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Cancer as a Fungus?

Has anyone else heard about this? It looks like the natural healing movement is running with the idea that cancer is some type of fungus and can be cured by making the body more alkaline. I've heard this on the radio and in news magazines, and seem to remember that its based on theories presented by an Italian doctor. I honestly know very little about it, but it seems like a significant enough thing that the wiki article on cancer could help place it into some kind of context. BlennGeck (talk) 01:18, 14 February 2011 (UTC)

Cancer is when some of your cells start dividing rapidly. The abnormal growth of cells can be harmless, or it can spread through out your body and cause a lot of harm. Since cancer is a growth of human cells it is definitely not fromed from fungus. Perhaps they are arguing that there is a fungus that causes your cells to divide rapidly, but it's more likely that mutation in the DNA from old age, UV radiation, carcinogens, and other factors cause this to happen. AerobicFox (talk) 05:34, 14 February 2011 (UTC)

AerobicFox has summed up the prevalent thinking. Do you really think that a major theory about cancer pathogenesis would have been left off this page after so many years? And "theories presented by an Italian doctor" sounds suspicious in its own right; cancer research is conducted by enormous groups of people. One person's views are unlikely to be notable in this area. JFW | T@lk 07:39, 14 February 2011 (UTC)

Clearly this is a fringe theory. If you google cancer and fungus, you do get a bunch of hits, and there are clearly a lot of people out there peddling this notion that a fungal imbalance somehow leads to cancer. I can't honestly say I totally understand their argument. I was just curious if any serious medical sources had addressed it, since it sounds like a potentially dangerous myth. I know wiki isn't in the business of exposing hoaxes or anything like that. But I had hoped to get some context on this topic by reading the wiki article. BlennGeck (talk) 13:50, 14 February 2011 (UTC)

The article already covers the microorganisms that are linked with cancer. I don't think anyone here will be able to explain the fungus-cancer theory because it is not founded on serious science. JFW | T@lk 22:21, 14 February 2011 (UTC)

Lol, I actually can explain it having just looked it up, and it is quite funny. Pointing to research that has found a lack of oxygen can sometimes cause cells to turn cancerous, they are stating that what this study is actually observing is the growth of anaerobic fungus. They claim that fungus spores are everywhere in the environment, and that they store into your body waiting for a lack of oxygen to kill your cells which they will then consume and grow. They state for instance that the fermentation process of tobacco results in the yeast spores being mixed into the tobacco which you then breath in when you smoke. These yeast spores they say stay inside your lungs, and as your lungs fill up with tar depriving your lung tissue of oxygen, these yeast spores begin to grow, and that growth is what they claim is lung cancer, yes, they are indeed claiming that the yeast used to ferment tobacco grows into lung cancer. They also claim that the sun kills cells on your skin which fungus spores can then eat and grow off of, and cite "sesame oil" and "aloe vera" as substances which have been shown to effectively treat fungus and cancer.

One "article" from associated content concludes with

We already have these substances, some of which are mentioned above, but do we have the will to put our love for mankind ahead of our love for money? While current cancer treatments make so much money for oncologists and pharmaceutical companies, will any other treatment or understanding of the disease really catch anyone's attention? To find the cure for cancer, first of all we must decide if we really want to help save lives, or make ourselves very rich.

I believe I speak for everyone when I say super-lol.AerobicFox (talk) 23:17, 14 February 2011 (UTC)

From more research it seems they view cancer as a fungal growth and a growth of cells around them trying to stop them. Oh and they also believe that cancer is a "solely extracellular phenomenon", and that "At the moment, sodium bicarbonate (in a solution of 5% or 8.4%) is the only remedy capable of making the tumours disappear completely." Surely they say it best when they claim this new theory "distinguishes itself by its simplicity and its "innovative" ideology."(italics and quotations my own).AerobicFox (talk) 03:42, 15 February 2011 (UTC)

No, my point is it should be covered as a fraudulent theory. It is a pretty widespread myth, so I thought it might be good to include what rela medical professionals have to say about it. BlennGeck (talk) 23:11, 14 February 2011 (UTC)

We can't possibly devote attention to every misguided theory! The amount of dross would overwhelm the article. JFW | T@lk 23:29, 14 February 2011 (UTC)

All the "alkaline food cures cancer" stuff goes back to the Edgar Cayce diet; it, along with many others, can be found at Alternative cancer treatments. WhatamIdoing (talk) 05:43, 15 February 2011 (UTC)

It's a notable and widespread misguided theory. Don't see any issue with including it (perhaps in a myth and misconception section). I know usefullness isn't generally a guideline for inclusion in articles. But I would think people just diagnosed with cancer would find that information helpful. Since they are going to be hearing a lot of misguided theories from people. BlennGeck (talk) 13:47, 15 February 2011 (UTC)

This article already mentions the fact that alternative theories exist and that some treatments are based on them. Given that you have conceded that this theory is misguided, I don't think it should be given more airtime than strictly necessary; the alternative cancer treatments article serves its purpose well. Several contributors (AerobicFox, WhatamIdoing, myself) have now tried to explain this to you. JFW | T@lk 15:20, 15 February 2011 (UTC)

It should be given airtime because it is misguided and potentially dangerous. I understand what you are trying to say, but I simply disagree. Disproven or questionable therapies should be addressed in the article so people seeking treatment will have some way of placing them in context. BlennGeck (talk) 17:24, 15 February 2011 (UTC)

Also, Aerobic Fox and I are in the middle of a dispute. I suspect he popped because the opportunity to disagree with me presented itself. BlennGeck (talk) 17:25, 15 February 2011 (UTC)

Actually, I was looking at the multiple user pages and other articles you were canvassing for support and just came across this, and being interested in the subject decided to post.AerobicFox (talk) 22:15, 15 February 2011 (UTC)

The relevant advice that I'd consult is WP:FRINGE, and this an unusual idea with few proponents, none of which is taken very seriously. As such, the due weight is nothing at all. There is no reason to include it in the article. SDY (talk) 18:20, 15 February 2011 (UTC)

Actually it is a widespread myth spread largely by the natural healing movement. It regularly appears on natural health radio programs, and is all over the place on the net. I realize it is a wacky theory. And I realize it shouldn't be presented so that it appears we are giving it legitimacy. But since lots of people with cancer use the wiki article as a first stop. I think it is important to include it as an unproven or potentially dangerous therapy. BlennGeck (talk) 18:52, 15 February 2011 (UTC)

I don't think you understand the scale of the issue.

Yes: It's a popular bit of nonsense. However, it is not the most popular bit of nonsense. It probably makes the top ten, but it probably doesn't make the top five myths and misunderstandings.

So if we included a paragraph explaining this particular bit of nonsense, we'd need to include a paragraph explaining all of the other, even more popular myths and misunderstandings, to put it in the proper context—and suddenly we'll have another huge section in this already-too-long article.

As a result, I think the best solution (the best balance between increasing education and decreasing bloat) is to put it in the Alternative cancer treatments article, and to exclude it from this one. The few people who want to know about it will find it, and the rest will hear only about the more common ones. WhatamIdoing (talk) 19:12, 15 February 2011 (UTC)

I see what you are saying, and I of course respect the consensus outcome of the discussion. I suppose the problem I have with the Alernative Cancer Treatment article is that, in a way, validates unproven treatments. I do like that it provides their status. However the Fungus theory appears under the heading of its treatment. So it is very easy to miss.

Would it really be a bad thing to include the top ten cancer treatment myths. I would imagine, as a patient, I would want to have that available in the cancer article so I know what to avoid. I do realize mythbusting isn't the domain of wikipedia. But medical articles and scientific articles do sometimes address myths and misconceptions in this way.

Much of this might be regional. But in the state where I am from, the fungus-cancer connection is the one I hear most often on the radio or just in general conversation. Of course, I don't know the best way to measure the popularity of each misconception. BlennGeck (talk) 19:59, 15 February 2011 (UTC)

My last response to you: please read WP:CONSENSUS. Nobody agrees with you. Please let it rest. JFW | T@lk 20:47, 15 February 2011 (UTC)

I understand consensus and stated I respect the consensus view of the talk page. Just adding my final thoughts for your consideration. We are allowed to continue discussion. And there is no reason to assume others won't join in later and change the consensus. All the guidelines people have noted so far, I fully understand. BlennGeck (talk) 20:50, 15 February 2011 (UTC)

See also WP:STICK. SDY (talk) 20:51, 15 February 2011 (UTC)

I don't see any reason to assume the debate is over after a single day. When many editors haven't even had an opportunity to weigh in yet. If you are unmoved by my arguments that is fine. But I have every right to continue responding so long as people are providing further rebuttals. BlennGeck (talk) 21:04, 15 February 2011 (UTC)

Piling on consensus to not add fringe theories to the article. OhNoitsJamie ^Talk 21:08, 15 February 2011 (UTC)

(after e/c) What about others who join in later and support the consensus? That would be me. Perhaps it could be covered more fully in the alternative cancer treatments article (keeping the emphasis on it being utter hogwash) but it shouldn't be covered here. This article is long enough covering what is known about cancer, sub-articles serve the purpose of adding coverage of things like "what you can get gullible people to believe". Franamax (talk) 21:11, 15 February 2011 (UTC)

"Perhaps it could be covered more fully in the alternative cancer treatments article "

That has already been suggested(near the top of this discussion) and the editors here have no problem with it being added there.AerobicFox (talk) 22:21, 15 February 2011 (UTC)

I think adding more in depth treatment on the sub article is fine. But perhaps the sub article should be renamed "Alternative Treatments and Myths". Since, to me at least, Alternative Treatment indicates a level of legitimacy. And my understanding is there is nothing legitimate about this treatment and many others in that section (it would also make it easier for people concerned about cancer treatment myths to link to). BlennGeck (talk) 21:26, 15 February 2011 (UTC)

Actually I was thinking too that an article on cancer myths might be a good idea, as in a place for the ideas about cancer that would definitely qualify as pseudoscience or (as close as possible to) definitely wrong. This would contrast with alternative treatments where evidence may be unclear or the theory still disputed among reputable clinicians and researchers. Although as you say, Wikipedia's job is not debunking, and also trying to definitively label something as a myth could get even more argumentation than we've seen here. :) Franamax (talk) 22:10, 15 February 2011 (UTC)

Now that I look again though, "Disproven or scientifically implausible" as a section heading pretty much says it all. So what that really leaves is perhaps a need to make a brief expansion there of this "fungus theory" and maybe figure out an appropriate redirect like Fungus theory of cancer that takes the reader right to the section where it's shown to be untrue. Franamax (talk) 22:15, 15 February 2011 (UTC)

I suppose there is also the question of whether "Alternative Treatments" and "Cancer Myths" really should be two separate articles with some cross over. I have to admit, if I am coming online specifically to look for myths about cancer, I am probably not going to guess it would be in the alternative treatments section. BlennGeck (talk) 22:22, 15 February 2011 (UTC)

Link?

I ran across this link to a patient-oriented booklet called "Advanced Cancer Care Planning: What Patients and Families Need to Know About Their Choices When Facing Serious Illness" from the American Society of Clinical Oncology (ASCO) at The New York Times. Would it be worth linking to it? I'm a little nervous about adding it under ==External links==, because any second link might prove to be spambait. Maybe ==Further reading== would be better? (I haven't read it, but I suppose it might be possible to use it as a ref, too.) WhatamIdoing (talk) 22:04, 18 February 2011 (UTC)

I'd also consider going up a level and providing the link to ASCO's list of publications and resources. I like to hold the line on link proliferation, but English language resources from organizations that have direct policy roles in their respective countries (ASCO is a sponsoring organization of AJCC) should be a hard criterion that can be employed to prevent needless proliferation. A hard limit of two or three links per country should maintain balance. The critical test is if the link adds anything that would not be present in the "ideal" Wikipedia article. In this case, I'd say the individual publication or the list would qualify.Novangelis (talk) 07:52, 20 February 2011 (UTC)

Cancer is Wrongly-named, Causes -v- Effects, and how most cancer is self-inflicted.

Wikipedia is a mirror that reflects the published, reliable sources. It is not a place to discuss our personal opinions.

What follows is my freely-stated opinion. It is however being shared by more and more people.

When will it be fully realized, that in going into the science and research of cancer cells themselves, of genetics and cancer-causing mutations, and of developing drugs and therapies to treat cancer, many researchers are concentrating, to ever-increasing levels of complexity and detail, on effects rather than causes. Cancer is not a disease. It is not a disorder. It is a SYMPTOM of a spectacular failure of the Immune System to spot these rogue, malformed cells and flush them out of the body. And so these cells remain, and multiply, until the patient develops a mass of them which we then call a tumor.

It wasn't until AIDS came along, and attacked the Immune System, that we all saw, to our abject horror, just how fast even the rarest cancers can appear when the Immune System goes down. Far from taking years to collect the neccessary rare mutations, in AIDS patients these cancers were appearing in weeks. The realization then dawned, that we ALL produce cancer cells, and regularly -- but our healthy Immune Systems quickly spot them and reject them out of the system. And this, and only this, is where healthy people differ from cancer patients.

We have to know this, in order to see that a cure for cancer will never work, so long as the Immune System remains unable to see new cancer cells developing from new mutations and remains unable to reject them. The cancer will just simply "come back again" as mutations, from DNA copying errors, from cosmic rays constantly raining down from space, and from radiation coming from the rocks beneath our feet shooting pieces out of our DNA, cause new rogue cells to appear in our bodies.

We also have to know this, in order to see that most the time and money that we spend on cancer research should be diverted AT ONCE into research on the Immune System, and into the problem of how to boost it so powerfully that no cancer cell will ever have a chance of remaining undetected in the body.

May I introduce a word -- IMMUNITIS -- which more appropriately describes the true beast we should be hunting here. Cancer, in all its forms, is "merely" one of its worst symptoms.

But is was never the business of the true professional to treat symptoms! Let alone pour trillions of dollars after such a folly!! Fancy any true pro, spending fortunes of the taxpayer's money running around after the mess that the rough-and-tumble of the universe makes of our bodies, after our Immune Systems have stopped protecting us.

Thankfully, our Immune Systems are generally robust and it takes a lot to make them stop working properly. Almost all cancer is self-inflicted. Just look, at the way we live, in contrast to how we lived only 100 years ago-- when cancer was almost unknown--- and yet the man himself has not changed. We stuff ourselves with purgatives, chemicals, food additives, we drink like fish and smoke like chimneys; in our lifetimes we will eat THREE TIMES our own weight in food additive chemicals. The wonder of it is, that cancer is not even more widespread. The body is taking what defences it has evolved against this abuse, and it is fighting to the Death. Put another way, Cancer (Immunitis) is a consequence of the abnormal way we have chosen to live, for a body which misses the happiness of the Stone Age and does not want to live this way.

But if we want the best of both worlds, to live in the modern age yet have no cancer, then we must regroup our forces, and this time identify the true target, the true cause, IMMUNITIS, -- and finally stop chasing around after its many and diverse effects. — Preceding unsigned comment added by Valhalan (talk • contribs) 02:18, 20 February 2011 (UTC)

Wikipedia is WP:NOT a forum for general discussion of our opinions about cancer. Please limit discussion to improvement of this Wikipedia article, based on published, reliable sources. WhatamIdoing (talk) 04:40, 20 February 2011 (UTC)

Incidentaloma

I'm not sure where to stick this, but I decided this sentence didn't fit the screening section:

When cancers are found accidentally, such as through a medical test for an unrelated condition rather than as part of an organized screening program, they are called incidentalomas.

If anyone's inspired, please WP:Build the web. WhatamIdoing (talk) 23:18, 26 January 2011 (UTC)

A tumor is not typed based on how it is found but on the tissue it arises from. I recommended deletion for the WP article, in its Discussion page. That page is here: [[1]] — Preceding unsigned comment added by Kernel.package (talk • contribs) 01:39, 11 April 2011 (UTC)

You are wrong. An incidentaloma is not necessarily a cancer. In fact, it rarely is. The phenomenon is well described in medical practice. JFW | T@lk 07:53, 11 April 2011 (UTC)

Edit request from 98.145.225.138, 3 April 2011

There is a subtle but important distinction that is true about hormones and cancer, especially as quoted about breast cancer and estrogen in women. Your article quotes Henderson, Brian E, et al (2000) as saying "Some hormones cause cancer." That is incorrect. Here are references that explain why:

1. "Estrogen does not cause cancer. While estrogen is an essential part of a woman’s physiology, its principal function is to speed up the process of cell proliferation. Therefore, estrogen can increase the chance of cell mutation and/or encourage the growth of cancerous cells once they appear." JoAnn V. Pinkerton, MD (2006) http://www.urogyn.org/documents/NAMS_News_1006.pdf

2. http://www.doctoroz.com/blog/lauren-streicher-md/new-hormone-therapy-and-breast-cancer-study (2010)

3. "Estrogen does not cause breast cancer" Rebecca Booth, M.D. http://www.huffingtonpost.com/rebecca-booth/estrogen-does-not-cause-b_b_332719.html

There are numerous additional credible resources that I can provide, if necessary. Thank you for your consideration of this important correction. KCMO

We generally use review articles rather than newspapers or blogs such as above. Those exposed to estrogen do have high rates of some types of cancer and thus one can in a way say it causes cancer.Doc James (talk · contribs · email) 21:13, 3 April 2011 (UTC)

It seems like a rather fine distinction. Since basically all cancers require multiple factors (at minimum, a mutagen plus a favorable microenvironment), we could just as easily say that there are no non-hereditary causes of cancer.

