Talk:Cancer

To Maintaining Low Blood Sugar as a New Cancer Treatment

Original research
The following discussion has been closed. Please do not modify it.
Many people believe that vegetarian diet is good for cancer. And many scientist tried to find out certain factor which is important thing as cancer treatment from vegetables and fruits. But, remarkable factor is not revealed in the world. So this writing is for the discovery of the factor. And perhaps side effect of surfeit of vegetable is the factor. For determine whether low blood sugar which is side effect of surfeit of vegetable is the main factor or have no relation to death of cancer, amount of sugar essential and total of sugar supply are partially calculated. A human cell has about 2.8billion(1) base pairs(or about 5.6 billion base) and 2.8billion base pairs have 11.2 billion deoxyriboses as a DNA back bone(2). Deoxyribose and glucose are sugar. So glucose maybe used as a raw material of DNA back bone. And for 1.12e+10 deoxyriboses, 3.3477e-12 g glucose may be essential as a raw material of deoxyriboses. The number of cancer cells is about 2000/mm^2(3) and the density of microvessel is about 200(count)/mm^2(3) and the average diameter of microvessels is about 10μm(). One microvessel of 200 microvessels in 1cm length of tumor is surrounded by 4472 cancer cells. 2000/mm^2 times sqrt{2000/mm^2} times 10mm div 200/mm^2 approx 4472.136 The concept of a cancer cell is a point. And the concept of a microvessel is a line. Cancer cells which surround one microvessel must needs 1.4971e-8 g glucose per 1cm as the raw material of the deoxyriboses. The blood flow velocity is about 0.49 mm/sec in capillaries(4). If the average blood sugar level is 100mg/dl, total amount of glucose which passes through a microvessel of10μm diameter is 3.323376e-6g/Day. 1.4971e-8 g is about 0.45% of 3.323376e-6g. But it's not calculated that how percent of 3.323376e-6g glucose is absorbed by 4472 cancer cells. And it's sure that 4472 cancer cells consume more glucose than 1.4971e-8 g. For calculating the percent of the absorption, osmotic pressure and diffusion velocity must be considered. And it must not ignored that the convection must be limited among the cancer cells. Most cancer cells starve(die) and 4% of survived cells induce KRAS Pathway Mutations in 9mg/dl glucose(5). This means that low blood sugar induce the necrosis of cancer cells. Besides, the density of microvessels in tumor have relation to cancer returns(6). Under 70mg/dl glucose in micorvessels may reach under 9mg/dl glucose among cancer cells. One microvessel manages about 40μm from itself. 40μm is 8 times of radius of microvessel of 10μm diameter. Cancer cell which closes to microvessel will absorbs more sugar than enough so another cell may absorbs less sugar than essential amount. Besides, the glucose concentration in a micorvessel of the cancer tumor will be getting lower as blood flows(figure1). Figure1 explains that why huge tumor have disadvantages in low blood sugar level. The calculation is not completed. But if someone completes this calculation, every things will be sure. Or if someone who has cancer maintains low blood sugar level(under 70mg/dl), we can know the relation between blood sugar level and cancer growth. At last, the change of dietary has relation to avoid cancer death(7) no matter that the relation are strong or not. The important thing is that perhaps the induced low blood sugar by vegetable based diets are the main reason to avoid cancer death. The concentration of amino acid also needs to consider. The purpose of this writing is to informing that to maintaining low glucose may be better treatment than chemotherapy. All of cancer patients have to know that perhaps to maintaining low blood glucose(always under 70mg/dl) is enough good as a new cancer treatment. Figure1. Conception of glucose loss when blood flows : As blood flows, concentration of glucose is getting lower as cancer cell absorb much glucose. e-mail : evilstriver@hanmail.net reference 1. http://en.wikipedia.org/wiki/Chromosome#Human_chromosomes 2. Levene P, (01 December 1919). "The structure of yeast nucleic acid". J Biol Chem 40 (2): 415–24. http://www.jbc.org/cgi/reprint/40/2/415. 3. Tsuyotoshi Tsuji, Yoshihiro Sasaki, Masanori Tanaka, et al: Microvessel Morphology and Vascular Endothelial Growth Factor Expression in Human Colonic Carcinoma With or Without Metastasis. Lab Invest 2002, 82:555–562 4. M.Stucker, V. Baier, T. Reuther, et al. Capillary Blood Cell Velocity in human skin capillaries located perpendiculary to the skin surface: Measured by a New Laser doppler anemometer. Microvascular research 52, 188-192(1996) 5. Jihye Yun, Carlo Rago, Ian Cheong, et al. Glucose Deprivation Contributes to the Development of KRAS Pathway Mutations in Tumor Cells. Science DOI: 10.1126/science.1174229 6. Noel Weidner. Intratumor Microvessel Density as a Prognostic Factor in Cancer. American Journal ofPathology, Vol. 147, No. 1, July 1995 7. WC Willett: Diet, nutrition, and avoidable cancer. Environmental Health Perspectives 103:165-170, 1995 (suppl 8)

— Preceding unsigned comment added by Evilstriver (talk • contribs) 08:21, 23 September 2009‎

Incorrect sentence in 1st paragraph

I don't agree with first sentence of this lemma : Cancer, also known as a malignant tumor, is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. come back later with arguments and proposal for correction --DerekvG (talk) 10:39, 13 October 2014 (UTC)

Ref one says[1]

"Cancer is a generic term for a large group of diseases that can affect any part of the body. Other terms used are malignant tumours and neoplasms. One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then invade adjoining parts of the body and spread to other organs."

