Talk:Prostate cancer/Archive 2

Archive 1

Archive 2

Archive 3

Screening useless?

An article in this week's Arch Intern Med[1] disputes the effects of DRE/PSA screening on mortality; it's a case-control study from a population of 71661, 501 of whom got prostate cancer and were matched with controls. JFW | T@lk 22:38, 9 January 2006 (UTC)

This is part of the difficult balance we faced with the screening discussion. We'd talked about having a whole article concerning the usefulness of screening and I would still be for it! InvictaHOG 22:52, 9 January 2006 (UTC)

I've nominated Screening (medicine) for the MCOTW. Please take a look. --Rewster 06:46, 10 January 2006 (UTC)

Celebrity sufferers

I have removed the list of celebrity sufferers from the page. I feel that if it belongs on Wikipedia, it should go on a separate page. Seriously, most men could be on this list and there's no easy way to verify (the list is not referenced!) InvictaHOG 02:10, 11 January 2006 (UTC)

Some prominent victims of prostate cancer (all deceased)

• Lew Anderson, American television actor
• Roone Arledge, pioneering American television producer
• Michael Bentine, British comic actor
• Bill Bixby, U.S. actor
• Stokely Carmichael, African-American (later based in Guinea, Africa) activist and black separatist
• Eldridge Cleaver, African-American activist
• Silvio O. Conte, Massachusetts politician
• Hume Cronyn, Canadian-born U.S. actor
• Richard Egan, actor
• Dean Gallo, U.S. politician
• Charles Haughey, 1980s Irish Taoiseach
• Chic Hecht, U.S. politician
• Charles Johnson, African-American sportsman in segregated times
• John B. Keane, Irish writer, novelist
• Timothy Leary, U.S. social activist
• Spark Matsunaga, U.S. politician
• François Mitterrand, French president
• Jerry Orbach, U.S. actor
• Joseph Papp, NYC stage director/producer
• Linus Pauling, scientist
• Johnny Ramone, musician from The Ramones (born John Cummings)
• Thurl Ravenscroft, U.S. voice actor
• Bobby Riggs, U.S. tennis player
• Michael Ritchie, film director
• Steve Ross (Time-Warner CEO), conglomerateur
• Telly Savalas, U.S. actor
• Dick Sargent, U.S. actor
• Sir Harry Secombe, British actor
• Francis Alexander Shields, father of Brooke Shields
• Jesse Unruh, California politician
• Richard VanderVeen, American politician
• Sam Wanamaker, expatriate American actor/director
• Walter Winchell, newspaper columnist and radio personality, devoted to gossip
• Ludwig Wittgenstein, German philosopher
• Earl Woods, former Green Beret & father of Tiger Woods
• Frank Zappa, U.S. musician

Link between masturbation and prostate cancer

I found an interesting article at the New Scientist website finding a ([[2]]) link between masturbation and prostate cancer. Way Back Machine ([[3]], [[4]]).

Basically in the article they were talking about carcinogens building up in the gland. At the end they pretty much summed it up by saying quote "The more you flush the ducts out, the less there is to hang around and damage the cells that line them"

Which I believe what they are saying is the more you clear the ducts of the carcinogens in your prostate the less likely you are to develop prostate cancer.

It's already in the article - InvictaHOG 02:44, 16 January 2006 (UTC)

I checked before posting this in the discussion. I just looked again under Prevention and couldn't find it. Out of slight curiosity, where is it exactly? Thanks va3atc

Epidemiology. There's no prospective data to suggest that it should be recommended for prevention. It's simply an observation. InvictaHOG 10:32, 19 January 2006 (UTC)

The edit that reintroduced the "masturbation - prevention of prostate cancer" linkage cited the discussion section of the cited manuscript. The discussion section does not support the specific link between masturbation and prostate cancer; in fact the authors state "The questionnaire focused on ejaculation irrespective of the context in which it occurred (intercourse with another, masturbation, nocturnal emissions, etc.)". Therefore, the specific attribution to masturbation of any finding in the paper is speculation and not supported .. cannot be supported .. by the data that they collected. Any re-introduction of this "fact" should be treated as vandalism. User:Ceyockey (talk to me) 21:40, 28 January 2006 (UTC)

If it was irrespective of any context then any context will do? That would include one would think masterbation. I think you use the term vandalism to lightly here, a carful wording with approprate citation saying essentally what you just said less the conclusion you drew that did not follow form yoru statments would be I think approprate for the article (not that I am going to add it). Dalf | Talk 22:25, 28 January 2006 (UTC)

I might add that at this point said link has entered the popular conciousness and if not true shoudl be debunked in the article, either way some mention is needed. Dalf | Talk 22:26, 28 January 2006 (UTC)

I disagree. The article covers the subject by presenting the relevant data with a link to a referenced, peer-reviewed article. There is no way at present either to prove or to disprove the "masturbation link" as presented in the disputed edit. I doubt that there will ever be a large scale prospective and/or randomized control trial of masturbation for prevention of prostate cancer, but we will certainly add it if the occasion presents itself! InvictaHOG 23:17, 28 January 2006 (UTC)

Excellent article, but I have a few thoughts

A few things I noted on the back of an envelope while reading this article:

1. As far as I am aware, there is no proof that carcinoma of the prostate (CaP) arises from prostatic intraepithelial neoplasia (PIN). The two are closely associated, and it has been estimated that approxiamtely 50% of men with high grade PIN will later have a diagnosis of CaP, but I have not read any proof that one leads to, or gives rise to, the other.

2. Your PSA values are not correct. Even using "older" reference ranges, above 4 ng/ml is abnormal. It is true that the risk of having CaP with a PSA of 4 - 10 does not change much across that range (approx. 25%), and significantly increases when above 10, I have never heard a PSA of, say, 9 being termed "borderline". More recently, in an attempt to improve the positive and negative predictive values of PSA, urologists are using age-specific reference ranges. Thus, 4.0 might be normal in an 80 year old, but abnormal in a 60 year old.

3. Lastly, you have incorporated the Gleason score in the staging of the disease. This is a bit of pedantry, but the Gleason score is *not* part of the staging. It is the grading of the disease. Two people can have identically staged diseases with different Gleason scores.

Other than these points, I think the article is spot on, and I don't think anyone would be grossly misled by the article as it stands (hence, I have not edited it). If anyone wants to incorporate my comments into the article, I would be pleased to find the appropriate references.

Jfbcubed 12:13, 29 January 2006 (UTC)

If it's wrong, fix it! Be bold! JFW | T@lk 12:37, 29 January 2006 (UTC)

Done Jfbcubed 13:12, 29 January 2006 (UTC)

Ta muchly :) GeeJo _{(t) (c)} • 18:59, 29 January 2006 (UTC)

"cervix" vs. "uterine cervix" (resolved)

A recent edit altered the phrase "female cervix" to "female uterine cervix". Is this really needed, the addition of "uterine"? It seems that there wouldn't be any confusion or inaccuracy by leaving "uterine" out. User:Ceyockey (talk to me) 21:41, 29 January 2006 (UTC)

• I added the word for clarity. I (as a urologist) have spent most of today trying to "tighten up" the nomenclature used in this otherwise excellent article. The linguists will be aware that "cervix" merely means "neck", and, in medical terminology, has many, sometimes 'non-female', uses. Otherwise, I agree with you. Remember, I was editing my own edit. Jfbcubed 21:48, 29 January 2006 (UTC)
  • It does not take a linguist to know that the term "cervix" is not specific to the female anatomical structure; this information is found in cervix at the very least. However, in the context used here and in common usage (as opposed to a medical textbook treatment), there can be no confusion. Also, it doesn't matter if you edited your own edit from my point of view. User:Ceyockey (talk to me) 21:54, 29 January 2006 (UTC)
  • A valid alternative would be to leave out the word "female". It has been so edited. Jfbcubed 21:52, 29 January 2006 (UTC)
    • Interestingly, the page you cite, cervix, refers only to the neck of the uterus and not the other uses of the word, but comments that it is also called the "cervix uteri". How is that (other than being in Latin) different than calling it the "uterine cervix"? Or is your objection to the word "female" (now removed)? Jfbcubed 22:00, 29 January 2006 (UTC)
    • Our edits came extremely close to colliding, thus my changing the indentation ... using "uterine cervix" and dropping the "female" tastes ok to me. It was the redundantness of having all three terms in the phrase. User:Ceyockey (talk to me) 00:05, 30 January 2006 (UTC)

External Link - American Cancer Society

A recent edit introduced then re-introduced after removal a link to the American Cancer Society in the External Links section. It seems that such a general link shouldn't be here, otherwise one should advocate addition of this link to every article in Wikipedia that has anything to do with cancer. User:Ceyockey (talk to me) 21:44, 29 January 2006 (UTC)

This was removed but it has been added back again. I'm wondering what the motivation is behind people adding this link back to the article over and over and over again? User:Ceyockey (talk to me) 00:07, 4 February 2006 (UTC)

External Link - Cancer Survivors Network

A recent edit introduced a link in the External Links section to the Cancer Survivors Network. This seems to be too general a link to include here and, like the American Cancer Society link mentioned above, could be added to every article in Wikipedia related to cancer. User:Ceyockey (talk to me) 21:47, 29 January 2006 (UTC)

Footnote numbering off by one

In the first section, there are two refs to ACS. They get numbered [1] and[2], although they point to the same numbered item. This is causing all the following refs to be off by one. I can diagnose the problem but I am not clear on how to fix it. David.Throop 03:01, 21 February 2006 (UTC)

Black men and prostate cancer

Hmm I want evidence to support the claim that cancer of the prostate is more deadly in black men than other men. I think the basis is that black men are less likely to seek help than others when it come to their cancer, but I doubt that it is more deadly because of the color of your skin. This claim should have a reference

• Well, there's evidence both ways. This month's journal Cancer (106(6):1276-85) suggests that the racial differences might just be explained by socio-economic differences (although, even adjusting for all this, African Americans still had a slightly higher (but just significant) mortality than Caucasians...). Furthermore, a meta-analysis in Urology (2004 Aug;64(2):212-7) suggests black men with hormone-refractory prostate cancer have no increased mortality compared to white men.

• On the other hand, there is evidence to support the assertion that, independent of reluctance to seek medical help, black men have a worse clinical course (see Freeman, et al. Am J Public Health. 2004 May;94(5):803-8). The SEER data analysis also found excess deaths in black men compared to white controls, but the dataset lacks potential confounders such social status (Ries, et al. SEER Cancer Statistics Review, 1975–2000. Bethesda, MD: National Cancer Institute).

• Whether ethnicity is, in itself, an independent preditor of disease outcome has been a matter of considerable debate for some time. There is a sizeable UK government study aimed, amongst other things, to try and establish this. For a reasonable review (albeit a bit out-of-date), see: Evans, S., Ben-Shlomo, Y. & Persad, R. (2003); "Prostate cancer in Black and White men: are there differences in risk or prognosis?". BJU International 92 (9), 878-879.

Jfbcubed 19:38, 3 April 2006 (UTC)

Preventable??

I have a serious problem with the following: "Many factors, including genetics and diet, have been implicated in the development of prostate cancer, but as of 2005, it is not a preventable disease."

Not preventable -- you mean despite the digital rectal exam, the PSA test, etc.

This is questionable and should be reviewed.

216.194.0.6 07:08, 10 April 2006 (UTC)

• I think I understand what you are getting at, but, technically, the statement is true. There is a small amount of evidence regarding prevention, with respect to lycopenes, 5-alpha reductase inhibitors, etc., but nothing proven. I fear you may be misinterpreting "preventable" to mean "curable". The DRE and PSA will only detect disease that is present (and even that is debatable). It will not identify people who are going to get the disease, and therefore cannot ensure prevention.

