EU REACH regulations show that there is concern, so does the myriad of epidemiological, toxicological, in vivo and in vitro studies. --Scottishscouser (talk) 09:56, 24 October 2009 (UTC)

The section on causes includes, as its very first subsection, chemical carcinogens. Coverage is comparable to the other listed causes of cancer and in most cases is more detailed. For further detail there is a linked article specifically about carcinogens. If you're suggesting that carcinogens require greater coverage within this article then you'll need to provide some solid rationale for this, for example demonstrating that chemical carcinogens are of greater significance relative to the other causes than is suggested by the current coverage. I also note that you are the originator of the article on the charity you mention. If you're associated with that charity and attempting to further their agenda, whoever noble or correct, you may be pushing the boundaries of Wikipedia's policies on neutrality/conflict of interest etc. Please have a look at the policy for guidance on this.DoktorDec (talk) 11:34, 25 October 2009 (UTC)

One thing I am not doing is trying to push an agenda, I am a research scientist interested in cancer prevention. Primary prevention of cancer seems to be an important topic and I am looking at things objectively. I understand that chemicals are covered in the carcinogenic section, however, the involuntary exposure to such chemicals in everyday products to my mind is not covered as well as it might be. I have no agenda, I just feel everything should be covered, which may contribute to the complex multifactoral disease of cancer. --Scottishscouser (talk) 09:19, 27 October 2009 (UTC)

Perhaps the place for such material would be the dedicated article on carcinogens, with a mention of some sort here. You'd need to give good primary sources, peer-reviewed of course, and you'd need to bear in mind that Wikipedia should at all times reflect the scientific consensus, whether you agree with the consensus or not. Good luck. DoktorDec (talk) 17:32, 29 October 2009 (UTC)

Vaccines

The section regarding the use of vaccines gardasil and the percentage of cancer cases caused by HPV has no reference. On the top of that it doesn't cite any of the deaths and serious damages that this vaccine has caused. —Preceding unsigned comment added by 194.74.151.201 (talk) 16:09, 11 November 2009 (UTC)

Do you mean it has caused deaths and serious damages? Perhaps you could produce a reference for that claim rather than expecting us to find it? JFW | T@lk 21:13, 11 November 2009 (UTC)

Censorishness

This probably sound silly, alright, but am I the only person who is bothered by the picture inserts? I can't really focus on the article with tumors hanging on the edge of my sight. Is there any way at all to make the pictures 'click to see' or anything like that, seeing as how there's already video inserts? --Too lazy to sign in. —Preceding unsigned comment added by 156.108.164.67 (talk) 19:00, 14 October 2009 (UTC)

WP:NOTCENSORED. JFW | T@lk 19:29, 14 October 2009 (UTC)

I wouldn't call it 'censoring', but rather a prudent decision of what imagery is necessary to illustrate the article, and what is merely cosmetic and, for some readers, off-putting. I'd suggest leaving at least one image of a tumour if it serves an informative purpose, and moving the other images to a gallery. Tczuel (talk) 05:47, 16 December 2009 (UTC)

Agree we T the current placement is strange since most of the pictures have nothing to do with the section they are in. Doc James (talk · contribs · email) 16:03, 16 December 2009 (UTC)

Propose split out section Cancer treatment to New article

The area of cancer treatment is quite a rich, active area and I think deserving of its own page. This would make page link construction from other articles easier and would allow for growth without weighing down the main cancer article (now at 122kb -- within the range that is indicative of a need to split). The treatment section is perhaps the largest section of the article, so is a good candidate for splitting out. Thoughts? SteveChervitzTrutane (talk) 07:08, 15 August 2009 (UTC)

Nope. That is why we have a main cancer article: to direct to subarticles. Another subarticle is a diversion. Rather, we should trim down the content on individual modalities and put that directly in the subarticles. JFW | T@lk 23:40, 15 August 2009 (UTC)
I'm fine with trimming. The sub-sections containing main page links could be boiled down further or made even more compact with a list like this. Any preference? SteveChervitzTrutane (talk) 07:09, 17 August 2009 (UTC)
I agree with the first post, the cancer page is already long (though I have nothing against being long) so I think the treatment page should be written as a new one and just have a link there. That way there would be less problem for people with slower internet connection too. The idea of making it something like that philosophy thing is also very acceptable. —Preceding unsigned comment added by 89.106.10.10 (talk) 06:35, 3 October 2009 (UTC)
I think that this is a good idea. It would trim the artice in a useful place, and create potentail for another much-coveted good page. We could keep a summary here, and also add a main article link.Lukefan3 (talk) 18:16, 9 October 2009 (UTC)

The cancer treatment content was moved to the Management of cancer article, created on 14 Nov 2009 by Jmh649 (thanks!). I just fixed the Cancer treatment redirect to point there (which, IMHO, would be a better name for that article). SteveChervitzTrutane (talk) 08:45, 5 January 2010 (UTC)

I prefer management but that is just me. It is more encompassing as often the end result is death with confort measures an important part.Doc James (talk · contribs · email) 10:53, 7 January 2010 (UTC)

Plagiarism

I find one article plagiarize my own idea. what shall I have to do? Please help me. the artcle is Seyfried BT, Kiebish M, Marsh J, Mukherjee P. Targeting energy metabolism in brain cancer through calorie restriction and the ketogenic diet. J Can Res Ther [serial online] 2009 [cited 2010 Jan 7];5:7-15. Available from: http://www.cancerjournal.net/text.asp?2009/5/9/7/55134

Targeting energy metabolism in brain cancer through calorie restriction and the ketogenic diet. above was Targeting energy metabolism in brain cancer: Review and hypothesis. but now they copy my idea and title were changed Targeting energy metabolism in brain cancer through calorie restriction and the ketogenic diet.

Seyfried TN, Mukherjee P. Targeting energy metabolism in brain cancer: Review and hypothesis. Nutr Metab (Lond) 2005;2:30.

the evidence of the Plagiarism is following

http://www.ireport.com/docs/DOC-294051 and http://eviltocancer.blogspot.com/2010/01/evidence.html

I sent my idea to ACS and NCI and etc. my e-mail is evilstriver@hanmail.net

Do not understand what you are getting at? Doc James (talk · contribs · email) 13:24, 8 January 2010 (UTC)

About Plagiarism problem

"Healthy Diet, Exercise Might Lower Chances of Cancer's Return (http://www.healthyontario.com/NewsItemDetails.aspx?newsitem_id=220)" In above news, tell us some fact that can be explained also by malnutrition. 'Vegetarian diet cause lower chances of cancer's return for only few years.'(In news) Vegetarian diet has low calories and it cause slight malnutrition but as the time flows, human body can be adapted for vegetarian diet. So, after adaptation for vegetarian diet, there is no malnutrition. Therefore, there is no reason for lower chances of cancer's return after adaptation. I think that the growth of cancer may depends on the blood-sugar level and the length of the time of enough blood-sugar level(Additionaly, the position of cancer and the size of tumor mass of cancer) like Photoperiodism(5th, 6th).

(In my writing)


Conclusions

We provide information on a new, alternative approach to brain cancer management using calorically restricted diets. The objective of this new therapeutic approach is to change the metabolic environment of the tumor and the host. Only those cells with a normal flexible genome, honed through millions of years of environmental forcing and variability selection, are expected to survive extreme shifts in metabolic environment.

In the common nature, cancer has no advantage and just absorbs the sugar from blood like a normal cell. But, generally, cancer absorbs much more sugar than normal cell does. Unfortunately, but actuality it means 'fortunately' for human beings, it can't be elucidated by cancer's absorbing ability. cancer has absorbing ability just like a normal cell has. Because normal cell and cancer are perfectly same cells like twins except few point. It's the problem of tendency but not the problem of competence. Cancer is not stronger than normal cells. Normal cell has a tendency to absorb sugar properly when it is necessary to maintain itself. But cancer absorb sugar as much as possible as it consumes much sugar for the segmentation and the growth. Normal cell can control itself in poor environment but cancer can not(cancer includes 'can', why can not? why it isn't can 'cer'? "......" it just a joke, sorry.). It's the important difference between cancer and normal cell. This difference may be the reason of miracle that the cancer get destroyed.

(In the article)

focus on the calories of diets and the blood-sugar level is my idea.


I want to focus on Plagiarism problem in this article.

my idea was exposed in 10 july 2009

That is why I said "I want to focus on Plagiarism problem in this article."


evidence link; http://www.ireport.com/docs/DOC-294051

http://eviltocancer.blogspot.com/2010/01/evidence.html (I sent mail(about http://www.ireport.com/docs/DOC-294051) to ACS or ect

Not evindence but same idea in case study;

http://1.bp.blogspot.com/_Y8ZdBDqqKeE/S0hFv65_H-I/AAAAAAAAAEA/rIrHZNuFzzg/s1600-h/K-2.png

Not evindence but same idea;

http://eviltocancer.blogspot.com/2009/09/hypoglycemia-and-cancer-tumorto.html

http://eviltocancer.blogspot.com/2009/10/alternative-cancer-treatments.html —Preceding unsigned comment added by 211.118.216.101 (talk) 09:29, 9 January 2010 (UTC)

Sorry I still have no idea what you are getting at. Please show me the block of wikitext that is plagiarized and I shall reword it for you. Ideas of course are not copyrightable. Thanks Doc James (talk · contribs · email) 10:11, 9 January 2010 (UTC)

Non cut-burn-and-poison cancer remedies

Bill Henderson's book and e-book 'Cancer-Free' describes and gives leads to hundreds of methods of authenticated cancer-cure without surgery, radiation-treatment or chemotherapy, and may be seen at http://www.booklocker.com/books/2929.html .