Like most high-quality sources, I believe we should follow the reasonable standard that if you take two identical groups, and give one of them something, and the results are different from the other group, then that something actually causes the difference in the response. This isn't proof of a direct biological mechanism or proof that it is the only cause, but it is a statement of cause and effect. WhatamIdoing (talk) 00:04, 4 April 2011 (UTC)

I've delayed in responding. I replaced the word "cause" because it is imprecise. My delay was about thinking up a more apropos analogy, but I'll go with the first one that came to mind: "Does pulling the trigger cause a gun to fire?" Yes and no;there has to be a bullet in the chamber. It's the same with hormones and cancer. In their absence, cancer will not appear without hormonal influence. Unopposed estrogens and endometrial carcinoma are the classic example. Hormones cause cancer in the sense that many cases would not occur in their absence, but other factors must be present. It is on this basis that I replaced the word, "cause": not for being wrong, but for being ambiguous. Thank you for drawing attention to this issue; reader feedback is always of use.Novangelis (talk) 00:39, 4 April 2011 (UTC)

By that standard, does asbestos cause lung cancer? Does HCV cause liver cancer? WhatamIdoing (talk) 03:41, 4 April 2011 (UTC)

There is no bright line, and as I said, I really wanted a better analogy. It depends on what is meant by cause. Unless you live in a bubble, everyone is exposed to asbestos, but exposures vary greatly. You can never have had HCV or not progress to chronic infection. Hormones differ in that the amounts present seldom vary by several orders of magnitude. When straightforward, cause can often be replaced by a more precise synonym that better reflects the role (in this case mitogenic vs. mutagenic) without becoming overly technical.Novangelis (talk) 04:33, 4 April 2011 (UTC)

Definition is incorrect

The tern "Cancer" does mean "neoplasm" but there are two types: benign and metastatic. Cancer may be a "malignant neoplasm" but since it may also be a "benign neoplasm" the article's definition as written is not correct. Since the page has been protected I decided to post this as a new Discussion section rather than making a chance to the article outright. If this section generates no discussion I will make the change in the future. Kernel.package (talk) 01:14, 11 April 2011 (UTC)

Neoplasm is not the same as cancer. Neoplasm is any clonal growth of a cell type, and may be benign (such as uterine leiomyomas) or malignant. Please don't make any changes until you've verified this. JFW | T@lk 07:53, 11 April 2011 (UTC)

Cancer is a genetic disease

Cancer is a genetic disease and it is a very broad term. Metastatic CA causes death to the host, benign CA does not. What causes the genetic change isn't clear but the changes found in cancerous tissue are clear. Quoting Wikipedia, "Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat." This quote comes from this URL: Oncogenesis and is situated underneath an image that was provided by the National Cancer Institute. Kernel.package (talk) 03:43, 11 April 2011 (UTC)

You can be genetically predisposed to cancer, but genetics does not cause cancer. Some cancers are caused by viruses(HPV), most are caused by old age and radiation(commonly UV radiation), or carcinogens(smoking, etc), but none that I know of are a genetic disorder(there may be one out there that is, but I don't think so).AerobicFox (talk) 07:34, 11 April 2011 (UTC)

There is no doubt that cancer arises because of mutations in the DNA, but that does not make it a "genetic disease" in the sense that it is heritable. I would avoid using the term "genetic disease" without further clarification to avoid this confusion. JFW | T@lk 07:53, 11 April 2011 (UTC)

Cancer Vaccines

Perhaps the personalised dendritic cancer vaccines made by Zwi Berneman, Viggo Van Tendeloo may be mentioned. The vaccines are intended mostly for myoloid leukemia, but is also useful for multiple myeloma and breast cancer (see http://www.kanker.be/index.php?option=com_content&task=view&id=2674&Itemid=2828 )

— Preceding unsigned comment added by KVDP (talk • contribs) 13:24, 21 March 2011 (UTC)

Add Section on Evidence-based Resources for Cancer Information

This Wikipedia article is one of the first resources that a cancer patient anywhere in the world might come across if he/she types in "cancer" into any of the search engines. It would be a great benefit to users if they found a section that linked to reliable evidence-based resources such as The American Cancer Society, National Cancer Institute, American Society for Clinical Oncology, CancerHelp UK. I would be willing to create such a section. Here is also a link to a fact sheet that might be very helpful for Wikipedia users of health information - Evaluating Health Information on the Internet Full disclosure: I work at the National Cancer Institute.

Quietvillager (talk) 17:40, 8 June 2011 (UTC)

Well, we're not really writing for patients, but I doubt that it would actually have that much interest for the typical patient (who, after all, is a tired, frightened, and very busy senior citizen, not a college student with plenty of time on his hands to go read a bunch of webpages).

We've kind of been limiting the WP:External links section to the DMOZ link, because hen we add more to a page like this, it tends to turn into a bit of "spam bait". Do you happen to know of a (single) page that already lists some of the best resources? One link to an outside source is sometimes more functional than directly providing half a dozen links, because it's less susceptible to "if you're going to link that page, then you have to link my (charity, dietary supplement manufacturer, etc.)..." problems. WhatamIdoing (talk) 22:33, 8 June 2011 (UTC)

Possible Cure for Cancer

http://nutritiondietnews.com/canadian-researchers-obtain-a-simple-cure-for-cancer-but-major-pharmaceutical-corporations-arent-interested/853757/

There is an article about a cure for cancer. Can this be included in the wiki page? Saiarcot895 (talk) 01:08, 17 May 2011 (UTC)

The ref you provided is not a reliable source per WP:MEDRS. The research is ongoing and funded by the Canadian Institutes for Health Research. Will need to see what the results are. Doc James (talk · contribs · email) 01:20, 17 May 2011 (UTC)

It's about DCA. We are still eagerly awaiting clinical trial results. The fact that it kills cells in a petri dish means nothing. Bleech does the same. JFW | T@lk 13:40, 17 May 2011 (UTC)

Dichloroacetate, or DCA's mechanism of action has been very well described in both in vitro (your petri dish...) and in vivo (mice) experiments. http://puredca.com/papers/A_Mitochondria-K+Channel_Axis_Is_Suppressed_in_Cancer_and_Its_Normalization_Promotes_Apoptosis_and_Inhibits_Cancer_Growth.pdf A scientific paper is a paper that has been evaluated and accepted as valuable by peers, you can't hide it from the public. The results have been published in Cancer Cell in January 2007, which is part of Elsevier Inc, one of the biggest and highly reliable science press out there. People are starting self-medicating with mostly great success and their testimony are getting more and more abundant. The DCA's wikipedia page has a long section on its potential use for cancer therapy, why can't the Cancer page include something on DCA? DCA is actually being clinically tested on human patients in many laboratories. Only the results have yet to be published before it is recognized by the health authorities as a very promising medication against cancer. DCA has been used in the treatment of lactate acidosis for over 30 years and at low intakes (10mg/kg of body weight/day) has basically no side effects. The only reason why DCA has to remain low profile is because the pharmaceutics won't benefit from it as it is already in production, is not patentable and is extremely cheap. For that reason, the pharmaceutics will never invest 1 cent in the clinical testing of DCA. You have to decide who you are working for, the people or the money? — Preceding unsigned comment added by Niceroad77 (talk • contribs) 00:17, 29 May 2011 (UTC)

If it has not been proven to work in cancer patients, it is not more notable than any of the 1000s of other compounds being tested. The fact that people are silly enough to be bowled over by mouse studies, and order a dangerous compound over the internet, does not need reporting here.

You are utterly wrong about investment by pharmaceutical companies, and this is a classical strawman argument. In the Western World, a significant amount of cancer research is carried out by charities or by academic institutions. This includes clinical trials. I can assure you that these organisations will do what they can to investigate a promising compound if it is indeed thought to be promising. JFW | T@lk 02:40, 29 May 2011 (UTC)

"In human bodies there is a natural cancer fighting Mitochindria, the powerhouse/engine of the human cell, however they need to be triggered to work. Scientists used to think these mitochondria cells were damaged and thus ineffective against cancer... This DCA ... triggers the mitochondria which in turn fights the cancer cells."

I recommend reading mitochondria . Mitochondria do not fight cancer cells.AerobicFox (talk) 22:28, 1 June 2011 (UTC)

If there are, say, news stories talking about any proper clinical trials that are currently underway, then it's possible that it would be appropriate to add it to the list of Experimental cancer treatments. If it's more of an AltMed thing, then it could certainly be listed at Alternative cancer treatments. WhatamIdoing (talk) 23:44, 1 June 2011 (UTC)

I wouldn't say DCA is alternative medicine. It's more undercooked medicine... JFW | T@lk 06:16, 2 June 2011 (UTC)

There was a long discussion on DCA starting in early 2007 (see archive thread page 3) Lets not rehash that again. Jellytussle (talk) 20:27, 30 June 2011 (UTC)

This type of information should have no place in wikipedia's elaborations on cancer because 1. It is not reported in a scientific journal 2. Even if it were reported, unless I get confirmatory reports in other scientific journals, including double-blind studies, I would not consider it standard of care. Let's keep the quality of wikipedia the highest possible. User:imyoung —Preceding undated comment added 18:17, 17 July 2011 (UTC).

Progress of disease and cause of death.

There is not much in the article about the progress or developemnet of the disease. Are there recognizable stages? What is the actual immediate of cause of death for those who die of cancer? There is nothing in the article that tells us anything about what the victim actually dies from e.g. heart failure. Tonygumbrell (talk) 19:34, 10 June 2011 (UTC)

I think that it depends on the details, but perhaps someone will know what general statements could be made.

A few years ago, someone proposed a general article on "physiology of dying" (or something like that). I don't think anyone found enough good sources to do much with that. WhatamIdoing (talk) 21:07, 10 June 2011 (UTC)

It depends on many factors, mostly the type of cancer. A brain tumor is going to kill you much differently then testicular cancer after all. Going into the different stages would probably be better suited then to their respective articles.AerobicFox (talk) 07:49, 11 June 2011 (UTC)

Cancer is not a single disease, therefore readers should be referred to specific Cancers for further enlightenment. Most cancers are chronic illnesses and in older patients the demise is usually due to cardiovascular events. For instance, Cancer of the Prostate often need not be treated in older men with low risk cancer (but they do need to be followed regularly by a physician trained in the disease, i.e. urologist or oncologist). Some general statement could be made regarding progression and outcome but it will be quite difficult to do so without becoming inaccurate. (Imyoung (talk) 01:12, 18 July 2011 (UTC))

Edit request from 122.61.41.137, 12 July 2011

The article on CANCER needs to be edited.

The section on alternative treatments is mostly ALL false.

I suggest you have informed medical persons write this section, as the person writing it, is obviously severly ignorant otherwise paid by someone to keep this information concealed, for the purpose of monetary gain from certain controling sections of the medical profession.

thousands upon thousands of peple healed and free of cancer worldwide, and this person says there is NO evidence, and just a case of the patient being relieved of their money.

Surely you cannot in all honesty print such rubbish, I am not sure how it passed any clearance.

this is beyond belief.

Paula — Preceding unsigned comment added by 122.61.41.137 (talk) 09:38, 12 July 2011 (UTC)

Two pieces of advice. Firstly: calm down. Secondly: provide us with high-quality evidence that any of these modalities has verifiably cured anyone (by which I mean published in a reliable medical source). Until you follow both bits of advice you are very unlikely to achieve anything. JFW | T@lk 20:22, 12 July 2011 (UTC)

Inflammation

Inflammation

Although there is plenty of evidence that chronic inflammation can promote cancer, the cause of this relationship is not yet understood. Scientists have identified a basic cellular mechanism that may be linking chronic inflammation and cancer.

Findings from numerous studies suggest that inflammation is likely to have an important role in bladder carcinogenesis and cancer disease progression. While macrophages (Mos) constitute a major inflammatory component of the stroma of human bladder carcinoma, the regulatory role of such inflammatory leukocytes in tumor cell survival and invasion remains elusive.

Inflammation also plays a role in breast cancer progression.

Since there is growing realization that cancer has a very strong inflammatory component, it is likely that high-dose omega-3 fatty acids (EPA and DHA) could have a significant benefit for cancer patients. Published data indicates that cachexia can be reduced by high-dose fish oil.

---

I've removed this new bit, because I couldn't figure out how to improve it. The sources are weak ("Allergy Consumer Report" from AchooAllergy.com? C'mon, we can do better than that) and the primary sources about isolated cells in vivo and a mouse study—not even humans.

There's probably something to be said about this subject, but I don't think that anything here really meets the basic standards for this article. WhatamIdoing (talk) 20:46, 21 July 2011 (UTC)

I agree, there have been a number of edits to medical articles by this user, who also has a website promoting an anti-inflammatory diet for RLS. Might be worth keeping an eye on. --PaulWicks (talk) 12:12, 24 July 2011 (UTC)

There's definitely some merit in including a section on inflammation and cancer - particularly as the evidence grows to support the use of anti-inflammatories such as aspirin in cancer prevention. For example articles here and here There's a lot of nonsense out there, but certainly a great deal of scientific truth to it that should be addressed,in my opinion. KatArney (talk) 13:19, 10 August 2011 (UTC)

Edit request from 68.84.52.140, 19 August 2011

Please change "commonest" to "most common" because "commonest" is not a word.

68.84.52.140 (talk) 04:46, 19 August 2011 (UTC)

Not done: As both forms of the word are considered acceptable, there is no need to make this change. Topher385 (talk) 09:56, 19 August 2011 (UTC)

"Cause" section needs to be rewritten to agree with the information in the "Cause" subsections

The section on causes should be updated. The "cause" summary section should include the fact that alcohol is the cause of up to 6% of all cancer (as per the "chemicals" subsection of the "causes" section which states that 10% of all cancers in men and 3% of all cancers in women are caused by alcohol in Western Europe).

Similarly, the section on "radiation" states that ultraviolet radiation from the sun the cause of most non-melanoma skin cancers, which are the most common forms of cancer in the world, yet the "cause" summary section says that radiation of all kinds is only responsible for 0 to 10% of all cancers. Obviously both of these statements can't be true.

The "lack of physical activity" in the "cause" section should be moved and included in the 30 to 35% caused by "diet and obesity", per the discussion in the subsection 'diet and exercise".

No estimate is given for the percentage of cancer caused by stress. No discussion of stress is provided in the various subsections, that I could find, and one is left to assume that it is at most a contributing factor to other causes. It seems pretty bogus to just list it as a cause at the top level without any supporting evidence.

Last but not least, no estimate is given for the percentage of cancer cases caused by environmental pollutants in the summary section. The only discussions in the various subsections that seem relevant to environmental pollutants in re cancer are the discussions on occupational cancers -- eg, benzene and asbestos, and asbestos like products. There is NO discussion of any other kind of environmental pollution causing cancer. If work related exposure is the only significant source of cancer from environmental pollution, perhaps the summary section should change the wording from "environmental pollutants" to "workplace exposure to environmental pollutants" and include the estimate of 2 - 20% in the summary. Granted, environmental pollution anywhere, not just as work COULD cause cancer, but if it in fact, ISN'T currently a major cause of cancer for anyone except people working with benzene and asbestos on the job, then that should be highlighted -- especially if 20% of all cancers are actually caused by working with benzene and asbestos. — Preceding unsigned comment added by 74.38.229.40 (talk) 18:29, 31 August 2011 (UTC)

Thank you for your comments. Would you mind reading all of that again, paying particular attention to the difference between "getting cancer at all" and "dying from cancer"? For example, about a third of "getting cancer at all" is caused by non-ionizing radiation, but less than 2% of "dying from cancer" is caused by non-ionizing radiation. Naturally, this makes a significant difference in the statistics. WhatamIdoing (talk) 19:16, 31 August 2011 (UTC)

Is there always a cause?

Cancer is caused by stacking mutations of body cells, the environmental 'causes' listed are simply things that increase the rate of these mutations. Now I don't have a problem with the environmental factors being listed as causes. But I think the article should reflect that the possibility of Getting Cancer is a consequence of being human, or indeed being any multicellular organism. Everyone can get cancer even if they would avoid every single one of all the 'causes' of cancer, indeed everyone will eventually develop Cancer if you don't die of something else first.Fransbal (talk) 20:59, 21 September 2011 (UTC)

friend, if you have sources, throw it on the porch and we'll see if the cat licks it up. — alf.laylah.wa.laylah (talk) 21:33, 21 September 2011 (UTC)

There are already sources in the article that say this, e.g., the quotation from Robert A. Weinberg in the epidemiology section.

Also, one of the problems with all of the stats is that most of cancer stats deal with subsets of subsets of subsets of cancer, not all cancer: When we say that tobacco use causes 25% of cancer deaths, we mean that tobacco use is associated with enough excess death from cancer to account for 25% of cancer cases that are (1) invasive, (2) significant enough to be diagnosed, and (3) result in death.