Ref two says:[2]

"Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems. Cancer is not just one disease but many diseases."

These support that cancer is also known as malignant tumor, that cancer is a group of diseases, that abnormal cell growth is involved, that their is a potential to spread or invade other body parts. Not sure what issue you see? Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:56, 13 October 2014 (UTC)

One might query "a malignant tumor" at the start as encompassing all cancers, no? (oh, this is the ref, not the text: Well cancer does not = neoplasm, as the sentence rather implies/says.) Haven't we had a section on this in the last 6 months? Can't find it though. Please come back with proposal - this is absolutely the right way tio do it. Wiki CRUK John (talk) 11:18, 13 October 2014 (UTC)

Cancer does not equal neoplasm. Cancer does equal malignant neoplasm but does not equal benign neoplasm. These terms are sometimes not used correctly. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:24, 13 October 2014 (UTC)

Oh! the discussion started without me, nice, wait for me chaps let me catch up  ;-)

I do agree with Doc James and with the two definitions that ref1 and ref2 provide, I think thos references actually support my statement that I don agree with the first sentence of this lemma. At least not as its worded now it implies that cancer is limited to malignant tumour and it isn't beacuse it aslo includes such cancers as lymphoma, and leukemia which to my non-medical knowledge don't have solid tumours or neoplasms, they are however "abnormnal cells with uncontrolled growth".

I woudl like to propose the following change to that sentence :

" Cancer is a generic term covering a large variety of diseases that share the following common caracterics :

- a) abnormally formed cells

- b) uncontrolled cell growth (division)

- c) with the potential to invade adjoining tissue or spread to other organs of the body.

Cancer is not limited to diseases that involve the development of malignant tumour(s), non-tumour forming diseases exist.

Not all neoplasm (solid tumour formation) is cancerous, benign tumours are excluded from the cancer group of diseases."

Thank you Wiki CRUK John for your remark that this is the way to make such fundamental changes to the wiki encyclopedia--DerekvG (talk) 11:03, 14 October 2014 (UTC)

One can have liquid neoplasms (also known as liquid tumors) (ie leukemia). And WHO uses the term neoplasm and tumor interchangeably. They do not restrict either of these words to just "solid mass". Have added malignant neoplasm as one of the possible terms.Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:13, 14 October 2014 (UTC)

By the way what is a "lemma" Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:13, 14 October 2014 (UTC)

A maths-derived term for a page, much used by Dutch & German speakers. Since I think we all agree that the WHO's "Other terms used are malignant tumours and neoplasms" isn't really precisely correct, and the text doesn't say that, we should look for a better ref. If we just remove "also known as a malignant tumor," aren't we all happy? Then we need something with a more qualified version of that bit, distinguishing benign/malignant & solid/not. Replacing "Not all tumors are cancerous; benign tumors do not spread to other parts of the body", how about:

"All cancers are classed as neoplasms, and most form solid tumors. Cancer is the group of neoplasms which are malignant, meaning that they spread to other parts of the body. Other neoplasms are called benign because they do not spread in this way, and so are not cancers." Wiki CRUK John (talk) 12:01, 14 October 2014 (UTC)

Indeed Wiki CRUK John, so I just outed myself as a dutch speaker, we do use the term "lemma" for a wiki subject page --DerekvG (talk) 15:54, 14 October 2014 (UTC)

Yes thanks John. The terms malignant tumours and malignant neoplasms are used and are correct because tumours and neoplasms represent both solid and liquid cancers. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:08, 14 October 2014 (UTC)

Allow me to respond to that as a patient advocate in the matter of cancer. In other discussions on Wp:MED i've defended the position that on initial pages we should make sure that anybody can read and understand clearly what is being said, that further down we get more technical and readers are supposed to "dig" further (to clarify what information they don't understand) is fairly understood and acceptable as policy. I do understand and acknowedledge the nomenclature of the WHO and different cancer research institutions and organisations such as EORTC, ACA or NCI. I think for the wikipedia reader, unfamiliar with medical terminology, we should clarify that solid tumours and liquid cancers exist and what their common caracteristics are even if we say that from that point onward the terms cancer, malginant tumour or malignant neoplasm, are considered interchangeable and covering all types of cancer (that is why I said i didn't agree with the sentence). IMHO Users of wikipedia without a medical background are most likely to drop into the subject at pages like cancer, tumor or any page with the name of a disease picked up during a converstaion with their physician, and that is why we need to provide relevant, accurate and unambiguous information or informatiopn presented in such a manner that the casual reader both understands the different aspects and nuances of the subject and that we dissipate confusion by providing the different termss that might be interchangebaly used to refer to the same thing especially if they seem to refer to a subset.--DerekvG (talk) 15:54, 14 October 2014 (UTC)