The primary underlying method is the correction of the unhealthy diet and way-of-life that originally gave rise to the condition, together with inexpensive supplementary diet to halt the development and metastasis of such tumours.

I will add that I am not Henderson.

Absolutelyamazin (talk) 10:22, 8 February 2010 (UTC)

Not a reliable source. No real evidence for this claims.Doc James (talk · contribs · email) 10:27, 8 February 2010 (UTC)

This article is cited by the Royal Rife article

The Royal Rife wiki article cites this article in order to make the claim that only about 15% of cancers are caused by microbes, viruses, parasites, and fungi, however, I just watched an infomercial with 20/20's Hugh Downs and Health Editor Arthur P. Johnson about Bottom Line's "Ultimate Healing" book.

In that ad a professor of medicine at Stanford University Medical School named Dr. Julie Parsonnet says that "after smoking, the number 2 cause of cancer is microbes, viruses, and so on (infections)."

This means that if a person does not smoke, nor hang around in smokey places, nor hang around sources of radioactive particle decay, the number one cause of cancer / malignancy is infections.

According to Google searches this doctor has written articles and books outlining this theme including the book "Find Microbes and Malignancy." She has also a Standford University Med School newsletter article outlining exactly the same claim that she makes in the book's infomercial.

In addition, the 2004 source cited in this cancer article says that up to 20% of cancers are caused by the pathogens of their study, and listed in their abstract. The second source from 1991 is the one that states the lesser number of 15%. The 2004 study also says "For some malignancies the viral agent appears to serve as a co-factor (Burkitt's lymphoma-EBV; mesothelioma - SV(40))." SV40 is a common monkey virus that contaminates vaccines so cultured, and has been well publicized by Dr. Len Horowitz in his various books, lectures, and video presentations--other authors and critics of the World Health Organization's disease control also mention this vaccine contamination virus as the source of much illness.

Also, is not the older 1991 cited reference prior to the awarding of the Nobel prize regarding the H. Pylori bacteria linking it to stomach troubles like ulcers?

Can someone please make two lists ranking the raw numbers of the top causes of cancer? -- one that would include and the other exclude easy to avoid sources like radioactive particle emissions and smoking? Thanks.

A Google search of Pub Med for pleomorphic virus OR bacteria OR fungus gives over 600 hits. One claim by alternative medicine practitioners is that weaponized germ warfare agents such as brucellosis derived mycoplasmas cause much illness. A case in point the HIV AIDS virus. Most credible origin of HIV AIDS theory sources say that the pentagon and congress funded the germ warfare research that resulted in the creation of the HIV AIDS virus. That virus shuts down the immune system that normally keeps cancer in check. Could not these various sorts of sources also drive incidence of cancer cases upwards? 99.224.61.118 (talk) 10:32, 26 February 2010 (UTC)

Nothing above is both a reliable source and addresses this question. I will look for some evidence when I have time.Doc James (talk · contribs · email) 21:01, 26 February 2010 (UTC)

Warburg effect In oncology

Otto Warburg won the nobel prize with this warburg effect?

In oncology, the Warburg effect is the observation that most cancer cells predominantly produce energy by a high rate of glycolysis followed by lactic acid fermentation in the cytosol, rather than by a comparatively low rate of glycolysis followed by oxidation of pyruvate in mitochondria like most normal cells. The latter process is aerobic (uses oxygen). Malignant rapidly-growing tumor cells typically have glycolytic rates that are up to 200 times higher than those of their normal tissues of origin; this occurs even if oxygen is plentiful.(In wiki)

Warburg effect is a lie

What is the plentiful oxygen?

Oxygens are shortage material in fast respiration.

The reason of Warburg effect is just the shortage of Oxygens.


I have direct evidence that the Warburg effect is wrong. The Warburg effect can not occur if oxygen is plentiful. But the plentiful oxygen means above 96mg/dl(30mM or 960ppm) glucose in 90mg/dl blood sugar level.


Electron transport chain in Mitochondria 24H + 6O2(oxygen) → 6H2O(water) + 34ATP

A glucose needs 6O2(oxygen) for aerobic respiration

180g/mol(glucose) ÷ 32g/mol(oxygen) = 5.625

5.625 : 1 × 6 = 5.625 : 6

So for fully aerobic respiration, 96mg/dl(30mM) O2(oxygen) is essentiality in 90mg/dl(5mM) glucose.

Dissolved oxygen of clean warter is about 7ppm to 14ppm. average blood sugar level of normal people is above 900ppm(90mg/dl)

I don't know how high but I'm sure Dissolved oxygen of host can not reach even 500ppm in 760 mmHg —Preceding unsigned comment added by 61.81.78.62 (talk) 20:02, 6 March 2010 (UTC)

External link to "Google - public data"

I propose the addition of an external link to "Google - public data" as follows.

[I will watch this page for any reply. -- Wavelength (talk) 05:00, 22 May 2010 (UTC)]

Why, does the rest of the world not count? JFW | T@lk 22:39, 22 May 2010 (UTC)

Vitamin D

Looking at the following statement "Low levels of vitamin D is correlated with increased cancer risk.[68][69]" Artical 69 states that Vitamin D is related to a decreased risk of cancer, why is this not mentioned? and why is it cited supporting a statement saying it is associated with increased risk of cancer?

Wildinc (talk) 10:49, 28 May 2010 (UTC) [1]

Perhaps "abnormally low" was intended. JFW | T@lk 07:56, 31 May 2010 (UTC)

Wikipedia Accurate But Poorly Written

Well there you have it.[4]. Good work. Sort of. --Harac (talk) 21:25, 3 June 2010 (UTC)

The origin of spontaneous(virus negative) cancer

Titia de Lange discovered that most cancer cells have short telomeres except for HeLa(virus positive cancer) cell line.

Some scientists already succeeded in making artificial(virus negative) cancer cell without any gene manipulations.

Spontaneous(virus negative) cancers must have strong connection with short telomeres.

When the telomere length of normal cells is reached critically short level, most cells die. But, in low chance, Some cells become cancer cells.

Proliferation in normal cells is caused by dead cells. When normal cell die, living cell have to replace dead cell with living cell. This is why proliferation is caused by dead cells.

When senescence cells which have critically short telomeres are in the strong pressure of proliferation, there is a risk of spontaneous cancer.

Spontaneous cancer is maybe programed life(or host) death by gene for old folks. old folks are not needed in breeding.

So gene maybe programed some diseases related with senescence, like a spontaneous cancer, for to reduce waste of limited provisions resources


reference : http://www.genethik.de/telomerase.htm ; The Cancer Connection ; Scientific American, 2/96, Carol W. Greider, Elizabeth H. Blackburn, page 92

'The teams had induced normal cells from humans to make a viral protein causing cells to ignore the alarm signals that usually warn them to stop dividing. The treated cells continued to proliferate long after they would normally enter senescence. In most of the cells,......; eventually death ensued. Some cells, however, persisted after their siblings died and became immortal.'


'Studies by Greider's, Bacchetri's and Harley's laboratories explained why the telomeres were so small. The teams had induced normal cells from humans to make a viral protein causing cells to ignore the alarm signals that usually warn them to stop dividing. The treated cells continued to proliferate long after they would normally enter senescence. In most of the cells, telomeres shortened drastically, and no telomerase was detected; eventually death ensued. Some cells, however, persisted after their siblings died and became immortal. In these immortal survivors, telomeres were maintained at a strikingly short length, and telomerase was present. These outcomes imply that telomeres in cancer cells are small because cells synthesize telomerase only after they have already begun to replicate uncontrollably; by then, the cells have presumably lost a substantial number of telomeric subunits. When the enzyme is finally activated, it stabilizes the severely clipped telomeres, allowing overly prolific cells to become immortal.'


'Even before such evidence was obtained, however, researchers had begun exploring some of the details of how telomerase might contribute to cancer. That work suggests telomerase probably becomes active after a cell has already lost its brakes on proliferation. The first clue was an initially mystifying discovery made independently by Titia de Lange, now at the Rockefeller University, and by Hasrie's group. In 1990 these investigators reported that telomeres in human tumors were shorter than telomeres in the normal surrounding tissue-sometimes dramatically so. Studies by Greider's, Bacchetri's and Harley's laboratories explained why the telomeres were so small. The teams had induced normal cells from humans to make a viral protein causing cells to ignore the alarm signals that usually warn them to stop dividing. The treated cells continued to proliferate long after they would normally enter senescence. In most of the cells, telomeres shortened drastically, and no telomerase was detected; eventually death ensued. Some cells, however, persisted after their siblings died and became immortal. In these immortal survivors, telomeres were maintained at a strikingly short length, and telomerase was present. These outcomes imply that telomeres in cancer cells are small because cells synthesize telomerase only after they have already begun to replicate uncontrollably; by then, the cells have presumably lost a substantial number of telomeric subunits. When the enzyme is finally activated, it stabilizes the severely clipped telomeres, allowing overly prolific cells to become immortal. These findings and others have led to an attractive but still hypothetical model for the normal and malignant activation of telomerase by the human body. According to this model, telomerase is made routinely by cells of the germ line in the developing embryo. Once the body is fully formed, however, telomerase is repressed in many somatic cells, and telomeres shorten as such cells reproduce. When telomeres decline to a threshold level, a signal is emitted that prevents the cells from dividing further. If, however, cancer-promoting genetic mutations block issuance of such safety signals or allow cells to ignore them, cells will bypass normal senescence and continue to divide. They will also presumably continue to lose telomeric sequences and to undergo chromosomal alterations that allow further, possibly carcinogenic mutations to arise. When telomeres are completely or almost completely lost, cells may reach a point at which they crash and die. But if the genetic derangements of the pre-crisis period lead to the manufacture of telomerase, cells will not completely lose their telomeres. Instead the shortened telomeres will be rescued and maintained. In this way, the genetically disturbed cells will gain the immortality characteristic of cancer. This scenario has generally been borne out by the evidence, although, once again, things may not be entirely as they seem. Some advanced tumors lack telomerase, and some somatic cells-notably the white blood cells known as macrophages and lymphocytes-have recently been found to make the enzyme. Nevertheless, on balance, the collected evidence suggests that many tumor cells require telomerase in order to divide indefinitely.'

http://www.genethik.de/telomerase.htm —Preceding unsigned comment added by 61.81.60.233 (talk) 01:40, 14 June 2010 (UTC)

Funny story within misinterpretation

They aleady discovered the cause of spontaneous cancer. But unfortunately, they can not notice that critically short telomeres and strong pressures of proliferation is the real reason of spontaneous(virus negative) cancer.

