Talk:Cancer

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Pictures of removed tumors

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

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

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

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

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

Fatigue

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

I believe it would be useful for patients, and fair to the subject, to write something that psycho-stimulants can be useful for treatment of cancer-fatigue. An article by the National Cancer Institute (found in [1] states the following (among other things):

"Psychostimulants - Although fatigue is one of the most prevalent symptoms in cancer, to date few trials are published on the use of psychostimulants as a treatment for fatigue in people with cancer. The support for their use arises largely from clinical anecdotal experience. Psychostimulants (caffeine, methylphenidate, modafinil, and dextroamphetamine) given in low doses are useful for patients who are suffering from depressed mood, apathy, decreased energy, poor concentration, and weakness. Extensive clinical experience with cancer patients indicates that psychostimulants promote a sense of well-being, decreased fatigue, and increased appetite."

Another reputable source on cancer (cancer.org) has at least two links on Ritalin for cancer-fatigue:

• [2]
• [3]

regards, marcelo1229; Jan3, 08; 19:15 US-PST —Preceding unsigned comment added by Marcelo1229 (talk • contribs) 03:18, 4 January 2008 (UTC)

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

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

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

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

The following quote from the article is a hopeless generalisation:

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

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

1)Cancer. sounds obvious, but curing or controlling the cancer is the single best treatment.

2)Metabolic disturbance. Eg Jaundice, renal failure, hypoabulinaemia, hypercalcaemia, cancer cachexia.

3)Anaemia, bone marrow failure. whether due to the malignancy itself or as a side effect of treatment.

4)Organ failure. Liver failure, renal failure, respiratory or cardiac failure, obstructed bowels etc etc tend to make one feel a bit under the weather.

5)Treatment. Surgery, chemotherapy, and radiotherapy are all noted causes of fatigue.

6)Old age. Cancer happens a lot in older people who simply do not possess much physiological reserve.

7)Depression and worry. Common in cancer patients. Depression makes one feel tired and apathetic, also associated with insomnia.

8)Pain and nausea. Two of the commonest symptoms of cancer. Potent causes of fatigue.

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

Useful Link

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

I'm really not sure what the need for such a link would be. This is an article for the general reader, and I think there is more to say for linking to the major international organisations rather than a fairly new low-impact factor journal. I presume it is a professional journal? JFW | T@lk 18:25, 5 February 2008 (UTC)

The journal is linked in the European Institute of Oncology page, this should suffice. I note, however, that this Institute is not linked in the Cancer article. Emmanuelm (talk) 18:35, 7 February 2008 (UTC)

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

Why is this article not a Wikipedia:Featured articles?

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

removed incorrectly placed template to nom that was never submitted

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

I removed the old, malformed fac template (that was never submitted), and highly recommend you first seek a peer review, announced at WP:MED. At minimum, the citations are going to need a lot of work before this article can succeed at WP:FAC. I suggest a review of autism, Asperger syndrome, influenza, tuberculosis or Tourette syndrome to understand the expectations at FAC. Lung cancer received very weak support at FAC, and is not the best article to compare to. This article would currently fail at least on citation level (1c) and citation formatting (2c) and there are WP:MOS issues as well. SandyGeorgia (Talk) 21:42, 15 February 2008 (UTC)

I will not spend hours reformatting references just to get a little star. This preoccupation with format over content is asinine. Fuhgetabutit. Emmanuelm (talk) 18:38, 16 February 2008 (UTC)

For the record, the reason references have to be properly formatted is to make it easier for others to see what sources you're using, and to verify those references. Nbauman (talk) 19:56, 16 February 2008 (UTC)

Suggested addition on Diet

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

• Sun Ha Jee, PhD, MHS; Heechoul Ohrr, MD, PhD; Jae Woong Sull, PhD, MHS; Ji Eun Yun, MPH; Min Ji, MPH; Jonathan M. Samet, MD, MS: Fasting Serum Glucose Level and Cancer Risk in Korean Men and Women, Journal of the American Medical Association, Vol. 293 No. 2, Jan. 12, 2005.
• Isabelle Romieu, Eduardo Lazcano-Ponce, Luisa Maria Sanchez-Zamorano, Walter Willett, and Mauricio Hernandez-Avila: Carbohydrates and the Risk of Breast Cancer among Mexican Women, Cancer Epidemiology Biomarkers & Prevention, Vol. 13, 1283-1289, August 2004.

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

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

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

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

True that the degree of causality is widely debated. However, from what I gather (bearing in mind I am not involved in the medical industry at all) the establishment has been quietly acknowledging that extreme consumption of simple carbohydrates is at least a poor idea for avoiding cancer.

Regarding serum glucose and sugar consumption I don't think there is anybody who seriously debates causality is there? I think this been well established, both empirically and theoretically. It is true that people who are overweight tend to have higher average serum glucose than others ("insulin resistance") but I believe it is well proven that in both groups restricting or eliminating simple carbs will drop serum glucose far more than these differences (although the patient might have to substantially drop simple carbs before the effect is seen).