Unfortunately the whole issue(s) of solid and liquid tumors, blood cancers, fixed and mobile tumors, which I agree needs explaining, even if not all are significant medical distinctions it seems, is not clearly handled at tumor/neoplasm, liquid tumor/Tumors of the hematopoietic and lymphoid tissues, or anywhere else that I can see. We need a patch that should go in all of these in some form. Wiki CRUK John (talk) 14:01, 15 October 2014 (UTC)

Quick note: If we're trying to be absolutely accurate, then "b) uncontrolled cell growth (division)" is wrong. The "rapidly dividing cells" idea is typical of what you read in the media, but cell accumulation via immortalization (i.e., via apoptotic failure) is sufficient to earn the label cancer. WhatamIdoing (talk) 18:07, 11 November 2014 (UTC)

Isn't that still "uncontrolled"? Johnbod (talk) 02:26, 12 November 2014 (UTC)

It's not "(division)", and "accumulation" is not exactly "growth" in the way that most people think of things that are growing. If you are talking about a leafy plant, for example, "the old leaves failed to die as fast as expected" is not what people usually call "growing leaves". "Growth" in this context implies the creation of new things (leaves, cells, or whatever). WhatamIdoing (talk) 03:31, 12 November 2014 (UTC)

Semi-protected edit request on 3 November 2014

Hat polemical screed
The following discussion has been closed. Please do not modify it.
All cancers 3 November 2014 All cancer cells emit X rays when there exposed to low power ultrasound. This means the cell is doing molecular nuclear fusion. Turning her pressurised water into helium, oxygen, heat and X rays. There is no biochemical source of X rays! 1 H2O+US->He+O+E2+Xray In 2002 the Moffitt cancer centre applying high intensity ultrasound to prostate cancer. And got a one appointment total cure the cancer. The making medical history! I have personally validated the 150 W 40 kHz for 30 seconds is HIUS. Though I now use 5 W 1 MHz for the same time. I have even cleared late stage inoperable liver cancer. HIUS to the armpits, liver and both sides of the head will clear all secondary us. Any other secondary will be cleared by ½ minute of external HIUS. Though the immune system should clear all secondaries automatically. The biochemical drug industry went ballistic! Suddenly there is a total physical cure to cancer that does line for biochemical treatments: which provide two years of expensive and agonising life before inevitable death. ‘it just works for prostate cancer’ they argued: have no conception how it worked out all. Medics have been using ultrasound since 1826. Lower power ultrasound does 1 for all cancers. HIUS steps up the heat output! To cause the cancer cell to heat up past 120° C. At which stage in fragments! Above 60° C it is dead. All cancers have to be pressurised in order to grow in a single cell way. He also need some viral genome. So cancers are composed of fragments of viral genome left behind by a fall infections. So all cancers are cleared with HIUS! This science was medically proved by our hundred patient double blind trial in 2002. It totally removes the need for a GP or hospital involvement. Which is why all medics have agreed not to use HIUS! To totally abandoned the first repeatable total cure to all cancers. Preferring instead to do cognitive manslaughter on their own patients-for money! Since 2002 they have executed 400,000,000 people around the world. There biggest intentional mass murder of all time. The cheapest source of HIUS is an ultrasonic massage device bought over the Internet. Search for ‘5 W 1 MHz ultrasonic massage device cheapest’. When it arrives, 30 seconds of external application will clear any cancer. Both coronary heart disease, arthritis, asthma and diabetes are caused by an inflated structure left behind by infective disease. HIUS applied to the top left the chest and the kidneys will clear coronary heart disease and raised blood pressure. 1 minute of HIUS to the chest will clear asthma. To arthritic joint three of the applications will clear the arthritis: in my personal direct experience! HIUS applied to the bottom right suggest will clear diabetes. Type 1 will take three days to totally remit. Type 2 were innate within turn sections. So all the diseases Astra Zeneca has a perfect biochemical treatment for can be totally cleared using an ultrasonic massage device purchased over the Internet. The same device applied to the chest throat and nose for ½ minutes, will clear all infections. Without the need of prescription or a medic! The world change is 2002. This is 2014. Doctors have August rated the biggest deliberate mass homicide in human history. For which they have been massively paid! In total contravention of the Hippocratic oath the altar, entering Medical Service. They can no longer apply medicine! They have deletes and cells from the medical registers around the world. Too well under five medicine is massive medical malpractice. The lawyers are going to have a field day! Jonathan Thomason JonThm9@aol.com 2.99.200.218 (talk) 17:17, 3 November 2014 (UTC)

 Not done as this appears to be an unsourced rant rather than a recommendation for a specific change. Yobol (talk) 18:11, 3 November 2014 (UTC)

Semi-protected edit request on 11 November 2014

The sentence, "Many cancers can be prevented by not smoking, eating more vegetables, fruits and whole grains, eating less meat and refined carbohydrates, maintaining a healthy weight, exercising, minimizing sunlight exposure, and being vaccinated against certain infectious diseases." appears in the opening section of the article, the opening sentence of the third paragraph. I would suggest changing "minimizing sunlight exposure" to "minimizing exposure to harmful radiation in sunlight" or something of the like, as this is more accurate and precise.