I guess, this is because no one knows that HeLa,have very long telomeres, is a virus positive cancer.

If HeLa is a spontaneous(virus negative) cancer, who can notice the connection between short telomeres and cancer against the HeLa of long telomeres except for me?

Beside, they already had a preconception that a telomerase is the cause of cancer, not the short telomere.

maybe, It never ever had been noticed that critically short telomeres and strong pressures of proliferation is the real reason of spontaneous(virus negative) cancer before I informed it?? —Preceding unsigned comment added by 61.81.101.165 (talk) 12:02, 18 June 2010 (UTC)

Very impressive emotions from the Information of the truth

Archived per WP:TALK, disusccion unreated to improving the article.
The following discussion has been closed. Please do not modify it.

jn.nutrition.org/cgi/reprint/119/2/286.pdf

http://www.ncbi.nlm.nih.gov/pubmed/2493082

Above article is a bible for a cancer patients.

Avove Data in the article tell us "Calorie restriction is not only good for cancer prevention but also good for a inhibition of a cancer growth"

Above article is Very impressive Information that we must have to know.

What made us(ordinary people) have been isolated from this Data from the article?? —Preceding unsigned comment added by 61.81.101.8 (talk) 13:24, 15 August 2010 (UTC)

Great, it works in rats. Any evidence it might apply to humans also? JFW | T@lk 16:44, 15 August 2010 (UTC)
Sadly,in vitro evidence is only. like http://www.sciencedaily.com/releases/2009/12/091217183053.htm In the statistics, obesity people's cancer tumors are more harmful and obesity people have higher cancer recurrence rate than cancer recurrence rate common people. I think it is a roundabout evidence for human. It is because obesity people must eat much calorie per meal, at once, per day. http://www.cancer.gov/cancertopics/factsheet/Risk/obesity
This cannot be included until there is reliable evidence in humans. JFW | T@lk 19:43, 16 August 2010 (UTC)
I wonder who want the evidence in humans? No one want the evidence at least in riches. Above article is very old thing but no one want the evidence in human for above 30 years.. the generation time of human cancer cell is just 18.6 hours in the best environment. But the generation time of a tumor in a human's body is much more long than 18.6 hours. The only different between a culture medium and a human body is just amount of energy supplies(ex;nutrient,oxygen). I just feel the pity about poor cancer patients who'll never know about this factor —Preceding unsigned comment added by 61.81.60.176 (talk) 11:13, 17 August 2010 (UTC)
There are plenty of phenomena originally described in animals that could not be reproduced in people. Cancer patients often have a poor nutritional status due to loss of appetite, side effects of treatment, and other problems. To suggest that they should starve themselves on the basis of animal studies is frankly nonsense. Please return when human studies have been conducted. JFW | T@lk 19:42, 17 August 2010 (UTC)
A poor nutritional status means what? About 0.3% of human muscle is replaced per day. And chemo destroys all separating cells including muscle cells. That mean 0.6%(0.3% is natural elimination and other 0.3% is chemical destruction) 0f muscle will be reduced per day during chemo. The lost of flesh is not the evidence of any poor nutritional status. I know a son of some patient in internet cafe about lung cancer communication for patient's family. The son's mother failed chemo and the mother's diet is just five spoon of boiled unpolished rice and cereals of water mixed, three spoon of soybean paste and 4~5 tea spoon of blended vegetables per meal is all. He said that she can eat more if she eat more, she suffer from diarrhea and her cough is getting serious. And he said that her blood sugar level is above 130mg/dl 30 minutes after the diet. What is the poor nutritional status? Above 130mg/dl after meal is the poor nutritional status? 130mg/dl is very normal. The loss of appetite can be one reason of The lost of flesh but many cancer patients have other majority reason of the lost of flesh. The reason is chemo. Chemo destroys all of every growing tissues. Who can get fat with chemo? The lost of 0.6% muscle per day is the lost of about 50% muscle per 115days at compound interest. Lost of muscle is one of majority cause of diabetes. I think the loss of appetite is the only reason that chemo extends the mean life span of cancer patients. But after muscle is reduced, the effect of the loss of appetite can not work since the muscle of host can not lower blood sugar level enough with a same calorie(diet) intake. I think that chemo is very funny idea. Every doctors try to chemo even if there a no growth of tumor. Tumor with no growth dose not need chemo since chemo can not eliminate the tumor completely. Actually chemo can eliminate the tumor completely olny if it does not matter that the host is killed by chemo. After chemo, there are no more chemo for 1~2weeks. Fast growing tumor can recover and can grow bigger than before chemo within 1~2weeks. I wonder what is the meaning of chemo? perhaps, It is the loss of appetite, side effects of treatment?? I feel so pity for poor cancer patients. cancer growing speed depends on nutritional supplies. There no doubt, the dependence on nutrition is aready measured for to find the best condition of a culture medium for cancer. Cancer cells in a host are much more bad condition than a culture medium. Cancer cells in a culture medium gain nutrition from surrounding liquid but cancer cells in a human body have to gain nutrition from vessels only. the URL is a same point of view http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1869874/ If intratumor microvessel density is high, nutritional supplies will become much amount. I think this is very meaningless talk because only few people will read this.. —Preceding unsigned comment added by 61.81.60.176 (talk) 07:37, 18 August 2010 (UTC)

WP:TLDR. JFW | T@lk 09:02, 18 August 2010 (UTC)

In short, I didn't said that they have to starve during the very funny chemo injection and there are no evidence of the poor nutritional status beside they look like mummies whose muscle is destroyed by chemo treatment. Chemo destroys all of growing tissue. So they can not be fat people but only some kind of mummy is allowed to become for them since chemo is a diluted very strong poison. To say that '130 mg/dl of patients of mummy shape is the evidence of a malnutrition' is frankly nonsense. 130 mg/dl = blood sugar level
You said 'To suggest that they should starve themselves on the basis of animal studies is frankly nonsense.' —Preceding unsigned comment added by 61.81.78.50 (talk) 16:18, 18 August 2010 (UTC)

The bottom line is, chemo has been shown to work in clinical trials involving real humans. Your theories are exactly that, theories based on your personal understanding of nutrition and cancer cell biology. I doubt your views are presently going to lead to a change in this article, and therefore I will not respond further. JFW | T@lk 16:45, 18 August 2010 (UTC)

The Cure

Archived per WP:TALK, disusccion unreated to improving the article.
The following discussion has been closed. Please do not modify it.

Hemp oil cures cancer. See the documentary Run from the Cure. —Preceding unsigned comment added by 67.51.153.238 (talk) 23:17, 30 July 2010 (UTC)

Yep. And pigs fly. JFW | T@lk 21:23, 31 July 2010 (UTC)

No JFW WOLFF, are you a crazies,

I believe that if the person sais HEMP OIL worked then i belive them, just like the HOXSEY CLINIC treatment cures cancer!!!!! and my friend and some other people i know, have been cured from HOXSEY treatment in MEXICO and there's a good reason why it is not in the UNITED STATES. It was banned from USA becuase then Chemo and Radiation wouldnt be much of a business right!!! if this is a free country then let them be here, but no, just like Marijuana can be maid of so many useful needed things, they banned it and lets make the rich richer and let them sell cigarretes... well United Stated is the best but corrupt in those political lawful ways...! Anyways.. hope someone reads this..and Id like opinions. —Preceding unsigned comment added by 63.95.246.178 (talk) 13:44, 10 August 2010 (UTC)

Now if the proponents of flying pig treatments had the brains to conduct proper clinical trials, the adherents of mainstream medicine would readily adopt them. To conduct a clinical trial requires a fair amount of effort, but if you are really convinced your treatment works that shouldn't be too difficult. Contrary to your claims, many alternative treatments also have very high stakes for commercial companies, but they bank on a certain contrariness (or disappointment with mainstream treatments) in their customers. In my mind, it is unethical to promote a treatment with no evidence of effectiveness - how do you know the remissions induced by the treatments you support are not spontaneous? And how strong is the proof that remissions in fact occurred? I will not respond to further posts, because they are not directly connected to the article and therefore against WP:TALK, but you need to understand why your position has opposition. JFW | T@lk 18:09, 10 August 2010 (UTC)

Edit request from 76.21.125.60, 24 June 2010

{{editsemiprotected}} you incorrectly stated that ductal carcinoma of the breast is so-called because the shape of the cell has the appearance of the duct. This is wrong. There are two types of breast cancer, ductal (the more common), which is located in the breast duct, and lobular, which is located in the breast gland. This can be verified in Dr. Susan Love's "The Breast Book".