Jfbcubed 19:37, 11 April 2006 (UTC)

According to the British Medical Journal in order to lower the pc occurrence by 50% is necessary to have at least 21 ejaculations per month. I've added a citation needed tag untile one is found.--BMF81 00:13, 24 August 2006 (UTC)

I have no idea what you are referring to here. I know of no (and a search has found none) study in the British Medical Journal dealing with prostate cancer and ejaculatory frequency. In fact, a large JAMA study found no association and the information on ejaculation is lucky to be in the article still. There's been one study (linked in the article) which was retrospective and simply found a correlation between a history of increased ejaculation and prostate cancer. Nowhere has there been a randomized or even simply prospective trial looking at ejaculation and prostate cancer and I would ask that you remove the citation needed tag unless you further explain what it is you object to. There has not been any proven method to prevent prostate cancer and the statement is thus true. InvictaHOG 09:34, 24 August 2006 (UTC)

Searching on google I've found that the research I was referring to, is actually already in the article :), as note 34. It is used in section "Epidemiology" with note 33 to substain: In recent years, studies have linked increased frequency of masturbation or ejaculation to decreased risk of prostate cancer. More precisely, Leitzmann's study (note 34) shows a risk decrease of 33% with at least 21 ejaculation per month. Should that sentence be moved to the article intro regarding prevention? Anyway I'll take out the fact tag until the end of discussion. (Redundancy note: Giles' study seems to present twice as note 23 and 33). --BMF81 10:32, 24 August 2006 (UTC)

I fixed the redundancy (it seems that half the people who edit the article have come here just to add that fact - I've removed several redundant instances in the past! I went ahead and got rid of the statement on prevention - it is a useless sentence fragment which can never be truly proven - how many cases do you have to prevent to say that prostate cancer is prevented? One? All? There's no need for it. If there were an easy way to explain the lack of prospective randomized data on prevention in the lead, it might be nice to add. But I couldn't think of one and it's out of the scope of the lead anyway, IMHO.InvictaHOG 10:44, 24 August 2006 (UTC)

A fine article

I'm a victim of prostate cancer, and I congratulate everyone involved in creating this excellent article, which is by far the best overview of the subject I've seen (and believe me, I've read everything I can). I just wanted to say to the younger men out there that my doctors have noticed a trend with younger men coming in -- some of them in their 20s -- with urinary dysfunction, and it turns out they have an aggressive cancer that has spread beyond the prostate. Please don't listen if your doctor tells you to wait until you're 50 to have a PSA test. Get it now.

• My experience, being a urology resident involved in the largest prostate cancer screening trial ever attempted (ProTect), is that using PSA to screen for disease below the age of 50 is of little value. The current trial protocol invites men over 50 with PSAs >3.0 to have a biopsy. When the trial started, men over 45 with PSAs >2.5 were also invited. Few men were recruited in this group, but extremely few in this age group with this PSA had disease and so this arm of the trial was discontinued. I am not trying to discredit the sentiments expressed above, but it must be remembered that the positive predictive value of a test is exquisitely sensitive to the prevalence of disease in the measured population. Thus, the inherent value of a PSA test falls as the patient becomes younger (basically, a high PSA is more likey to represent benign inflammation the younger you are, rather than cancer).

Jfbcubed 19:48, 11 April 2006 (UTC)

Incidence rates that apply to the USA

When I read it, the article said:

It is the second most common type of cancer in men, and among men it is responsible for more deaths than any other cancer except lung cancer.

As prostate cancer rates vary profoundly throughout the world I have added a qualifier to the sentence. It now reads:

It is the second most common type of cancer in men in the United States, and is responsible for more male deaths than any other cancer except lung cancer.

Please see [5] Michael Glass 07:28, 12 April 2006 (UTC)

This is an article about prostate carcinoma, not prostate cancer

Okay, I'm being pedantic, but an encyclopedia probably should be pedantic. Prostate carcinoma is by far the most common form of prostate cancer, but prostate rhabdomyosarcoma is more common in children and younger men, up to something like 30 yrs old.

Either someone should do a global replace of "prostate carcinoma" for every "prostate cancer" including the title, or leave the title and replace most of the other references and add something about other forms of prostate cancer.

I'll do it myself, if others agree. But I didn't want to butcher up a featured article with my first contribution to it. Jpbrody 17:38, 17 April 2006 (UTC)

Well, if that's the case, shouldn't it be prostate adenocarcinoma then! Changing the title to "prostate carcinoma" is probably too pedantic and may be counterproductive to the overall goal of the article. Rather than a global replace, perhaps a mention of the distinction between adenocarcinoma and rhabdomyosarcoma would be helpful. Andrew73 17:50, 17 April 2006 (UTC)

I also think it is pedantry, but I guess I agree with the accuracy. There are also other types of prostate tumours (including malignant solitary fibrous tumour of the prostate we've described, see [6]) It should read "adenocarcinoma" - but I would leave the title as "Prostate Cancer" - we still want people to find the page! Jfbcubed 18:08, 17 April 2006 (UTC)

Wikipedia:Version 0.5 Nominations

This article has been selected for inclusion into Version 0.5 due to its importance and quality; however, is it possible to convert the bare links on the lead section to proper references? Titoxd^{(?!? - help us)} 07:41, 31 May 2006 (UTC)

Prevention and Epidemiology

Hi, I noticed your edits on prostate cancer. I'm not sure what the driving force for consolidation of the Prevention and Epidemiology sections was. They are obviously quite different in scope, though some overlap is to be expected (and could be excised!). It also deviates from the template for medical articles and makes the epidemiology section quite long. I am inclined to revert the changes but would love to hear your thoughts on the matter! You can either reply on my talk page or that of prostate cancer! InvictaHOG 20:38, 17 August 2006 (UTC) Copied here by Nunquam Dormio 12:12, 18 August 2006 (UTC)

Hi InvictaHOG, The 'driving force' was someone adding stuff about lycopene into Prevention that was already present in Epidemiology. There is also duplication over other items e.g. ejaculation frequency. In a spontaneous decision, I thought it best to get these overlapping sections together, so duplication and differences are made more obvious and can then be added. I wasn't aware of any template and don't have strong feelings about restoring two sections, just so long as they have clear and distinct purposes and don't end up largely overlapping. Nunquam Dormio 12:12, 18 August 2006 (UTC)

rate of deaths

I don't see anywhere in the article where it says this and I think it's of importance since that's what I was looking for when I looked for this article. 84.109.52.88 18:50, 2 September 2006 (UTC)

The prognosis section breaks it down by country, diagnosis, etc. If you need something more specific, just let us know and we'll add it if it is known. InvictaHOG 22:19, 2 September 2006 (UTC)

Archive 1

Archive 2

Archive 3

Gamma-rays vs. X-rays

I'd just like to point out that linear accelerators produce radiation by accelerating electrons and focussing them at a high-Z target. The resulting Bremmstrahhlung photons are technically x-rays. Gamma-rays are produced by radioactive decay of an unstable isotope, the most famous in the context of radiotherapy being Cobalt-60. —The preceding unsigned comment was added by 137.82.96.26 (talk) 05:17, 4 January 2007 (UTC).

It sounds like you know far more about this than I do. Feel free to edit the article! InvictaHOG 19:55, 5 January 2007 (UTC)

"Stiffness"

Someone replaced "erection" with "stiffness" in the Symptoms section. I have changed the word back to "erection," since this is the legitimate, neutral term for erection of the penis. People, this is the prostate cancer page, we should be mature enough to have the word "erection" on it. "Stiffness" seems like something Borat would say, or akin to the slang "stiffie," and is not a good euphemism for "erection." It is what it is. The animal researchers call erections "flips," but I don't think laypeople would understand that word. I hope nobody reverts the word back. Whatever, there are thousands of words in the article, but this one matters some.--Dr.michael.benjamin 04:09, 2 March 2007 (UTC)

Carbs

I can't see any evidence that carbohydrates affect the likelyhood of getting prostate cancer. I'm removing that until someone provides cites. Novalis 14:54, 24 May 2007 (UTC)

Study: Pectin kills prostate cancer cells

“What this paper shows is that if you take human prostate cancer cells and add pectin, you can induce programmed cell death,” said Mohnen, a professor of biochemistry and molecular biology. “If you do the same with non-cancerous cells, cell death doesn’t occur.” [7] Brian Pearson 02:12, 21 August 2007 (UTC)

Now a trial in people, and perhaps it may be notable. JFW | T@lk 15:47, 16 September 2007 (UTC)

A couple of things. In the radiation section, no mention is made that once radiation is used, it makes it virtually impossible to try other invasive methods later on. That doesn't make radiation a bad option, just a finalizer. No mention of this has been made.

Also, can there be more about experimental treatments? Are there any success stories out there, or are they all urban legends? —Preceding unsigned comment added by 76.95.68.69 (talk) 05:27, 27 December 2008 (UTC)

It seems unlikely they'd ALL be urban legends, but I would imagine finding solid information on a topic where so much money is being made will be difficult. I myself tend to shy away from conspiracy theories but in my experience there is a lot of money and politics wrapped up in anything medical... therefor it is hard to find real, unbiased information. 75.48.16.182 (talk) 04:02, 28 September 2010 (UTC)

Until a full trial has been performed we can't really claim that there are any "successful" methods, since they haven't been shown to have an effect yet; I see no reason not to include information on some putative new treatments though (those which have shown to be promising in the lab or in animal trials), providing the article makes it clear they're still in development and are not currently used as treatments. GiftigerWunsch [TALK] 07:32, 28 September 2010 (UTC)

JCI article

doi:10.1172/JCI31791 reviews the biology and treatment of prostate cancer in this month's J Clin Invest. JFW | T@lk 15:47, 16 September 2007 (UTC)

bad link?

reference 21 points to http://tools.wikimedia.de/~magnus/makeref.php which is some sort of "reference-generator" :S Vancomycin (talk) 19:05, 17 December 2007 (UTC)

I've replaced the reference with the journal article that the news article was referring to, the url should work. - Optigan13 (talk) 03:43, 18 December 2007 (UTC)

Contradictory information?

There seems to be some information that contradicts itself on this article.

Under "Etiology" the article says: "Other dietary factors that may increase prostate cancer risk include low intake of vitamin E (Vitamin E is found in green, leafy vegetables), omega-3 fatty acids (found in fatty fishes like salmon), and the mineral selenium. "

However under "Prevention" the article says: "Two dietary supplements, vitamin E and selenium, may help prevent prostate cancer when taken daily."

I am assuming under Etiology is should be decrease instead of increase?

OR

Is it saying "low intake" as in insufficient ammounts of vitamin E may increase risk of prostate cancer?

Either way the way its worded is a little confusing and my first impression is that this was a typo.