137.155.240.64 (talk) 10:33, 11 November 2014 (UTC)

That I think is too complicated for the lead. I have updated the references and changed the sentence to: "Many cancers can be prevented by not smoking, maintaining a healthy weight, not drinking too much alcohol, eating plenty of vegetables, fruits and whole grains, being vaccinated against certain infectious diseases, not eating too much red meat, and avoiding too much exposure to sunlight." - alcohol wasn't even included, and this order better reflects the current evidence. I've preferred "too much" to "more" or "less", though all rather beg questions. Wiki CRUK John (talk) 14:37, 11 November 2014 (UTC)

Confusing summary of incidence/prevalence statistics

The introduction includes the following: "In 2012 about 14.1 million new cases of cancer occurred globally. It caused about 8.2 million deaths or 14.6% of all human deaths." ... "Skin cancer other than melanoma is not included in these statistics and if it were it would account for at least 40% of cases."

This raises several questions. Is the fact that non-melanoma skin cancer is not included in the 14.1 million annual new cases in the WHO report stated in the WHO report itself, or is the WHO report referred to in one of the later references, the reports of the Facial plastic surgery clinics of North America? All three require a purchase or subscription to read and verify. If this statement can be verified, why is the first figure given without including non-melanoma skin cancers? And if there is a good reason, why is the exclusion not immediately pointed out? It would be clearer to say: "In 2012, about 14.1 million new cases of cancer (excluding non-melanoma skin cancers)..." The fragment of the final source that is available appears to refer to non-melanoma skin cancers as accounting for 40% of cancer cases in terms of prevalence. If that is so, it can't be directly compared to the original 14.1 million figure, as that refers to incidence. In any case, it would be clearer to show both totals (including and excluding non-melanoma skin cancers) in absolute terms, rather than setting the reader an algebra test. Cimbalom (talk) 05:04, 20 December 2014 (UTC)

Yes the statements are correct:

• Per "why is the first figure given without including non-melanoma skin cancers". The reason is that non-melanoma skin cancers (basal cell and squamous cell) are not particularly serious because they are visible and easily cut of. They also very rarely metastasise.

WCR states "Results from GLOBOCAN [3] show that in 2012 there were an estimated 14.1 million new cases of cancer diagnosed worldwide (excluding non-melanoma skin cancer)"

Other ref says "Nonmelanoma skin cancer is the most common form of cancer in the world and approximately 40% of all malignancies. "

Doc James (talk · contribs · email) 05:59, 20 December 2014 (UTC)

So I've updated the paragraph to clarify from the outset that NMSC is excluded. I've also clarified that the 40% figure is a prevalence figure. I've added skin cancer into the list of the most common forms of cancer for men and women. An alternative edit without NMSC would be: "The most common types of serious cancer in males..." and likewise in females. Cimbalom (talk) 15:28, 20 December 2014 (UTC)

I doubt "the 40% figure is a prevalence figure" - cancer figures tend not to use prevalence for obvious reasons. Johnbod (talk) 16:27, 20 December 2014 (UTC)

Adjusted a little further. Yes it is incidence not prevalence. We already mention that these states do not contain non melanoma skin cancers and this applies to all three of the first sentences. Doc James (talk · contribs · email) 19:45, 20 December 2014 (UTC)

Semi-protected edit request on 29 December 2014

Cancer 2nd & 3rd stage purely recovery stories Subhankariam (talk) 14:27, 29 December 2014 (UTC)

Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. I am assuming you wish this youtube link to be added as an external link? If so, by what rationale? There are thousands of other videos of cancer patients recovering, what makes this one special? Cannolis (talk) 14:32, 29 December 2014 (UTC)

Recent study large role for 'bad luck'

The introductory paragraph suggests that Cancer can be prevented by a healthy lifestyle, which is incorrect. It should state something that the chance of developing cancer is influenced by lifestyle. However a recent study showed that the number of stem cell divisions can explain why certain organ tissues are more likely to give rise to cancer, i.e. the more often the stem cells divide, the higher the chance of a mutation that leads to cancer can occur. This study claimed that 65% of cancer cases can be explained by bad luck. Just to clarify, this has nothing to do with genetic predisposition to develop certain types of cancer. Suggestions on how to implement this in the introductory paragraph? — Preceding unsigned comment added by 128.176.213.7 (talk) 17:35, 6 January 2015 (UTC)