76.21.125.60 (talk) 21:30, 24 June 2010 (UTC)

Can you provide a page number and/or direct quote for that? Avicennasis @ 07:28, 26 June 2010 (UTC)
That's an unreliable source. —Preceding unsigned comment added by 128.252.16.235 (talk) 20:44, 30 June 2010 (UTC)

I'd like to see a source for the current statement about cell shapes, since this statements contradicts the common way of naming cancers by the organ they appear in. Please note that ductal carcinomas are located in ducts - is this just a coincidence? Gon-no-suke (talk) 23:52, 20 October 2010 (UTC)

Merger proposal carcinogenesis and oncogenesis

Merger of these 2 articles has been proposed, discuss here. Richiez (talk) 13:58, 18 September 2010 (UTC)

Edit request

{{editsemiprotected}} On the following grounds the text "It is estimated that 2% of future cancers will be due to current CT scans." under the section "Ionizing radiation" an edit is requested:

1) The interval "future" is unspecified. Hence the value of 2% cannot be related to a number of cancers.

2) The report concerned US alone. Not the whole world.

3) The report concerned CT scans performed during the year of 2007. The wording "current" is inaccurate.

Suggested wording: One report estimates that approximately 29 000 future cancers could be related to the approximately 70 million CT scans performed in the US in 2007. 85.225.243.35 (talk) 22:01, 16 August 2010 (UTC)


Edited. Thanks for pointing that out! — Guillaume Pelletier ~ 22:22, 9 November 2010 (UTC)
One should read the entire source. The source also states that future cancers based on current CT usage maybe as high as 2%. I have clarified this. The review also comments on the UK. Yes it is true that world data is not being referred too. So yes thanks. --Doc James (talk · contribs · email) 23:10, 9 November 2010 (UTC)

I added immunotherapy as another treatment option (provenge). I also added radon as a cancer causing condition (21,000 deaths a year) I mentioned the 2 cancer prevention vaccines HPV and HVB in the front of prevention. I also referenced that they were covered under a seperate section. I also added the (HPV) and (HVB) abreviations. I also added an explaination of epitopes after the use of that word. Bgordski (talk) 07:18, 12 November 2010 (UTC)

Yes radon causes cancer but this is via radiation thus no need to restate. If one wishes the defination of epitopes they can click the link. Immunotherapy is not typically used as far as I am aware. I guess if there is a ref that says it is we can readded it.Doc James (talk · contribs · email) 02:15, 18 November 2010 (UTC)

Error in History

From discussions with people off Wikipedia and reading of reference 96 I think the sentence "He called benign tumours oncos, Greek for swelling, and malignant tumours carcinos, Greek for crab or crayfish. This name comes from the appearance of the cut surface of a solid malignant tumour, with "the veins stretched on all sides as the animal the crab has its feet, whence it derives its name"." Refers to Galen not Hippocrates as the paragraph implies so I'm going to correct this.Donhoraldo (talk) 15:15, 4 November 2010 (UTC)

Cancer patients suffer from all around of muscle loss by chemo

About 0.3% of all muscle is replaced by new separating muscle cells per day. Chemo is very famous for every separating cell killer like cis-platin. There are no doubt that after natural elimination of 0.3% muscle, 0.3% of new separating muscle cells will be get critical damage by a chemical attack. So about 0.6% of all muscle will be reduced per day during the chemo injection. Chemo injection makes a mere skeleton of a cancer patient about 1~2 years after periodical chemo injection. If It was a result of malnutrition, why the enough eating people turn into mere skeleton? Like this?—Preceding unsigned comment added by 61.81.101.60 (talk) 01:07, 19 August 2010 (UTC)

Please see WP:TALK. This is not a forum, nor an obituary page. If you continue to post these messages I shall have to remove them without discussion. JFW | T@lk 14:18, 19 August 2010 (UTC)

Not sure about entering this on the wiki page but can expand on the above re:.3% muscle loss. Besides death, hair loss, fingernails falling out, eyes swelling and needles needing to be inserted to drain them there is this: Mitoxantrone attacks heart muscle and has a lifetime limitation based on body surface area. Hopefully all who pass here understand why cytotoxic (chem) is rejected by 2/3 of some patients. Bgordski (talk) 02:07, 18 November 2010 (UTC)

I have no idea where you got that figure of 2/3 from. Chemotherapy should not be offered if the risks outweigh the benefits. JFW | T@lk 11:45, 18 November 2010 (UTC)

Edit Request - Fix false statement...

Under the section 'Causes' the article states:

"The virtual absence of cancerous malignancies in ancient human remains suggests that cancer is mainly a man-made disease of the Industrial Age caused by environmental changes and the modern diet.[6]"

The statement is false. The document this statement comes from, is not a reliable source of information. The document makes various false claims including the following:

"...There is nothing in the natural environment that can cause cancer. So it has to be a man-made disease, down to pollution and changes to our diet and lifestyle.”"

This is incorrect. See the Wikipedia 'Carcinogen' article:

"There are many natural carcinogens. Aflatoxin B1, which is produced by the fungus Aspergillus flavus growing on stored grains, nuts and peanut butter, is an example of a potent, naturally-occurring microbial carcinogen. Certain viruses such as Hepatitis B and human papilloma viruses have been found to cause cancer in humans." —Preceding unsigned comment added by 66.62.194.239 (talk) 18:32, 28 November 2010 (UTC)

A good point. Many viruses are ancient, particularly DNA viruses, which include those that cause cancer. "The virtual absence of cancerous malignancies in ancient human remains" could be explained by life-expectancy. Cancer is often a disease of old age. Perhaps the human remains are of relatively young people, as seen from a modern perspective? I think that a problem with WP:NPOV might be caused by citing this source. I am interested in what the regular editors of this article think about this. Graham Colm (talk) 18:44, 28 November 2010 (UTC)

Edit request, 14 October 2010

Revision 18:19, 14 October 2010 adds doubtful material on the causes of cancer from newly-published research. One of the authors claims [5] that "There is nothing in the natural environment that can cause cancer." which is manifestly untrue. There is a discussion of this paper in New Scientist [6].

The newly-added text reads:

"The virtual absence of cancerous malignancies in ancient human remains suggests that cancer is mainly a man-made disease of the Industrial Age caused by environmental changes and the modern diet."

This despite many of the most significant causes of cancer predating the Industrial Age: sunlight, alcohol, tobacco, radon, infections, aflatoxins, heterocyclic amines from cooked meats, dioxins from wood fires, ...

The added text is at odds with established consensus, as indicated in New Scientist, above, and on the website of Cancer Research UK [7], and shouldn't be accorded such prominence in the introductory paragraph of the Causes section.

—Preceding unsigned comment added by 86.133.41.99 (talk) 19:15, 14 October 2010 (UTC)

I agree completely. The text even contradicts itself since further downs it says that "viruses [are] responsible for up to 20% of human cancers worldwide", and viruses are very much a thing of nature. I propose that the discussion of this paper is deleted entirely. Gon-no-suke (talk) 23:36, 20 October 2010 (UTC)

Gon-no-suke - Agree. It is also impossible to reconcile the added text with the review article which provides the source for the immediately preceding sentence on causes of cancer.
I am not up to speed on Wikipedia policy, but this text was added on the day the newspapers carried this research, occupies quite a prominent place in the article, contradicts other more established sources and makes the article text logically inconsistent. Nevertheless it has overnight become sacrosanct as attempts to remove it have been quickly reverted.
The source is what Nature Reviews Cancer term an Opinion piece - "an opportunity to present a new or revised model or hypothesis on the basis of research data" [8].
The paper's conclusions have drawn strong criticism from the scientific and cancer research community (examples above), essentially as invalid extrapolations from a sample unrepresentative of the modern population.
Debating the merits of this paper is not the role of an encyclopedia. But what should be a concern is that it is a new hypothesis with no corroborating sources, which is at odds with consensus and which reputable commentators argue is not supported by the data.
If the new claims were true they would overturn well-established data on causes of cancer, many of which are not modern. Wikipedia policy does note that "Exceptional claims require exceptional sources", and a single outlier article - the conclusion of which depends on questionable extrapolations - doesn't come close.
It is particularly unhelpful to present confusing and contradictory text in an article such as Cancer, which lay people are going to turn to for reliable information. 86.140.61.158 (talk) 11:28, 21 October 2010 (UTC)
I think it should be noted in the article that while science does not know exactly what the genesis of cancer is, it certainly was not observed in antiquity at rates comparable to today. What is the harm in noting that? Abe Froman (talk) 02:54, 28 November 2010 (UTC)
At the time of your comment the article did note this - in the first paragraph of the Causes section. Read before editing? And this edit request was, in fact, to remove that statement as there are some serious problems with the source (among other things, discussed in the links above and elsewhere: (a) the statement contradicts other well-sourced data about known causes of cancer; (b) it was based on analysis of a small number of mummies, most of which had short lives by modern standards, and cancer *was found* even in this small sample; (c) in the press release accompanying the paper one of the authors has gone on record stating there are no carcinogens in nature, which reveals a lack of basic knowledge in the field of their paper).
As regards "What is the harm in noting that?": Cancer researchers, such as Cancer Research UK, linked above, think it is harmful as they believe the science in the paper is poor and the conclusions invalid, and that it may cause people to believe that - as an apparent byproduct of an industrialized society - they are helpless against cancer when the reality is that many cancers are caused in part by lifestyle factors that can be addressed. (Not that this is the concern of an encyclopedia - I'm just answering your question.) The concern from an encyclopedic POV is that an article shouldn't contradict itself and spread confusion when the scientific consensus is clear - this paper is not a scientifically strong enough piece of work to throw the existing consensus into question.
While I was typing this, a new edit request 'Fix false statement...' appeared at the bottom of this page and the 'offending' lines have now been hidden. I believe this is the correct editorial decision, although the two separate edit request discussions may lead to confusion. 81.129.24.110 (talk) 19:17, 28 November 2010 (UTC)
I apologise for my not paying attention and not having seen this discussion before adding my comment below. I think the text, which I hid earlier this evening, is not at all useful and not accurate, despite the reputation of the publishers of the source given it seems very biased. Graham Colm (talk) 19:45, 28 November 2010 (UTC)