If you count "all cancers", not just cancers that meet all three of those conditions, then tobacco represents a much smaller piece of the pie, because it's likely that almost every older adult's body contains, or has previously contained, at least one "cancer"—just not a clinically significant, invasive cancer. WhatamIdoing (talk) 04:26, 22 September 2011 (UTC)

Language?

Hi, I was wondering if it would be possible to make edits to this article to increase readability (ie by making more use of plain English). Given that it's a page with huge public interest, and likely to be found by patients, I feel that the language could be clarified in places without sacrificing accuracy. What do people think? (by way of disclaimer, I work for Cancer Research UK and have the best part of 7 years experience in communicating complex concepts about cancer and research to the public in plain English) KatArney (talk) 13:19, 10 August 2011 (UTC)

Feel free to make changes, Kat. You seem to be very qualified to make them. JFW | T@lk 20:39, 10 August 2011 (UTC)

Hello, I've mad some changes to the language in the opening section, as discussed above, to make them a bit more 'plain English'. I've also made some changes to reflect the fact that cancer isn't either environmental OR genetic - it's a compbination of both, and it's very difficult to ascribe a cause in any one specific case. Hope that's OK - let me know what you think. KatArney (talk) 12:04, 28 September 2011 (UTC)

Oncology

Shouldn't the article maybe mention oncology more prominent, preferably in the lede? Some people may not be aware of the term and would miss relevant sources when looking for information because of this. For example, the Oxford Journals listing of Medicine related publications has three journals with the word "oncology" in the title but only one with the word "cancer". DS Belgium (talk) 23:11, 25 September 2011 (UTC)

We mention the treatment modalities (chemo and radiotherapy) but not oncology. This may be because the treatment of cancer is a multidisciplinary process. We should slip it in somewhere. At the same time, I don't believe counting journals is a reliable way of establishing the importance of a concept. JFW | T@lk 05:18, 26 September 2011 (UTC)

Maybe I should have expressed myself better, I only meant using the word in the lede or somewhere in the article itself, which would give readers a link to the oncology article explaining the term. The only direct link seemed to be the one in the tumors template at the bottom of the page. I wikilinked the first occurence of "oncologist" (which redirects to the article) instead; I should have done that in the first place instead of posting here probably... DS Belgium (talk) 01:52, 3 October 2011 (UTC)

Oncologist redirects to oncology, as it should do. JFW | T@lk 16:21, 3 October 2011 (UTC)

Prevention - Bad phrasing

Prevention --> Dietary --> Second paragraph: Horribly worded sentence:

"Some studies have found that consuming lots of fruits and vegetables has little if any effect on preventing cancer.[51]"

Please change the phrasing ("Some studies" and "lots of fruits and vegetables") to something like "A study following 142,605 men and 335,873 women from 1992-2000 showed a very small inverse association between intake of total fruits and vegetables and cancer risk.[51]" — Preceding unsigned comment added by 71.217.25.5 (talk) 07:18, 9 October 2011 (UTC)

This is what you get when you base an important section in a major article on primary sources. What we need is to replace references 42-53 with secondary sources (see WP:MEDRS), apart from the coffee & liver cancer meta-analysis. Perhaps the team of contributors from Cancer Research UK could be persuaded to tackle this issue. JFW | T@lk 09:08, 9 October 2011 (UTC)

I have replaced the above with

An increase in overall fruit and vegetable consumption is unlikely to reduce the cancer rate in a well-nourished population; though it is not known whether populations with low fruit and vegetable intake have a higher cancer risk than those with moderate intake, and specific nutrients found in some fruit or vegetables may have an as yet unidentified effect.

Key TJ (2011). "Fruit and vegetables and cancer risk". Br. J. Cancer. 104 (1): 6–11. doi:10.1038/sj.bjc.6606032. PMC 3039795. PMID 21119663. {{cite journal}}: Unknown parameter |month= ignored (help)

--Anthonyhcole (talk) 07:27, 22 December 2011 (UTC)

Forty per cent of all cancers are preventable - according to news report

It has been on the news today (December 8 2011) that forty per cent of all cancer deaths are preventable, if people ate a more salubrious diet, stopped smoking or lived in the right environment. While I would not like to edit this article as I have no expertisein this field, I have noticed it has not been edited for a while. I am only going but what I heard on news reports, which are not, it is true, reports in medical journals, but if any one can find reliable sources for this claim, it would be good if this could be in the article. ACEOREVIVED (talk) 22:17, 8 December 2011 (UTC)

We are already citing a previous study that found the same thing. JFW | T@lk 23:35, 8 December 2011 (UTC)

Alternative cures

Why are alternative cures listed a hoax but not chemotherapy? Chemotherapy is very risky and much more expensive while having a good chance to fail. Pyrolord777 (talk) 15:47, 18 December 2011 (UTC)

Where to begin... Chemotherapy is based on clinical trials, often of 100s of people, and it is only used when the expected benefit outweighs that of any side-effects. Alternative cures would not be "alternative cures" if they were supported by the same quality of evidence. JFW | T@lk 16:55, 18 December 2011 (UTC)

And what of a scenario where some "alternative cures" work better than chemotherapy but the government covers up the facts due to loosing money from chemotherapy? Anything is possibly and I have no doubts that the companies providing chemotherapy would loose alot of money if safer cures for cancer were found. Pyrolord777 (talk) 22:02, 21 January 2012 (UTC)

Ah, conspiracy theories. Difficult to take seriously in the absence of good evidence, don't you agree? Governments would be thrilled to have cheaper and safer cancer treatment. As it happens, a lot of chemo drugs (particularly the older ones) are not expensive. JFW | T@lk 23:23, 21 January 2012 (UTC)

Ulcerates

The word ulcerates probably shouldn't link to ulcerate, which seems to be a page about a death metal band. Should it link to Ulcer_(dermatology)? 96.252.95.7 (talk) 04:19, 11 January 2012 (UTC)

 Done Good call. Thanks.Novangelis (talk) 06:18, 11 January 2012 (UTC)

Don't we just love the use of medical terminology by heavy metal groups and their subclasses? Although interestingly Metastasis is from the 1950s. JFW | T@lk 11:35, 11 January 2012 (UTC)

Edit request on 13 February 2012

I recently recovered from cancer and I noticed important information regarding the diagnosis and prevention of cancer missing on the Wikipedia page. I like to replace the first few lines of the current diagnosis statement with the one I have supplemented below. I think that the Classification and Pathology should stay as is. I would also like to add the following paragraph in the Prevention section. Sources cited are listed at the bottom of the page with coordinating numbers.

    4. Diagnosis

Initial lumps or other symptoms may be apparent to the patient, thus causing them to see a doctor. In order to diagnose a patient with cancer several steps must be taken. Depending on the type of cancer, certain testing measurements may or may not be necessary. 1) Physical exam. Your doctor will look for physical changes in the area of concern and ask about your risk factors, such as excessive exposure to radiation and a family history. 2) Blood tests. In some people blood tests may be useful in monitoring tumor extent and progression. 3) Fine-needle aspiration. Fine-needle aspiration gathers cells to view under a microscope (biopsy) and is generally the first test to distinguish between benign and malignant tumors. 4) Imaging tests. You may have one or more imaging tests, such as X-rays, magnetic resonance imaging (MRI), computerized tomography (CT) scans, positron emission tomography (PET) or ultrasound. These tests can help detect whether the cancer has spread. In tests that involve radiation, specialists carefully monitor doses to avoid the risk of radiation overexposure. 5) Genetic testing. Depending on the cancer, genetic testing may be necessary. Some cancers are genetically transmitted while others are not. [4]

 5. Prevention
 5.4 Protection

Protection from radiation is a simple yet vital step that should be taken to avoid any unnecessary radiation. “Most scientists and regulatory agencies agree that even small doses of ionizing radiation increase cancer risk, although by a very small amount. In general, the risk of cancer from radiation exposure increases as the dose of radiation increases. Likewise, the lower the exposure is, the smaller the increase in risk. But there is no threshold below which ionizing radiation is thought to be totally safe.” [1] Avoid any unnecessary exposure to radiation, especially with CT scans. “CT scans deliver far more radiation than conventional X-rays -- between 50 and 200 times as much, As a result, the average radiation dose people in the U.S. get has nearly doubled since 1980, says David J. Brenner, PhD, of Columbia's Center for Radiological Research.” [2] Examples of protection: led apron, gonad shield and thyroid shield for x-rays and sunscreen for UV rays. [3] [1] http://www.cancer.org/Cancer/CancerCauses/OtherCarcinogens/MedicalTreatments/radiation-exposure-and-cancer [2] http://www.webmd.com/cancer/news/20071128/radiation-related-cancers--rise [3] http://hps.org/publicinformation/ate/faqs/leadgarmentsfaq.html [4] http://www.mayoclinic.org/thyroid-cancer/diagnosis.html [5] http://www.health.ny.gov/publications/4402/

Wipperfurth (talk) 04:11, 13 February 2012 (UTC)

Per WP:MEDR we typically use review articles or major textbooks.Doc James (talk · contribs · email) 04:21, 13 February 2012 (UTC)

That link should be WP:MEDRES. Dru of Id (talk) 04:48, 13 February 2012 (UTC)

Actually it's WP:MEDRS. Yobol (talk) 04:49, 13 February 2012 (UTC)

Not done: Per above, sources need to be better. Thanks, Celestra (talk) 05:59, 14 February 2012 (UTC)

Hereditary cancer citation needed

Citation needed for sentence in second paragraph: "Approximately five to ten percent of cancers are entirely hereditary." — Preceding unsigned comment added by 68.101.75.70 (talk) 05:58, 2 February 2012 (UTC)

You'll find the citation at the end of the first sentence under Cancer#Causes. We don't usually repeat citations every time the same fact is mentioned. WhatamIdoing (talk) 18:53, 13 March 2012 (UTC)

the "surveillance" theory

I believe we need to add this theory as to Causes:

In Bernie Siegel's words:

One of the most widely accepted explanations of cancer, the "surveillance" theory, states that cancer cells are developing in our bodies all the time but are normally destroyed by white blood cells before they can develop into dangerous tumors. Cancer appears when the immune system becomes suppressed and can no longer deal with this routine threat. It follows that whatever upsets the brain's control of the immune system will foster malignancy

--Zaurus (talk) 23:47, 30 January 2012 (UTC)

Major textbook or recent review article as support per WP:MEDRS... Doc James (talk · contribs · email) 23:58, 30 January 2012 (UTC)

That's not really a "cause", anyway; it's more "pathogenesis". The cause is whatever makes those cancer cells "develop all the time" in the first place. WhatamIdoing (talk) 01:21, 31 January 2012 (UTC)

If health people's bodies "develop [cancer cells] all the time", then it's not so relevant what makes those cells in the first place. What's important is what causes life-threatening cancer growths and tumors, and that appears immune system suppressing related events... --Zaurus (talk) 16:14, 2 February 2012 (UTC)

Googling[2] it does produce three books in the last 10 years which reference this theory. However if little progress on this research then there's nothing wrong with citing Bernie Siegel's book from the 1980s on it. --Zaurus (talk) 18:04, 13 March 2012 (UTC)

Well, there is something wrong with citing a 30-year-old book: We need to use up-to-date sources per Wikipedia:Identifying reliable sources (medicine)#Use_up-to-date_evidence. WhatamIdoing (talk) 18:54, 13 March 2012 (UTC)

Your link says up-to-date just gets preference. Also the oldest book where Siegel writes about this is 26 years old. I didn't read his 2011 book, but giving his ongoing work in the field, his 1986 book on the topic must surely qualify for wikipedia's notability guidelines related to the topic of cancer. --Zaurus (talk) 22:10, 19 March 2012 (UTC)

WP:Notability is about whether the book would get a completely separate article entirely about the book, not about whether it should be mentioned in any other articles. WhatamIdoing (talk) 22:17, 19 March 2012 (UTC)

Maybe I chose the wrong word (notability). Any feedback on my "not 30 year old" rebuttal? Thanks. --Zaurus (talk) 20:57, 20 March 2012 (UTC)

Sure, I'd be happy to address that point: The guideline I pointed you at says, "Look for reviews published in the last five years or so, preferably in the last two or three years." Using an arithmetic skill normally taught in the US to six year olds, I point out that twenty-six, although less than thirty, is still noticeably greater than five. WhatamIdoing (talk) 23:10, 20 March 2012 (UTC)

Treatment using parvoviruses ?

Perhaps treatment with parvoviruses needs to be mentioned, see http://www.faqs.org/patents/app/20110020287#b , http://www.dkfz.de/en/f010/groups/rommelaere/index.html — Preceding unsigned comment added by 91.182.243.15 (talk) 08:15, 19 March 2012 (UTC)

It looks like this is still in the pre-clinical stages (e.g., mouse testing), not regular treatment, so it's probably not appropriate here. (Think about how unreadable this page would be if we included every "promising" treatment being studied somewhere in the world.) You might consider adding it to Experimental cancer treatments, though. WhatamIdoing (talk) 22:20, 19 March 2012 (UTC)

Environmental

It feels silly to have to explain this, but what we call "lifestyle choices" like diet and tobacco use are a part of an organism's biophysical environment. The dichotomy used here is genetic vs non-genetic, not genetic vs some of the non-genetic causes vs other non-genetic causes.

The reason that they draw the line there is because the real world is messy: is your poor diet due to "lifestyle choice" or due to drought? Is your second-hand tobacco exposure due to "lifestyle choice" or due to being born into a family that chain-smokes around its children? If you live in an area with poor sanitation systems, and that results in a bladder cancer secondary to a parasitic infection, do you call that a "lifestyle choice" or pollution? WhatamIdoing (talk) 22:54, 19 March 2012 (UTC)

You might like to read this, and to consider the many high-quality sources "lifestyle+and+other+environmental" like this one, which talks about "dietary, lifestyle and other environmental determinants of cancer risk". Dietary and lifestyle determinants couldn't be "other environmental determinants" if they weren't a type of environmental determinant in the first place. This is a very typical division in the literature. I know it's not obvious to the average person, but that's why we tell them about this quirk of the field. WhatamIdoing (talk) 23:09, 19 March 2012 (UTC)

Are we happy with what User:Zaurus has changed it to now? Doc James (talk · contribs · email) 15:07, 20 March 2012 (UTC)

No, because it introduces a serious error: that source does not say that lifestyle factors directly cause most cancers; it says that lifestyle factors contribute to most cancers, i.e., they are sometimes one factor among many: e.g., smoking plus occupational benzene exposure plus smog caused a case of head and ncek cancer, not just tobacco.

Additionally, it's not just a matter of adding things up. Let's start here by pretending that you've decided second-hand smoke and living in an area without access to clean water are "lifestyle choices" rather than environmental situations. That list of non-genetic causes totals 95% of cancers already, and that's without including the three major environmental causes listed there, or occupational chemical exposures, childbearing choices, medications, and several other classes of causes that aren't listed there. Our list of causes noticeably exceeds 100%. That's because researchers double-count causes when multiple causes are relevant. For example, hormone replacement therapy and alcohol consumption may both contribute to the same case of breast cancer, and that one case will be counted by both the HRT and the alcohol studies as being causes by the thing they happen to be studying.