Thanks

Stvns78 (talk) 22:01, 12 January 2008 (UTC)

"Low is used as in "insufficient." Because of the qualifiers here "insufficient" may incorrectly sound as if there is a known "sufficient" quantity. —Preceding unsigned comment added by 75.18.49.189 (talk) 17:19, 12 March 2008 (UTC)

Agreed - this article is a mess. It also often indicates that many dietary and behavioral factors are "associated," without saying WHICH WAY - increasing or decreasing risk. Am I alone in thinking that is useless and crazy? —Preceding unsigned comment added by 69.86.224.237 (talk) 04:55, 21 May 2010 (UTC)

NICE guideline

We should probably integrate some content from National Institute for Health and Clinical Excellence. Clinical guideline 58: Prostate cancer. London, 2008. JFW | T@lk 08:54, 29 February 2008 (UTC)

Diet

I've removed the following paragraphs:

===Diet===

There is now growing medical evidence for the effectiveness of diet in counteracting prostate cancer. Lycopene is a naturally occurring chemical found in tomatoes, watermelons, pink grapefruits, papaya, and guava (Gann, Peter H., Giovannucci, Edward L. p.14-15). Cooked tomatoes and tomato sauce are actually better than raw tomatoes because cooking them releases lycopene from their storage sites, changes the way our bodies absorb it, and affects the growth of prostate cancer cells. Next, we have cruciferous vegetables such as broccoli, cauliflower, cabbage, brussel sprouts, bok choy, and kale. This is because they contain sulforaphane, a compound that increases protein activity that cleans up the damage done by ingesting cancer-causing carcinogens (Gann, et al, p. 16-17). Polyphenols found in red wine and green tea have shown to prevent, slow, and kill the formation of cancer cells, as have isoflavones (genistein, daidzein, and equol) from soy-based foods. However, too much can neutralize its benefits (Alberts & Hess, p. 298).

The "Western-style" diet is notorious for including a lot of fats and red meat. This kind of diet has long been associated with a high risk for many diseases and cancers. The previously cited report Nutrition and Prostate Cancer (Gann, et al) focuses on two issues of the "Western-style" diet: the type of fat and the cooking method. Substituting some fish for red meat is not only a "heart healthy" choice, but research shows that the omega-3 fatty acids in fish and fish oils decreases the risk of developing prostate cancer by 26 percent. Those who like to grill meat may want to switch to an alternate form of cooking. Charring left on meat off the grill has been linked to cancer-causing carcinogens. One dieting alternative, as reported in the article Cancer Proof Your Prostate by Matt Bean of Men’s Health Magazine, is a Mediterranean-style of diet. It states that the reason why Western European men have much lower prostate cancer rates than Americans do is because they eat decent amounts of garlic, pasta sauce, and scallions. In fact, those that eat more than 10 grams of garlic or scallions daily have a 50 percent lower risk of developing prostate cancer.

1. Moyad, Mark A. The ABC’s of Nutrition and Supplements for Prostate Cancer, Sleeping Bear Press, MI, USA, 2000. 2. Alberts, David S., Hess, Lisa M. Fundamentals of Cancer Prevention, Springer Publishing Company, Berlin, Germany, 2005, p. 277-283, 292-307. 3. Gann, Peter H., Giovannucci, Edward L. "Nutrition and Prostate Cancer," Prostate Cancer Foundation, 2005. 4. Bean, Matt. "Cancer Proof Your Prostate," Men’s Health, www.menshealth.com, Rodale Inc., 2007. Wells, Sara. "Hedonist’s Guide to Prostate Prevention," Men’s Health, www.menshealth.com, Rodale Inc., 2007.

There are a couple of issues. The sourcing is not adequate (Men's Health?) We should discuss lycopene, but we need to use better sources. There is a lot of published literature and even a few recent review articles on the subject (e.g. PMID 17893870, PMID 18006906). Let's use those. Also, this should be in the "Prevention" section, worked into the existing text there, and not in the "Treatment" section. Let's work on it here. MastCell ^Talk 05:38, 2 March 2008 (UTC)

MastCell makes a good point here. Though there is some population data that certain dietary modifications can reduce the risk of developing cancer, no reliable data that I know of show that it can fight cancer. I try to work on the text for placing this in "Prevention" when I have a little more time. Djma12 ^(talk) 14:47, 2 March 2008 (UTC)

I would like to propose a new section titled "Diet" under the "Prevention" header with research from Dr. Dean Ornish regarding "intensive lifestyle changes" which had beneficial effect on prostate cancer (The Journal of Urology, Sept '05 pp1065-1070). I'm working on the actual text, but would like to see if anyone has a better suggestion for where "diet and exercise changes" might go?
--Thomas.vandenbroeck (talk) 19:24, 28 September 2009 (UTC)

Here's the text I would like to add:

A 2005 secondary prevention study published in the Journal of Urology by Dr. Dean Ornish(footnote), showed that an "intensive lifestyle change" had a beneficial (lowering) effect on prostate-specific antigen(PSA) levels after one year. A total of 93 men, all of whom had chosen not to undergo conventional treatment for prostate cancer, were randomly assigned to an experimental group which would be asked to make an "intensive lifestyle change" and a control group who were not required to make any changes. The control group experienced a 6% increase in PSA levels with 6 patients having to leave the study for conventional treatment due to disease progression. The experimental group was prescribed the following "intensive lifestyle changes":

• vegan diet, supplemented with:
  • soy (1 daily serving of tofu plus 58gm of a fortified soy protein powdered drink),
  • fish oil (3gm daily),
  • vitamin E (400IU daily),
  • selenium (200mcg daily), and
  • vitamin C (2gm daily)
• moderate aerobic exercise (walking 30 minutes 6 days a week)
• stress management techniques (gentle yoga based stretching, breathing, meditation, imagery and progressive relaxation for a total of 60 minutes daily
• participate in a weekly 1-hour support group to enhance adherence to these major lifestyle changes

The experimental group which adopted these "lifestyle changes" experienced a 4% reduction in PSA levels with no patients having to leave the study for conventional treatment due to disease progression.

--Thomas.vandenbroeck (talk) 04:00, 29 September 2009 (UTC)

Recent reverts

Why were the sections reverted (see http://en.wikipedia.org/w/index.php?title=Prostate_cancer&diff=199887399&oldid=199105475) that started:

"Computed tomography (CT) and magnetic resonance imaging (MRI) currently do not add any significant information in the assessment of possible lymph node metastases in patients with prostate cancer according to a meta-analysis."

and

"In the hands of an experienced surgeon, robotic assisted laparoscopic prostatectomy (RALP) can reduce positive surgical margins when compared to radical retropubic prostatectomy (RRP) among patients with prostate cancer according to a retrospective study." [I think 'may reduce' might be better than 'can reduce']

reverted by user:orangemarlin for reasons of advsertisting. All that was done was report two medline abstracts. I do not see how this is advertising. Ok to restore these sections (at the same time fixing the links to PubMed using citeref)? Thanks - Badgettrg (talk) 21:00, 24 March 2008 (UTC)

I think Orangemarlin was indeed worried about advertising. If we remove the URine tests and replace them with cite templates everything should be fine. JFW | T@lk 19:59, 25 March 2008 (UTC)

I had put the following on Finasteride:

A 2008 study found that finasteride reduces the of prostate cancer rate by 30%!

For some reason, what I took to be important news was deleted. I am putting it back in.

Masturbation

Sorry guys, I can't find any serious peer-reviewed articles that state frequent masturbation has an effect on the risk of prostate cancer. Mostly, what I find in the most recent studies is that there is no effect. I deleted most of the paragraph, since much of the writing was related to a newspaper article. I ran a pubmed to see if anything came up (so to speak, I know, there are dozens of puns here), and all I could find was not much. OrangeMarlin ^{Talk• Contributions} 07:40, 18 June 2008 (UTC)

I saw the above and looked at the original sources, then followed them up and found the study. Peer-reviewed, saying quite what the text had said. Then I looked at the article Orangemarlin had cited, calling it "the most recent studies," -- it's one study, issued shortly after the Australian study -- and it appears to confirm the Australian study, but the matter is a bit unclear, since, in the abstract, which is all I've read, two opposite conclusions seem to exist. There is also a reply by Giles to the later study in JAMA, which isn't abstracted, I'd have to get access to full text. The Giles study has attracted a lot of attention, to remove this wasn't proper. The issue isn't "masturbation," the issue is ejaculation frequency, and earlier studies had only focused on sexual intercourse, looking for evidence of infectious agents. One follow-up to the Giles study seems to criticize it for not considering the effect of oxytocin, which is a bit puzzling to me, since that would be a mechanism and not particularly relevant to the finding re frequency, perhaps the Giles article speculates about mechanism. I've replaced the material, including expanding what Orangemarlin inserted to make it more balanced. --Abd (talk) 14:11, 18 June 2008 (UTC)

I do not understand that part .They contradict eachother,I feel confused and troubled.If it increases the risk of it or even if it causes it immediatley then I feel like i got damned for it. But since this article answers nothing how can i know the answer?

Does it increase the risk or not? —Preceding unsigned comment added by 94.100.49.4 (talk) 23:14, 13 May 2009 (UTC)

I think the implication of the studies (1) indicating that frequent ejaculation was associated with decreased risk; and (2) that intercourse was not, logically lead to this conclusion. Is there another interpretation I am missing? —Preceding unsigned comment added by 69.86.224.237 (talk) 04:43, 21 May 2010 (UTC)

Robotics

Insert non-formatted text here

As is true with the general trend of treatment discussions in the US, this article has a heavy slant toward RALP being a better treatment option. It may or or may not be and if it is, it's only after a rather steep learning curve. The data isn't ready for that yet. In addition to that, the perineal doesn't even get mentioned despite the fact it's still done, has no abdominal incisions, short catheter duration, etc etc etc. Intuitive has done a wonderful advertising job for their product and we don't need to serve for more free advertisement here. —Preceding unsigned comment added by Yourskeptic (talk • contribs) 12:24, 21 July 2008 (UTC)

Mistake in redirection ?

It looks like the redirection comment about HRPC is wrong (top of the article). ... I have no idea how to update this. 85.27.110.140 (talk) 01:43, 23 July 2008 (UTC)

Cannabinoids

Could something regarding the use of cannabinoids to treat prostate cancer be added to the article? Unfortunately there are no current treatments avaialble but numerous research has shown that cannabinoids can cause apoptosis. Particuarly this paper [8] - which states the following.

"Treatment with a cannabinoid (WIN55,212-2) resulted in a dose-dependent inhibition of cell growth and induction of apoptosis in cancer cells..... Based on these data we suggest that cannabinoid receptor agonists should be considered as novel agents for the management of prostate cancer". Also this paper from 1999.

Supposed (talk) 01:49, 24 July 2008 (UTC)

Death

How do people die from prostate cancer.

not treating it.

They generally die from metastatic disease (cancer going to the bone or other organs.) Very locally advanced cancer can also invade into surrounding structures (bladder, rectum), etc... Djma12 ^(talk) 18:38, 25 March 2009 (UTC)

Incorrect statement on the main page

This is the quote from the prevention section that is incorrect. It is also flawed in other ways as well.

"Green tea may be protective (due to its polyphenol content),[39] although the most comprehensive clinical study indicates that it has no protective effect.[40]"

The study quoted was not a clinical study, but a prospective epidemiologic one.

It would be nice if someone with more time and knowledge of the workings of Wikipedia would ask them to post some guidlines for contributors, or immprove the ones they have.

Comments like the quote above that have a date limited time span should include the date. E g the quote above should have read, "although", AS OF 2006 "the most comprehensive clinical study indicates that it has no protective effect"

Papers reporting a numerical value should be quoted, not paraphrased. E G The most comprehensive clinical study reported a nonsignificant OR of .85 (95% confidence interval 0.50-1.43, trend P=0.81) for those drinking over five cups/day. It can then be seen that the report does not indicate no protective effect.

Review papers, not individual studies should as a rule be quoted when available.

In 2007 a Japanese study that was 2.5 times as "comprehensive" published, finding, and I quote, "Green tea was not associated with localized prostate cancer. However, consumption was associated with a dose-dependent decrease in the risk of advanced prostate cancer. The multivariate relative risk was 0.52 (95% confidence interval: 0.28, 0.96) for men drinking 5 or more cups/day compared with less than 1 cup/day (p(trend) = 0.01). Green tea may be associated with a decreased risk of advanced prostate cancer." PMID: 17906295

Language such has "Green tea was not associated with localized prostate cancer" is permitted by medical custom. But acutual values are prefferred by most scientists. Failure to use the preferred method can be construed as bias.