In antiquity, people did not live long enough to develop cancer. JFW | T@lk 04:22, 28 November 2010 (UTC)

From what I read in the study, diseases of old age were present in the several hundred to a thousand mummies studied. What I do not understand about this discussion is this: a group of editors appear to get together and decide whether real scientists are correct or not, based on their work's sample sizes, relative reputation to other scientists, and such. Correct me if I am wrong, but isn't that the definition of the POV slanted writing that we are all trying to avoid? Abe Froman (talk) 07:06, 30 November 2010 (UTC)
Of course editors have to make decisions! Editors of an encyclopedia science article should present the consensus where a clear consensus exists. When a new paper conflicts with this consensus, the question is whether the paper is scientifically strong enough to overturn the body of evidence on which the consensus rests.
The investigative work in this paper may be sound, but the conclusion is fairly speculative (this is clear when reading the peer-reviewed paper which uses much more nuanced terms than the accompanying press release) because most of the sample were relatively young and not all cancers will be evident in remains (in bone samples, for example, they were mainly hoping to find osteosarcomas, which are rare).
Against this we have extensive statistical and lab data on causes of cancer, many of which predate the modern era, and a long historical record of cancer (we get the term 'carcinoma' from Hippocrates in the 5th century BC).
If you can point to respected cancer information sites (major cancer research charities, government health information sites, etc.) that endorse this paper in their discussions of the causes of cancer please do so.
(For a scientific paper, by the way, the author's standing relative to their peers should not be an issue. I see no mention of that. There are Nobel Laureates who've put out some batshit crazy stuff.) 81.129.24.110 (talk) 11:22, 30 November 2010 (UTC)

Pathophysiology and the "Hallmarks of cancer"

Does anyone else think it would be appropriate and more reader-friendly if the Pathophysiology section would be organized as per the 6 "Hallmarks of Cancer" ?

I think this could be preceded with an explanation on the genetic vulnerabilities that lead to manifestation of one or more of said "traditional hallmarks". If no one objects I might edit the article myself sometime Friday. — Guillaume Pelletier ~ 03:10, 1 December 2010 (UTC)

Sounds fine. JFW | T@lk 09:55, 1 December 2010 (UTC)

Other organisms

The article reads as if cancer-like diseases are exclusively human. I came to see what animals/organisms can develop uncontrolled growth of cells, but it's all about humans. Even if it were called "cancer" only within human medicine, it is clear that at least other mammals can develop tumors. I'd be bold and make changes, but I figured there might be a reason for the narrow scope. 137.146.170.88 (talk) 21:58, 7 December 2010 (UTC)

That would be great if you wished to add something about cancer in other animals or organisms. Per WP:MEDMOS this would go in a section just before the references called "In other animals" or "In other organisms" Doc James (talk · contribs · email) 23:05, 7 December 2010 (UTC)

News from Croatian Wikipedia: Neoplasm or, at Croatian, "Novotvorina"

Only attachment-link as the connection between English and Croatian Wikipedia:

http://en.wikipedia.org/wiki/Tumor

78.0.158.74 (talk) 08:29, 19 December 2010 (UTC)

Why does this matter? JFW | T@lk 13:15, 19 December 2010 (UTC)

Statistics on Cancer Research

At the bottom of this article, it states that

Despite this substantial investment, the country has seen a five percent decrease in the cancer death rate (adjusting for size and age of the population) between 1950 and 2005.

. This value is not representative of the impact of cancer research. For instance, imagine that cancer death rates did not change at all in the last 60 years, but while those who got cancer 60 years ago lived (overall, on average) five years (after diagnosis)-- while today they live (overall, on average) 25 years (after diagnosis). This would represent a huge improvement in cancer treatment, despite no change in death rates. As the years go on, mean life expectancy is moving progressively upwards and the rate of deaths per year is decreasing for most causes is decreasing. I propose that we replace this statistic with one more representative of the improvement in cancer medicine. Munkeegutz (talk) 04:52, 5 January 2011 (UTC)

Do we have a review article that states something different? Doc James (talk · contribs · email) 04:54, 5 January 2011 (UTC)
I suspect another reason that the death rate dropped so little is that cancer occurrence may have increased, not only age related. Breast cancer had a 300% hike in the last century, impact of smoking probably became much more dramatic sometimes after 1950. Richiez (talk) 13:10, 5 January 2011 (UTC)
This is a complex area, with lots of potential confounding factors... the overall death rate remains 100%... if efforts to improve heart disease, stroke, airways disease etc. are even fractionally more effective than the cancer improvements, then things continue to appear bad for statistics regarding the bigC. Lies, damn lies etc.TamePhysician (talk) 11:13, 7 January 2011 (UTC)

Edit request: The age of cellular pathology was born.

As far as I know there has been no Age (http://en.wikipedia.org/wiki/List_of_time_periods) known as the cellular pathology age. Might I also recommend replacing the "born" operative with "conception." 208.74.117.9 (talk) 17:26, 10 January 2011 (UTC)

I don't understand the second request ("The age of cellular pathology was conceived"?), and I oppose the first. There's no need for Wikipedia articles to be written in the dullest, most literal language possible. "Engaging, even brilliant" prose is a goal, not a problem. WhatamIdoing (talk) 04:43, 11 January 2011 (UTC)

Moved from article

We link complicated terms and then have a whole page on which to define them. This section seems strage and important concepts should be combined into the appropriate section.

== Glossary ==

The following closely related terms may be used to designate abnormal growths:

  • Tumor or tumour: originally, it meant any abnormal swelling, lump or mass. In current English, however, the word tumor has become synonymous with malignant neoplasm, specifically solid neoplasm. Note that some neoplasms, such as leukemia, do not form tumors.
  • Neoplasm: the scientific term to describe an abnormal proliferation of genetically altered cells. Neoplasms can be benign or malignant:
    • Malignant neoplasm or malignant tumor: synonymous with cancer in everyday speech.
    • Benign neoplasm or benign tumor: a tumor (solid neoplasm) that stops growing, does not invade other tissues and does not form metastases.
  • Invasive tumor is another synonym of cancer. The name refers to invasion of surrounding tissues.
  • Pre-malignancy, pre-cancer or non-invasive tumor: A neoplasm that is not invasive but has the potential to progress to cancer (become invasive) if left untreated. These lesions are, in order of increasing potential for cancer, atypia, dysplasia and carcinoma in situ.

The following terms can be used to describe a cancer:

  • Screening: a test done on healthy people to detect tumors before they become apparent. A mammogram is a screening test.
  • Diagnosis: the confirmation of the cancerous nature of a lump. This usually requires a biopsy or removal of the tumor by surgery, followed by examination by a pathologist.
  • Surgical excision: the removal of a tumor by a surgeon.
    • Surgical margins: the evaluation by a pathologist of the edges of the tissue removed by the surgeon to determine if the tumor was removed completely ("negative margins") or if tumor was left behind ("positive margins").
  • Grade: a number (usually on a scale of 3) established by a pathologist to describe the degree of resemblance of the tumor to the surrounding benign tissue.
  • Stage: a number (usually on a scale of 4) established by the oncologist to describe the degree of invasion of the body by the tumor.
  • Recurrence: new tumors that appear at the site of the original tumor after surgery.
  • Metastasis: new tumors that appear far from the original tumor.
  • Median survival time: a period, often measured in months or years, over which 50% of the cancer patients are expected to be alive.[2]
  • Transformation: the concept that a low-grade tumor transforms to a high-grade tumor over time. Example: Richter's transformation.
  • Chemotherapy: treatment with drugs.
  • Radiation therapy: treatment with radiations.
  • Adjuvant therapy: treatment, either chemotherapy or radiation therapy, given after surgery to kill the remaining cancer cells.
  • Neoadjuvant therapy: treatment either chemotherapy or radiation therapy, given before surgery to shrink a tumor to make its resection easier.
  • Palliative care: treatment that does other than cure the disease i.e. reduces severity of disease, relieve suffering and improves quality of life.
  • Prognosis: the probability of cure/remission after the therapy. It is usually expressed as a probability of survival five years after diagnosis. Alternatively, it can be expressed as the number of years when 50% of the patients are still alive. Both numbers are derived from statistics accumulated with hundreds of similar patients to give a Kaplan-Meier curve.
  • Cure: A cancer patient is "cured" or "in remission" if they live past the time by which 95% of treated patients live after the date of their diagnosis of cancer. This period varies among different types of cancer; for example, in the case of Hodgkin's disease this period is 10 years, whereas for Burkitt's lymphoma this period would be 1 year.[3] The phrase "cure" used in oncology is based upon the statistical concept of a median survival time and disease-free median survival time.[4]

Doc James (talk · contribs · email) 09:55, 21 December 2010 (UTC)

Should be merged with the list of cancer-related terminology that exists somewhere on Wikipedia. This paragraph itself is not encyclopedic. JFW | T@lk 01:38, 22 December 2010 (UTC)
I can't find any such list. Any guesses on its name? WhatamIdoing (talk) 18:21, 19 January 2011 (UTC)
Probably this: List of oncology-related terms. Novangelis (talk) 18:24, 19 January 2011 (UTC)

Cases vs deaths

The numbers in the lead seemed odd to me (really? We actually know what caused 95% of cases of cancer?), and a quick look at the source suggests that we have a problem. Here's what it says:

The evidence indicates that of all cancer-related deaths, almost 25–30% are due to tobacco, as many as 30–35% are linked to diet, about 15–20% are due to infections, and the remaining percentage are due to other factors like radiation, stress, physical activity, environmental pollutants etc.