What we can accurately say is that 90–95% of cancers are caused by non-genetic, i.e., biophysical environmental, causes. We cannot accurately say that most cancers are caused by lifestyle choices. It might be true, but we don't actually know that, even though it looks obvious to anyone who doesn't know what's behind these numbers. I realize that it's a fine point, and perhaps even hair-splitting, but it's a matter of accuracy. We can afford to be accurate here. WhatamIdoing (talk) 23:07, 20 March 2012 (UTC)

Agree with above, "lifestyle" as a substitute for "environmental" is clearly incorrect. I would have no problem with "non-genetic" with an explanation that includes lifestyle, but currently it does not really represent reality. Yobol (talk) 16:13, 21 March 2012 (UTC)

A phrase like "not solely due to hereditary genetic factors" might be more precise. After all, 100% of cancers involve genetic changes. WhatamIdoing (talk) 14:23, 23 March 2012 (UTC)

WhatamIdoing makes a strong case for cancer not being a personal choice. However I feel it's not an accurate reflection of the source. Life-style choice in the source [3] is clearly defined as a point about the preventability of cancer through personal choices. Perhaps we could find a source more closely aligned with WhatamIdoing's opinion. However right now, the text in the cited source says the opposite of the article. --Zaurus (talk) 19:18, 21 March 2012 (UTC)

The named source simply does not say that lifestyle choices are not a part of the organism's biophysical environment. The article therefore does not say the opposite of the named source. WhatamIdoing (talk) 14:23, 23 March 2012 (UTC)

I don't think the cited definition [4] can be said to equal "non-genetic". Perhaps you can explain what's wrong with simply using the two words "environment and lifestyle" like the first source [5], or even "non-genetic" as Yobol suggested, instead of Environmental, as used by cancer researchers, means any cause that is not inherited genetically, not merely pollution.. It's certainly shorter and easier to understand (IMHO). --Zaurus (talk) 17:30, 23 March 2012 (UTC)

Minor typo in section "Screening"

Second paragraph reads:

Cancer screening is not possible for may types of cancers as of 2011

I think it should probably be

Cancer screening is not possible for many types of cancers as of 2011,

--AFigueiredo (talk) 18:27, 29 March 2012 (UTC)

Classification

This might be an interesting addition to the classification section:

Cancer cells can be classified by identifying the MicroRNA expression. These mRNA expression levels can be used as a diagnostic and prognostic tool in tumor and cancer classifications, although current tumor classification methods do not incorporate experimental knowledge. As is evident in experimental knowledge, different types of cancer can be associated with the irregular expression of particular miRNAs. Other parameters considered to be critical are the location of the miRNAs on the strand, cancer associated genomic regions, epigenetic alteration of miRNA expression and abnormalities in processing target genes and proteins. Recent evidence show that miRNAs play an important role in human malignancies and could act as a tumor/oncogene suppressor. — Preceding unsigned comment added by Squirrelypants (talk • contribs) 20:58, 4 April 2012 (UTC)

Inflammation and cancer

inflammation seems to play an important role in the process of cancer development. See for example the following article:

"Recent data have expanded the concept that inflammation is a critical component of tumour progression. Many cancers arise from sites of infection, chronic irritation and inflammation. It is now becoming clear that the tumour microenvironment, which is largely orchestrated by inflammatory cells, is an indispensable participant in the neoplastic process, fostering proliferation, survival and migration. In addition, tumour cells have co-opted some of the signalling molecules of the innate immune system, such as selectins, chemokines and their receptors for invasion, migration and metastasis. These insights are fostering new anti-inflammatory therapeutic approaches to cancer development." http://www.ncbi.nlm.nih.gov/pubmed/12490959

Or this article: "A new study shows how inflammation can help cause cancer. Chronic inflammation due to infection or to conditions such as chronic inflammatory bowel disease is associated with up to 25 percent of all cancers." http://www.sciencedaily.com/releases/2011/04/110419091159.htm and http://dx.doi.org/10.1073/pnas.1101795108 — Preceding unsigned comment added by 79.199.39.228 (talk) 17:29, 6 April 2012 (UTC)

you can google to find more papers with reliable sources: http://scholar.google.de/scholar?q=Inflammation+and+cancer

i think these informations should be included into the article. i have not the knowledge in this area to do it. can anybody help? --79.199.39.228 (talk) 16:45, 6 April 2012 (UTC)

For sources to be useful, they need to be reliable sources (reviews in high-quality journals, textbook chapters). The 2002 source is simply too old in such a fast-moving field. The interaction between malignant cells and the immune system is the subject of intense study, so it wouldn't be a bad thing if we added a few sentences on this. JFW | T@lk 21:05, 8 April 2012 (UTC)

Rename to "Cancer in Humans"?

This article seems to be written as if it was only meant to inform on cancer in Homo Sapiens, rather than multicellular organisms in general, although some of the information in it also applies more generally. 87.121.52.64 (talk) 11:12, 2 May 2012 (UTC)

Oppose. In common usage when we humans say cancer mean cancer in human. --Doc James (talk · contribs · email) 12:23, 2 May 2012 (UTC)

Oppose. Per James. If we ever have Cancer in veterinary medicine or similar, we can point the reader to it, but most readers searching for "cancer" will have humans in mind. --Anthonyhcole (talk) 13:35, 2 May 2012 (UTC)

We do have sections at the end called "In other animals" per W:MEDMOS. Feel free to write up such a section using secondary sources if you like.--Doc James (talk · contribs · email) 15:44, 2 May 2012 (UTC)

Snowball oppose. Naming conventions suggest the principle of least astonishement. JFW | T@lk 21:32, 2 May 2012 (UTC)

Oppose based upon WP:ASTONISH. While "Cancer with an emphasis on human cancer" might be more technically accurate, most searches based upon a single word will want this article. There is a hatnote to the disambigation page, and numerous sectional redirects to other related articles; if another article on veterinary or feline or canine cancers (why not murine or plant tumors, as well?) are brought to sufficient quality that they would be of high interest, discussion of their addition to the hatnote would be appropriate at that time. Concur with application of WP:Snowball clause.Novangelis (talk) 22:02, 2 May 2012 (UTC)

Include comment?

The source "Global cancer statistics" by Jemal et al is heavily cited. I'm wondering whether the commentary on that paper by Brawley doi:10.3322/caac.20107 should too. Views? LeadSongDog come howl! 17:28, 4 May 2012 (UTC)

Sounds like an excellent idea. Neither one are reviews by the looks of it. Would love to see this article brought to GA.--Doc James (talk · contribs · email) 18:56, 4 May 2012 (UTC)

Sure, why not? WhatamIdoing (talk) 19:01, 4 May 2012 (UTC)

For reference, the commentary by Brawley is PMID 21296854 (LeadSongDog, could you verify we're thinking of the same commentary?) MastCell ^Talk 22:47, 4 May 2012 (UTC)

I believe that it is PMID 21296855 for the Jemal source.

James, why do you think this (the Jemal paper) is not a secondary source? WhatamIdoing (talk) 20:40, 7 May 2012 (UTC)

My mistake thanks WAID, not sure what I was look at. Doc James (talk · contribs · email) 20:14, 10 May 2012 (UTC)

Types of cancers

Please put a list of what types of cancers there are. I want them in alphabetical order. Thank you. — Preceding unsigned comment added by 124.168.160.102 (talk) 03:08, 2 July 2012 (UTC)

Well, why didn't you change anything then? — Preceding unsigned comment added by 124.168.160.102 (talk) 03:15, 2 July 2012 (UTC)

Wikipedia is a volunteer project and no one is obligated to do research for you. However, this might help. --NeilN ^{talk to me} 03:20, 2 July 2012 (UTC)

Hi IP! Your second post replied to an artificial life-form (aka bot) named SineBot. It is not programmed to change anything in the text, like it did here. Sorry for the confusion caused; I will report this bug. Alfie↑↓© 10:06, 2 July 2012 (UTC)

Edit request on 4 July 2012

DCA is an odourless, colourless, inexpensive, relatively non-toxic, small molecule. And researchers at the University of Alberta believe it may soon be used as an effective treatment for many forms of cancer.

Dr. Evangelos Michelakis, a professor at the U of A Department of Medicine, has shown that dichloroacetate (DCA) causes regression in several cancers, including lung, breast, and brain tumors.

Levi levi32 (talk) 10:25, 4 July 2012 (UTC)

This does not meet the criteria of a medical source that we would be able to include. DCA is most definitely toxic, and since this 2007 report there has been an enormous amount of fluff but no proper data in man. Instead, the stuff is being sold on the internet without proper clinical supervision; you can imagine the mayhem. JFW | T@lk 22:12, 4 July 2012 (UTC)

Removing "General Consensus" Statements from [Prevention: Dietary] Section

The dietary suggestion from the referenced document (48) is not clinically backed by any research or studies within the reference. In fact, it is clearly stated as "general consensus", an not relavant to this section. I think it should be replaced by, "Large claims have been made for the effectiveness of particular diets in preventing cancer or inhibiting its progression. However, more recent clinical studies have not confirmed this. Instead it seems that rather than specific dietary constituents, total calories influence cancer incidence and progression." This is the actual conclusion of their research.

--Jjttitus (talk) 16:54, 23 August 2012 (UTC)

One, that's a WP:Copyright violation, which is impermissible.

Two, even though the particular study doesn't believe that eating your veggies will prevent cancer, the fact is that this recommendations are actually made. We need to describe what experts say to do, even as we note that the expert recommendation might be worthless. WhatamIdoing (talk) 18:30, 8 September 2012 (UTC)

Preventable

I removed a claim unsupported by the reference, below. The cited source shows 35% of cancers worldwide are due to identified preventable risk factors. That's certainly not a "vast majority", and if anything seems to say that cancer is mostly *not* preventable (though clearly 35% is substantial!). -- Beland (talk) 16:54, 8 September 2012 (UTC)

Removed text

The vast majority of cancer risk factors are due to environmental (including lifestyle) factors, and many of these factors are controllable. Thus, cancer is largely considered a preventable disease.

It's more complicated than that. The text here does not say that the vast majority are preventable; it says that the vast majority are environmental. Environmental means "not due to inherited genetic mutations". 35% of cancer deaths are due to controllable environmental factors; 55% are due to non-controllable environmental factors (e.g., cosmic radiation); 10% are due to non-controllable genetic mutations. If you re-do the numbers to account for cancer cases, the controllable environmental factors account for more than half the cases (due entirely to the effects of non-melanoma skin cancer, which is 98% non-fatal and probably also 98% preventable).

So while I agree that the second sentence might be a bit misleading, the first is entirely correct: 90–95% of cancer deaths are due to environmental causes, and >95% of cancer cases (including non-invasive skin cancer) are due to environmental causes. I think that counts as "the vast majority". I'll see if I can fix the sentences; feel free to improve on them. WhatamIdoing (talk) 18:20, 8 September 2012 (UTC)

Mesothelioma is not lung cancer

Edited for accuracy; mesothelioma is not lung cancer, but rather is a cancer of the serous membrane. UberMitch (talk) 08:29, 18 November 2012 (UTC)

Communication

These two columns [6][7] have information and links to sources about communication about cancer and might be useful for a section on that topic. WhatamIdoing (talk) 01:53, 8 December 2012 (UTC)

Cannabis Cancer Treatments

A long discussion about cannabis derivatives and their potential as cytostatics

Cannabis compounds have demonstrated effectiveness in significantly reducing cancer and tumor growth and have even completely eradicated multiple forms of cancers and tumors altogether. Numerous studies have been replicated and published highlighting this effect and these results should certainly be displayed in Wikipedia's article about cancer. For example: http://mct.aacrjournals.org/content/6/11/2921, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2673842/?tool=pmcentrez — Preceding unsigned comment added by Jackpots777 (talk • contribs) 13:26, 6 May 2012 (UTC) In vitro studies in isolated cell lines can’t demonstrate efficacy. False claims are not helpful. Alfie↑↓© 13:55, 6 May 2012 (UTC) These are replicated scientific studies consistently demonstrating the efficacy of cannabis components in eliminating cancer. They should be included in this article for this reason. Jackpots777 (talk) 14:46, 7 May 2012 (UTC) Along with the results of the numerous studies demonstrating the efficacy of cannabis components in eliminating cancer, information about the use of cannabis by patients with chemotherapy-related nausea and vomiting should also be included. Jackpots777 (talk) 17:20, 7 May 2012 (UTC) Clearly, no cannabis-derived agent is about to be used against cancer. We should not pretend we can predict the future, as loads and loads of investigational compounds never even make it to phase III trials. Just the fact that some of those compounds are derived from dope doesn't make them any more special. With regards to cannabinoids in CINV, this is already discussed in that article and doesn't require specific mention here. JFW | T@lk 17:42, 7 May 2012 (UTC) It should be noted that your comment is simply an opinion rather than a fact about the future potential of cannabis compounds and the numerous scientific studies including the ones beyond those listed here are factual, verifiable, and based upon scientific analysis that is sound and replicated. Since this article is about cancer, and the research being performed in relation to cancer is an important aspect of this topic, the results of multiple studies showing THC eliminating cancer cells while leaving healthy cells untouched should be highlighted somewhere within it. Please stick to facts when deciding whether or not this information should be included to ensure this article provides those searching for factual information about cancer with a complete picture of the existing database of human knowledge that exists pertaining to cancer. As to the inclusion of cannabis use to stave off chemotherapy-induced nausea and vomiting, other articles are irrelevant since this discussion is about the cancer article. With cannabis being widely used by patients suffering from cancer due to its effectiveness in managing chemotherapy-induced nausea and vomiting as can be verified by numerous organizations and scientific publications, this information should also be included in this article. Jackpots777 (talk) 23:02, 7 May 2012 (UTC) We use review articles which is NOT the same as peer reviewed articles as sources. These do not quality as reviews. Doc James (talk · contribs · email) 23:13, 7 May 2012 (UTC) Numerous acceptable sources can be used to reference information about the results of scientific studies testing the efficacy of cannabis compounds in treating cancer. It appears the discussion should be more focused on how this information should be included at this point. Verifiable information provided by reliable and acceptable sources are available concerning the use of cannabis compounds to eliminate cancer cells in multiple replicated scientific studies and this qualifies this information for inclusion. A reference to the hypotheses stating the possible efficacy of THC and other cannabinoids as cancer treatments by reputable experts in the field along with a general overview of the results of these studies should be included with references to the pros and cons of these studies also being addressed.— Preceding unsigned comment added by Jackpots777 (talk • contribs) 23:45, 7 May 2012 (UTC) Numerous replicable studies will show that gasoline quickly kills cancer cells in a petri dish, too. So do any number of thousands of substances. In fact, I'm not sure there is any substance in existence that won't kill cancer cells, except maybe solid pieces of glass, metal, or plastic. I can kill cancer cells with the extract of any living organism, so long as you let me pick the dose. I can even kill them with plain old water. It's incredibly easy to kill cells in a dish. In fact, it's keeping them alive that requires skill and effort. This article generally does not include information about treatments that are not actually approved by regulators after successful testing in real, live humans. You can keep talking if you want, but the answer is no, and the answer is going to remain no unless and until there is non-experimental use of these compounds in real people in the real world. WhatamIdoing (talk) 00:03, 8 May 2012 (UTC) These studies show cancer cell apoptosis, programmed cell death, without damaging surrounding living cells. The information that should be included is not a treatment but information highlighting these studies and this article is incomplete without this information.Jackpots777 (talk) 00:22, 8 May 2012 (UTC) Completely trivial. Lots of things of zero medical significance induce apoptosis differentially. Come back no sooner than Phase II trials.Novangelis (talk) 00:30, 8 May 2012 (UTC) Come back with review articles. Doc James (talk · contribs · email) 00:54, 8 May 2012 (UTC) The only requirement for a Wikipedia article is a reliable and trusted source. Since this information is available from such sources, it is suitable for this Wikipedia article and will be added. — Preceding unsigned comment added by Jackpots777 (talk • contribs) 18:19, 8 May 2012 (UTC) It fails WP:MEDRS as it should be in a review (WP:PSTS) that demonstrates medical significance, not just a curious laboratory effect that has no overt signs of development (WP:DUE).Novangelis (talk) 18:42, 8 May 2012 (UTC) It fulfills the requirement for Wikipedia WP:MEDRS as a topic concerning current affairs. http://en.wikipedia.org/wiki/Wikipedia:MEDRS#Popular_press Jackpots777 (talk) 19:10, 8 May 2012 (UTC) This is not the kind of content one would wish to base on sources in the popular press. It's hardly "current affairs" isn't it? Anycase, a large number of editors has now made it clear that the content you wish to include is not suitable; without consensus everything else stops. JFW | T@lk 19:17, 8 May 2012 (UTC) Dozens of recently completed studies showing cannabis compounds killing cancer cells without affecting healthy cells certainly qualifies as current affairs. Numerous additional sources can be used that adhere to Wikipedia's guidelines for sources. Another potential source is a reputable major medical and scientific body: National Cancer Institute http://www.cancer.gov/cancertopics/pdq/cam/cannabis/healthprofessional/page4 http://en.wikipedia.org/wiki/Wikipedia:MEDRS#Medical_and_scientific_organizations Nope, not even close, and the "current affairs" canard is worthless as an end run around WP:MEDRS. There is no point is placing speculations ("preclinical") in with demonstrated treatments (WP:DUE). It is time to move on.Novangelis (talk) 21:01, 9 May 2012 (UTC) Showing a statement by a reputable major medical and scientific body such as the National Cancer Institute qualifies as a source for this article and this is a clear cut fact with no room for a rebuttal since it is a Wikipedia policy. Also, there are thousands of editors. Many more editors than the five who have spoken here should be given a proper amount of time to voice their opinions on this matter. Of the five editors who have voiced their opinion thus far, two present information that has no relevance to the actual studies being referenced and three make false claims concerning the lack of suitable sources. Since a single sentence referring to the verifiable fact that multiple reputable scientific studies have shown cannabis compounds protecting test subjects from cancer as verified by multiple reputable sources including the National Cancer Institute, the consensus is presently in favor of adding this sentence.Jackpots777 (talk) 21:16, 9 May 2012 (UTC) If this article were about killing cancer cells in vitro, then I'd be happy to support a mention. But it's not. It's about cancer in humans, and you've not produced any sources that show that this is actually being used (not talked about or studied) in humans (living, breathing whole bodies, not just cells in a dish). This page does not cover details like this. There are hundreds of compounds with just as many papers behind them, and in fact far more reason to believe they will become successful treatments in the near future, and we don't mention any of them. The fact that these compounds are cannabis-derived is irrelevant. We have no interest in naming any specific experimental cancer treatment on this page. We don't even mention any specific drugs by name, even drugs that are currently being used by hundreds of thousands of patients. WhatamIdoing (talk) 21:51, 9 May 2012 (UTC) Your arguments against the addition of this information are being placed in the wrong section, for your argument is based on your personal opinions, not Wikipedia policy. Wikipedia policy presently declares that statements and information provided by a reputable major medical and scientific body such as the National Cancer Institute is suitable for Wikipedia.Jackpots777 (talk) 13:11, 10 May 2012 (UTC) I withdraw my recommendation for the addition of this material. If someone could please delete this section so that the discussions may focus on more relevant topics your help would be greatly appreciated. Thank you. — Preceding unsigned comment added by Jackpots777 (talk • contribs) 06:43, 29 May 2012 (UTC) It has already been put in a collapsible box to make this talkpage more manageable, and all discussions are automatically archived 90 days after the last comment is added. JFW | T@lk 08:48, 29 May 2012 (UTC) I agree with Jackpots777. I would also like to ad that you are wrong by saying that - If this article were about killing cancer cells in vitro, then I'd be happy to support a mention. But it's not. It's about cancer in humans. - Says who ? The title of the article is Cancer, not Cancer in humans ! Therefore technically there could even be a section within the same article on cancer in animals. You gasoline analogy is also quite rediculous. While I agree that there are many chemicals that kill cancer cells "in vitro", these chemical don't alway do that without harming normal cells. I suspect gasoline would harm normal cells as well and therefore it's not as effective as marijuana compounds, although I do agree that in vitro is not the same as in human bodies. However there should still be space in this artice to include in vitro cancer studies IN ADDITION to human studies (or mention of sufficient lack thereof). All aspects of cancer can and should be mentioned in brief even if it includes alternative treatments that don't work and this fact is emphasized clearly. You clearly display your short-sitedness as not everything has to be about a cure of cancer just because this is an article on cancer. There are many aspects to cancer which can be discussed especially if given it's own paragraph, or section in the article and not over done. PS. the main reason that human clinical trials never happen for alternative, natural anti-cancer treatments is because there has to be more than scientific interest in a substance in order to finance its participation in a phase 3 clinical trial - there has to also be a financial incentive. A financial incentive does not rely only of the likely success of a drug, or chemical, but it also relies on the profitability of that drug or chemical. Naturally occuring anti-cancerous drugs, or chemicals cannot be patented and therefore while likely effective, they will NEVER be put through phase 3 clinical trials because that takes millions and there is no financial incentive for a return on investment. This clearly does not mean that alternatives do not work. In fact if the naturally occuring chemicals in our food did not supress cancer you would have been dead from cancer years ago and would not even be healthy right now!--197.64.17.242 (talk) 22:52, 25 January 2013 (UTC) RE: ALTERNATIVE THERAPIES kalijuri: i am not familiar with wiki in how to really use it so i hope i am commenting in the right place. i have tried a few already. i was trying to make an addition to the CANCER wiki page under 'alternative therapies' in order to add cannabis oil and also antineoplaston therapy. both medicines cure cancers, verifiably. proven over and over again so i won't go into it here. anyway, i stumbled into the collapsed box on an obvious hot mess of an argument. i would like to put my 2c in here: jackpots777 who is trying to get the admins (not sure why a cancer page needs admins or semi/protected use. doesn't seem right or fair. plainly it is wrong. i thought wikipedia was a reliable source, but now i realize it is not. it is just a joke of sorts. any alternative therapies, treatments, etc., should be editable on the main page. it is an act of treason to not allow such a thing. wikipedia is not an advertisement for the cancer industry. it IS an industry. it should be open to fairness in the name of all humanity. i was disgusted by the lack of professionalism in the talk section. someone, jackpots777, trying to get ALL the information out not just what the admins of the cancer page want to be published. really disgusting stuff, folks. cannabis oil and antineoplaston therapy (dr. burzynski) MUST be put on the cancer page. it should be against the law NOT to have them in plain sight on the main page for someone that might be using this 'encyclopedia' to gain information about a diagnosis they may have just received. I, for one, will not be using wikipedia for any research or knowledge seeking on any level. I find this whole episode appalling. peace k — Preceding unsigned comment added by Kalijuri (talk • contribs) 16:51, 19 September 2012 (UTC)