Language such as "indicates that it has no protective effect" clearly has a different meaning, and is not permitted by medical custom.

Here's a quote from the most recent review paper I know of "RESULTS: Forty-three epidemiological studies, four randomized trials and one meta-analysis were identified. The overall quality of these studies was evaluated as good or moderate. While some evidence suggests that green tea has beneficial effects on gastrointestinal cancers, the findings are not consistent. CONCLUSION: Green tea may have beneficial effects on cancer prevention. Further studies such as large and long term cohort studies and clinical trials are warranted." PMID: 18940008

The review was for overall cancer. In the full text, available free on line at pubmed prostate cancer was mentioned as one of the cancers potentially benefitted by green tea. If I recall correctly.

69.69.48.43 (talk) 21:00, 29 May 2009 (UTC) Thomas Carter69.69.48.43 (talk) 21:00, 29 May 2009 (UTC)

Yes definitely a work in progress. Any help is much appreciated.--Doc James (talk · contribs · email) 11:17, 6 August 2009 (UTC)

Some sections too long

Some long sections (eg Screening) summarize (or duplicate) other articles (Prostate cancer screening). Any objection to condensing the long sections here ? Rod57 (talk) 12:24, 23 September 2009 (UTC)

Prevention

Prostate cancer folate supplementation is a new article that I believe would be best handled by merging into the "Prevention" section of this one. While there is a list of URLs for references, the subject is probably too narrow to justify a full article about it. WhatamIdoing (talk) 06:24, 18 November 2009 (UTC)

More on Diet

Diet is a very interesting and important issue, but the current section is more speculation than fact. One small study proves nothing. Findings that "approach significance" are NOT significant, and can't be considered evidence of a causal effect. Wikipedia articles on important health issues should be based on more authoratative research information, such as several peer-reviewed studies or at least one very large, well-designed study. I deleted a few sentences and plan to delete more of this section but will wait to see if there are any comments or if anyone can add some better references.

Umarylandmd (talk) —Preceding undated comment added 04:09, 8 January 2010 (UTC).

I support Umarylandmd's edits. It's important that Wikipedia articles on science and medicine reflect a broad consensus within the research community rather than the latest (or, in some cases, a rather stale) primary research finding. Keepcalmandcarryon (talk) 22:53, 14 January 2010 (UTC)

Thanks for your support. I moved all the dietary studies from the prevention section into the diet section. I also deleted a couple of preliminary studies and some sentences that made dietary claims but had no references to back them up. It isn't helpful to say one study shows one thing and another study shows the opposite unless we can provide useful information about the quality of the studies.

Umarylandmd (talk) 17:30, 18 January 2010 (UTC)

I added the 2005 Dean Ornish study to the Diet section which I posted in this discussion page back in Sept. Yes, I agree "diet" isn't a glamorous section but is important for people dealing with prostate cancer.
--Thomas.vandenbroeck (talk) 17:53, 24 January 2010 (UTC)

Devoting a long paragraph to this single study does not seem to be encyclopaedic, nor would it appear to satisfy WP:MEDRS in the absence of corroborating evidence and review coverage in the past five years. Keepcalmandcarryon (talk) 19:26, 24 January 2010 (UTC)

And, honestly, a 4% reduction in PSA levels? Keepcalmandcarryon (talk) 19:27, 24 January 2010 (UTC)

As I said before, the update that I added yesterday I had already posted in this talk section back in Sept. If you had issues with it you should have brought that to my attention then and we could work on it. However, this study is significant because cancer is considered a progressive disease. One may stop it temporarily or surgically remove it completely, but it comes back time and again. To see cancer regress through diet and exericse is what make this study unique, important and pertinent to the Diet section. Please revert my update. Thanks.
--Thomas.vandenbroeck (talk) 18:56, 25 January 2010 (UTC)

I apologise; I didn't edit this article until recently and hadn't seen your proposal. However, I maintain that what you've written is inappropriate for this article, our main article on prostate cancer. If you are interested in this topic, perhaps you could create a new article on alternative, complementary or holistic treatments for prostate cancer, to which this level of detail would be more suited. Keepcalmandcarryon (talk) 19:22, 25 January 2010 (UTC)

Screening with PSA

Recommended less [9] Doc James (talk · contribs · email) 21:31, 3 March 2010 (UTC)

Screening before Diagnosis?

It seems that "screening" would be more useful and logical if placed before "diagnosis." I'd like to move it if there is no objection. --Wikiwatcher1 (talk) 07:04, 12 March 2010 (UTC)

support.--Amaher (talk) 11:18, 12 March 2010 (UTC)

Section on "Controversy"

It seems that new material added to this section may have affected the neutrality issues and needs reworking. As the edit differences indicate, [10], almost all of the material added came from a single source, and are phrased where one doctor from Roswell is presenting conclusions from another doctor at the same institute. There are also lengthy and repetetive quotations from this single source, where the source itself was written in order to present contrary information to cited material in the section. This may go against conflict of interest guidelines with the potentially excessive quotations leading to undue weight to the contrary point of view. The fact that it came from an industry-specific newsletter by American Urological Association, also implies a POV source.

I think that the new citation should, of course, be added, but trimmed so that it does not become a mere recitation from one source. Nor should cited material be removed without explanation, especially where it gives conclusions from other institutions and replaces them with contrary conclusions, such as in this paragraph which was deleted without explanation:

"A study by the New England Journal of Medicine found that over a 7 to 10 year period, "screening did not reduce the death rate in men 55 and over."[59] Former screening proponents, including some from Stanford University, have come out against routine testing. In February 2010, the American Cancer Society urged "more caution in using the test." And the American College of Preventive Medicine concluded that "there was insufficient evidence to recommend routine screening." --Wikiwatcher1 (talk) 18:50, 14 April 2010 (UTC)

Updating article

I have added some information on several new treatments for metastatic prostate cancer, including this, and this. Immunize (talk) 22:36, 11 May 2010 (UTC)

Section on Autopsy data

"Autopsy studies of Chinese, German, Israeli, Jamaican, Swedish, and Ugandan men who died of other causes have found prostate cancer in thirty percent of men in their 50s, and in eighty percent of men in their 70s." This appears to be incorrect. I read through the cited article and it appears to be conflicting. The actual numbers, based on figures 1 and 3, appear to be closer to 10% and 35%, respectively rather than 30% and 80%. 171.65.79.247 (talk) 23:26, 25 May 2010 (UTC)

Small cell carcinoma

Seems to need more on "Small cell carcinoma" which is mentioned briefly just once, and not in the classification section. Rod57 (talk) 21:12, 12 June 2010 (UTC)

Apparently it comprises only about 1% of cases so I've added that. Rod57 (talk) 11:19, 14 June 2010 (UTC)

Metastatic prostate cancer

It's not easy to find in the article anything on metastatic prostate cancer. Rod57 (talk) 21:12, 12 June 2010 (UTC)

10.3 ?

There's a section (10.3 atm) with unknown title. Can someone move this into a more relevant location or remove it entirely?

Bigmantonyd (talk) 20:11, 6 July 2010 (UTC)

Light Blue? wtf?

The following sentence appears at the end of the research section: "The Color of Prostate Cancer Awareness is Light Blue." I have absolutely no idea what this sentence means! Can we have some sort of explanation and maybe a citation, please. Mandolamus (talk) 17:06, 1 February 2011 (UTC)

This means that if you want to wear a ribbon to support prostate cancer awareness it should be light blue. The statement is probably puzzling outside the US and maybe to some people within it as well, but the person who inserted the statement assumed that everyone knew about pink ribbons for breast cancer and would understand the analogy. Here's a link:

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

This one I might be able to fix later but I do not have time right now. — Preceding unsigned comment added by Elinruby (talk • contribs) 23:28, 20 March 2011 (UTC)

Didn't seem to belong in any section of this article so have deleted that sentence. - Rod57 (talk) 10:33, 22 April 2011 (UTC)

Problem with reference numbering

it shows up in the epidemiology section, where the sequence is 127, 128, 129...2...stray </ref> tag....131, 132, 133...

2 goes to what might be a plausible reference for that statement; but based on the markup the stray ref tag goes to 131 and isn't working because someone did not replace "journal" with the journal name. I do not know if fixing this will make the numbering work properly -- I don't understand what happened to 130 -- and am afraid to mess with the citations in this very complex and well-researched article. Not sure I could fix it if I broke it, at least maybe not without painfully learning some markup ;) — Preceding unsigned comment added by Elinruby (talk • contribs) 23:09, 20 March 2011 (UTC)

Section on Prevention / Medications

Thanks for writing this entry. According to this article from the July 14th 2011 issue of the New England Journal of Medicine, the FDA is not approving the use of finasteride or dutasteride for prevention of prostate cancer because two recent trials have shown that although the drugs reduce prostate cancer diagnoses overall, they also lead to a increase in the incidence of more serious forms of the disease.

Dmfedor (talk) 18:31, 22 July 2011 (UTC)

Lack of objectivity or unclear

The assertion that there is an anti-male bias in cancer research and funding based solely on comparing breast cancer with prostate cancer is irresponsible. Some questions one would have to address in order to actually make a factual statement about bias include: what are the rates of incidence male and female cancers? what is the rate of fatality and at what age do those with male or female cancers die? and to compare speed of referral one would also have to account for the difference in the rate of growth of these cancers. Isn't comparing only breast cancer to only prostate cancer comparing a cancer that kills many younger women (and can kill them faster) to one that kills fewer numbers of men who are closer to reaching the average life expectancy? The language should at least reflect the difficulty of making a factual statement when comparing two cancers that are very different in their prevalence, outcomes, and tumor growth rate.

Also regarding the section that suggests that frequent ejaculation may lower risk: this section starts off with a statement that says yes this is true, before it goes on to say a number of other things that seem to indicate that the theory is either not true or has not been proven in studies. The section should start by saying that there are conflicting studies and go on to weigh why that might be so.

74.109.66.152 (talk) 12:27, 9 August 2011 (UTC)

Early Detection and Diagnosis

The American Cancer Society's position regarding early detection is "Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. The American Cancer Society believes that men should not be tested without learning about what we know and don’t know about the risks and possible benefits of testing and treatment. Starting at age 50, (45 if African American or brother or father suffered from condition before age 65) talk to your doctor about the pros and cons of testing so you can decide if testing is the right choice for you."

The only test that can fully confirm the diagnosis of prostate cancer is a biopsy, the removal of small pieces of the prostate for microscopic examination. However, prior to a biopsy, less invasive testing can be conducted.

According to Professor Hardev Pandha, The Prostate Project Chair of Urological Oncology at the University of Surrey's Postgraduate Medical School, a non-invasive test looking for the presence of the protein Engrailed-2 (EN2) in the urine to be more reliable and accurate than existing tests.

"In this study, we showed that the new test was twice as good at finding prostate cancer as the standard PSA test. Only rarely did we find EN2 in the urine of men who were cancer free, so if we find EN2 we can be reasonably sure that a man has prostate cancer. EN2 was not detected in men with non-cancer disorders of the prostate such as prostatitis or benign enlargement. These conditions often cause a high PSA result, causing considerable stress for the patient and sometimes also unnecessary further tests such as prostate biopsies."