We're presenting it as all cases of cancer, and they're only talking about people who died from cancer (which is only about half the cases). As a result, we're certainly overstating the role of tobacco (lung cancer) and infections (liver cancer) and understating the role of sunlight (easily cured skin cancers).

I don't have a coherent proposal for fixing this, but we need to do something about it. WhatamIdoing (talk) 05:20, 31 January 2011 (UTC)

For now, I've pulled the misleading stats. They'd probably be better off later in the article anyway. WhatamIdoing (talk) 21:29, 31 January 2011 (UTC)
Agree they are only dealing with cancer deaths. And not all cancers cause death. Doc James (talk · contribs · email) 01:10, 7 February 2011 (UTC)

Screening recommendations

The section on screening recommendations isn't working for me. First of all, it's US-specific, and there are small variations in the recommendations. Secondly, it's just kind of a data dump. I think it would be far more appropriate to discuss the how-and-why of screening than the current "answers". For example, it would be appropriate to discuss issues about harms from testing (e.g., radiation exposure), costs (time and money), the problem of false positives and false negatives, and possibly how the positive predictive value of a given positive test varies with the population being tested. I think that might be more educational than "here's the current schedule". WhatamIdoing (talk) 01:09, 21 January 2011 (UTC)

I concur. For me, the first thing that pops to mind with worldwide cancer screening recommendations is comparing Japan and the U.S. for gastrointestinal screening. In Japan, they screen for stomach cancer the way the U.S. screens for colon cancer because that's what the cost-to-benefit ratio supports. I don't have any handy sources, but I can certainly come up with something. (Endoscopy wasn't even listed in the general discussion, although two forms were in the U.S. details.) I've been thinking that "Signs and symptoms", "Screening" and "Diagnosis" should be grouped together in some logical arrangement (but without formal grouping) for "identifying that cancer is present". I'd put it after "Pathophysiology" and "Epidemiology", but I don't know that my instincts represent the general readership's interest. Similarly, I'd put "Prognosis" just in front of "Society and culture".Novangelis (talk) 04:07, 21 January 2011 (UTC)
Well, it's undersourced (despite being entirely verifiable), but what do you think of my change? Please feel free to improve it.
I cited the historic 1968 paper partly because I could. Some things don't change much, and its principles are still used, often word-for-word (e.g., [9]). WhatamIdoing (talk) 23:18, 26 January 2011 (UTC)
I do not really like all the bold. What is presented here is not really data specific to cancer screening but a discussion of how one determines what to screen for an what not to screen for. We could potentially screen for many none cancerous things like STI in sexually active women, hypertension, hyperglycemia ect. IMO much of what was added would belong best on a page about medical screening.Doc James (talk · contribs · email) 01:54, 28 January 2011 (UTC)
I'm not wild about bold (it'd be italics in a book), but I think that's the official MOS-approved style for lists of this type.
I think it's appropriate to show how the usual systems apply to cancer screening, but I agree that medical screening requires some work as well.
I'm just not excited about announcing any recommendations that are specific to a single agency in a single country. If you were in Japan and curious about stomach cancer screening, do you think you would be happy about seeing the irrelevant US recommendations for colon cancer called out, and the Japanese guidelines ignored?
Additionally, the USPTF isn't really the sole or best source for cancer screening recommendations. Their 2009 mammography guideline, in particular, is widely disputed (e.g., today's news), and thought to be too passive by basically every US organization. Why name theirs, and ignore the American Congress of Obstetricians and Gynecologists, American Cancer Society, American Medical Association, National Comprehensive Cancer Network, the Canadian Task Force on Preventive Health Care and the World Health Organization, all of whom recommend mammography earlier and/or more frequently? WhatamIdoing (talk) 02:16, 28 January 2011 (UTC)
We could mention more detail. We also have the Cochrane review that says the evidence does not even support the USPTF recommendations. Doc James (talk · contribs · email) 01:12, 7 February 2011 (UTC)
Why not simplify by leaving out at least the ones that are disputed (e.g., mammography) or vary by country even within the developed world (e.g., colonoscopy)?
Going through the arguments over the timing and frequency of, e.g., mammograms for average-risk women seems too detailed for an article about cancer in general. WhatamIdoing (talk) 16:10, 7 February 2011 (UTC)

90-95% of cancers is down to environmental factors

I think the above claim in the current article is deeply misleading and scientifically illiterate about the current state of research and thinking about cancer.

The template of an environmental factor is smoking; that smoking "causes" lung cancer is almost the Platonic form of what a genuine environmental cause should look like. And there is absolutely no scientific doubt about the link between smoking and lung cancer. More than 90-95% of all lung cancer is caused by smoking and anyone who tries to deny that is being scientifically idiotic.

So I have no doubt smoking causes lung cancer. I have no doubt it will kill 95 people a day or result in 39,000 avoidable and unnecessary deaths a year in the UK alone. The stats are bleak. The current lifetime risk of a male smoker developing lung cancer is 17.2%. It’s slightly lower for women. But some would argue that the risk is actually as high as 33%. One in three of all male smokers will get lung cancer and the only reason that’s no quite as obvious as it should be is that some smokers who would have gone on to get lung cancer are killed off by other smoking-related diseases first.

If you die from a heart attack caused by smoking in your mid-fifties, you’re not going to be included in the stats for smokers who get lung cancer in their sixties. The lifetime risk of lung cancer for non-smokers varies from country to country, especially in Europe. But the worst case scenario (in Eastern Europe) is that non-smokers only have a 0.5% chance of getting lung cancer, i.e. only 1 in 200 non-smokers get the disease.

But some studies in Western Europe reduce that risk by 10 times and seem to indicate that only 1 in 2000 non smokers will ever get lung cancer. If this figure is right and you take the higher 1 in 3 figure for smokers, smokers are 630 times more likely to get lung cancer than non-smokers. So medical advice not to smoke is about as good as medical advice gets. And really, really, really should be taken if you’re not a complete halfwit.

But here’s my problem with the science of the article's claim that "90-95"% of cancers are the result of environmental causes. Although 1 in 3 of all smokers will get lung cancer and that will be caused by a simple environmental determinant, i.e. they smoke; 2 in every 3 smokers won’t get lung cancer, despite being exposed to exactly the same environmental risk.

So why don’t they get lung cancer?

Well, for a long time, people believed this would be down to an environmental factor like dosage. Men who smoked 60 cigarettes a day were at far greater risk than women who have a couple after their evening meal. And there is some truth in this. But not nearly enough.

The reasons why someone like Winston Churchill didn’t get lung cancer despite the fact that Winston was very heavy smoker is almost certainly down to genes. Like aggressive breast cancer in young women, to get lung cancer, even if you’re a smoker, you have to be genetically susceptible to it.

No one knows which gene(s) yet, but there are a host of competing alleles and loci out there being studied as potential candidates, and perhaps they work in combination anyway. For example a study led by Professor Richard Houlston for The Institute of Cancer Research team reporting in 2009 compared the DNA of 1,900 lung cancer patients and 1,400 healthy individuals (and then tested another 2,000 patients with lung cancer and a similar number of healthy volunteers) found specific differences associated with lung cancer risk were found on chromosomes 5, 6 and 15.

Those with certain genetic changes on chromosome 5 were more likely to get a type of cancer called adenocarcinoma and the region highlighted on chromosome 6 seemed to influence whether a patient developed adenocarcinoma or another type called squamous cell carcinoma. On chromosome 15, they pinpointed two independent sites that have a role in whether or not a smoker develops lung cancer. These areas of the genome contain a family of genes that influence smoking behaviour but also cell growth and cell death. Current or former smokers who carry one copy of each of these genetic variants increase their risk of lung cancer by 28%. That increases to 80% in smokers who carry two copies. ( By the way, non-smokers who carry these genes are unaffected)

Even at the risk of "mixing" an important medical health message, if we want to be scientifically scrupulous, so much is clear. People like Winston Churchill, people like the 2 out 3 smokers who won’t get lung cancer are protected against it by something in their genome. So although lung cancer is undoubtedly caused by an environmental factor, two thirds of the factors which will determine whether you get it or not are going to be genetic.

This is even more true of other cancers. So to claim that 90-95% of all cancers are caused by environmental factors is wrong. To imply that 90-95% of all cancers are exclusively caused by environmental factors is wildly misleading. All cancers are caused by both environmental and genetic factors which will vary according to the type of cancer involved.

Accordingly, to be accurate, I think the article should include a more tempered and measured discussion of the mix of genetic and environmental factors which will determine whether individuals will get a particular cancer. Ideally, I think this should be written by a scientist who is currently working in the field. But if no one else steps forward, I will attempt a draft myself.