— Preceding unsigned comment added by Kalijuri (talk • contribs) 16:51, 19 September 2012 (UTC)

Clinical trials

The main reason that human clinical trials almost never happen for alternative, natural, anti-cancer therapies is because there has to be more than just a scientific interest in a substance in order to finance its participation in a phase 3 clinical trial - there has to also be a financial incentive. A financial incentive does not rely only on the likely success of a drug, or chemical in trials, but, like anything else being studied, it also relies on the potential profitability of that natural drug, or chemical. Naturally occuring anti-cancerous drugs, or chemicals cannot be patented and therefore while likely to be affective, they will NEVER be put through Phase III clinical trials because that takes millions of dollars and there is no financial incentive for a return on investment due to the patent issue mentioned. This clearly does not mean that alternatives do not work, or are unlikely to work. In fact if the naturally occuring chemicals in our food did not surpress cancer you would have been dead from cancer years ago and would not even be healthy and living at all right now! These facts need to me included somewhere in the article. We need to start comparing apples with apples. If a law was passed tomorrow that allowed companies, or individuals to patent naturally occuring plant based chemicals for a limmited period of time before the patent will expire, we would then have hundreds of new applications for clinical trials at the FDA by hundreds of new investors within a month! --197.64.17.242 (talk) 23:12, 25 January 2013 (UTC)

Thanks for your interest in Wikipedia. I understand what you're saying, but we are mainstream here in the sense that we cite scholarly work. Scholarly work may have covered your concern in great detail. Have you checked? If you can find the sources, you can add them, as long as the article remains neutral. Biosthmors (talk) 00:15, 26 January 2013 (UTC)

My point is simply that not all scholarly work is made up only of FDA approved clinical trials, but that is the what is being forced down people's throat. i.e. Scholarly work, or studies that do not include phase 3 clinical trials conducted with accordance to the rules and regulations set out by the FDA cannot be considered reliable. Why should any one entertrise/agency have a monolopoly over an entire industry as far as what is accepted as scientifically reliable is concerned? And why should an unbiased encyclopedia not consider the countless other studies not approved by the FDA as being authoritative? There have been many successful and reliable human studies done on alternative cancer treatments over many years that were not classified as FDA approved phase III clinical trials.--197.64.17.242 (talk) 01:02, 26 January 2013 (UTC)

As you can see at WP:MEDRS we don't rely on any specific government agency. Can you please make specific recommendations about how to edit this page? That's the point of it. Not to vent or blog or express an opinion. =) Biosthmors (talk) 01:08, 26 January 2013 (UTC)

Contradiction shows bias - Cancer treatments are NOT effective

This article states: "The improved understanding of molecular biology and cellular biology due to cancer research has led to a number of new, effective treatments for cancer since President Nixon declared "War on Cancer" in 1971. Since 1971 the United States has invested over $200 billion on cancer research; that total includes money invested by public and private sectors and foundations.[126] 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.[127]"

If there are now "new, effective treatments for cancer since President Nixon declared "War on Cancer" in 1971", then why since 1971 has the "$200 billion" invested in cancer research seen only "a five percent decrease in the cancer death rate (adjusting for size and age of the population) between 1950 and 2005.[127]" - "Despite this substantial investment" !!! Therefore these new treatments can't be very "effective" ! Why is there no mention of native tribes in Africa, or historically in Europe with low, or no incidences of cancer? - The Kenyan Maasai a prime example.--197.64.17.242 (talk) 23:57, 25 January 2013 (UTC)

It seems like one concept that would help your confusion (and the article) is the quality-adjusted life year. Maybe someone will include data about it in the article. Are you willing? Even if a treatment reduces mortality by 5 or 10%, that's an effective way to prevent death. Clinical effectiveness has nothing to do with $. Please feel free to also point to a WP:MEDRS you think should be cited to maintain a WP:NPOV. Biosthmors (talk) 00:11, 26 January 2013 (UTC)

I understand the concept clearly, but even so, a 5%, or 10% decrease in death rate (no matter how you calculate it) is NOT EVEN CLOSE to being considered "effective". Surely any logical person would agree. The term "effective" should only be used in cases of a say maybe 50%, or 70%, or 90% reductions in death rates. Therefore this section is contradictory at best and biased at worst. I'm just being logical here. What would you say to your doctor if he told you there was a 5% chance he could cure you of a disease and he then continued by saying that 5% is considered very good and highly "effective" ? Surely you understand what I am trying to say ?--197.64.17.242 (talk) 00:37, 26 January 2013 (UTC)

Most Maasai die around the age of 40. Historically, very few have lived past the age of 60. Cancer is largely a disease of old age. In fact, until about the time of World War I, almost all of the increase in cancer was due to people living long enough to develop it. It's hardly desirable to tell people "Live like those healthy Maasai: die in your early 40s, and we can guarantee that you won't get cancer in your 50s, 60s, 70s, or 80s!" WhatamIdoing (talk) 01:05, 26 January 2013 (UTC)

I know what you're trying to say. 5% sucks, but it's infinitely better than 0%. If the 5% is real, it's still effective, just in a marginal and sucky way. Biosthmors (talk) 01:12, 26 January 2013 (UTC)

That should allay most of your concerns, right? I think it's an improvement. Biosthmors (talk) 01:19, 26 January 2013 (UTC)

Thanks for making the change to the article, although I don't know how you can say "it's still effective, just in a marginal and sucky way." Either it sucks, or it's not effective, how can it be both? - ps. Do you really think that alternative medicine cannot beat a 5% reduction over such a long period of time? Makes you think, don't ya think so :-) — Preceding unsigned comment added by 197.64.17.242 (talk) 02:35, 26 January 2013 (UTC)

Well I already explained the distinction I see but I'm glad you appreciated the edit! Article talk pages aren't for personal opinions without a bearing on article content, but feel free to contact me at my talk page. Best. Biosthmors (talk) 02:41, 26 January 2013 (UTC)

I think it's very important to understand that progress in treating cancer has not been homogenous. Some malignancies have gone from universally fatal to nearly universally curable (hematologic malignancies like Hodgkin lymphoma and childhood acute lymphoblastic leukemia come to mind). The improvement for those diseases isn't 5% or 10%; it's more like 90%. On the other hand, some cancers - especially metastatic solid tumors like pancreatic or gastric cancer - have seen very little progress in effective treatment, although one could argue that advances in supportive and palliative care have improved quality of life for people with those conditions. I think you could argue that the magnitude of progress is disappointing given the scale of resources invested in the "War On Cancer" - in fact, many people do make that argument. As an aside, in the few instances where alternative cancer therapies have been rigorously compared to "conventional" approaches, the alternative approaches have fared very poorly, often producing shorter survival and worse quality of life (e.g. PMID 19687327). MastCell ^Talk 18:16, 22 March 2013 (UTC)

Genetic modification

Perhaps that genetic modification of humans can be proposed in the prevention or management section. Appearantly, the gene P16 makes naked mole rats immune to cancer and is also present with humans (with humans it's inactive) Making this gene active could thus make humans immune to (some?) cancers

Mention in article 109.130.206.155 (talk) 14:20, 22 March 2013 (UTC)

I think that this is too small and too speculative a detail to include in the main article. It might be worth a brief mention in a more specific article like Cancer research or Genetics of cancer or something like that. WhatamIdoing (talk) 00:11, 23 March 2013 (UTC)

Stages of cancer

I came to the cancer article to understand the stages, but there was no mention of it. There is a cancer staging article on Wikipedia, so there should be mention of stages linking to that article.

It is curious that this is missing from the article, seeing as it is a very basic (and rather important) part of the subject matter. Also, why is the article locked? I would've added linking to staging if it were editable. — Preceding unsigned comment added by 72.211.224.112 (talk) 08:52, 27 March 2013 (UTC)

There is the separate article Cancer staging. I agree that at least of a summary of the content of that article should be present in this one. This article has been semi-protected so that only registered users can edit it because it has been the target of persistent vandalism. If you would like to suggest specific content to be added to the article, you can make that suggestion here, following the directions at {{Edit semi-protected}}. Deli nk (talk) 16:38, 27 March 2013 (UTC)

ref

ref to cancer animals — Preceding unsigned comment added by 85.26.186.108 (talk) 13:02, 18 April 2013 (UTC)

Causes and cures

This article states: "Common environmental factors that contribute to cancer death include tobacco (25–30%), diet and obesity (30–35%), infections (15–20%), radiation (both ionizing and non-ionizing, up to 10%), stress, lack of physical activity, and environmental pollutants.[2]"

If tobacco smoking causes cancer, then reducing, or totally preventing tobacco smoking will decrease you chance of getting cancer, or stop more of the same type of cancer from forming on top of your current cancer, right ?

If infections are a cause of cancer, then reducing, or totally preventing infections will decrease you chance of getting cancer, or stop more of the same type of cancer from forming on top of your current cancer, right ?

Therefore if diet (or dietary defficiencies) can also cause cancer, then surely reversing dietary defficiencies and even over-reversing dietary defficiencies (EATING MORE OF CERTAIN SUPER-FOODS) will stop more of the same type of cancer from growing, or reverse the cancer caused by the dietary defficiency, right? WRONG! Wikipedia disagrees with this logical theory and states (or implies) that alternative therapies do not work! If our cells make use of certain vitamins, minerals and anti-oxidants to repair damaged cellular DNA all the time, then how can cancer not be reversed by these same vitamins, minerals and anti-oxidants if cancer is nothing more that a cell with damaged DNA instructions ! But oh, no, we doctors are not allowed to say that in case we lose our medical licences, or worse, get thrown in jail. Or maybe we CAN say that, as long as we don't use the word "cure" in the same sentence, especially not in a Wikipedia article ! PATHETIC! If 90–95% of cancer deaths are due to environmental causes and these causes are mostly preventable, then this proves that fact that natural cures exist (including dietary) — Preceding unsigned comment added by 197.64.17.242 (talk) 23:35, 25 January 2013 (UTC)

Of course eating healthier can prevent cancer. But I don't know to what extent this is caused by not eating good food. I think it might mostly be due to overeating. I don't know; do you have any WP:MEDRS you're aware of that mention undernutrition as a cause of cancer? Biosthmors (talk) 00:19, 26 January 2013 (UTC)

This article states: "diet AND obesity (30–35%)" - so dietary defficiencies therefore do play a part since a disctinction here is made between diet and obesity, otherwise it would have just said obesity, or obesity DUE to diet. Also, I am not talking about general malnutrition. It is common knowledge that dietary defficiences of certain naturally occuring chemicals causes problems within cells, such as problems with DNA. Therefore if cancer is caused by abnormal DNA mutations in cells, and defficiencies of certain nutrients can cause these mutations, then it makes sense that dietary defficiencies of certain nutrients cause cancer, which is what this article is bordering on saying, but not clearly enough. — Preceding unsigned comment added by 197.64.17.242 (talk) 00:49, 26 January 2013 (UTC)

Sources rule here, not what we type or our own unverifiable original research. Got any sources? Biosthmors (talk) 01:10, 26 January 2013 (UTC)

I will bring sources for nutrition and cancer, but I am sure the studies in those sources won't be considered good enough if they are not FDA approved clinical trials and all my hard work will be removed despite Wikipedia's written policies of not expressly forbidding citations of non-FDA approved clinical trials published in non-mainstream journals that don't all recieve advertising money from the pharmaceutical companies whose very same drugs appear in the journals trials.--197.64.17.242 (talk) 02:27, 26 January 2013 (UTC)

How about name one relevant (and recent) review article on the subject that has been indexed in PUBMED and we'll start there. Giving a PMID will help. That shouldn't be hard. Biosthmors (talk) 02:38, 26 January 2013 (UTC)

Every single editor pulls the "source" card whenever you use logic to understand something. It is like "the sky is blue." I am going to need a source for that statement . . . 68.50.119.13 (talk) 05:01, 9 May 2013 (UTC)

No problem: the source you want is doubtless listed at Rayleigh scattering.

The problem with the "diet" thing is that it's more complicated than that. The typical thing is to assume that "dietary causes" mean "eating a bad food" or "not eating a good food". The fact is that nearly all of the dietary cause is "eating too much food" and thus becoming obese. Even "perfect" foods (no matter what your belief is about which foods are "perfect") can cause cancer if you eat too much of them. WhatamIdoing (talk) 22:34, 14 May 2013 (UTC)

Epigenetics

Cancer#Epigenetic_alterations seems like too much detail. Is there an article on this subject that this can be merged to? WhatamIdoing (talk) 22:13, 27 May 2013 (UTC)

Is this not something that can be moved to carcinogenesis? Agree it is excessive, but could not find the time to move it. JFW | T@lk 22:55, 27 May 2013 (UTC)

I've found it: Cancer epigenetics. (I'd been looking for titles starting with "Epigenetics of..."). WhatamIdoing (talk) 01:02, 28 May 2013 (UTC)

cell phone cancer risk

after Non-ionizing radio frequency radiation from mobile phones, electric power transmission, and other similar sources have been described as a possible carcinogen by the World Health Organization's International Agency for Research on Cancer.[30]

please insert this sentence:

However, studies thus far have not shown a consistent link between cell phone use and cancers of the brain, nerves, or other tissues of the head or neck. More research is needed because cell phone technology and how people use cell phones have been changing rapidly.

http://www.cancer.gov/cancertopics/factsheet/Risk/cellphones

Bigdoorprize69 (talk) 20:44, 28 May 2013 (UTC)

Done Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:13, 29 May 2013 (UTC)

I should note Mobile phone radiation and health is in a horrible shape from a WP:MEDRS standpoint. Yobol (talk) 02:28, 29 May 2013 (UTC)

Edit request on 27 June 2013

A typo in the "Genetic testing" section: "than" should be replaced with "then"

Instead of "..mutations may THAN undergo.." it should be "..mutations may THEN undergo.."