There are also several other tests that can be used to gather more information about the prostate and the urinary tract. Digital rectal examination (DRE) may allow a doctor to detect prostate abnormalities. Cystoscopy shows the urinary tract from inside the bladder, using a thin, flexible camera tube inserted down the urethra. Transrectal ultrasonography creates a picture of the prostate using sound waves from a probe in the rectum. Pbmaise (talk) 03:26, 30 September 2011 (UTC)

Browser highjacking

I am trying to read about prostate cancer diagnosis, particularly staging, for a friend with prostate cancer, & every time I click on the Wikipedia site for "Prostate Cancer," the article I want pops up & is replace within one minute by this article by Maryana Pinchuk, a disguise for asking for money. I am already a monthly donor to Wikipedia, but if this persists, I shall become a former donor. James A Prentice gasman1937@yahoo.com 24.155.178.141 (talk) 18:38, 7 October 2011 (UTC)

It sounds like your web browser has been hijack. When I enter "prostate cancer", I am lead directly to this article with no mention of "Maryana Pinchuk". Boghog (talk) 18:50, 7 October 2011 (UTC)

TED.com

TED.com is not an appropriate source, per WP:MEDRS. We need to use high quality sources here. Yobol (talk) 02:48, 6 July 2012 (UTC)

Agree completely. Doc James (talk · contribs · email) (please reply on my talk page) 02:53, 6 July 2012 (UTC)

Two editors in Teahouse disagree, and I read primary in wiki again and TED qualifies. I will also back up the TED with journal research articles.32cllou (talk) 15:34, 6 July 2012 (UTC)

The Tea house editors unfortunately are mistaken. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 15:43, 16 July 2012 (UTC)

Proposed para in lead

I realize the main dispute is Yobol's removal of "overtreatment" but leaving in overdiagnosis and controversy. Below is more true to the reference, removes the Economist stuff, removes the old findings, removes the NYT:

The presence of prostate cancer may be indicated by symptoms, physical examination, prostate-specific antigen (PSA), or biopsy. The United States Preventive Services Task Force in 2012 recommended against screening for prostate cancer using the prostate-specific antigen testing, noting that the test may result in “overdiagnosis” and “overtreatment” because "most prostate cancer is asymptomatic for life," and treatments involve risks of complications that exceed potential benefits. The USPSTF found that “the potential benefit does not outweigh the expected harms.” Further tests, such as CT scans and bone scans, may be performed to determine whether prostate cancer has spread.32cllou (talk) 15:34, 6 July 2012 (UTC)

Sure changed wording to include overtreatment. Doc James (talk · contribs · email) (please reply on my talk page) 20:58, 6 July 2012 (UTC)

Thanks. We need a ref for that last sentence, any suggestions?32cllou (talk) 23:14, 6 July 2012 (UTC)

First of all stop removing the references that are already there.Doc James (talk · contribs · email) (please reply on my talk page) 00:52, 7 July 2012 (UTC)

BMJ sentence out of date

Your changes are almost OK, though the BMJ is factually out of date. You know that the test indirectly actually increases total mortality. 2 heart attacks, one died, and one operation related death for each one saved from prostate cancer. Please reconsider your forcing incorrect info.

How about "The presence of prostate cancer may be indicated by symptoms, physical examination, prostate-specific antigen (PSA), or biopsy. Prostate-specific antigen testing increases cancer detection but does not decrease (may increase) mortality."32cllou (talk) 16:02, 7 July 2012 (UTC)

The line "but does not decrease mortality" means that it either does not change mortality or increases mortality. Thus it is neither out of date nor incorrect. If the subsequent ref does not say it increases mortality than neither do we. There is something called statistical significance. 2010 is not out of date. Doc James (talk · contribs · email) (please reply on my talk page) 21:21, 7 July 2012 (UTC)

BMJ reports under the heading "All cause mortality

As event rates were not available in all studies, we used the inverse variance method to pool data.." and later "The randomised controlled trials we included failed to report complications rates in the screening and control group so we could not quantitatively pool data." That's partly why I say factually out of date.

Not only is it two years older, but the USPSTF lists specific complications from a larger meta. That list of complications includes 1 death and 2 heart attacks and several often terminal events. Therefore we should say increases total mortality. You made changes not included in the summary. Please be accurate.32cllou (talk) 01:43, 8 July 2012 (UTC)

Does it say increased mortality? If not we do not say increased mortality. Doc James (talk · contribs · email) (please reply on my talk page) 02:32, 8 July 2012 (UTC)

You are correct, and I won't. I read a commentary that said it increased by pulling more from the meta results, but you probably wouldn't accept just a DR complications summary conclusion.32cllou (talk) 02:43, 8 July 2012 (UTC)

NCI secondary, then primary going deeper same line of thinking

Moved from my talk. Please just discuss in article talk.

These include review articles and major medical textbooks. Note that review articles are NOT the same as peer reviewed articles. The content you have added has been removed partly for this reason. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 23:33, 15 July 2012 (UTC)

I understand that I can use primary research when secondary (NIH / NCI) initiates / makes the statement. In this case, once the NCI says there's some evidence in review that plant food rich diets (vegetables and fruits mentioned) reduce incidence of cancers and chronic diseases. Note I qualified that statement with one spec to prostate cancer. I added back the BJC review, though it is is secondary to the NCI, since the NCI takes many such reviews and comes to independent conclusions. They are a review of the reviews.32cllou (talk) 15:26, 16 July 2012 (UTC)

This [11] is a primary research report. We are not going to be using it to refute recent secondary sources. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 15:38, 16 July 2012 (UTC)

Here's a direct quote from NCI, which is secondary per Wiki:

"People whose diets are rich in plant foods such as fruits and vegetables have a lower risk of getting cancers of the mouth, pharynx, larynx, esophagus, stomach, lung, and there is some suggested evidence for a lower risk of cancers of the colon, pancreas, and prostate. They are also less likely to get diabetes, heart disease, and hypertension. A diet high in fruits and vegetables helps to reduce calorie intake and may help to control weight.

To help prevent these cancers and other chronic diseases, experts recommend 4 to 13 servings of fruits and vegetables daily, depending on energy needs. This includes 2 to 5 servings of fruits and 2 to 8 servings of vegetables, with special emphasis on dark-green and orange vegetables and legumes. There is no evidence that the popular white potato protects against cancer."

So the sentences are supported by secondary. The NCI is preferred to BJC, but I left it in for you.32cllou (talk) 15:43, 16 July 2012 (UTC)

Have added a summary of the animal data from the NCI.Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 16:13, 16 July 2012 (UTC)

Have to study further so edits tomorrow, but here's another review to ref statements you deleted. http://www.dietandcancerreport.org/cancer_resource_center/downloads/WCRF%20Policy%20US%20Summary_final.pdf 32cllou (talk) 16:38, 16 July 2012 (UTC)

Looks like a good reference. Can you provide a diff where I deleted it? Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 16:43, 16 July 2012 (UTC)

U didn't understand what I wrote. I will use http://www.dietandcancerreport.org/cancer_resource_center/downloads/WCRF%20Policy%20US%20Summary_final.pdf instead of the NCI. You deleted NCI secondary findings paraphrased. See your last revert.32cllou (talk) 16:48, 16 July 2012 (UTC)

Ah you mean I deleted the primary source from NCI. And that you will use this secondary source http://www.dietandcancerreport.org/cancer_resource_center/downloads/WCRF%20Policy%20US%20Summary_final.pdf going forwards. Good. However do not remove the secondary sources which are already there. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 16:53, 16 July 2012 (UTC)

Note to Jmh649

Thank you for providing better references, but in the process, important information was lost. According to the article I cited, the incidence of prostate cancer is rapidly increasing in the developed world. Shall I find a reference for this, or will you? Rick Norwood (talk) 19:40, 16 July 2012 (UTC)

I did add this content "with increasing rates in the developing world." which was supported by the ref in question Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 20:43, 16 July 2012 (UTC)

Yes, but the reference I cited also said the rate in the developed world was increasing. Rick Norwood (talk) 14:00, 17 July 2012 (UTC)

Yes in 2001. Is that however still the case now 11 years later? Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 00:22, 18 July 2012 (UTC)

I'll try to find more up-to-date data. Rick Norwood (talk) 13:53, 18 July 2012 (UTC)

Great thanks. Doc James (talk · contribs · email) (if I write on your talk page please reply on mine) 16:12, 18 July 2012 (UTC)

Diet sections need help!

The sections "Cause" and "Prevention" both contain a subheading "Diet." These subsections are in really bad shape. The one under "Cause" is self-contradictory - folate is said to triple the risk of prostate cancer and to reduce the risk, at both high and low levels. Very little of that section is about diet per se. Most is about dietary supplements, and absolutely none of it is conclusive. Under the heading "Cause," the only thing that can be truthfully said is that we don't know the cause. So far, all that has been published in the research literature about diet and prostate cancer are a few weak associations.

As for the Prevention section, again, all that has been published in the research literature about diet and prostate cancer are a few weak correlations, nearly all of which disappear when tried in prospective studies. No credible research recommends a vegetarian diet for prevention of prostate cancer. The only clinical professional organization position statement on the subject says that a vegetarian diet can be done safely, not that it is recommended [J Am Diet Assoc. 2003;103:748-765]. Secondary sources point to one large study when referencing a claim that meat of any kind is associated with increased risk, but that study covered a narrow (though large) population of white Seventh Day Adventists living in California, and their dietary habits were far from representative of the general population. So-called nonvegetarians in this study consumed an average of 3 servings of beef and just over one serving combined of fish and poultry per week. They also weighed considerably more than the vegetarian group (6 kilos, 13.2 lbs) and drank more often, both coffee and alcohol. (Yes, there's a study linking coffee to prostate cancer too.) The Adventists study's authors conclude that "among Seventh-day Adventists, vegetarians are healthier than nonvegetarians but this cannot be ascribed only to the absence of meat." [Am J Clin Nutr 1999;70(suppl):532S–8S] In fact, vegetarian diets have been studied by others as an intervention against prostate cancer [see review in Curr Opin Urol. 2009 May;19(3):263-7, also reviewed in Bratisl Lek Listy. 2008;109(10):463-6], but they didn't help prevent or mitigate prostate cancer. A few pilot studies have given researchers reason to continue studying the issue, but they can't conclude anything germane to this article.

It's taken me hours to read up on this problem. I'd prefer to let someone else handle the re-writing, if that's the consensus. Might I suggest starting with the American Cancer Society: www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-risk-factors Dcs002 (talk) 08:43, 19 September 2012 (UTC)

Yeah what I saw was in need of help. Thanks. Well we try to start with WP:MEDDATE but that website was helpful to give me a rough idea of what a good section might look like. I took a stab at the diet section in causes. Thanks for bringing this issue to the talk page. I'll try to come back to make more progress later. Biosthmors (talk) 09:15, 19 September 2012 (UTC)

Wow! Thank you for such a quick response! The truth is, I'm a neuroscientist with a Ph.D. in nutrition, and I find it hard to write for a broad audience without getting mired in the details and analyzing primary sources. But I'm good at spotting problems. I know, there's a WP saying that says something about fixing it rather than complaining, but I've also got Asperger's syndrome, which also makes it difficult to write concisely. And yesterday I was diagnosed with BPH (which scared me a little), so I'm not feeling very neutral on this subject myself right now. Thanks again for helping with this! Dcs002 (talk) 02:57, 20 September 2012 (UTC)

BTW, I was looking around for secondary sources for the folate and multivitamin supplements increasing risk, and I found this review. [doi: 10.3122/jabfm.2012.01.110117 J Am Board Fam Med January-February 2012 vol. 25 no. 1 111-119] It doesn't support or refute either statement, but it might be a helpful review for working on this topic. It's available free online at [[12]] Dcs002 (talk) 03:22, 20 September 2012 (UTC)

Another review [Esp Urol. 2011 Oct;64(8):720-34.] contains the statement "These dietary factors may act as late-stage promoters, rather than initiators, transforming a relatively harmless, latent prostatic neoplasia into a more aggressive form." This might be used to help explain why some factors seem to be associated with higher mortality among patients, yet don't appear to be associated with increased prevalence of prostate cancer (morbidity). This review shows signs of bias in favor of nutrition or nutrient intervention. It refers to "nutritional chemopreventive agents" as if they are well established when the evidence of their existence is poor, at least concerning prostate cancer. (I'm trying to be helpful with these posts without actually doing the writing...) Dcs002 (talk) 04:15, 20 September 2012 (UTC)

Addition

A 2006 study suggests the use of pomegranate fruit extract for its antioxidantproperties to slow the growth of prostate cancer cells and tumors. Cancer Research UK finds that "countries that have a low fat and high vegetable intake in their diet have lower rates of prostate cancer" and that when men move from a lower risk country to the US there is a dramatic increase in the rate of prostate cancer; however, there has not been a definitive link with dietary fat.