References

I heard that story too and I'd love to see it mentioned somehow. Problem is it doesn't quite meet WP:MEDRS since its primary research. BakerStMD T|C 20:34, 17 January 2015 (UTC)

I can see nothing in the lead that "suggests that Cancer can be prevented by a healthy lifestyle", which is indeed incorrect. Johnbod (talk) 20:37, 17 January 2015 (UTC)

Please note that disease prevention does not only mean *eliminating* (eradicating) risk of disease, but also significantly *reducing* the risk. A healthy lifestyle does not mean that you won't get cancer, but that you'll be less likely to get it. 86.134.203.235 (talk) 18:55, 21 January 2015 (UTC)

Need a secondary source. This is primary [3] Doc James (talk · contribs · email) 00:30, 18 January 2015 (UTC)

That study is limited by presenting data for only most cancers, but not for two of the most common (breast and prostate). "65% of some cancers" is not as interesting as "65% of all cancers".

Johnbod, a great deal of the lead talks about lifestyle, without coming right out and saying "lifestyle causes almost all cancers". See "Many cancers can be prevented by [long list of healthful lifestyle choices]". The lead completely omits the fact that most invasive cancers in non-smokers, i.e., more than 50% of cancer cases, cannot be prevented through individual action ("lifestyle choices"), and that many cannot be prevented through collective action (like curbing polluting industries), either.

However, there is significant overlap here. How does drinking scalding hot tea cause esophageal cancer? Because it increases the rate of cell division. How does alcohol abuse cause liver cancer? Because it increases the rate of cell division. Do we attribute those cases to "bad luck" or to "lifestyle choices"? It's kind of both. "Bad luck" explains why some people who engage in the risky behavior get cancer, and "good luck" explains why some people who engage in the risky behavior do not.

Looking over the list, some of the other items may or may not be in the list of "lifestyle choices": The main sources of infectious caner are sexually transmitted infections. Neither this article nor the main article on infectious causes of cancer even mention how the typical person acquires these infections. Having a lot of sexual partners is usually an individual lifestyle choice (we all hope, right?), but whether to get multiple expensive vaccines isn't always a choice, and even lifelong monogamy is not a guarantee. I also wonder if "getting vaccinated" is the right way to present the infectious disease component in the lead. It is a rather Western-wealthy-country-centric approach, and there aren't vaccines for all of the infectious agents. "Avoid getting certain sexually transmitted viruses" (regardless of the means you employ to avoid getting infected) is more accurate. I expect that the Wikipedia community would be a bit squeamish about non-drug approaches to STI control, though. WhatamIdoing (talk) 18:09, 18 January 2015 (UTC)

It doesn't say anything at all like "lifestyle causes almost all cancers"! The main bit, before what you quote, is "Tobacco use is the cause of about 22% of cancer deaths.[1] Another 10% is due to obesity, a poor diet, lack of physical activity, and drinking alcohol.[1] Other factors include certain infections, exposure to ionizing radiation, and environmental pollutants.[4] In the developing world nearly 20% of cancers are due to infections such as hepatitis B, hepatitis C, and human papillomavirus.[1]", then 10% for inherited genetics. So the main individual "lifestyle" factors account for 32%, which clearly isn't even "most", never mind "almost all". Adjust the wording if you like - the headline from the paper was nothing new & that most cancers are sporadic can be referenced easily enough. Wiki CRUK John (talk) 18:41, 18 January 2015 (UTC)

John, don't do the arithmetic. Most of our readers won't. Instead, count up the number of things that are (or could be) counted as "choices" that cause cancer, and compare it to the amount of space given to things completely outside the patient's control. I'll save you some trouble. Here's the relevant parts of the lead text. I've color-coded it.

Tobacco use is the cause of about 22% of cancer deaths.[1] Another 10% is due to obesity, a poor diet, lack of physical activity, and drinking alcohol.[1] Other factors include certain infections, exposure to ionizing radiation, and environmental pollutants.[4] In the developing world nearly 20% of cancers are due to infections such as hepatitis B, hepatitis C, and human papillomavirus.[1] These factors act, at least partly, by changing the genes of a cell.[5] Typically many such genetic changes are required before cancer develops.[5] Approximately 5–10% of cancers are due to genetic defects inherited from a person's parents.[6]

Many cancers can be prevented by not smoking, maintaining a healthy weight, not drinking too much alcohol, eating plenty of vegetables, fruits and whole grains, being vaccinated against certain infectious diseases, not eating too much red meat, and avoiding too much exposure to sunlight.[8][9]

I've highlighted "all your fault" in orange, things that the typical person might believe could go either way in yellow (people might disagree, for example, on whether working as a radiology tech or living in a smoggy city is a "lifestyle choice"), and things that are "not your fault" in green. Here are the questions you need to answer:

1. Does that seem about right to you? Thinking about the perception of the median patient, with median education attainment (in the US, that's a high school diploma), would you put anything that I've marked as orange into the green category?
2. Which color do you see the most of? WhatamIdoing (talk) 04:25, 19 January 2015 (UTC)

Of course. But what do you do? You can add more green, but that doesn't take long at this level of simplicity. Then do you cut the orange and yellow to reflect a "correct" balance? At the end of the day the orange is relatively complex information that you can do something about and the green isn't either of those, which is why it tends to get predominance in coverage. The 3rd world infectious causes count as "not your fault"/nothing to worry about for Western readers surely? Wiki CRUK John (talk) 09:03, 19 January 2015 (UTC)

Worth remembering perhaps that lifestyle choices ≠ individual fault (culture is a key player). 86.134.203.235 (talk) 19:48, 21 January 2015 (UTC)

86.134, you're not an American, are you?