66.30.218.121 (talk) 15:16, 27 June 2013 (UTC)

 Fixed. Thanks for catching the error. Deli nk (talk) 15:26, 27 June 2013 (UTC)

"entirely hereditary" is not what the citations says

The following review based statement was relegated to "Research" by Jmh649. But reviews now find they (or the absence) are a primary factor in cancer. Primary means it should be in the introduction. Here is the proposed last sentence in the second paragraph. "Phytochemicals from dietary plants and spices have been shown to prevent cancer initiation, promotion, and progression by exerting anti-inflammatory and anti-oxidative stress effects, and have been shown to induce apoptosis in cancer cells and suppress tumor growth in vivo.[171]"

Why is such lead worthy material put down in research, when it's known and no longer subject to debate.

Phytochemicals are now being used as therapeutic agents.

5 - 10% is for breast cancer only, and there is no general statement as you wrote in the introduction.32cllou (talk) 23:53, 14 July 2013 (UTC)

The 5–10% issue merely cited the wrong source. The correct source specifically says all cancer cases, not just breast cancer (and the previously cited source merely named three genes affecting breast cancer, colorectal cancer, endometrial cancer, and stomach cancer risks, which is already a lot more than "breast cancer only").

I don't think that the balance of evidence (i.e., the number of sources indicating general acceptance) supports the claims you're making. What you wrote will be interpreted by most readers as "taking phytochemical pills will prevent and cure cancer".

What's behind your statement ("Phytochemicals from dietary plants and spices have been shown to prevent cancer initiation, promotion, and progression by exerting anti-inflammatory and anti-oxidative stress effects, and have been shown to induce apoptosis in cancer cells and suppress tumor growth in vivo.") is no proper real-world clinical trials on this point, but a bunch of lab studies. "Mice live longer on this kind of diet" is not the same thing as "works in humans". We tend to avoid non-human work in this article. A review of animal studies is much better than an individual animal study, but it's still not good enough. We want reviews of human studies here. WhatamIdoing (talk) 00:44, 15 July 2013 (UTC)

Yes thanks wrong ref. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:34, 15 July 2013 (UTC)

Thanks are due to WhatamIdoing for correcting the heredity source, that should resolve that issue, right?

The phytochemical content was sourced to PMID 20798979. This review is very tentative, it discusses "potential molecular targets and signaling pathways" and "some of the phytochemicals that are capable of targeting these signaling pathways which would make them potentially applicable to cancer chemoprevention" (emphasis mine). This review is all potential and theory, it is not the review of clinical trial data that we're looking for to make a statement about the efficacy of phytochemicals. That said, I don't agree with removing all mention of phytochemicals from the article altogether - they're frequently discussed in popular press and should be mentioned. In my opinion the article should have a brief (one sentence) mention of them and the current state of the research on them - that they look interesting but we're far from having enough data on them to make any kind of recommendations for their use. Zad68 01:12, 15 July 2013 (UTC)

We could put something like "Phytochemicals are being studied regarding a potential role in the prevention of cancer." Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:34, 15 July 2013 (UTC)

Yes, in the Research section, not in the lead. I think the sentence should also have "...but there is no conclusive evidence that any particular phytochemical prevents or fights cancer in humans" although I am not sure the source provided PMID 20798979 supports that - if not another one should be found. I am looking at this but a journal article should be found. Zad68 01:42, 15 July 2013 (UTC)

The 5 - 10% is being grossly misstated. The cite does not say "entirely hereditary" by a huge margin! The sentence should parallel the citation, which says "Only 5–10% of all cancer cases can be attributed to genetic defects, whereas the remaining 90–95% have their roots in the environment and lifestyle." Lifestyle includes phytochemicals, and I am free to use that review.32cllou (talk) 02:36, 15 July 2013 (UTC)

Nobody is 'free to do' anything - Wikipedia editing is a collaborative process, and where there is a dispute, we work towards consensus. And why do you persist in discussing two different issues at once? AndyTheGrump (talk) 02:46, 15 July 2013 (UTC)

How about this for the last sentence to the second paragraph in the lead: Approximately 5–10% of all diagnosed cancers can be attributed to genetic defects, while 90–95% have their origin in the environment and lifestyle.32cllou (talk) 02:56, 15 July 2013 (UTC)

The lede currently says more or less the same thing, as far as I can see. What is wrong with the existing wording? AndyTheGrump (talk) 03:21, 15 July 2013 (UTC)

Well, nothing, I think, unless you're hoping to make people feel "defective" if they have a genetic mutation that puts them at higher risk for cancer, or perhaps hoping to sell the idea that taking pills from an herbal medicine store will prevent or treat genetically caused cancers.

There are two big challenges in describing that kind of information in the lead. The first is that normal people and cancer researchers have very different ideas of what "environment" means. The other is that all cancers are caused by genetic mutations. It's just that most of these mutations are not hereditary. We're trying to differentiate between the cancers that happen because one of your parents gave you a gene that results in cancer vs the cancers that happen despite having "typical" genes from your parents. WhatamIdoing (talk) 05:23, 15 July 2013 (UTC)

You guys choose that source, and having done so, must abide by it's true content. Your current text is in violation of the information content of your citation. If you have problems with the reference, you must find another one to support and qualify your current text.

WhatamIdoing, all cancers are initiated by a genetic mutation(s). Environmental factors can promote the occurrence of those mutations. I read mutations are ongoing in the most healthy (low stress, low environmental toxins exposure, exercising, very healthy eaters) individuals, and the most important factor leading to an eventual diagnosis of cancer is the promotion of those cancers. 90% of initiated breast cancer cells self-destruct. 50% of breast cancers (identified by mammography and biopsy) disappear without treatment. Few of the diagnosed breast cancers spread (to then eventually cause death). Reviews find that diet is an important factor in reducing the probability of cancer promotion. I will add those reviews to the proposed sentence, and say in a petri dish instead of in vivo, because that makes it more clear the science (in reviews) is currently limited to those types of studies.32cllou (talk) 23:10, 15 July 2013 (UTC)

Scratch that last sentence above. I rewrote the second paragraph to properly reflect the statements in your source. It was a good review reference. Thank you for providing.32cllou (talk) 01:02, 16 July 2013 (UTC)

Phytochemicals

And I suggest as the last sentence to the second paragraph: Phytochemicals from dietary plants and spices have been shown to prevent cancer initiation, promotion, and progression by exerting anti-inflammatory and anti-oxidative stress effects, and have been shown to induce apoptosis in cancer cells and suppress tumor growth in vivo.32cllou (talk) 03:09, 15 July 2013 (UTC)

Phytochemicals are being used as therapy clinically. I find no reviews, but they have Medicare payment approval.32cllou (talk) 03:11, 15 July 2013 (UTC)

Can you explain why you think this particular matter deserves mention in the article lede? What makes this more significant than any other area of ongoing research? AndyTheGrump (talk) 03:18, 15 July 2013 (UTC)

This would be undue weight. They have not been shown to prevent cancer in those we care about most, humans. And besides phytochemicals are a class of substances not a single one. Research is ongoing to see if they might help prevent or treat cancer. Not ready for prime time yet, more research is needed. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:37, 15 July 2013 (UTC)

See the above regarding cancer initiation, versus promotion. Cancer promotion is the most important factor when considering the risk of dying from an initiated cancer cell. 90% of diagnosed cancers (your reference) is environmental and lifestyle. 90% (certainly more than your 5 - 10% mutations) belongs in the lead. FYI, I read several primary studies finding heredity is a less than 5% factor, which makes your current text even more unwarranted (certainly undue emphasis). Diet is the most important environmental factor (assuming use of tobacco is lifestyle).

PS, I meant to say Medicare reimbursement in my second paragraph above, which is very hard to get approval for.32cllou (talk) 23:19, 15 July 2013 (UTC)

A heavy tobacco user is more likely to get cancer from the tobacco than an overeater is likely to get cancer from his diet. The fact that overnutrition is more common than tobacco use does not mean that overnutrition is inherently more risky than tobacco use. WhatamIdoing (talk) 21:51, 16 July 2013 (UTC)

I never intended for users to think some individual phytochemical supplement might help prevent cancer, so I will not use that phytochemical review in the lead. The important facts were all in your reference saying whole grains fruits vegetables may help prevent and are well supported thus weighted (from the source abstract) in the lead.32cllou (talk) 00:59, 16 July 2013 (UTC)

Have reverted these edits here

[8] This is because this is not true "The most important lifestyle choices leading to cancer-related deaths may be dietary factors (30-35%), particularly the consumption of fried foods and red meat." I believe it is a misinterpretation of the source in question. The dietary factor that increase the risk the most is obesity not fried foods or red meat per say. Also the lead is for an overview not an indepth discussion. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:57, 16 July 2013 (UTC)

My text re diet is very well supported by your reference and my additional reference. See "The link between diet and cancer is revealed by the large variation in rates of specific cancers in various countries and by the observed changes in the incidence of cancer in migrating. For example, Asians have been shown to have a 25 times lower incidence of prostate cancer and a ten times lower incidence of breast cancer than do residents of Western countries, and the rates for these cancers increase substantially after Asians migrate to the West (http://www.dietandcancerreportorg/?p=ER)."[[9]]

Please provide your review reference basis for saying "I believe it is a misinterpretation of the source in question." Again, several large population studies have concluded that dietary factors are the most important (to predicting death from cancer). Your personal opinion(s) should not taint Wikipedia.

Your current text is unnecessarily and too vague, and not supported by thrust of those two primary references. Fried foods and meat show up in several studies (are our two referenced reviews) as strongly correlated with diagnosed cancers. I will put those factors in the prevention sentence.

I will implicitly (without violating the references) increase the importance of obesity. Remember, it's a poor diet that makes (strongly correlated) people obese!

Note, there are two supporting references. Both references (both broad reviews of the literature) reach the same conclusions.

Pertaining only to your second sentence, please re read your primary reference, which says "Everybody talks about the genes that they received from their mother and father, for this trait or the other. But in reality, those genes have very little impact on life outcomes." Your second sentence is based on unknown content from a simple book (not a peer reviewed, and not a review of the literature), it's old/dated (2002 is VERY old when studying genetics!), and there is no way for anyone (not buying that expensive book) to confirm your wiki text. Is that a textbook currently used by professors to teach a graduate class? If so, provide proof. If not, it is highly questionable, and certainly not worthy of the lead. Finally, in general, cancer promotion (lifestyle and environment) is much more important (to predicting cancer death) than cancer initiation (genes and mutated genes). Again, population studies and the inability of gene therapies and gene altering pharmaceuticals to (other than rarely) improve outcomes say your personal opinion is either incorrect or not worthy of the lead.32cllou (talk) 17:43, 16 July 2013 (UTC)

PS, your reference does not say anything like your text: Approximately five to ten percent of cancers are entirely hereditary.[2] Please read your reference before writing strong and incorrect statements into wikipedia.32cllou (talk) 17:56, 16 July 2013 (UTC)32cllou (talk) 18:42, 16 July 2013 (UTC)

The review in question does not say that fried foods and red meat are the most important. The review says that eating too much (of anything: sugar, grains, poultry, anything) is responsible for more than half of the diet-related cancer deaths. The fact that some primary sources focus on one thing or another is completely irrelevant. WhatamIdoing (talk) 22:04, 16 July 2013 (UTC)

Suggested second lead paragraph

Roughly 5–10% of diagnosed cancers can be traced to heredity or genetic defects, while 90–95% have their origins in an individuals lifestyle (sociology) choices and environmental factors. The most important lifestyle choices leading to cancer-related deaths may be dietary factors and potentially associated obesity (30-35%), 25-30% of cancer deaths can be attributed to the use of tobacco products. Other known lifestyle factors include use of alcohol, and lack of sufficient physical activity. Environmental factors include exposure to pollutants, infections, stress, and exposure to radiation and sunlight. Prevention of cancer generally involves smoking cessation, increased consumption of vegetables and fruits, the use of whole grains, minimized consumption of meat products, minimized consumption of fried foods, reduced caloric intake, exercise, minimized exposure to sunlight, and the use of vaccinations.

Short, concise, current (2008 and 2009) review (2, both highest quality references) material, which is (wiki) recommended for the lead to a subject. Note the lead in Wiki should guide wiki users to the content in the body.32cllou (talk) 18:40, 16 July 2013 (UTC)

I'm not convinced that it's an improvement over the existing paragraph. For one thing, it provides no information about how these risk factors cause cancer. WhatamIdoing (talk) 22:08, 16 July 2013 (UTC)

Current version is better IMO Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:55, 17 July 2013 (UTC)

WhatamIdoing, I'm sorry to say the how does not seem (yet) to be found in a review. Jmh649 personally requires reviews, though Wikipedia generally does not. There is a huge body of independent research to answer your question.

The current text is grossly inaccurate, compared to the content of it's reference.

Jmh649, as for IMO, for your patients benefit should study anti-angiogenesis.

Jmh649, again, please provide your review reference basis for saying "I believe it is a misinterpretation of the source in question." (diet NOT being the strongest factor). You must know personal opinion does not belong in Wikipedia.32cllou (talk) 01:44, 17 July 2013 (UTC)

The "cause" of diagnosed cancer is not cancer initiation, which happens constantly. Diagnosed cancers are more a function of angiogenesis.32cllou (talk) 01:49, 17 July 2013 (UTC)

So you have two editors who disagree with your proposed changes and now you are going to try to edit war it into place? Would recommend you revert yourself and get consensus first. Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:03, 17 July 2013 (UTC)

Three editors disagree it's an improvement, including myself... The change removes some important how information. It also introduces low-level details, like the proposed percentage breakdowns, into the lead; the lead should be a high-level overview. Zad68 02:42, 17 July 2013 (UTC)

I removed how information, because it is old (2002 is old for cancer research), from a book that is not generally usable, and is not currently accurate ("cause").32cllou (talk) 02:59, 17 July 2013 (UTC)

I have ordered the book used by Jmh649 as the reference (see Zad's complaint that I removed a "how" sentence). Jmh refuses to provide any supporting text, or evidence of relevance. In fact, the two recent review references downplay the importance of genes, gene mutation, and heredity. You all should look into gene expression (strongly influenced by diet). I will leave out percentage breakdowns, which do constitute high-level overview, but to which Zad objects.

Zad's claim of 3RR potential violation in my talk is false. I did not revert, but rather made the requested changes in the text, presented in Talk, waited for comment, and then inserted that new text into the subject.

I hope more eyes see Jmh649's whole gang involved (same players again, as in breast cancer and mammography) to dominate and degrade wikipedia subjects. "Again", writes Zad in my Talk, and I say yep he's back again. The current text in Cancer is an embarrassment to wikipedia standards. I read behavior like this frequently drives good editors to quit. It may be worth it to bring all this group out for observation. Thank you.32cllou (talk) 05:19, 17 July 2013 (UTC)

This is not completely correct "two recent review references downplay the importance of genes, gene mutation, and heredity" While they downplay heredity, as do we, the importance of genes and gene mutation have not changed since 2002. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:39, 17 July 2013 (UTC)

Does heredity belong in the lead 5-10% of diagnosed cancers?

Jmh649, you write "Approximately five to ten percent of cancers are entirely hereditary.[2] That sentence is false.

The reflective (supported by the reference) sentence is Approximately 5 - 10% of cancers "can be attributed to genetic defects." There is a huge difference between hereditary (parental legacy), genetic defects (post zygote mutations), and gene expressions. Each of those three might encourage or discourage the incidence of death from cancer. Heredity is the smallest of those three factors. You have it as the most important and only genetic factor.

Again, "Approximately five to ten percent of cancers are entirely hereditary.[2]" is opposite what the citation says. Genetic defects (the 5 - 10%) are not usually hereditary, but rather a function of lifestyle and/or environment. From the reference Introduction: "looking to the human genome for solutions to most chronic illnesses, including the diagnosis, prevention, and treatment of cancer, is overemphasized in today’s world." But, that is happening with that sentence in the lead!32cllou (talk) 17:15, 17 July 2013 (UTC)

I hope my most recent edit represents an acceptable match to the references and compromise.32cllou (talk) 17:37, 17 July 2013 (UTC)

PS, population studies and both those last two references support the word "most".32cllou (talk) 17:39, 17 July 2013 (UTC)

Support

Were does the ref in question support "Most cancer deaths are due to metastasizes." [url=http://www.nccn.com/component/content/article/54-cancer-basics/925-what-is-metastasized-cancer.html] Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:04, 18 July 2013 (UTC)

Near the bottom of the page: "Treatment and survival rates are determined by whether or not a cancer is local or has spread to other locations. If the cancer spreads to other tissues and organs, it may decrease a patient's likelihood of survival." and "Although most metastatic cancers are incurable,..."

Implicitly most. Note that most is a relative term. Most compared to the much lower probability of death from a localized (primary) cancer.

Maybe you need to cite another page (same source?) saying ~localized cancer survival rates are good (which is now true). Or, I was hoping you knew of a journal review reference to cite.

I wonder the sentence shouldn't be something more readable, like "Most cancer deaths are due to cancer that has spread from it's primary site to other organs (metastasized)."