There is some evidence that lycopene, commonly found in tomatoes, through their antioxidant effects can reduce prostate cancer; cooking and processing tomatoes helps the body to absorb the lycopenes more, so tomato ketchup is a good source. Cooking tomatoes with carotenoids and dietary fat, such as olive oil, helps absorption.

There is some speculation that phytoestrogens in soy may lower risk through reduced estrogen levels, since phyto (plant) "oestrogen is weaker than the oestrogen produced by our bodies." There are thoughts thatisoflavonoids, "particularly one called genistein" are the relevant active ingredients. One laboratory study has found that curcumin (found in turmeric) in combination with "isoflavones was more effective in lowering prostate-specific antigen (PSA) levels than using either compound alone."

A small (60 men) trial of green tea capsules suggests "that green tea catechins may lower the risk of prostate cancer in patients at high risk for the disease. Two year follow-up showed that this effect was long-lasting."Population studies reinforce this assumption and also indicate that black tea has no effect. It is thought that the active ingredients are polyphenols including catechins, and particularlyepigallocatechin-3-gallate (EGCG), due to their antioxidant effect. Laboratory experiments show that EGCG blocks androgen effects "on human prostate tumor cells, slow their spread, and increase cell death." EGCG also increases radiation effectiveness on cancer cells. It is thought that EGCG may be effective "by blocking histone deacetylases (HDAC)" activity. Studies of animal models in mice give further support to the effectiveness of green tea.

Modified citrus pectin shows some promise in reducing increases in prostate-specific antigens.

Laboratory studies of human prostate cancer cells with Zyflamend show decreased levels of androgen receptor and PSA levels, with a greater effect with higher doses.

The Prostate Cancer Foundation recommends: exercise, reduced animal fats, avoiding more than 1500 mg of calcium per day, fish (omega-3), avoid trans fatty acids, tomatoes cooked with olive oil, cruciferous vegetables (e.g.broccoli and cauliflower), soy, green tea, avoiding smoking and too much alcohol, lowering stress, and avoiding "over-supplementation with megavitamins."

While the available evidence is poor, tentative results suggest that frequent ejaculation may decrease the risk of prostate cancer. Two large studies: "Ejaculation Frequency and Subsequent Risk of Prostate Cancer" and "Sexual Factors and Prostate Cancer" suggest that frequent ejaculation over a lifetime offers some protection against prostate cancer. The US study involving "29 342 US men aged 46 to 81 years" suggests that "high ejaculation frequency was related to decreased risk of total prostate cancer".The Australian study involving "1079 men with prostate cancer and 1259 healthy men" found that "there is evidence that the more frequently men ejaculate between the ages of 20 and 50, the less likely they are to develop prostate cancer".

the protective effect of ejaculation is greatest when men in their twenties ejaculated on average seven or more times a week. This group were one-third less likely to develop aggressive prostate cancer when compared with men who ejaculated less than three times a week at this age.

— Cancer Council Victoria

We need to use high quality secondary sources. Thus moved. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:31, 9 February 2013 (UTC)

i appreciate your rigor and the amount of work you have done to keep this article as a reliable source of information; however:

"Ideal sources for such content includes general or systematic reviews published in reputable medical journals... and medical guidelines or position statements from nationally or internationally recognised expert bodies.

A secondary source in medicine summarizes one or more primary or secondary sources...Examples include... medical guidelines or position statements published by major health organizations.

Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge.

Medical and scientific organizations

Statements and information from reputable major medical and scientific bodies may be valuable encyclopedic sources. These bodies include... U.S. National Institutes of Health... The reliability of these sources range from formal scientific reports, which can be the equal of the best reviews published in medical journals, through public guides and service announcements, which have the advantage of being freely readable, but are generally less authoritative than the underlying medical literature." Wikipedia:Identifying reliable sources (medicine)

"The National Cancer Institute (NCI) is part of the National Institutes of Health" NCI article. Public guide, e.g.: http://www.cancer.gov/cancertopics/pdq/cam/prostatesupplements/Patient. Formal scientific reports, e.g.: http://www.cancer.gov/cancertopics/pdq/cam/prostatesupplements/healthprofessional

i would be quite happy to add the "health professional" links. I would also be quite happy to take this issue to Wikipedia:Reliable sources/Noticeboard, Wikipedia talk:WikiProject Medicine or Wikipedia talk:WikiProject Pharmacology. I am less than happy with a blanket "Reverted to revision 535859467 by Vrenator: better before". David Woodward ☮ ♡♢☞☽ 14:11, 9 February 2013 (UTC)

Sure feel free to bring to WT:MED. This is not notable "Laboratory studies of human prostate cancer cells with Zyflamend show decreased levels of androgen receptor and PSA levels, with a greater effect with higher doses." [13] This is an article about cancer in humans not in cell culture. And what is the clinical significance of PSA levels and androgen receptors? Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:20, 9 February 2013 (UTC)

"PSA is present in small quantities in the serum of men with healthy prostates, but is often elevated in the presence of prostate cancer or other prostate disorders." reference: Catalona, W. J.; Richie, J. P.; Ahmann, F. R.; Hudson, M. A.; Scardino, P. T.; Flanigan, R. C.; Dekernion, J. B.; Ratliff, T. L. et al. (1994). "Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: Results of a multicenter clinical trial of 6,630 men". The Journal of urology 151 (5): 1283–1290. PMID 7512659. "The androgen receptor helps prostate cancer cells to survive and is a target for many anti cancer research studies; so far, inhibiting the androgen receptor has only proven to be effective in mouse studies." reference: Narizhneva NV, Tararova ND, Ryabokon P, Shyshynova I, Prokvolit A, Komarov PG, Purmal AA, Gudkov AV, Gurova KV (December 2009). "Small molecule screening reveals a transcription-independent pro-survival function of androgen receptor in castration-resistant prostate cancer". Cell Cycle 8 (24): 4155–67. doi:10.4161/cc.8.24.10316. PMC 2896895. PMID 19946220.

"Wikipedia is, first and foremost, an encyclopedia, and as such, its primary goal is to be a fully comprehensive and informative reference work; that is, it does not purposefully omit (i.e. suppress or censor) non-trivial, verifiable, encyclopedically-formatted information on notable subjects."

"if information is solidly verifiable, then it's already "out there" in the reliable source. All removing the information from Wikipedia does is make it less accessible; it does not magically obliterate it from existence, and determined people can still find it. And if it's not in a reliable source, then mere lack of verifiability already justifies its removal."

"We see our role as making available all knowledge, not solely such knowledge as is universally deemed acceptable."— Wikimedia Foundation Board of Trustees, Resolution:Commissioning Recommendations from the Executive Director

1. Wikimedia is Dedicated to Intellectual Openness

In the first category is the overriding principle that animates all Wikimedia efforts – the unrelenting, unremitting and rigorous commitment to non-censored openness and “intellectual freedom” (to borrow a term from the library community) that Wikimedia attempts to provide for the world. The belief in providing open information and complete knowledge to the world’s inhabitants is not only a slogan for Wikimedians – it is the principle that animates virtually every decision and activity taken over its many platforms every day. We have been told time and again as we conducted this study that Wikimedia’s commitment to intellectual freeedom is not merely its mission statement – it is the key to its success in the world. The more open the projects can be, it was argued, the greater their potential success. By and large, we agree with this perspective. Wikimedia projects are trusted in the world because they are seen to be fair and unbiased (to the extent that that is possible in a world filled with contention). Open and full access to information is a principle that is both intellectually sound and practically efficient.

2. Wikimedia's Openness Does Not Change When Content is Contentious

As an educational enterprise, Wikipedia’s commitment to intellectual openness is no means to an end – it is an end in itself. It is a public service, the reason the projects exist. ... “Wikimedia does not censor”... There is much in the world to learn about – ... not all of it is uncontroversial... But it is there, and by and large, Wikimedia is there to document it. The principle of radical openness belongs to Wikimedia’s intellectual DNA."— Robert Harris and Dory Carr-Harris, 2010 Wikimedia Study of Controversial Content

WP:COMPREHENSIVE

"Wikipedia should provide encyclopedic information regardless of concerns about theoretical harm or religious / personal distaste." User:Jmh649/Suppression of content

David Woodward ☮ ♡♢☞☽ 12:54, 12 February 2013 (UTC)

Diet and lifestyle

I think the current first sentence best reflects the reference information. Jmh's version does not reflect that source. Please explain or make another submittal.

I tried to organize the main topics into paragraphs, instead of lumping all into one run-on disorganized first paragraph.32cllou (talk) 17:40, 20 March 2013 (UTC)

Have reverted these edits as they are based on a number of primary sources and removes secondary sources.

This is a primary source [14]

As is this [15]

This ref works just fine were I am [16] and is a secondary source. Doc James (talk ·contribs · email) (if I write on your page reply on mine) 20:12, 20 March 2013 (UTC)

The first sentence of our section on prevention is "The data on the relationship between diet and prostate cancer is poor" and is based on this ref which concludes "Due to the number and heterogeneity of published studies investigating diet and PCa, it is difficult to determine what nutrients make up the perfect diet for the primary and secondary prevention of PCa." and "Current literature linking these nutrients to PCa is limited at best". All conclusions are made in light of this. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:20, 20 March 2013 (UTC)

I agree taking out those two primary studies. I didn't put them in, just left them (As did you in your prior edit).

These two reviews are quite usable: http://eprints.ucl.ac.uk/4841/1/4841.pdf and http://www.cancer.org/acs/groups/cid/documents/webcontent/002577-pdf.pdf WHICH YOU REMOVED. Please explain.

As for the first sentence; Just as mine was taken almost verbatim from that review, your's is too. But yours is too strong (poor, versus scant or limited in number). And you remove the "Context" of the Western-style diet. Based on the other two reviews (see paragraph above) lets try (see article).32cllou (talk) 17:27, 21 March 2013 (UTC

I've added a second very high quality secondary source to support the first sentence in diet and lifestyle.32cllou (talk) 18:43, 21 March 2013 (UTC)

If you look at this sentence "There is some tentative evidence for foods containing lycopene and selenium." you will notice that the review is there just properly formatted.

If you look at this sentence "Men who get regular exercise may have a slightly lower risk, especially vigorous activity and the risk of advanced prostate cancer." you will notice that the other review is also there.

