Talk:Prostate cancer

message: * The sentence about erectile dysfunction seems out of place, or maybe just oddly worded, as relates to "Signs and symptoms".
*:The wording here has changed a bit since July. Let me know if you still think it's clunky. Ajpolino (talk) 22:22, 27 November 2023 (UTC)
thread_title:  Signs and symptoms 

message: * Jargon alert: The transition from castrate-sensitive to castrate-resistant prostate cancer is also ... previously undefined terms.  SandyGeorgia (Talk)  21:28, July 12, 2023 (UTC)
* Actually, that whole para has a lot of undefined terms -- maybe reorganize flow and wikilink more?  SandyGeorgia (Talk)  21:30, July 12, 2023 (UTC)
**Solved if we stick with the new organization. Ajpolino (talk) 00:16, 13 July 2023 (UTC)
thread_title:  Pathophysiology 

message: * As mentioned above, this seems backwards, and should be part of screening ...  If DRE shows enlarged prostate, could explain elevated PSA ... routine part of screening ... SandyGeorgia (Talk)  21:58, 12 July 2023 (UTC)
thread_title: Diagnosis 

message: *I know what this means, but the average reader is going to stumble: . SandyGeorgia (Talk)  22:28, 12 July 2023 (UTC)
thread_title:  Management 

message: *  I frequently saw one in six for US in 2018 (rather than the one in eight now stated here); can we get some ranges on regions to show the variance?  SandyGeorgia (Talk)  23:00, 12 July 2023 (UTC)
thread_title:  Epidemiology (2) 

message: * Lung ???   SandyGeorgia (Talk)  23:12, 12 July 2023 (UTC)
thread_title:  Research 

message: * Do we really need the Mayo video?  Pretty much every NCCN Urology department has one ... SandyGeorgia (Talk)  23:48, 12 July 2023 (UTC)
thread_title:  External links 

message: * ah ha ...we do have this in the lead, but it the flow/organization issues in the body (described above) need to account for this.   SandyGeorgia (Talk)  23:18, 12 July 2023 (UTC)
replies: text: Ajpolino, I haven't been able to catch up here because of two funerals ... I may not be able to weigh in until after Christmas, but I do plan to ... Bst, SandyGeorgia (Talk)  18:47, 14 December 2023 (UTC)
replies: text: Take your time SandyGeorgia. This can always wait. Let me know if there's anything I can take off your plate here on WP. Otherwise, sending warm wishes as you navigate challenging times. Ajpolino (talk) 19:58, 14 December 2023 (UTC)
replies: text: Thank you, Ajpolino; kind thoughts help in difficult times.  I only had time ot glance quickly at the lead, and wonder if you have yet worked on it?  There seems to be a bit too much emphasis on the least likely scenarios.  For example, in the first paragraph of the lead, we have "Some tumors eventually spread to other areas of the body, particularly the bones and lymph nodes. There, tumors cause severe bone pain, leg weakness or paralysis, and eventually death."  I suspect you haven't yet tackled the lead, but when you do, it may need re-orientation to reflect the more likely outcomes, with less emphasis on the catastrophic. Or the old adage, "most men die with prostrate cancer, not because of it".  I hope to have some time after Christmas, and before the two January funerals, to be able to catch up here. SandyGeorgia (Talk)  13:37, 17 December 2023 (UTC)
replies: text: Hm. I see your concern about emphasis. I had already reworked the lead, but I'd mostly summarized the sections in the order they appear – apparently not a surefire recipe for an artful lead. I've tried some rearranging to have the clinical information flow more chronologically, which hopefully puts the emphasis closer to where it belongs. Let me know if we're moving forward or backward. Ajpolino (talk) 20:38, 19 December 2023 (UTC)
thread_title:  Lead 