John, I don't think that it can be usefully solved. It simply takes more words to write a basic explanation for the "what you can do" part than for the "you're helpless about the rest" part. But the result is that readers will feel like cancer is mostly under individual control. We could maybe add another sentence that says something like, "Most cancers cannot be prevented solely through individual lifestyle choices", and perhaps put that first instead of last, but I don't think that the problem can be easily solved. WhatamIdoing (talk) 18:03, 22 January 2015 (UTC)

• Here, btw are User:HenryScow's thoughts on the original study and it's press coverage. Wiki CRUK John (talk) 14:52, 20 January 2015 (UTC)

That's a healthy read :) 86.134.203.235 (talk) 20:00, 21 January 2015 (UTC)

On a related matter...

One of the opening sentences of ==Causes== currently reads [4]:

Common environmental factors that contribute to cancer death include tobacco (25–30%), diet and obesity (30–35%), infections (15–20%), radiation (both ionizing and non-ionizing, up to 10%), stress, lack of physical activity, and environmental pollutants.⁴

I've requested clarification [5] on the Causes of cancer page^{(the present page is semi-protected)} as to how "obesity" can be listed/counted as "environmental" – when it isn't, given that it's not an external factor. A somewhat similar consideration could be made for "stress" (ie the organism's response, as distinct from environmental stressors).

This 'review' source (PMID 18626751) from 2008 is actually *proposing* a "unifying hypothesis". I feel PMID 24351322^paywalled and PMID 23514316^paywalled might be useful recent MEDRS.

@HenryScow: Perhaps WikiProject CRUK could somehow help get this key cancer-related content right? 86.134.203.235 (talk) 17:07, 22 January 2015 (UTC)

If we're doing it here, I'll repeat here the comment I made on that talk page:

I'm not happy about this edit [6], which leaves the start of the article not making much sense. The previous version, I think adjusted by me following a discussion elsewhere (in which 86 participated as 109), defined "environmental", as used by epidemiologists, as anything not caused by inherited genetics, so including obesity, as well as sporadic "bad luck" cancers. This was supported by the 1st ref (although it comes after that ref, which is of course too old (2008) and I think rather tendentious in implying that all such cancers are preventable), whose use of "environmental" explicitly covers obesity. Now the sum using that definition (90-95 + 5-10 = 100) remains right at the start ("The great majority of cancers, some 90–95% of cases, are due to environmental factors. The remaining 5–10% are due to inherited genetics"), but the definition of "environmental" has been significantly altered, leaving no place in that implied sum for "internal" environmental factors, and "bad luck" ones, which actually represent the majority of cases! We could do with better sources, of course, but either the whole para should be changed, or left.

User:WhatamIdoing, what do you think? Wiki CRUK John (talk) 12:46, 22 January 2015 (UTC)

- It all goes back to an earlier discussion on this page, now archived (link in quote). The "ref 1" at causes is this, which is very happy to describe both obesity and sporadic "bad luck" as "environmental factors". Wiki CRUK John (talk) 17:30, 22 January 2015 (UTC)

I think it "all goes back" to whether we're actually getting it right or not... Restarting with more appropriate sources might help, imo. I agree that environmental factors + inherited genetic factors = 100% (in terms of factors that are *preventable* – in the broadest possible sense). Other individual factors such as obesity and stress are 'downstream' of that equation. Btw, in the present (ie epidemiological) context there's no such thing as "internal" environmental factors. 86.134.203.235 (talk) 18:04, 22 January 2015 (UTC)

I think that the problematic edit is this one, which uses a completely different (and minority) definition and then claims that it applies to the stats produced using the original definition. That is not exactly an example of "getting it right".

To give you an idea of how significant this difference is, the definition that was added declares that the number of children a woman has, the age she starts having children, and whether and how long she breastfeeds—which are all significant biological factors in sporadic breast cancer due to "inside the body" hormones—are entirely non-environmental. Back here in the real world, those are seriously cultural factors, and human culture is definitely environmental. Worse, since this paragraph sets up a binary system, it effectively implied that these are therefore somehow hereditary genetic factors, which is just nonsense. (Obesity, by the way, is the cancerous tissue's environment, so that's not even as wrong as it sounds when you first hear it.)