I am not suggesting that the article should say that restricting sugar/starch is a "cure" or is considered a "therapy" but since these things are considered unhealthy anyway and some relationship has been demonstrated it seems worth mentioning.

--Mcorazao (talk) 03:38, 20 February 2008 (UTC)

P.S. Some other articles:

• Francesca Bravi, Cristina Bosetti, Lorenza Scotti, Renato Talamini, Maurizio Montella, Valerio Ramazzotti, Eva Negri, Silvia Franceschi, and Carlo La Vecchia (October 2006). "Food Groups and Renal Cell Carcinoma: A Case-Control Study from Italy". International Journal of Cancer 355:1991-2002.
• High carbohydrate diet implicated in pancreatic cancer, Journal of the National Institute of Cancer, 2002.
• Nebeling L et al. (1995) "Implementing a ketogenic diet based on medium-chain triglyceride in pediatric patients with Cancer." J AM Diet Assoc; 95:693-697.
• High-fat, Low-carbohydrate Diet Significantly Slows Tumor Growth And Enhances Health In Mice
• Association of Diet-Induced Hyperinsulinemia With Accelerated Growth of Prostate Cancer (LNCaP) Xenografts, Journal of the National Cancer Institute, 2007

Proposal for Diet section

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

• FOODS AND DRINKS THAT PROMOTE WEIGHT GAIN

Limit consumption of energy-dense foods and avoid sugary drinks

• PLANT FOODS

Eat mostly foods of plant origin

• ANIMAL FOODS

Limit intake of red meat and avoid processed meat

• ALCOHOLIC DRINKS

Limit alcoholic drinks

• PRESERVATION, PROCESSING, PREPARATION

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

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

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

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

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

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

Inclusion of Electrochemotherapy paragraph?

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

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

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

It is an esoteric and experimental treatment that has only been studied in a fairly small group of patients. It is not presently recommended in the treatment of any malignancies. As I have previously indicated, I don't think ECT (no, not electroconvulsive therapy) belongs on this page. JFW | T@lk 09:21, 25 March 2008 (UTC)

Agree with JFW.Jellytussle (talk) 22:44, 25 March 2008 (UTC)

This one is hitting pretty much all the red flags... MastCell ^Talk 03:34, 26 March 2008 (UTC)

I think this material does have a place in a more specialised article on cancer chemotherapy, as there are good sources that discuss this eg PMID 18041666 and PMID 17614247, but since this is still a very new and not particularly common technique, it isn't really appropriate for the general article on cancer. Tim Vickers (talk) 03:51, 26 March 2008 (UTC)

Question about Cure for Cancer

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

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

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

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

Picture

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

Prognosis and the mention of celebrities.

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

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

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

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

TheUbie.com

Cut & pasted from top of this page

RFC: For some time I have herolded my product [TheUbie.Com The 'Ubie'] as a cure for cancer. Being 90% less toxic then traditional smoking the ubie would represent a cure for 27% of all cancer. That is, 90% of all smoke related tumors. However, because a person's genes are also affected by toxins the rate shoudl also extend to children of smokers. What is the lasting effect of smoking on the risk of cancer? If someone could email me @ TheUbie.com that woudl be great.

Thanks Tim Sheridan

PS My current thinking is that a parent may only acumulate perhaps 10 years of risk before passing on 'risk' to offspring. Therefore the risk would be additive over time. indicating that a roughly similar number of cancers in offspring would ocurr but over several generations. For instance if the average age of illness for smokers were after 50 years of smoking then the 10 years of gamate exposure would take 5 generations for the Ubie to double it's single genration risk prevention effect. Thus for preparent smokers the long term benifits may well equal or exceed the short term benifits for a given generation.

A doubling of the apparent 27% prevention figure (to over 50%) is extreemly hopefull for our ability to fight disease and to ultimatly overcome the many chalanges we still face.

Tim, several issues, the most important being the interdiction to publicize commercial products in Wikipedia. Second, you may describe you product in general terms in the article on Smoking cessation. Clearly, the Cancer article is not the right place. Emmanuelm (talk) 12:59, 23 April 2008 (UTC)

External links (again)

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

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

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

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

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

Followup

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

Pathophysiology

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

Melatonin

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

Altmed

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

Chemoprevention

The first paragraph of this section reads as follows:

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

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

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

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

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

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

To Jfdwolff: I have not "stuffed" the article with tags, I have inserted the appropriate tags into the appropriate sections.

Although it is easy to point out POV issues with descriptive words as I have done, it is not always easy to replace information, especially as this is not my area of expertise by any means. Someone with sufficient knowledge on the relevant body of research should take the matter in hand, but just because I can not do this does not mean the removal of tags is warranted.

Kst447 (talk) 19:42, 29 June 2008 (UTC)

Vitamins

There is a concept

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

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

Cancer bacteria

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

The lead is overwhelming, firstly because cancer is overwhelming, and secondly because people have over the months been trying to cover absolutely everything in the lead. If you think content needs to be removed, see WP:BOLD.