For people with diagnosed localized cancer, it's very important to keep a primary cancer from spreading. That's why I recommended that you study anti-angiogenesis. There are simple lifestyle, and advanced medical, strategies to dramatically lower the probability that a cancer can establish itself elsewhere. Here's a start http://www.ncbi.nlm.nih.gov/pubmed/21977033

Removing the primary does not seem to help all that much, partly because secondary site cancer growth rates are suppressed by the primary mass. Nobody seems to know why, but it should be investigated (it would be a HUGE market for a drug company). Finally, that's partly why mammography (and potential resulting medical interventions) doesn't really pay off.

Thank you for helping Cancer be more comprehensive and accurate! I see all those other percentages lower in the subject. And it's good to have phytochemicals in the research section.32cllou (talk) 20:26, 18 July 2013 (UTC)

Yes I am sure most deaths are secondary to mets. Except for some brain and cardiac cancers the mass effect of a single primary cancer is usually not a huge issue. Will eventually look for a better ref to support this, I agree with the improved wording.Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:01, 19 July 2013 (UTC)32cllou (talk) 02:43, 19 July 2013 (UTC)

Citation of Aggarwal article

I notice that we lean heavily in the lead on an article by Anand et al. to source the claim that only 5-10% of cancers are "genetic" while the remainder are due to lifestyle. I have some concerns, at least indirectly, with this source. Its senior author is Bharat Aggarwal at M.D. Anderson. Aggarwal is currently the subject of an investigation by his institution, M.D. Anderson, for "alleged fabrication and falsification in a host of published studies about the cancer-fighting properties of plants." According to Retraction Watch, Aggarwal has withdrawn two submitted manuscripts, corrected two others, and had another two subject to "Expressions of Concern" from the journal in which they were published ([10]).

The merit of these allegations is difficult to assess pending the completion of the investigation. Even if true, it's not clear that they impact directly on the paper that we cite. Nonetheless, I do wonder whether we should consider alternate sources. I'd suggest the American Cancer Society page on heredity and cancer, which similarly notes the 5-10% figure but in a slightly more precise context. Thoughts? MastCell ^Talk 22:00, 22 July 2013 (UTC)

Yes happy to see the other ref used. Or the use of both. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:20, 23 July 2013 (UTC)

Fish

The American Cancer Society Guidelines [[11]] also cited above explicitly does not support fish. Jmh649, please provide support. "Fish is a rich source of omega-3 fatty acids. Studies in animals have found that these fatty acids suppress cancer formation or hinder cancer progression, but there is limited suggestive evidence of a possible benefit in humans.166 While consuming fish rich in omega-3 fatty acids is associated with reduced risk of cardiovascular disease, some types of fish may contain high levels of mercury, poly-chlorinated biphenyls (PCBs), dioxins, and other environmental pollutants. Levels of these substances are generally highest in older, larger, predatory fish such as swordfish, tilefish, shark,and king mackerel. (In addition, some studies have shown that farm-raised fish may carry more of these toxins than fish caught in the wild.) Women who are pregnant, planning to become pregnant, or who are nursing, and young children should not eat these fish.167 Consumers should be advised to vary the types of fish consumed to reduce the likelihood of exposure to excessive levels of toxins. Research has not yet demonstrated whether the possible benefits of fish consumption may be reproducible by taking omega-3 or fish oil supplements."[[12]]32cllou (talk) 00:18, 24 July 2013 (UTC)

Source

This 2011 review article [13] has been described by 32cllou as a poor source [14]. I would say it is preferable over a 2006 source which is getting a little old. Wondering what peoples thoughts are on this edit [15]? Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:21, 24 July 2013 (UTC)

Jmh649 did not understand my edit note, which meant to say omega-3 benefits are not well sourced (I can't find good support in ref or elsewhere)

His ref does not support fish providing dietary benefit against cancer. I have requested that he provide a quote from the text (from his ref) to support his (not MastCell's) edit stating fish is beneficial.

The American Cancer Society Guidelines (see quote above) does say fish is not supported as written in Jmh649's paragraph.32cllou (talk) 00:34, 24 July 2013 (UTC)32cllou (talk) 00:38, 24 July 2013 (UTC)

The quote is "They estimated that one third of all cancer cases could be prevented by a healthier diet; a statement which was widely accepted in the scientific literature. Since then, a large number of studies and meta-studies have been published with varying and often contradicting results. Nonetheless, there is a general consensus that a “prudent” diet composed of mainly vegetables, fruit, whole grain and fish and a reduced intake of red meat, animal fat and refined sugar should be recommended, and that over-nutrition should be avoided." and "In addition, there are some limited data that consumption of fish and w-3 long chain polyunsaturated fatty acids may be beneficial" [16] And if you note the bit you are attempting to remove "However, these recommendations are based on relatively limited evidence." Yes all agree the evidence base is poor. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:20, 24 July 2013 (UTC)

Agree current content "Dietary recommendations for cancer prevention typically include an emphasis on vegetables, fruit, whole grains, and fish, and an avoidance of red meat, animal fats and refined carbohydrates. However, these recommendations are based on relatively limited evidence." - including mention of fish - is supported by Wickia 2011. I don't see an issue with the source itself. Can't see a reason based on the sourcing to remove the mention of fish. Zad68 02:16, 24 July 2013 (UTC)

I had not been able to find supporting text/information promoting fish (Jmh649's cited reduction of cancer risk due to fish consumption) from Jmh649's reference. He has now provided that supporting text.

There is no scientific doubt that eating fish also means consuming many chemicals and metals known to promote cancer, as noted in the "~old" 2006 Am. Cancer Society Guidelines (which are regularly updated IF there's new info).

As for new data, note that consumption of fish and mussels recently also yields significant human exposure to radiation [[17]][[18]][[19]], which is known to initiate and promote cancer.32cllou (talk) 05:16, 24 July 2013 (UTC)

PS, my concern was prompted by the reports showing the radiation plume from Japan has grown and strengthened tremendously since the nuclear meltdowns. Fish bioaccumulate, in particular polonium-210.32cllou (talk) 05:29, 24 July 2013 (UTC)

Two of these are primary sources. And the third one mentions seafood but not fish. It mentions radiation but not cancer. And it does not make any statement that fish causes cancer or effects rates of cancer. Additionally much fish is fresh water rather than salt and thus not seafood. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:39, 24 July 2013 (UTC)

Agree with DocJames and Zad68, I'm not seeing why we should remove "fish" here, and we certainly shouldn't be using primary studies to rebut secondary sources (see MEDRS). Yobol (talk) 15:22, 24 July 2013 (UTC)

Doc James (Jmh649)

I worry that Jmh649 is misleading Wikipedia/Cancer [[20]] to say eating fish reduces the risk of getting cancer. He also purposely omits known risk factors (processed meats, and fried or charbroiled foods).

In general, much of the observed "benefit" may be a substitution effect; thus substitution of red and processed meats for fish may reduce cancer risk[[21]], and how you cook the meat or fish is very important (fish is less likely to be BBQ'd or fried). Finally, the the reference that may support the 2011 review statement that fish is beneficial is vague, and is based on dated observational cohort studies. I say dated (old) because the concentrations of environmental pollutants has increased over time, and is significantly higher now than when the data for those studies was collected.

From the reference [[22]] you will find the following quote:

 "Limit consumption of processed and red meats.

   • Choose fish, poultry, or beans as an alternative to beef, pork, and lamb.

   • When you eat meat, select lean cuts and eat smaller portions.

   • Prepare meat by baking, broiling, or poaching rather than by frying or charbroiling."

Here are several recent peer reviewed journal published studies finding increased risk (or known risk factors) of cancer from eating fish. [[23]] [[24]] [[25]]

Jmh649 writes above that "User:32cllou...is attempting to replace the conclusions of a 2011 review with one from 2006 as per here [26]with a review from 2006. Thoughts? As it is an active area of research I consider the 2011 review more uptodate." Note that the Am Cancer Society Guidelines are updated as soon as new data is available.

Here is the text I think most reflects the facts and review references (includes avoid processed meats, fried, or charboiled and removes fish): Dietary recommendations for cancer prevention typically include an emphasis on consumption of vegetables, fruits, and whole grains, and an avoidance of red meat, processed meats, fried of charboiled foods, animal fats, and refined carbohydrates.

Please comment, or join in Cancer Talk[[27]].32cllou (talk) 19:53, 24 July 2013 (UTC)

"eating less meat" encompasses "red meat, processed meats, animal fats" we could add refined carbohydrates and fried food. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:39, 24 July 2013 (UTC)

There appear to be confuse regarding what is a secondary source or review article. 16 and 17 are primary sources. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:40, 24 July 2013 (UTC)

In the 2012 ACA guideline fried foods are only discussed in respect to weight gain.[28] Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:48, 24 July 2013 (UTC)

What about this bit "Choose fish, poultry, or beans as an alternative to red meat (beef, pork, and lamb)." [29] Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:51, 24 July 2013 (UTC)

I don't think many Wikipedia users think about red meat, processed meat, and animal fats when they read "meat"; so I recommend being specific (list all). Agree we should add refined carbohydrates and fried foods. I'm OK with "choose fish, poultry, or beans as an alternative to beef, pork and lamb (again being specific). I really agree to add beans! The sentence is still short when it is specific to all important factors (currently listed in reviews).

Next time, I'll introduce a change via your personal talk and ask for suggestions.32cllou (talk) 19:13, 25 July 2013 (UTC)

We typically summarize the source in question rather than copy the wording exactly due to issues around copyright. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:33, 25 July 2013 (UTC)

Granted. I'm working on it now.32cllou (talk) 19:40, 25 July 2013 (UTC)

Please be more specific than "not an improvement."32cllou (talk) 19:59, 25 July 2013 (UTC)

Edit conflict, I do not consider this an improvement [30] thus have reverted. We are writing a general encyclopedia and terms like "Migrant and other ecological studies suggest" is overly complicated. The text before was more to the point.

Have merged the last and first sentences regarding the lack of evidence

We mention weight in the paragraph above therefore do not need to mention it again. Have added processed meat to read meat.

Additionally we do not write in a "how too style" which was done here "When choosing between sources of protein, fish, poultry, or beans may be preferable to beef, pork, and lamb." Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:02, 25 July 2013 (UTC)

Granted no how to. Need cohort/migrant because they are numerous, consistent, and strong. Clinical is not the only valid source or research, so lack of evidence is not true.32cllou (talk) 21:07, 25 July 2013 (UTC)

All the cohort and mirgant data has been taken into account and the overall summary is that the evidence is poor. By the way what page of this http://eprints.ucl.ac.uk/4841/1/4841.pdf are you using? Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:24, 25 July 2013 (UTC)

Evidence for diet

Currently we state "While many dietary recommendations have been proposed to reduce the risk of cancer, they are based on relatively limited evidence." This is supported by this 2011 review which states

• "This stands in sharp contrast to the paucity of evidence, most of which is derived from epidemiological data. Controlled trials, on the other hand, are mostly missing."
• "However, there is no convincing evidence that fat uptake per se (i.e. independent from total energy uptake and obesity) is a risk factor for malignant disease"
• "There is currently no compelling evidence that supplementing vitamins, antioxidants or other micronutrients reduces cancer incidence."

Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:31, 25 July 2013 (UTC)

Pg 22 - 25 in [[31]]. It is better said (2012, and more comprehensive) here in Overview of Guidelines. See "Prospective cohort studies were weighted more heavily than case-control studies, especially when results were available from several cohorts. Population-based case-control studies with at least 200 cases of cancer were considered more informative than smaller or hospital-based case-control studies. Studies that adjusted for total energy intake, considered other dietary factors, and controlled for other known risk factors were considered more credible than those that failed to meet these criteria."32cllou (talk) 21:35, 25 July 2013 (UTC)

Sure so overall the evidence is rather limited. We are a general encyclopedia and we should write in a generally accessible style. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:38, 25 July 2013 (UTC)

On page 22 it states "While not providing strong evidence for causation, such studies generated hypotheses for possible links between specific nutritional factors and cancers" So basically it agreed with the text we had before. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:44, 25 July 2013 (UTC)

[[32]] 2012 > 2011. More comprehensive review. Includes clinical. "...the evidence is not definitive." You can not say limited.32cllou (talk) 21:47, 25 July 2013 (UTC)

Limited is an easier to understand way of saying "not definitive" Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:56, 25 July 2013 (UTC)

How about "While many dietary recommendations have been proposed to reduce the risk of cancer, the evidence to support them is not definitive." Even though I consider the original wording better. Also two refs should be enough. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:06, 25 July 2013 (UTC)

There is extensive observation / cohort research with strong results. Clinical has trouble making it definitive. How can we make that distinction understood?

I still have problems with fish. See "Choose fish, poultry, or beans as an alternative to red meat (beef, pork, and lamb)."[[33]] It is only recommended as an alternative.

I prefer [[34]] as the second reference.32cllou (talk) 22:13, 25 July 2013 (UTC)

Correlation is not causation, but numerous observational have consistent results. Problem is trying to extract the specific factors. For example is it less meat or more veggies and fruit? Clinicals isolate a factor, make a small change to that factor, and observe minor if any change in outcomes. The cohort changes are huge but multiple, for example going from almost no meat to lots, at the same time going from lots of fruit and veggies to little plus lots of refined carbs. Which is the cause?32cllou (talk) 22:25, 25 July 2013 (UTC)

The conclusions however are tentative. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:40, 25 July 2013 (UTC)

The 2012 ACS states

• consuming a diet that contains a variety of vegetables and fruits, whole grains, and fish or poultry or that is lower in red and processed meats is associated with a lower risk of developing certain cancers
• A dietary pattern that is rich in vegetables, fruits, poultry, fish, and low-fat dairy products has been associated with a reduced risk of breast cancer in observational studies
• Several studies suggest that diets high in certain vegetables (including tomatoes/tomato products, cruciferous vegetables, soy, beans, or other legumes) or fish are associated with decreased risk; however, the evidence is not yet convincing
• Does eating fish protect against cancer? Fish is a naturally rich source of omega-3 fatty acids. Studies in animals have found that these fatty acids suppress cancer formation or hinder cancer progression, but there is limited suggestive evidence of a possible benefit in humans.

Which is why it is important to state how limited the evidence is to support the recommendations around diet. Fish included. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:46, 25 July 2013 (UTC)

Limited with respect to a specific food type recommendation, not the totality (more fiber, less meat). 2012 ACS says fish as "an alternative to meat" in the final recommendations. Fish today is high in pollutants and radioactive metals, compared to historically.32cllou (talk) 23:07, 25 July 2013 (UTC)

No consensus for the change and you keep making it [35]. This is your 4th revert in 24 hours and I would suggest you self revert it. Still disagree that it is an improvement. I disagree with the changes around the wording for fish and the extra text you added on "clinical studies" is redundant. Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:14, 25 July 2013 (UTC)

Back to your last. I thought minor additions to agreement are different from a "revert". "Clinical" isn't in your text, so I don't find "redundant" use of clinical. I think you are basing too much on your one Swiss review. I'm trying to find a review of the observational studies. Did you find fault with the omega-3 (from fish or supplements) and aggressive prostate cancer studies?32cllou (talk) 23:58, 25 July 2013 (UTC)

Thanks, have restored the bit we are both okay with. This bit " Fish may be preferred as an alternative to meat". Fish is meat so it does not make sense. Get consensus here first and then the changes will stick. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:00, 26 July 2013 (UTC)

The ACS diet recommendation states "3. Consume a Healthy Diet, With an Emphasis on Plant Foods: Limit consumption of processed and red meats; Choose fish, poultry, or beans as an alternative to beef, pork, and lamb." Current article content is "Dietary recommendations for cancer prevention typically include an emphasis on vegetables, fruit, whole grains, and fish, and an avoidance of processed and red meat (beef, pork, lamb), animal fats, and refined carbohydrates." Wicki 2011 Conclusions largely focuses on the diet's effect on avoiding obesity as the preventive factor, and not really the consumption of any particular type of food. I think the current article content summarizes the sources well and doesn't need to be changed. I'd also suggest adding a sentence stating that the principle guiding the recommendations is avoiding obesity, and not that any particular nutrient has been found to significantly affect cancer risk. Zad68 02:21, 26 July 2013 (UTC)

Yes under the prevent heading we discuss obesity. We could clarify this though.Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:34, 26 July 2013 (UTC)

Diet and Cancer #2, Review primary author may have a Conflict of Interest

The above was getting congested, and I want to focus on the most recent American Cancer Society (2012) review[[36]] compared to your Swiss Medical Weekly (2011) review Diet and Cancer.[[37]]

Sorry about my text saying fish isn't meat. I preferred saying red meat, so red meats? I don't think most people think other than beef, and the main point may be animal proteins (which raise free IGF-1 blood levels). You seemed to reject saying pork, beef and lamb. I prefer listing those three major different red meats, and saying fish may be consumed as an alternative to those red meats (just like the 2012 ACS review guidelines).

I'm trying to be more prepared with the review materials by reading all the Swiss Medical Weekly Diet and Cancer review references. I did not find a good review of the several (Okinawans, Sardinians, Seventh Day Adventist, Mediterranean diet, Chinese, and Finlander) studies on diet and health risks, including cancer.