Steve Coombes

http://news.bbc.co.uk/1/hi/8212658.stm

Above is the link to BBC report of Houlston's team's research into genes which affect lung cancer. Below is a list of recent articles published by ICR on genetic factors affecting a whole range of cancers.

http://publications.icr.ac.uk/cgi/search/simple?screen=Public::EPrintSearch&q_merge=ALL&q=richard+houlston&order=-date/creators_name/title&_action_search=Search — Preceding unsigned comment added by Skcoombes (talk • contribs) 18:43, 5 February 2011 (UTC)

I agree that the "90-95% is environmental" is an overly simplistic formulation of the problem, and I think the context of the intro says that, it's just the one sentence that's overly conclusive and misleading. 22:10, 5 February 2011 (UTC)


I agree, that sentence sounds very misleading, but I looked at the article it references, and while it is a broad simplification, the statistics and conclusion appear to be accurate. The paper pretty much uses the exact same phrasing. Any suggestions for how to better phrase it? --MrBleu (talk) 17:02, 6 February 2011 (UTC)
The joy of being an editor is that if a source uses badly written language but OK numbers, we don't have to be burdened by their poor wording and construction. I don't think it would be seen as OR or SYN to paraphrase the source into less clunky language, especially since a hereditary component to environmental cancers is, as Skc points out above, a very mainstream idea. Reading through the cited paper, it is not so much presenting data as presenting an argument, and while we might consider it useful for the numbers, the opinions represented shouldn't be given too much weight, especially if those opinions don't represent mainstream thought. Honestly, I would phrase this as a disagreement among scientists as to which is the primary cause and which is the contributing cause and give both viewpoints. In that vein, saying that 90-95% of cancer is environmental, full stop, may be a WP:NPOV problem. Honestly, this probably should be in the article itself rather than in the lead, because we really could be clearer by saying a bit more. SDY (talk) 17:54, 6 February 2011 (UTC)
I think that the most important point to make is that "environmental" means "every single case of cancer except those that are absolutely, directly, without a doubt, caused solely by an inherited genetic problem."
I've contemplated changing it to read "5–10% caused solely by inherited genetic disorders, and 90–95% caused by all other factors, which researchers call 'environmental'".
I've not seen any significant dispute over the 5–10% number; has anyone else? WhatamIdoing (talk) 18:05, 6 February 2011 (UTC)
Sounds about right to me. What hasn't been clear in the lead is that it originally sounded like 90-95% of cancers were not in any way related to genetics, which is an unusual stance that shouldn't be given undue weight. My understanding is not that they aren't "genetic" or "not," they are "exclusively genetic", "a mix" (e.g. melanoma and moles my personal interest here), and/or "exclusively environmental" (e.g. Daigo Fukuryū Maru) and that most are in that middle ground, and that's not what the article was saying. SDY (talk) 21:00, 6 February 2011 (UTC)
There are a lot of sources that say most cancers are due to environmental factors. We mention in the body what some of them are (smoking, obesity, etc) We could add this too the lead but I do not see evidence / reasons to change what is there.Doc James (talk · contribs · email) 23:10, 6 February 2011 (UTC)
This ref says

The good news is that a large number of cancers can be prevented. It is estimated that as many as two-thirds of all cancer cases are linked to environmental causes. This number may even be higher. Many of these are linked to lifestyle factors that can be modified. For example, we know that onethird of all the cancer deaths in this country could be prevented by eliminating the use of tobacco products. In addition, about 25 to 30 percent of the cases of several major cancers are associated with obesity and physical inactivity.[10]

Now no one is saying that all these cancers do not have a genetic mechanism but that is pathophysiology. We do have some genes that make one at lower risk of disease than the general population ( there is a genetic change that a few people have that leads to high HDL levels and thus lower heart disease ) but we do not say that the 99.5% of the population that do not have it have a genetic risk. I do not see how the current statement is misleading especially if we have sources that emphasis that environmental changes can prevent a significant number of cancers.Doc James (talk · contribs · email) 23:12, 6 February 2011 (UTC)
I agree, and since "no one is saying" it the article shouldn't either. Stating that "90-95% are due to environmental causes" could be misinterpreted to mean that there is no genetic component whatsoever. That is the language that the source uses, and I don't think the source is wrong, I just think that it is a poor choice of wording for our article. I agree there are some cancers where genetic risk is so common that heredity plays little part, but that is not an accurate description of all "non-hereditary" cancers. SDY (talk) 13:26, 7 February 2011 (UTC)
I do not think it will be misinterpreted. We state the cause and then discuss the pathophysiology. Most people release that environmental factors can damage DNA.Doc James (talk · contribs · email) 13:47, 7 February 2011 (UTC)

(undent) For the leading sentences of a general use encyclopedia, we should probably not assume that the reader has more than a very basic understanding of genetics. For a medical textbook it would be fine. For a twelve-year-old trying to make sense of why grandpa just died, it's not very helpful. Assuming that the reader knows what we're talking about defeats the purpose of having an article on the topic, especially the overall intro article on a technical subject that has to be understood by non-technical people. SDY (talk) 13:54, 7 February 2011 (UTC)

So how about something like this:

Researchers divide the causes of cancer into two groups: those that are caused exclusively by hereditary genetics (5–10% of all cancers), and those that are not. Most cancers are not caused exclusively by hereditary genetic factors. They may be caused entirely by non-hereditary factors, or by a combination of hereditary and non-hereditary factors.

Does that seem reasonable accurate and accessible? WhatamIdoing (talk) 16:42, 7 February 2011 (UTC)
I think we should go with what the references say. 90% are due to environmental factors. Many people think that cancer is not preventable as they think it is primarily genetic or due to factors beyond there control. While the pathophysiology is genetic the cause of these mutations not. Many are surprised when told that much of it is preventable. Here is a great book on the topic [11] I do not support attempt to de emphasis the importance of the environment as a cause with out appropriate references. Doc James (talk · contribs · email) 00:41, 8 February 2011 (UTC)
I don't think we're de-emphasizing anything, we're just trying to clear up the writing. Stating that 90-95% of cancers have no hereditary component whatsoever is simply not accurate, so the article should not say that or imply it through poor writing. I think WaId is getting the right idea, though the last two sentences could really be merged with the final sentence (i.e. "Most cancers are either caused entirely by non-hereditary factors or by a combination of hereditary and non-hereditary factors.") SDY (talk) 03:43, 8 February 2011 (UTC)
The ref says approx 30% due to tobacco, 30% due to obesity/diet, 20% due to infections, 10% due to radiation and less than 10% due to hereditary genetic conditions. I do not understand you problem with saying that 90% is due to the environment? If we where to eliminate many of the viral diseases like hepatitis, everyone stopped smoking and was of a normal weight, we fixed the ozone layer and ordered all MRIs instead of CT scans the amount of cancer would decrease. I do not understand how saying 90% of cancer is environment is misleading. We have a whole section on the pathophysiology of cancer that emphasis the genetic mechanism.
The argument above could be used to say all health problems are genetic (which they are in a way). If humans where designed better we would not get gout (we are missing an enzyme that most other animals have) but downplaying the significance of diet and obesity in that condition is not how public health is done and would be a disservice to the population at large. Saying all causes of gout are genetic would ignore all the cases that are preventable.Doc James (talk · contribs · email) 04:18, 8 February 2011 (UTC)
Also we should discuss the more common causes first followed by the less common causes per WP:DUE Doc James (talk · contribs · email) 00:44, 8 February 2011 (UTC)
If we want to discuss the most common causes first, then the item for the #1 position is sunlight, not tobacco. I don't think that non-melanoma skin cancers are the most important, but they are the most common, and there are (very approximately) twice as many sunlight-induced skin cancers as there are tobacco-induced lung cancers each year. WhatamIdoing (talk) 17:36, 8 February 2011 (UTC)
The pdf from the NIH above says only two-thirds of cancers have an environmental cause, and up to 5% are familial cancer syndromes. Does anyone know what their explanation for the other quarter is? Perhaps an interaction between genetic and environmental factors?
Also, I'm a little worried about the equation of "environmental" with "preventable". Cosmic background radiation is "environmental", and it clearly causes cancer, and there really is nothing at all that you can do to prevent being exposed to it. WhatamIdoing (talk) 17:36, 8 February 2011 (UTC)
I was putting them most common by mortality rather than by number of cancers induced. WRT environmental and preventable, we state 90% are environmental 30-40% are preventable. Thus there are none preventable environmental causes I agree. Doc James (talk · contribs · email) 01:19, 9 February 2011 (UTC)

Physical agents

Are "Physical agents" and "Physical trauma and inflammation" not sufficiently similar that we could combine them under one section? We state that inflammation does not cause cancer in and off itself thus is it significant enough to be in a heading? May be we should move it to the other section? Doc James (talk · contribs · email) 01:12, 8 February 2011 (UTC)

I replied to this on my user talk page. Fundamentally, the distinction is one of mechanism—that is, the actual cause (the body's repair mechanism), not the proximate cause (falling off the monkey bars). WhatamIdoing (talk) 17:39, 8 February 2011 (UTC)

Diet

About this and this, I think we should think a little broader in the diet section. It seems very focused on what is derisively called the Standard American Diet focused right now, which leaves out a good deal of the world. For example, I believe it's generally accepted that a diet high in sugar and refined starch is a risk factor for cancer of the pancreas, and a diet high in vinegar is a risk factor for cancer of the stomach and esophagus. The latter is one of the usual explanations for the relatively low incidence of stomach cancer in the US and Canada. WhatamIdoing (talk) 17:53, 8 February 2011 (UTC)

Salt is associated with increased gastric carcinoma.(ref) Novangelis (talk) 01:19, 9 February 2011 (UTC)
Yes and as soon as it is support by review articles rather than primary research we should re add it.Doc James (talk · contribs · email) 01:17, 9 February 2011 (UTC)

Age

As a result of this, the epidemiology section once again completely ignores the #1 epidemiological factor. Cancer is primarily a disease of old age. "Aging" may not be a cause, strictly speaking, but it is a very significant risk factor.