As for cancer bacteria, this is a subject that has been discussed in extenso in the past. Some editors insisted that we devote large amounts of space to Alan Cantwell's debunked theories on mycoplasma, but common sense prevailed. The very maximum that I think is acceptable is a link in "see also", but really no more than that because there are simply no reliable sources linking bacterial infection to cancer barring Helicobacter pylori. JFW | T@lk 09:46, 15 July 2008 (UTC)

I know Is there a better page than heritability for the whole "Complex interactions between carcinogens and the host genome may explain why only some develop cancer after exposure to a known carcinogen"? Also, a PubMed search for cancer AND bacteria turns up a whopping 11k reviews. Here is a recent review. There seems to be a somewhat stronger relationship. I think I found a better place for the wikilink. II | (t - c) 10:42, 15 July 2008 (UTC)

The only real "hypersensitivity to known carcinogen" mutations are in hereditary DNA repair disorders. I don't think we have a page on hereditary predisposition to cancer.

Regarding cancer bacteria: this has been discussed to the death (see this archived discussion). The review you are mentioning, apart from being in a low-prominence journal, only really concludes what we already know: that H. pylori is linked with upper digestive tract malignancies and a big question marks over all others. Nothing else to be done, methinks. JFW | T@lk 12:31, 15 July 2008 (UTC)

Oh no... as soon as I saw "cancer bacteria" on my watchlist, I had a serious flashback to the months of tendentiousness surrounding the topic way back when. I know that shouldn't prejudice me, but still... I don't think we need to push this too hard - it's an idea (one of literally hundreds) about cancer that has received some research interest, but not something we need to focus on in an overview article. MastCell ^Talk 20:55, 15 July 2008 (UTC)

PMID 17208515 is also a good review. H. pylori are worth mentioning in this article, but the relevance of other bacteria to human cancer in general is presently speculative. Tim Vickers (talk) 21:14, 15 July 2008 (UTC)

Tim, I'm not sure if we should be using the World J Gastroenterol citation you added. That journal hasn't got an impact factor because of unusual editorial practices. JFW | T@lk 05:52, 16 July 2008 (UTC)

OK, I'd chosen that since it was open-access. Substituted new ref. Tim Vickers (talk) 15:13, 16 July 2008 (UTC)

Error

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

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

Vaccination

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

Causes of death

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

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

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

In contrast to Emmanuelm, I also think we might need to mention the actual mechanisms of death. If we're writing for people at the beginning of the disease (which is one of the many legitimate audiences for WP), then we have an ethical obligation to give them information without WP:CENSOR. They must make decisions, involving adverse effects for example, so they need to understand their disease as thoroughly as possible.

People often tell me that patients "can't handle" the truth, but I don't know of any evidence to support that. Do you? If anything, I've seen articles in the English-language medical journals that doctors aren't forthright enough.

I did see a study of interviews with people with serious or terminal diseases. Some of them wanted more information, and others didn't. I assume that the people who don't want more information won't be looking it up on WP. Nbauman (talk) 21:09, 7 September 2008 (UTC)

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

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

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

obstructive jaundice and liver failure from metastases obstructing the biliary outflow.

renal failure due to an obstructing lesion in the kidney, ureter, bladdre, or prostate

Superior Vena Cava Obstruction due to a tumour in the superior mediastinum

Raised intracranial pressure, convulsions due to a tumour in the brain

Uncontrolled haemorrhage from directly from a tumour, or caused by tumour eroding a blood vessel in the lungs or neck.

Obstruction or perforation of the bowel from an obdominal or pelvic cancer.

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

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

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

Cancer and Chinese Medicine

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

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

Proposed Entry for Cancer and Chinese Medicine

Cancer and Chinese Medicine

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

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

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

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

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

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

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

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

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

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

There are numerous other alternative modalities used in the treatment of cancer. I'm unconvinced that TCM needs any more mention than all the other modalities, given that at the moment there is no solid evidence that TCM improves mortality or response rates. JFW | T@lk 19:39, 26 August 2008 (UTC)

To be open-minded and fair about it -- if you can find a well-designed randomized, controlled trial in a major peer-reviewed journal, or at least a journal on PubMed, I'd leave it in. Otherwise, I'd delete it. That web site seems to be self-published, by someone who sells the products, not a WP:RS.

Is there anything on Chinese medicine for cancer on the Cochrane collaboration? Nbauman (talk) 05:13, 27 August 2008 (UTC)

Are you suggesting my response was not open-minded and fair? JFW | T@lk 22:33, 27 August 2008 (UTC)

You could substitute, "to be as generous as possible to traditional Chinese medicine." Nbauman (talk) 01:50, 28 August 2008 (UTC)

Diagnostic error

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

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

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

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

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

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

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

I agree with JFW, this discussion does not belong here. I would add that a general discussion of QA, QC and errors would be more appropriate in the Anatomical Pathology article.

Bye the way, I am familiar with the incident in Newfoundland and with another incident in my own Canadian province. Along with two other pathology error scandals in Canada over the past 12 months, they created a "perfect storm" that will lead to a tightening of error reduction measures for Anatomical Pathology in Canada. Emmanuelm (talk) 19:09, 21 September 2008 (UTC)

All animals?

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

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

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