I've reverted for now. I think we need improvements, but this attempt wasn't working. My general recommendation is that when we're presenting definitions and statistics, then we need to have the definition match the one used by the people producing the statistics. Perhaps the first place to start is with a proper lead sentence, like "There are many causes of cancer. Most of them cannot be easily controlled by individuals." It might also help to put the "hereditary genetics" first, so that the category of "non-hereditary genetics" seems more natural. WhatamIdoing (talk) 18:18, 22 January 2015 (UTC)

WAID, could you perhaps look at that again? In particular, on what basis do you say the definition I paraphrased is "completely different" (and minority)"? It's supported by highly authoritative sources, as well as the "original" source (which was/is being misrepresented here]). No-one is disputing that obesity is *related* to environmental factors – just that it's NOT itself an environmental factor.

86.134.203.235 (talk) 18:44, 22 January 2015 (UTC)

Adding: I've been trying to understand WAID's objection above (stemming from a simple misreading of this version maybe?). Perhaps it regards the choice of the NIH source (ref 2, above), with its rather specific focus on environmental "substances"? Having some professional background in epidemiological / environmental health research myself, I didn't (and don't) see that brief definition as conflicting in any real way with the more extensive definition provided by Kravchenko et al in ref 3. However, I'm not wedded to use of any one particular source. Fwiw, I do agree that further elucidation is needed (which is why I pinged User:HenryScow at CRUK, who clearly has a good overall grasp of these causality questions). 86.134.203.235 (talk) 23:03, 22 January 2015 (UTC)

If we are saying that "environmental factors" is restricted to those arising outside the body then the opening sentence "The great majority of cancers, some 90–95% of cases, are due to environmental factors" just isn't true, surely? Wiki CRUK John (talk) 23:39, 22 January 2015 (UTC)

That is exactly the problem. WhatamIdoing (talk) 23:45, 22 January 2015 (UTC)

Sorry, I hadn't seen you've addressed that in the article. Wiki CRUK John (talk) 23:48, 22 January 2015 (UTC)

(ec) adding: Talking of the US, one of the PMID links above, "Current perspective on the global and United States cancer burden attributable to lifestyle and environmental risk factors", by Schottenfeld D1, Beebe-Dimmer JL, Buffler PA, Omenn GS, gives (in the abstract) a maximum of 60% of US cancers to the big external environmental factors plus infections. The big UK survey of a year or two back gave around 45% to the big external environmental factors as I recall. You only get to 90-95% by adding sporadic unexplained mutations, as the first ref used does. Wiki CRUK John (talk) 23:46, 22 January 2015 (UTC)

86.134, perhaps it will be easier if you try to explain what pregnancy-related hormones are. Are they "outside the body", or not? Well, no, obviously hormones are inside the body. And if they're not "outside the body", then are they "inherited genetics"? Well, no, the are obviously not inherited genetics. So what are they?

This paragraph is using a strict binary system: All causes of cancer, without exception, are either A or not-A. All causes of cancer, without exception, are either in the group that causes 90–95% of cancers, or in the group that causes 5–10% of cancers. This simple pie graph shows the central point that we're talking about. There are only two pieces in the pie. All causes are either one or the other. One piece is labeled "Genes" and the other is labeled "Environment". We want to tell people what those two numbers are. We want them to know that one of those numbers involves way the heck more than pollution.

You have just (accidentally) re-defined one of the terms so that we now have logical nonsense. You have re-defined it so that we have 90–95% caused by "things outside the body", 5–10% caused by "inherited genetics", and 0% leftover for the very sizable contribution of things inside the body that are not inherited genetics (for example, pregnancy-related hormones).

You seem to want to create a trinary system:

1. things outside the body that cause cancer (e.g., pollution),
2. things inside the body that are not hereditary genetics and cause cancer (hormones), and
3. inherited genetics

—but if we do that, then we need a different statistics (i.e., statistics that nobody has been able to find, because good sources don't make that particular three-way distinction).

If we could find stats, we could use the other binary system:

1. Internal factors (both inherited genes and hormones)
2. External factors (both pollution and sunlight)

but I haven't seen recent reliable sources with statistics for this system.

As I see it, the immediate realistic options are either:

• Remove the definition that is not used by the people who created these statistics, or
• Remove the statistics that are not following the definition posted on the unrelated website you cited.

What we cannot do is say that "A" is defined this way, and then say that "A" is 95%, when we know perfectly well that the people who said "95%" used a noticeably different definition for "A". It would be like saying that "Luxury cars are defined by source #1 as any automobile with air conditioning" and then saying that luxury cars cost an average of US $90,000—according to source #2, whose definition of "luxury cars" had very little to do with the presence of air conditioning. That's what we've got right now, and it needs to be fixed right now. The definition and the stats need to be congruent. That means telling the reader that this 95% "environment" group includes far more than "substances outside the body". WhatamIdoing (talk) 23:49, 22 January 2015 (UTC)

@WhatamIdoing: This conversation seems to me to be going off-track. Fwiw, as I indicated in my comment above, in the field of environmental epidemiology, individual factors like obesity, stress, pregnancy-related hormones are understood as being *related* to environmental factors (such as diet, physical activity, sleep etc; stressors; and the ones you yourself mention above), but they aren't considered, in themselves, to be environmental factors. Since (with genuine respect) I don't think it's altogether reasonable to require a Wikipedia editor to expound in any depth on the methodological relevance and implications of such matters, instead I'll try to reframe my genuine editorial concerns here in purely WP terms.