message: Sorry I haven't done much. Sat down to look at it yesterday and then got dragged away. I realise the prostate cancer screening stuff is controversial. When I read the lead "Most cases of prostate cancer are detected by prostate cancer screening programs" I thought, well that's not true in the UK. We don't have a prostate cancer screening program. So none of our prostate cancer is diagnosed through a screening program. You have to actually visit your GP, be aged over 50, have read and discussed the pros and cons and decided it is still for you, and then the GP can request/do it. They don't advertise it or encourage it. I don't know what portion wait for symptoms before going.
:I'm back, and easing back into this... "programs" was a poor choice of words. Your description mirrors the situation in the US exactly (... except for the recommendation starting at age 55). I've tweaked the wording of the lead, but I may have mangled the sentence. If you have suggested wording I'm happy to hear it. Otherwise I'll revisit in a few days once I've knocked some of my rust off. Ajpolino (talk) 20:09, 11 September 2023 (UTC)
replies: text: Agreed, it's a fine line, and the difference is somewhat arbitrary. I split out "screening" as a section here because sources tend to discuss it this way, with "screening" referring to PSA tests and occasionally the digital rectal exam, and "diagnosis" referring to "what we do next to folks who have high PSA values". Ajpolino (talk) 20:09, 11 September 2023 (UTC)

text: Most sources say "African-American", though possibly just because the writer is American. Putting this at the top my to-do list. Ajpolino (talk) 20:09, 11 September 2023 (UTC)

text: Looked into this more and found a review that directly addresses the topic. Updated to what I believe is the mainstream view (men with "African or African Caribbean ancestry" are at increased risk) and added the review as a ref. Ajpolino (talk) 00:48, 27 September 2023 (UTC)

text: Good point, I've had a go at trimming this back. Ajpolino (talk) 19:37, 27 September 2023 (UTC)

text: Best I can tell, AJCC and UICC are supposed to be giving us unified TNM systems, but instead their systems differ slightly for some diseases (differences reviewed for urological cancers including prostate here). For prostate cancer Brits and Americans alike seem to be citing the AJCC's 8th edition manual. Even in the Cancer Research UK site if you scroll down to references you can see they reference the American version. I'm not sure if this preference is just because the AJCC manual came out more recently (2018) than the UICC one (2016) or if it's because of the differences mentioned in that review above. But if I can sort out why I'll add context if helpful. Ajpolino (talk) 19:11, 17 October 2023 (UTC)

text: Found another review on the topic and updated the text to clarify. Apparently it's robot-assisted surgery for those who can afford it. In countries that can't afford the equipment, you'll get open surgery or a "traditional" laparoscopic approach (hand tools and a camera working through small holes in your abdomen) which is just as good for your cancer, but will leave you in bed a bit longer. Ajpolino (talk) 19:12, 19 October 2023 (UTC)

text: It'll take me a few days to find some time for this, just dropping by to say thank you (and SG above) for your feedback so far! The article will be much-improved for it. Ajpolino (talk) 16:37, 21 July 2023 (UTC)
replies: text: Popping by to say I'm not dead, just away for regular life reasons. Still planning/hoping to return to this shortly. Hope all are well. Ajpolino (talk) 03:44, 22 August 2023 (UTC)
replies: text: No problem. There's no rush. But I'm glad you are not dead. :-). -- Colin°Talk 07:26, 22 August 2023 (UTC)
thread_title: Colin

message: You changed the section order, moving Causes/Pathophysiology up to sit between Signs & symptoms and Diagnosis. Screening got moved down to a subsection of Prevention. Some Risk factor-related info got moved from subsections of Epidemiology to subsections of Causes.
The rationale for the old order was that the opening six sections flowed in the order of a person's prostate cancer experience. Clinical stuff came first, then more academic stuff. Signs & symptoms > Screening (which for prostate cancer, is not a preventative, but rather something that precedes diagnosis) > Diagnosis > Management. The small Prevention section was inserted kind of randomly, and could float elsewhere. After the clinical information, the story flowed from prostate cancer's Cause > Pathophys > Epidemiology, etc. I think moving up Causes disrupts the flow of the article, as does pushing the risk factors-related info into that section. Ditto moving screening down, when it's something that readers will probably interact with in their own healthcare system and be interested in. Happy to discuss more, but I've got to step away from the computer for a few hours. Will return later. Thanks Ajpolino (talk) 13:18, 26 May 2024 (UTC)
replies: text: Thank you for your efforts, I tried to explain my changes above. I hope you have some enjoyable hours away from the computer. –Tobias (talk) 14:04, 26 May 2024 (UTC)
thread_title:  Section order