You will notice the primary research in the article before my edit and it not being there after [17] specifically this source [18]

You have still not provided justification for why you have removed this textbook Male Reproductive Cancers. Springer New York. 2010. p. 27. ISBN 9781441904508. and its conclusions. Thus reverted again as there is no consensus for your changes. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:54, 21 March 2013 (UTC)

You were also missing page numbers in for the WCRF. And the caps in the heading are wrong. Doc James (talk · contribs · email) (if I write on your page reply on mine) 21:58, 21 March 2013 (UTC)

Let go through sentence by sentence

You write "The incidence of prostate cancer is associated with consumption of the common "Western-style" diet." Yet page 194 of the ref states "Analysis of data from the Health Professionals Follow-Up Study found no association between a ‘western’ dietary pattern and prostate cancer risk."[19] and no page number for the above is given. The other ref says it is correlated with regions where men consume a so-called Western diet and that is only context not conclusion [20]. Doc James (talk · contribs · email) (if I write on your page reply on mine) 22:04, 21 March 2013 (UTC)

Good to talk more. I am sorry to have added that [21] reference, because it wasn't needed (the existing masko2012 meta had that statement). The sentence you cited (from page 194) is from a primary study and can't be used here. The sections 1.3 and 1.4 delve into diet / migrant studies which support the sentence. But I'll take out the citation if you want.

We are free / encouraged to include "Context" from a meta.

You have removed lots of other text from secondary sources. Why?32cllou (talk) 22:56, 21 March 2013 (UTC)

Which text are you referring to? I have summarized some of the text supported by reviews further.

So section 1.3 and 1.4 but what page and exactly? Doc James (talk · contribs · email) (if I write on your page reply on mine) 23:01, 21 March 2013 (UTC)

The sentence you selected (pg 194) was citing one primary study; It's not in general overview text, or conclusions. See pg 76? The migrant studies 1.3 - 1.4 simply find much higher incidence of cancer in general after people move to eat a Western diet. I will not use that reference because the meta you use for the first sentence already contains the meaning under Context. I guess you left the two other reviews, but why insist on such a short sentences? How about: The incidence of prostate cancer seems to be correlated with the common "Western-style" diet.32cllou (talk) 00:26, 22 March 2013 (UTC)

I think we should use "probable cause" just like the review.32cllou (talk) 00:30, 22 March 2013 (UTC)

Why do you write "In light of this?32cllou (talk) 00:33, 22 March 2013 (UTC)

The heading should be diet and lifestyle, not just lifestyle. More that half the text is about foods.32cllou (talk) 00:49, 22 March 2013 (UTC)

The reference on pg 27 does not support "While the available evidence is poor," in the masturbation / pc sentence.[[22]] They say pretty much the opposite. I can't find why you included pg 16 [[23]] so I took that reference out.32cllou (talk) 03:46, 22 March 2013 (UTC)

And next we work on Dietary.32cllou (talk) 04:02, 22 March 2013 (UTC)

Sorry, I reverted a few changes that didn't make the best use of the sources. The most important point of Masko is the poor evidence, same with Foulkes. Also reverted were some wording changes, article content was more clear in version reverted to, and clear wording is essential to expressing what's in the source. Zad68 04:30, 22 March 2013 (UTC)

I do not believe you read the study abstract and book references before making those statements.32cllou (talk) 20:57, 22 March 2013 (UTC)

Masko says that the state of the evidence makes it "difficult to determine" recommendations and "further prospective studies are warranted", so it's correct to characterize the evidence as poor, and this sort of wording is accessible to the general reader. Per WP:MEDRS we focus on evidence quality, so this is important and should not be removed from the article. The reasoning for the characterization of the evidence discussed in Male Reproductive Cancers is similar. The bit sourced to Comprehensive Textbook of Genitourinary Oncology is tentative and old but it's on a topic without a huge research base, I'll look for something more recent but I'm OK with it coming out until something more recent and/or definitive is found. Zad68 03:49, 24 March 2013 (UTC)

Hogwash. What you are doing is synthesis, which is prohibited! I was nearly quoting the source. Wikipedia is corrupt to the core.32cllou (talk) 18:55, 25 March 2013 (UTC)

Since I PERSONALLY think the research is scant, I've no reason to fix this sentence to make it accurate. Next time Jmh, Talk before warring.32cllou (talk) 19:21, 27 March 2013 (UTC)

This is a very unbalanced page

The introduction to this article presents as settled a topic which is in fact extremely controversial, i.e., the question of prostate cancer screening and its effect on mortality. I am far from a Wikipedia expert, but every attempt I have made to introduce balance has been immediately revised back to baseline. In point of fact, the best evidence to date demonstrate clearly that there is a mortality benefit screening, though this of course does come at the cost of overdiagnosis. This is not an opinion, is rather a statement of fact. I added citations to both primary and secondary sources supporting this and they were all deleted. I have on three occasions attempted to insert references to guidelines which disagree with the USPSTF and in all cases they were immediately deleted. The USPSTF did a poor job with its evidence review. The fact that they have the imprimatur of the government does not mean they are the only experts (indeed, with one exception the task force membership has no expertise whatsoever in prostate cancer). It is a major disservice to general readers that both sides of the controversy are not presented here. I realize there is a separate page devoted to the controversy, but the overall introduction to prostate cancer on the page cannot start with incorrect information without any disclaimer or rejoinder. Drcoop (talk) 23:43, 4 April 2013 (UTC)

— Preceding unsigned comment added by Drcoop (talk • contribs) 23:36, 4 April 2013 (UTC) 

A number of suggestions were made on your talk page. I think you're right that something should be mentioned about the other guidelines, though I think the USPSTF just by default should be the one with the most space in the lead paragraph. Perhaps something like "Other specialty societies have publicly disagreed with the recommendations of the USPSTF" with references, and then perhaps a bit more explication either in the screening section, or on the Prostate cancer screening page (as I suggested at your talk page). If I have some time in the next few days and there is no disagreement with this approach I should be able to do so myself. I think you may also find benefit from taking a look at WP:PILLARS, WP:AGF, WP:NPOV, WP:UNDUE and WP:MEDRS. -- [ UseTheCommandLine ~/talk ] # _ 23:54, 4 April 2013 (UTC)

Ginger has been shown to benefit prostate cancer. see: http://www.ncbi.nlm.nih.gov/pubmed/21849094 Arydberg (talk) 20:01, 7 August 2013 (UTC)

Squid Ink for Prostate Cancer

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3497014/ does this study meet the standards for a medical article? — Preceding unsigned comment added by CensoredScribe (talk • contribs) 14:43, 14 August 2013 (UTC)

Simple answer is: No. That's an in vitro primary research study. We're looking for secondary sources to make statements about health effects in humans. See WP:MEDRS. Zad68 14:49, 14 August 2013 (UTC)

NICE guideline

National Institute for Health and Clinical Excellence. Clinical guideline 175: Prostate cancer. London, 2014. is out. It might be useful. JFW | T@lk 06:50, 15 January 2014 (UTC)

clinical prostate cancer?

What is the difference between clinical prostate cancer and regular prostate cancer? I'm just wondering if it's wordy or verbose? Zaurus (talk) 18:28, 28 February 2014 (UTC)

Yes just wordy and verbose. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:57, 28 February 2014 (UTC)

Poor diagram

I think the diagram with the caption "When normal cells are damaged beyond repair, they are eliminated by apoptosis." is very simplistic and should be removed. Firstly, it is general to all cancers so should be on the main cancer page if anywhere. But the main problem is that it is so simplistic that it adds absolutely nothing to the article, and the caption requires no illustration. Andrewthomas10 (talk) 14:05, 12 July 2014 (UTC)

Agree and done. Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:57, 15 July 2014 (UTC)

UK Epidemiology

Hi, I'm from Cancer Research UK and going to add some UK stats to the epidemiology section complied from ONS, ISD Scotland, Welsh Cancer Intelligence and Surveillance Unit and the Northern Ireland Cancer Registry as summarised on the Cancer Research UK website. Franks08 (talk) 15:46, 3 October 2014 (UTC)

Female prostate cancer

See main article on prostate. Women have prostates (surprise!) and can get prostate cancer (isn't equality grand?). 184.77.68.158 (talk) 06:04, 6 October 2014 (UTC)

You need to provide a ref. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:56, 6 October 2014 (UTC)

On my talk page, I replied to the IP about common use of the term prostate. Flyer22 (talk) 11:30, 7 October 2014 (UTC)

Prostate cancer and frequency of ejaculation

Why is there no mention (certainly in the section "Risk Factors : Sexual Factors") on the fact that studies have proved that more frequent ejaculation significantly lowers the risk of Prostate Cancer ? :
http://www.harvardprostateknowledge.org/does-frequent-ejaculation-help-ward-off-prostate-cancer
http://www.newscientist.com/article/dn4861-frequent-ejaculation-may-protect-against-cancer.html#.VH7XoWdybcs
http://news.bbc.co.uk/1/hi/health/3072021.stm
--JustinSmith (talk) 09:06, 3 December 2014 (UTC)

Discussed here under prevention "While the available evidence is weak,[93] tentative results suggest that frequent ejaculation may decrease the risk of prostate cancer.[94]" Doc James (talk · contribs · email) 10:33, 3 December 2014 (UTC)

I think more recent evidence gives a stronger link, but certainly no RCTs afaik. These are 2005 & 2010. I'll ask what the latest is. Wiki CRUK John (talk) 11:09, 3 December 2014 (UTC)

Thanks. I check not to long ago and could find only a couple of primary sources from the early 2000s Doc James (talk · contribs · email) 11:41, 3 December 2014 (UTC)

Yes, actually it seems nothing more. The CRUK position for the press is that there is no "firm" evidence! Wiki CRUK John (talk) 12:02, 3 December 2014 (UTC)

Well I read the reports on those two links and they seem pretty conclusive to me, insofar as any research can ever be conclusive. I can`t help thinking that if it were a less controversial area , e.g. if the same reduction was seen by altering eating habits, we`d hear a lot more about it. And, I suspect, it`d be in this article, even if it is qualified by "the studies so far indicate" or whatever.--JustinSmith (talk) 13:47, 3 December 2014 (UTC)

Well that is not the conclusion of professionals, nor indeed of the American study itself, which says in the discussion section:

"In this prospective cohort study among predominantly white men, higher ejaculation frequency was not related to increased risk of prostate cancer. Our results suggest that high ejaculation frequency possibly may be associated with a lower risk of total and organ-confined prostate cancer....

Although each of several analytic approaches indicated that high ejaculation frequency was related to decreased risk of total and organ-confined prostate cancer, there are several plausible alternative explanations for our results...."

There are obvious difficulties in designing such studies. You have now added this to risk factors. The whole article needs an overhaul, but for now I will just move most of it to the right place & ce a bit. Wiki CRUK John (talk) 11:19, 5 December 2014 (UTC)

There seems to be more going on here than just doubt about the scientific studies involved. The following sentence used to appear in the lead: "Several studies suggest that masturbation reduces the risk of prostate cancer, but the results are controversial.[5][6][7]" The references were:

5.Jump up ^ Leitzmann MF, Platz EA, Stampfer MJ, Willett WC, Giovannucci E (Apr 7, 2004). "Ejaculation frequency and subsequent risk of prostate cancer.". JAMA: the Journal of the American Medical Association 291 (13): 1578–86. doi:10.1001/jama.291.13.1578. PMID 15069045.

6.Jump up ^ Giles GG, Severi G, English DR, McCredie MR, Borland R, Boyle P, Hopper JL (23 July 2003). "Sexual factors and prostate cancer". BJU International 92 (3): 211–216. doi:10.1046/j.1464-410X.2003.04319.x. PMID 12887469.

7.Jump up ^ Dimitropoulou P, Lophatananon A, Easton D, Pocock R, Dearnaley DP, Guy M, Edwards S, O'Brien L, Hall A, Wilkinson R, Eeles R, Muir KR (Jan 2009). "Sexual activity and prostate cancer risk in men diagnosed at a younger age.". BJU international 103 (2): 178–85. doi:10.1111/j.1464-410X.2008.08030.x. PMID 19016689.