(Btw, what you call a "simple pie graph" I do not look upon in any way as being a *simple* pie chart – though as far as I can see the information (confusingly) presented in it appears to be unsourced and, presumably, represents original research work conducted by the authors themselves, using unspecified methods.) 86.134.203.235 (talk) 10:13, 23 January 2015 (UTC)

That's a deep link to a diagram in a review article. If you want to read the methods, then you need to read the rest of the paper.

(I wonder why "diet, physical activity, sleep etc" are not considered "individual factors". Surely they are not group factors, and the mechanism for sleep, at least, ought to be in the same general class as the mechanism for obesity.) WhatamIdoing (talk) 15:56, 23 January 2015 (UTC)

@WhatamIdoing: RE If you want to read the methods, then you need to read the rest of the paper. Erm, what "methods", where? The only explanation of methods that I've been able to find is in the caption to the figure. In particular: A provides no indication of how or where the 5–10% / 90–95% ratio was obtained (and the relevant paragraph at the start of the 'Prevention of cancer' section of the main text is completely unsourced); although B at least provides a bit more information about what the figures are intended to represent, it also says "data shown here is taken from a study conducted in Utah..." (hmm... what study on what population, using what methods? have those data even been peer-reviewed?); C again gives some information on what the figures represent ("the attributable-fraction of cancer deaths due to the specified environmental risk factor") but doesn't explain how those estimates were extracted, or how the authors avoided pitfalls such as counting the same data twice in different categories. That's not what I would call an acceptable description of methods.

But, like I said, my understanding of MEDRS is that a Wikipedia editor shouldn't be expected to provide a detailed critical appraisal ("review") of a paper's methodology to question the editorial weight given in Wikipedia to the data it reports. Anyway, per WP:MEDASSESS, I've seriously questioned (I think) "the quality of the study". I've also pointed out that the content of the paper was "outside the journal's normal scope" (not altogether surprisingly, imo).

Disclaimer: I have absolutely no POV to push – I just don't think we should be giving such a strong encyclopedic voice to these figures. I believe it's unjustified and, ultimately, mistaken and unhelpful. Rather, we should also be considering how other potential MEDRS^{[including "ideal" ones]} approach these matters (see below). 86.134.203.235 (talk) 17:55, 23 January 2015 (UTC)

Arbitrary break: some MEDRS considerations

Although the paper in question is presented and indexed as a review, it claims (at the start of the Conclusions) to "propose a unifying hypothesis". On purely WP editorial grounds, I think we're conferring undue weight to one particular possible MEDRS (one which also happens no longer to satisfy WP:MEDDATE). WP:MEDRS specifically warns about using articles whose "content [is] outside the journal's normal scope", as is the case I think of this environmental epidemiology paper published in an off-topic journal called Pharmaceutical Research

I've already proposed two alternative potential MEDRS (both unfortunately paywalled), which I think could be considered here: PMID 24351322 and PMID 23514316.

86.134.203.235 (talk) 10:13, 23 January 2015 (UTC)

• The 'Etiology' section in the WHO 2014 World Cancer Report begins:

  Most cancers are associated with risks from environmental, lifestyle, or behavioural exposures.

  I think this could be a reasonable starting point (something like this perhaps?). As far as I can see, the report doesn't attempt to provide any more specific estimates regarding proportions of cases of this heterogeneous class of diseases that can be attributed to these overlapping categories of exposure (something I don't find altogether surprising). 86.134.203.235 (talk) 11:02, 23 January 2015 (UTC)
• To avoid this problem, I have previously proposed describing these two categories as "genetic and non-genetic", but that disturbs people who say that all cancer is genetic (which is not unreasonable). (That's when we fell back to the approach of telling readers that the source was using specialist jargon.) WhatamIdoing (talk) 15:56, 23 January 2015 (UTC)

I only have a short break, away from any desk, but there is a large recent UK study, referred to above. In Nature or the BMJ I think. I tried to reference that somewhere a while back, but it was removed by Doc James as primary which slightly puzzled me at the time. The WCR is indeed remarkably unforthcoming about the overall picture, and their factsheet, used as a ref later in the lead, is a far from ideal source, with a string of large % figures, which we use, shortly followed by saying (something like) "30% of cancers are preventable", which we don't use. In general we should identify 1 or 2 big detailed sources & follow them consistently. I'm back in the office on Monday & will try to consult. Wiki CRUK John (talk) 16:29, 23 January 2015 (UTC)