Furthermore, I suggest that not only is The New York Times a policy-compliant source for a direct quotation from a renowned expert, but also that it is actually the only acceptable source for that particular direct quotation. WhatamIdoing (talk) 17:58, 8 February 2011 (UTC)

We have better references to support this point that the NYTs. We do state in the lead that "While cancer can affect people of all ages, and a few types of cancer are more common in children, the overall risk of developing cancer increases with age. In 2007 cancer caused about 13% of all human deaths worldwide (7.9 million), and the number of cases is rising as more people live to old age." Will add something better tonight. Doc James (talk · contribs · email) 01:04, 9 February 2011 (UTC)
This BTW is wrong "Essentially all of the increase in cancer rates between ancient times and the beginning of the 20th century in England is due to increased lifespans." What about scrotal cancer is chimey sweeps? Doc James (talk · contribs · email) 01:08, 9 February 2011 (UTC)
I'd have to look for references, but as I recall, after roughly the age of 85, the incidence of cancer falls off.Novangelis (talk) 01:22, 9 February 2011 (UTC)
Yes I plan to make a nice graph like the one we see here [12] or I guess we could us the one to the right. This does not support the NYTs article. Absolute number of deaths drop aswell. Doc James (talk · contribs · email) 01:35, 9 February 2011 (UTC)
No, we can't. "Getting cancer" is not the same thing as "dying from cancer". This graph shows only the trend in deaths ascribed to cancer, not the trend in people being formally diagnosed with (much less actually developing) cancer. WhatamIdoing (talk) 02:48, 9 February 2011 (UTC)
Yes that would be a nice graft too.--Doc James (talk · contribs · email) 03:13, 9 February 2011 (UTC)
The increase in scrotal cancer for 18th century chimney sweeps was dramatic, but it represents a tiny fraction of total cancer cases, and it was basically a temporary problem that had pretty much been solved, after improvements in both chimney design and child labor laws, by the beginning of the 20th century (the time frame used for comparison).
See PMID 16786146: "Relative tumor frequencies on an age- and sex-adjusted population basis (using a mathematic model of skeletal involvement of malignant tumors in a well-defined English study population from AD 1901 to 1905) indicated that the tumor rates were not statistically different between ancient Egyptian, the historical Southern German and the recent English reference population.... Therefore, we conclude that the current rise in tumor frequencies in present populations is much more related to the higher life expectancy than primary environmental or genetic factors." (That's one of the studies the NYT article referred to.) It's pretty clear: once you control for age and sex, people in ancient Egypt, people in late Renaissance Germany, and people who died in the first years of the 20th century England all had about the same amount of cancer.
This appears to be the general consensus, not merely a single report. For a more general statement, see ISBN 9780123744197: "Cancer is predominantly a disease of old age. Thus, advancing age is the most important risk factor for cancer development..." (emphasis added). Or ISBN 9781841842967 p. 15: "Increasing age represents the single most important risk factor for cancer." Or ISBN 9780781768054 p. 156: "Increasing age is considered the single most important risk factor for the development of cancer."
More than half of cancer cases in the developed world are diagnosed after age 65 or 70. The median age for diagnosis of lung cancer is about 70. This doesn't mean that old age causes lung cancer, but it does explain why the index of suspicion for lung cancer is much higher when confronted with a 70-year-old smoker with a persistent cough than with a 20-year-old smoker who has identical symptoms.
I believe that it's not the incidence of cancer, but the incidence of people bothering to formally diagnose cancer, that actually falls off in late life. We stop screening mammograms, for example, around age 75 and the incidence of diagnosed breast cancer promptly drops by about a third. However, I've seen reports that up to one-third of elderly European (Danish?) women have undiagnosed breast cancer at the time of their deaths (excluding those women who had been diagnosed with breast cancer). When someone's heart disease has advanced to the point that treatment for a slow-growing cancer is irrelevant or impossible, then you quit looking for it. WhatamIdoing (talk) 02:35, 9 February 2011 (UTC)
True good point. We should still use better refs. Doc James (talk · contribs · email) 03:15, 9 February 2011 (UTC)
This review states "The global burden of cancer continues to increase largely because of the aging and growth of the world population and an increasing adoption of cancer-causing behaviors, particularly smoking, within economically developing countries." Jemal, A (2011 Feb 4). "Global cancer statistics". CA: a cancer journal for clinicians. PMID 21296855. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help) Doc James (talk · contribs · email) 11:05, 9 February 2011 (UTC)
This ref PMID 16786146 is a primary source. It does not address changing rates of obesity, smoke exposure, infectious diseases, or radiation exposure so I do not see how it came to this conclusion. The review above seems to give a more balanced picture. Doc James (talk · contribs · email) 11:40, 9 February 2011 (UTC)
Yes, it does address the changing rates of exposure during the 20th century: They specifically picked their reference group to avoid these problems. Obesity became a public health issue in the last generation—not among people who died more than a century ago. Tobacco use in England picked up after WWII—almost half a century after the people in the last study group died. Medical radiology wasn't invented until these people had been dead for a good quarter-century. Effective treatments for infectious diseases also appeared after these people were dead. If you died in 1901, your lifetime exposure to carcinogens were not dramatically different from people who died in 1701—NB that's according to the sources, not according to me—and your lifetime risk of developing cancer was not dramatically different, either (also according to the sources, not me).
I feel like you're missing the whole purpose of that paragraph. The purpose is to say—and this is, in fact, the mainstream position, widely agreed by everyone in the field—that the difference in cancer rates between ancient Greece [median life expectancy at birth: 18 years] and 1901 in England [median life expectancy at birth: 48 years] is basically all due to increased lifespan.
Note that it does not say that the difference in cancer rates between 1901 and 2011 [median life expectancy at birth: 75 years] is entirely due to increased lifespan. It says nothing at all about the difference in cancer rates between our great-great-grandmothers' generation and ours. The question it addresses is the (lack of) difference between cancer rates between our great-great-grandmothers' generation and Plato and Aristotle's generation. It happens that increased tobacco use, increased obesity, decreased use of coal- and wood-burning stoves, better treatments for infections, etc., are all widely believed to have changed the rates, but lifestyle changes in 1950s (tobacco) and 1970s (obesity) and 2000s (medical radiation) do not have the slightest effect on people that were born (on average) in 1850 and thus were long dead before these changes happened. WhatamIdoing (talk) 20:09, 9 February 2011 (UTC)

Than we have stuff like this "Incidence rates for all childhood cancers combined increased 0.6% per year from 1975 to 2002"Nerlich, AG (2006 Jul). "Malignant tumors in two ancient populations: An approach to historical tumor epidemiology". Oncology reports. 16 (1): 197–202. PMID 16786146. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help) Doc James (talk · contribs · email) 11:46, 9 February 2011 (UTC)

Several of the cancer sites with increasing trends are plausibly explained

by changes in known risk factors or improvements in diagnosis. For example, trends in melanoma can be accounted for by generational trends in sun exposure and the increase in thyroid cancer is largely attributable to diagnostic artifact. For several other cancers with increasing trends, the explanations are less clear. These include multiplemyeloma, renal adenocarcinoma, testicular cancer, and non-Hodgkin’s lymphoma. The fact that the incidence rate of a particular cancer is changing over time is not, in itself, evidence that any specific environmental factor is responsible for that change. Multiple changes occurred in the United States and other industrialized countries during the 20th century. These include large changes in diet, physical activity, tobacco use, medical diagnostic and therapeutic practices, as well as rapid increase in synthetic chemicals. It is both essential and challenging to view environmental factors related to cancer in this broad context. The decrease in incidence and death rates from many cancers in industrialized countries has been achieved by applying knowledge about cancer prevention, early detection, and treatment at the population and individual level. Much progress has been made, but even greater challenges remain. Among the most pressing needs is to apply these lessons in developing countries, where the globalization of tobacco smoking and obesity as well as the uncontrolled exposure to industrial pollutants and agricultural pollutants are compounding environmental risks related to air and water quality, infectious diseases, and

inadequate nutrition.

Doc James (talk · contribs · email) 12:54, 9 February 2011 (UTC)

This review argues that cancer incidence does decrease past a certain age PMID 14624062 Doc James (talk · contribs · email) 13:14, 9 February 2011 (UTC)
No, what it really says is that clinical incidence—the "bothering to diagnose it"—declines. The actual incidence—the existence of cancer that won't ever bother the patient, because s/he is going to die from heart disease before the cancer becomes clinically evident—apparently does not. WhatamIdoing (talk) 20:09, 9 February 2011 (UTC)
  1. ^ http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Vitamin_D_Has_Role_in_Colon_Cancer_Prevention.asp
  2. ^ http://www.cancer.gov/templates/db_alpha.aspx?CdrID=44158
  3. ^ "Definition of Cure for Hodgkin's Disease." Cancer Research 31 1970 p 1828-1833
  4. ^ http://jco.ascopubs.org/cgi/content/full/23/34/8564
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