On July 1, 2014, Doc Jones removed this sentence with the comment "moved primary sources out of the lead". In fact, the sentence and all three primary sources were removed from the article entirely. This seems to have gone unnoticed at the time. There was no discussion in Talk. If, as JustinSmith notes above, studies had shown that eating vegetables reduced the risk of prostate cancer, that would certainly be in the lead, and would have been widely reported in the press. While the press is reluctant to use words such as "masturbation" and "ejaculation" (while talking almost non-stop about sex) I expected better of Wikipedia. Rick Norwood (talk) 13:21, 5 December 2014 (UTC)

Checking more recent versions, I notice that Leitzmann and mention of ejaculation are back. Giles GG is cited for a different study, but not the one mentioned above. Dimitropoulou is still absent. The word "masturbation" does not appear in the article.Rick Norwood (talk) 13:28, 5 December 2014 (UTC)

Yup three primary sources in the lead were removed. We should not be using primary sources per WP:MEDRS. Any reviews or position statements? I added some textbook lower in the article. The correct term is ejaculation. Doc James (talk · contribs · email) 13:37, 5 December 2014 (UTC)

Is it not possible to put a link on the "see below" to where more information on this is because it is not easily found ? I`m not sure how to put a link on to a sub section. :
On the other hand, some studies have suggested that a higher and regular frequency of ejaculation may reduce prostate cancer risk (see below).
I tend to agree with Rick Norwood about whether it should be in "the lead"...... --JustinSmith (talk) 13:43, 5 December 2014 (UTC)

there are several plausible alternative explanations for our results...."
There aren`t that many pieces of research, particularly medical/lifestyle research, where that cannot be said !--JustinSmith (talk) 13:46, 5 December 2014 (UTC)

You mean linking to a section lower in the article? That is allowed, per Wikipedia:Manual of Style/Linking#Section links. Flyer22 (talk) 13:48, 5 December 2014 (UTC)

We really should not be using primary research at all, let alone in the lead. These papers have been out for 10 years and have been picked up by nearly no secondary sources. The main stream medical community has not been convinced. We already give it more weight than we should. Have moved the content up. Doc James (talk · contribs · email) 14:26, 5 December 2014 (UTC)

Agreed, certainly not in the lead. As it is, it probably walks on the edge of WP:UNDUE in terms of the amount on it compared to other survey/rewiew sources on the cancer. Wiki CRUK John (talk) 15:12, 5 December 2014 (UTC)

Compounds that produce "very rapid" and "massive [programmed cell death] in human prostate cancer cells" seems like something worth noting in the article, no?

I encountered a few of these citations while looking for reviews on 15-lipoxygenase, 15-lipoxygenase inhibitors, and eoxins (the last of which we really need an article on...).

I normally wouldn't bother with doing all of this, but after seeing the very significant claim made by the title of this primary source and observing that neither 5-lipoxygenase nor any 5-lipoxygenase inhibitors were mentioned in this article or the management subarticle, I figured this lack of coverage really needs to be addressed. It's probably worth noting that 5-LOX inhibitors generally have very mild adverse effect profiles, some being nearly indistinguishable from placebo; so this content is really worth including in the article provided that the following clause in the article is true for the other treatments: "all treatments can have significant side effects".

In any event, here's 3 citations (2 MEDRS reviews and the primary source from above which is cited by the first MEDRS review) which cover 5-LOX inhibitors as treatments for prostate cancer. It's probably also worth noting that these quotes include more effects of 5-LOX inhibitors on prostate cancer than just the aforementioned significantly marked/rapid apoptotic effect on human prostate cancer cells.

I'm not really comfortable with editing cancer-related topics since I lack the background knowledge to put this in context of the other text on the page, so I'm just going to leave these references+quotes here for one of you other WP:MED editors to (hopefully, or I will facepalm) summarize and include in the article. It might be worth linking 5-LOX inhibitors, which contains a list of these drugs with suitable references.

References

That's my 2¢. Seppi333 (Insert 2¢ | Maintained) 17:39, 3 January 2015 (UTC)

 Added it myself... so nevermind. Seppi333 (Insert 2¢ | Maintained) 03:34, 7 January 2015 (UTC)

Have moved to the research section. Many substances have great effects in cell culture and much less benefit within people with cancer. Doc James (talk · contribs · email) 03:40, 7 January 2015 (UTC)

Reference 7

Dennis LK, Coughlin JA, McKinnon BC, Wells TS, Gaydos CA, Hamsikova E, Gray GC (October 2009). "Sexually transmitted infections and prostate cancer among men in the U.S. military". Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 18 (10): 2665–71. doi:10.1158/1055-9965.EPI-08-1167.PMID 19755645. is not a systematic review or a meta-analysis and instead of being a high quality med reference it reports the result of only one study. To combine the statement about the 20% risk of prostate cancer with a statement about HSV-2 correlation is misleading and outdated. The later, more comprehensive study and reference indicated that there is no correlation between HSV-2 and prostate cancer.

  Bfpage |leave a message  19:02, 8 July 2015 (UTC)

i actually thought that is what you would argue about which is why i didn't remove it. deleted. Jytdog (talk) 20:18, 8 July 2015 (UTC)

Thank you so much! I can actually live with the edit that you made about the risk. I absolutely HATE reverting another editor's editing, it actually makes me queasy, but you came up with some wording that looks like we both can agree upon. Good job, and thank you for your willingness to work through this issue with me. The article is better for it. Best Regards,

  Bfpage |leave a message  00:50, 9 July 2015 (UTC)

Blacklisted Links Found on Prostate cancer

Cyberbot II has detected links on Prostate cancer which have been added to the blacklist, either globally or locally. Links tend to be blacklisted because they have a history of being spammed or are highly inappropriate for Wikipedia. The addition will be logged at one of these locations: local or global If you believe the specific link should be exempt from the blacklist, you may request that it is white-listed. Alternatively, you may request that the link is removed from or altered on the blacklist locally or globally. When requesting whitelisting, be sure to supply the link to be whitelisted and wrap the link in nowiki tags. Please do not remove the tag until the issue is resolved. You may set the invisible parameter to "true" whilst requests to white-list are being processed. Should you require any help with this process, please ask at the help desk.

Below is a list of links that were found on the main page:

• http://healthncare.info/prostate-cancer-survival-rates-and-life-expectancy-in-canada/

  Triggered by \bhealthncare\.info\b on the local blacklist

If you would like me to provide more information on the talk page, contact User:Cyberpower678 and ask him to program me with more info.

From your friendly hard working bot.—^{cyberbot II}_{Talk to my owner:Online} 17:23, 11 August 2015 (UTC)

External links modified

Hello fellow Wikipedians,

I have just added archive links to 3 external links on Prostate cancer. Please take a moment to review my edit. If necessary, add {{cbignore}} after the link to keep me from modifying it. Alternatively, you can add {{nobots|deny=InternetArchiveBot}} to keep me off the page altogether. I made the following changes:

• Added archive https://web.archive.org/20141204221606/http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_prostate_cancer_36.asp to http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_prostate_cancer_36.asp
• Added archive https://web.archive.org/20121011224552/http://www.timesonline.co.uk/tol/news/uk/article579050.ece to http://www.timesonline.co.uk/tol/news/uk/article579050.ece
• Added archive https://web.archive.org/20121011224552/http://www.timesonline.co.uk/tol/news/uk/article579050.ece to http://www.timesonline.co.uk/tol/news/uk/article579050.ece

When you have finished reviewing my changes, please set the checked parameter below to true to let others know.

N An editor has determined that the edit contains an error somewhere. Please follow the instructions below and mark the |checked= to true

• If you have discovered URLs which were erroneously considered dead by the bot, you can report them with this tool.
• If you found an error with any archives or the URLs themselves, you can fix them with this tool.

Cheers. —^{cyberbot II}_{Talk to my owner:Online} 05:07, 29 August 2015 (UTC)

Can we have a clearer definition of aggressive prostate cancer please

Is it based purely on a single Gleason score or some other test(s) - or on changes over time ? and Is PC either 'low-risk' or 'aggressive' or is there a 'typical' type too? - Rod57 (talk) 14:02, 18 September 2015 (UTC)

Link between gonorrhea and prostrate cancer

The source of this addition to the article is a medical journal systematic review and meta-analysis where 83 other studies were evaluated and the results were very clear in the connection between gonorrhea and prostate cancer. I know this is an extraordinary claim but the reference is excellent from a very reputable journal. Other sexually transmitted diseases were implicated but not enough so to include in the article.

  Bfpage |leave a message  11:08, 8 July 2015 (UTC)

Please keep in mind that correlation is not causation in your editing of health content. Thanks. Jytdog (talk) 13:29, 8 July 2015 (UTC)

There is nothing in study that states that there is a correlation, if there were I would have stated that fact. The statement is about increased risk. The sample size was huge-10,000. It is only a statement of risk. The causation or the mechanism by which gonorrhea increases the risk is unknown. I respectfully ask that you revert your edit. Best Regards,

  Bfpage |leave a message  18:46, 8 July 2015 (UTC)

There are basically two kinds of relationships or as you call them "links" between things - causation or correlation. You say that "gonorrhea increases the risk" and this is not correct. That is a statement of causation. Please read Correlation does not imply causation which talks about a famous example of this from medicine, about hormone replacement therapy and cardiovascular risk. Jytdog (talk) 19:44, 8 July 2015 (UTC)

This can't be true. There are 'associations' between one pathogen and another, or sometimes authors will say 'there is link', or sometimes they say 'there could be a link', sometimes there is a 'synergistic effect' between two pathogens that increases the risk of acquiring another pathogen, sometimes they even say 'there is correlation'. I rarely, if ever read, "x causes y". But there are lots of authors who will make assessments of the risk. The WHO and CDC websites are full of statements about increasing risk or reducing risk without referring to causation or correlation. They don't discuss correlation or causation in most cases since they deal in generalities. We can't limit our editing into two boxes called causation (a very rare box, indeed) and correlation (I guess that would be everything else). There is so much more in describing these 'links'. The words aren't mine anyway, if a group of researchers states that: "men who have had gonorrhea have a 20% increase of developing prostrate cancer", I have not described a cause or correlation, I have only reported what the researchers have written, paraphrased of course. Nice discussion, btw. I get so little feedback about my editing, actually. It's nice to be challenged-it keeps me honest. Best Regards and valuing your opinion and input on this topic,

  Bfpage |leave a message  00:40, 9 July 2015 (UTC)

let's wait and see what others say. Jytdog (talk) 01:14, 9 July 2015 (UTC)

Have simplified it to "An association with gonorrhea has been found, but a reason for this relationship has not been identified." Doc James (talk · contribs · email) 07:42, 9 July 2015 (UTC)

That's so vague it could include having prostate cancer increases ones risk of gonorrhea. If supported by the study shouldn't we say "men who have had gonorrhea (in the past) seem to have a 20% increase in the relative risk of developing prostrate cancer" - Rod57 (talk) 14:41, 14 January 2016 (UTC)

New review of castration-resistant PC

eg says "Targeting the AR-signaling pathway beyond abiraterone and enzalutamide is an area of active research.[53] Novel CYP17 inhibitors such as galeterone (TOK-001) and VT-464, and AR inhibitors such as ARN-509 and ODM-201, are being tested in clinical trials. EPI-001 is a unique AR antagonist that inhibits the amino-terminus domain of the AR protein and may overcome resistance mediated by splice variants and AR mutations.[47]" - Rod57 (talk) 02:20, 23 February 2016 (UTC)