I bet you agree the ACS (2012) American Cancer Society guidelines on nutrition and physical activity for cancer prevention is a better review for this subject section. For example, it has many more authors or contributors (10 versus 2), more peer review, it is more frequently cited, and has many more (and I think better quality) references (376 versus 99). The Swiss Medical Weekly is a small or minor publication (and seems to be rarely cited).

I'm also very concerned that the first (of only two) listed author may have a severe conflict of interest, being employed and remunerated primarily by medical business (and therefore likely to be strongly motivated to move interest away from possible dietary interventions):

• "Successful healthcare entrepreneur and investor with over 15 years of experience in the pharmaceutical and biotechnology industries. He was co-owner and CEO of ANAWA Holding AG and Clinserve AG, two Contract Research Organisations specialising in analytical services."32cllou (talk) 16:06, 27 July 2013 (UTC)32cllou (talk) 16:14, 27 July 2013 (UTC)

PS, the second author is primarily involved in genetics, not diet or cancer research. Professional focus on genetics may also constitute a source of bias because inherited genetics is only (per the ACS) 5 - 10% of cancer diagnosis risk.32cllou (talk) 16:26, 27 July 2013 (UTC)

Maybe try a RfC. We seem to have a bit of a language barrier. Stuff like "your Swiss Medical Weekly (2011) review" It is a review, it is not my review as I was not involved with writing it. In fact I added the 2012 ACS review aswell. Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:33, 28 July 2013 (UTC)

I agree with the above that if we're still stuck on this one small content issue we should have an RFC. At this point I'm not exactly sure what content change 32cllou is looking for, maybe if that were clarified here on this Talk page we can put together the RFC. Barring that, there isn't consensus for the changes that have been proposed. Zad68 19:07, 28 July 2013 (UTC)

Yes I am not sure what change he is wishing either. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:33, 29 July 2013 (UTC)

The second paragraph in Diet should say While dietary recommendations are made to reduce the risk of cancer, the evidence for a specific factor is not definitive.[5][93] Below is the supporting section (2012 ACS):

"For many issues concerning nutrition and cancer, the evidence is not definitive because the published results are inconsistent or because the methods of studying nutrition and chronic disease in human populations continue to evolve. Part of the uncertainty has resulted from studies that focus on specific nutrients or foods in isolation, thereby oversimplifying the complexity of foods and dietary patterns; the importance of the dose, timing, and duration of exposure; and the large variations in nutritional status among human populations. Nutrition and physical activity research is equally challenging in RCTs, generally considered the gold standard for scientific inference. Studies may fail to find an effect if the intervention begins too late in life, is too small, or if the follow-up is too short for a benefit to appear. In addition, RCTs of lifestyle interventions cannot be blinded, and disease endpoints such as cancer require many years of follow-up. No single trial can resolve all of the questions that are relevant to the potential effects of nutrition throughout the lifespan. Moreover, many important questions about how diet, physical activity, and obesity relate to cancer cannot presently be addressed in RCTs. For example, while there is substantial interest in the effects of early-life body size and dietary patterns on the risk of adult cancer, it is practically not feasible to conduct RCTs to determine the long-term consequences of interventions that begin in infancy and extend for many years.

Inferences about the many complex interrelationships between body weight, physical activity, diet, and cancer risk are therefore based, for the most part, on a combination of shorter-term clinical trials and observational studies coupled with advancing understanding of the biology of cancer. These Guidelines are based on the totality of evidence from these sources, taking into account both the potential health benefits and possible risks from adopting them."

The second paragraph in the lead should say Only "approximately 5 - 10%" ... heredity (as does the ACS).

The Diet section should say "fish" as an alternative to lamb, pork and beef.

State here if you will permit a (well supported) sentence saying A 100x difference in cancer death rates by region in epidemiology research suggests that lifestyle, particularly diet, is an important factor in risk of dying from cancer.32cllou (talk) 18:26, 30 July 2013 (UTC)

32cllou, so you are proposing four changes:

1. Change to first sentence of Prevention - Dietary: While many dietary recommendations have been proposedare made to reduce the risk of cancer, the evidence to support themfor a specific factor is not definitive.
2. Change to start of sentence in second paragraph of lead: Only approximately 5-10% of cancers...
3. - Is still a bit unclear. Current content is "Dietary recommendations for cancer prevention typically include an emphasis on vegetables, fruit, whole grains, and fish, and an avoidance of processed and red meat (beef, pork, lamb), animal fats, and refined carbohydrates." How would you like it to read, exactly?
4. - You would like to introduce the sentence "A 100x difference in cancer death rates by region in epidemiology research suggests that lifestyle, particularly diet, is an important factor in risk of dying from cancer." Where in the article do you want this sentence to go, and what source are you proposing to support it?

Zad68 19:35, 30 July 2013 (UTC)

Maybe try one propose at a time. Than we can discuss and have a RfC if needed. I disagree with a number of your proposed changes as I have explained previously. Doc James (talk · contribs · email) (if I write on your page reply on mine) 01:00, 31 July 2013 (UTC)

One at a time, Fish

The American Cancer Society Guidelines do not support the current statement that consumption of fish will reduce the risk of dying from cancer. Please see bold in the quote below:

"Fish is a rich source of omega-3 fatty acids. Studies in animals have found that these fatty acids suppress cancer formation or hinder cancer progression, but there is limited suggestive evidence of a possible benefit in humans.166 While consuming fish rich in omega-3 fatty acids is associated with reduced risk of cardiovascular disease, some types of fish may contain high levels of mercury, poly-chlorinated biphenyls (PCBs), dioxins, and other environmental pollutants. Levels of these substances are generally highest in older, larger, predatory fish such as swordfish, tilefish, shark,and king mackerel. (In addition, some studies have shown that farm-raised fish may carry more of these toxins than fish caught in the wild.) Women who are pregnant, planning to become pregnant, or who are nursing, and young children should not eat these fish.167 Consumers should be advised to vary the types of fish consumed to reduce the likelihood of exposure to excessive levels of toxins. Research has not yet demonstrated whether the possible benefits of fish consumption may be reproducible by taking omega-3 or fish oil supplements."[[38]]

Also, see pg 6, TABLE 1 American Cancer Society (ACS) Guidelines on Nutrition and Physicial Activity for Cancer Prevention (2006) [[39]], and note that fish is not recommended. You do find the following quote:

"Limit consumption of processed and red meats.

• Choose fish, poultry, or beans as an alternative to beef, pork, and lamb.”

Remember, an alternative to something bad is not good (just relatively better).

Recent confirmed primary research (not reviewed in the ACS 2006 or 2012, or Swiss Weekly 2011 review) finds increased or possible risk of cancer death from eating fish:

”Study confirms link between high blood levels of omega-3 fatty acids and increased risk of aggressive prostate cancer. Consumption of fatty fish and fish-oil supplements linked to 71 percent higher risk.”[[40]]

Consumption of fish and mussels recently (thanks to Japan’s nuclear meltdowns) also yields significant human exposure to radiation (also not in the recent reviews).[[41]][[42]][[43]], which is known to initiate and promote cancer.

Finally, I found this review yesterday "A review of methionine dependency and the role of methionine restriction in cancer growth control and life-span extension"[[44]] Fish contains more methionine than any other meat.

All the above to request we just leave fish out of the recommendations.32cllou (talk) 19:26, 31 July 2013 (UTC)

• I like this approach of doing one piece at a time. My reading of the ACS's recommendations is that they suggest fish instead of red meat not because fish itself is cancer-preventive but because per portion fish has a healthier balance of macronutrients as compared to red meat, and that because obesity in general is associated with increased cancer risk (see for example this), and higher cholesterol is associated with increased risk, a healthier diet should be associated with lower risk. I actually agree with you, 32cllou, in the suggestion above that the article say something like "the evidence for a specific factor is not definitive". The ACS seems to be saying, "Here is a healthy diet. It may even lower your risk of cancer." but there isn't good evidence demonstrating it.

  However, regarding the specific removal of "fish", if we're going to be citing the ACS as a source, I can't see a reason to remove it. Wikipedia isn't making the recommendation to substitute fish for red meat, all Wikipedia is saying is "When diet recommendations are made, these are the kinds of things recommended." Both Wicki and the ACS say "fish". Can you find an authoritative source talking about diets recommendations to reduce cancer risk that do not say fish, or recommend against fish? If you could that would help support the recommended change. Zad68 18:10, 31 July 2013 (UTC)

Okay no need to continue referencing primary research sources and news sources. We are not using those as references. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:52, 31 July 2013 (UTC)

Currently we state "Dietary recommendations for cancer prevention typically include an emphasis on vegetables, fruit, whole grains, and fish, and an avoidance of processed and red meat (beef, pork, lamb), animal fats, and refined carbohydrates."

• Which is supported by the 2011 review "Nonetheless, there is a general consensus that a “prudent” diet composed of mainly vegetables, fruit, whole grain and fish and a reduced intake of red meat, animal fat and refined sugar should be recommended" [45]
• And the 2012 ACS review which states "whereas consuming a diet that contains a variety of vegetables and fruits, whole grains, and fish or poultry or that is lower in red and processed meats is associated with a lower risk of developing certain cancers5, 113, 114 or dying from cancer" [46]
• A 2009 statement from the Australian Cancer Council concludes that the evidence is limited and recommends people eat fish.[47] "For fish consumption, there is limited but suggestive evidence that it may be linked to a reduced risk of breast, colorectal and prostate cancer" [48]

I see no reason to remove "fish" from the dietary recommendations as proposed by 32. Additionally a few lines above we state "While many dietary recommendations have been proposed to reduce the risk of cancer, the evidence to support them is not definitive".Doc James (talk ·contribs · email) (if I write on your page reply on mine) 18:59, 31 July 2013 (UTC)

Fish is not recommended in either main table 2006 or 2012 ACS guidelines. In the 2006 and 2012 text it is treated as a better alternative than bad (worse?) meats. Again, see the main (ACS 2012) recommendations table on page 32 TABLE 1. American Cancer Society Guidelines on Nutrition and Physical Activity[[49]]. Fish is NOT included. Again, suggesting an alternative is not a recommendation to consume (as Wikipedia currently states). The 2011 Swiss Weekly primary author is primarily a businessman and paid consultant to Industry.32cllou (talk) 19:29, 31 July 2013 (UTC)

There are two separate questions 1) what does the evidence show with respect to fish (evidence is insufficient) 2) what do national organizations recommend, both the Australian Cancer Council and the ACS support the consumption of fish. Doc James (talk · contribs · email) (if I write on your page reply on mine) 19:34, 31 July 2013 (UTC)

I don't agree that a satisfactory argument has been made that Wicki is not a reliable source. What exact conflict of interest are you suggesting Wicki has in stating "Nonetheless, there is a general consensus that a 'prudent' diet composed of mainly vegetables, fruit, whole grain and fish and a reduced intake of red meat, animal fat and refined sugar should be recommended, and that over-nutrition should be avoided."? Zad68 19:37, 31 July 2013 (UTC)

We rely on our review recommendations. Fish is not recommended by the best (ACS 2012) review. Jmh649 now introduces an Australian review, but does not provide the page and link.

What is Wicki?32cllou (talk) 19:46, 31 July 2013 (UTC)

"What is Wicki?" ... when you said The 2011 Swiss Weekly primary author is primarily a businessman and paid consultant to Industry, who were you talking about exactly? What is the name of the person who is the primary author of the Swiss Weekly article you were talking about? Zad68 19:50, 31 July 2013 (UTC)

You should provide links for the probable Rfc. Relative to "Wicki" (Wicki 2011)[[50]], the ACS (2012) American Cancer Society guidelines on nutrition and physical activity for cancer prevention is a better review for this subject section. For example, it has many more authors or contributors (10 versus 2), more peer review, it is more frequently cited, and has many more (and I think better quality) references (376 versus 99). The Swiss Medical Weekly is a small or minor publication (and is rarely cited).

The first (of only two) listed author may have a severe conflict of interest, being employed and remunerated primarily by medical business or industry(and therefore likely promote fish, or to be strongly motivated to move interest away from possible dietary interventions):

• "Successful healthcare entrepreneur and investor with over 15 years of experience in the pharmaceutical and biotechnology industries. He was co-owner and CEO of ANAWA Holding AG and Clinserve AG, two Contract Research Organisations specialising in analytical services."32cllou (talk) 20:07, 31 July 2013 (UTC)

Yes this could be a concern if any of these three sources disagreed. They do not so it does not matter. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:15, 31 July 2013 (UTC)

Jmh649 introduces an "Australian" review, and I then requested he provide the link and page or quote. The ACS disagrees with "Fish preventing cancer death." There is no recommendation for fish. The Wicki (2011) is a very poor review and is disregarded.32cllou (talk) 20:28, 31 July 2013 (UTC)

Two links were provided? Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:29, 31 July 2013 (UTC)

I request that Jmh649 present the link and page for the Australian review that he said supported a recommendation to eat fish to reduce the risk of cancer. He has not.

We have two other reviews (ACS 2006 and ACS 2012). I provided pages and links. Neither recommends fish in their main Tables, and in the text fish is treated as an alternative (not as bad as) beef, pork, and lamb. The third review (Wicki 2011 is probably biased, and certainly not worthy relative to the ACS reviews (see above detail).32cllou (talk) 20:38, 31 July 2013 (UTC)32cllou (talk) 20:54, 31 July 2013 (UTC)

Actually I have provided two links. Have you looked at them? I have even provided the exact text from those two links to make it easier for you.Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:59, 31 July 2013 (UTC)

I just read the Australian review. It is 2009 (before increased radiation risk, and found increase of aggressive prostate cancer). It says omega-3, which can come from fish or filtered fish oil pills. Your second review very limited in scope (few studies included) and possibly biased (authors suspect and not in the field).32cllou (talk) 21:20, 31 July 2013 (UTC) ACS 2012 is better than the (more limited in scope) Australian Cancer Council.32cllou (talk) 21:26, 31 July 2013 (UTC)

Correct first sentence of Prevention - Dietary

In keeping with the 2012 ACS review, I recommend changing the first sentence of Prevention - Dietary to read "Several dietary recommendations are made to reduce the risk of cancer, though the evidence for a specific factor may not definitive." — Preceding unsigned comment added by 32cllou (talk • contribs)

Reverted you again. This does not make sense "a specific factor may not definitive". Maybe try getting consensus here first. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:13, 31 July 2013 (UTC)

You understand the problem with the current sentence. Can you provide a suggestion?32cllou (talk) 20:29, 31 July 2013 (UTC)

There is nothing wrong with the current sentence thus no need to change it from "While many dietary recommendations have been proposed to reduce the risk of cancer, the evidence to support them is not definitive" We could change "not definitive" to tentative or not conclusive.Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:35, 31 July 2013 (UTC)

The fact is that recommendations are made. They are not proposed to be made.32cllou (talk) 20:43, 31 July 2013 (UTC)

The recommendations are made and then it has been proposed that they reduce cancer. So IMO proposed is the correct wording. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:00, 31 July 2013 (UTC)

They are being made by national bodies because the weight of the evidence suggests reduced cancer risk benefit. Read the 2012 ACS review.32cllou (talk) 21:13, 31 July 2013 (UTC)

Second lead paragraph sentence to add only

In keeping with the tone (gist that genetics is currently overemphasized) and text of the reference, I recommend that the sentence read "Only approximately 5-10% of cancers"...heredity.32cllou (talk) 19:42, 31 July 2013 (UTC)

Is 5-10% high or low for the number of inherited cases? We can and should just state the percentage without editorializing and allow our readers to decide. What we have currently is an encyclopedic tone. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:11, 31 July 2013 (UTC)

This sort of wording is unnecessary and is actually the kind of wording that WP:GA good articles should not have in them, see WP:EDITORIALIZING for the problems with editorializing adverbs like this. Zad68 20:11, 31 July 2013 (UTC)

Read the source again. The paragraph is critical of the current overemphasis on genetics / heredity. We need "Only" to convey the meaning of that 5 - 10% ...heredity is minor compared to lifestyle.32cllou (talk) 20:32, 31 July 2013 (UTC)

I had readWP:GA, and know that I write well (fitting an encyclopedia).32cllou (talk) 20:33, 31 July 2013 (UTC)

I am sure people can draw their own conclusions perfectly well. As cancer is a disease that primarily affects the elderly some might consider 5-10% to be high not low. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:37, 31 July 2013 (UTC)

I'll concede "only", though the gist then misrepresents the reference.32cllou (talk) 20:45, 31 July 2013 (UTC)

I think that part of what people are looking for is some sort of way to figure out whether cancer is the patient's own fault. For example, everybody blames tobacco users who get lung cancer—even though we know that some of of those cases of lung cancer weren't caused by tobacco use. (Using tobacco doesn't make you immune to all the other causes of lung cancer, like radon gas.)

What might be useful is an external link to some sort of calculator along the lines of Your Disease Risk, except in reverse. Then you could put in "My neighbor is 50 years old, obese, not a tobacco user, no significant family history of cancer, and has colon cancer: what are the odds that it's all her fault?" A useful response would be something like "___% chance that the cancer is due to eating too few vegetables, ___% chance that the cancer is due to overeating, ___% chance that the cancer is due to factors outside the patient's control". I don't know of any such calculator, but it ought to be possible for a group of researchers to create one, at least for the major categories. WhatamIdoing (talk) 00:26, 27 August 2013 (UTC)