Talk:Atypical teratoid rhabdoid tumor

message: This Wiki page was originally based on a Public Domain Paper by Loice Swisher MD.  Her child died of AT/RT.
Preliminary Draft:  June 24, 2002
I have been slowly rewriting her work and bringing it up to date.  For example, I have been putting in Intro/Content materialm, adding a more 2005 St. Jude Study and doubling the number of citations.  I propose to write a section on Pediatric CNS Cancer Funding  (very limited).  Also, I will try to include some graphs on Mortality.
ITBlair 05:22, 8 June 2007 (UTC)
thread_title: Article too long

message: A large part of the Clinical Trials section was deleted and not moved to the Clinical Trial Article.  In the main this consisted of Hospitals and Other Institutions that run Clinical Trials.  Often their trails eventually get into the Federal Clinical trial Registry.  I intend to replace this information.
ITBlair 05:29, 30 June 2007 (UTC)
replies: text: The consensus of clinical trial editors is to delete all such lists, the reason being that Wikipedia is not a directory (WP:NOT) and such lists both are and attract link spam.  IIRC, talk:clinical trial has a long discussion of this.  I don't remember if I deleted the list, but I do remember deciding not to move it.  Personally, I don't care much, and even if I did care of course you are welcome to add the list, but I recommend you don't bother:  someone else will delete it.  Also, I would rather hospitals came here to recruit patients, rather than we "beat the bush" to send patients to them. --Una Smith 02:38, 8 July 2007 (UTC)
thread_title: Clinical Trials

message: Please explain the term teratoid.  Una Smith 04:30, 11 June 2007 (UTC)
replies: text: So put that in the article.  Perhaps add a note that teratoid in this case has nothing to do with teratoma. Una Smith 20:04, 11 June 2007 (UTC)
thread_title: Teratoid

message: In what sense is AFP not found in AT/RT tissues?  Babies normally have elevated AFP, and AFP is a transport molecule that enters cells.  Does the immunohistology test for AFP test for AFP per se, or for expression of AFP (eg, for mRNA encoding AFP)? Una Smith 04:30, 11 June 2007 (UTC)
replies: text: There are immunohistochemical tests for AFP in fixed tissue samples.  The question is:  what test was used to produce the results mentioned in this article?  My point is that a baby conceivably can have AT/RT despite testing positive for AFP.  AFP is more complicated than some other tumor markers.  The wiki page on AFP is a work in progress. Una Smith 20:04, 11 June 2007 (UTC)
thread_title: AFP

message: Note getting protein analysis from spinal fluid cells.  Add Subsection on Protonomics - DONE  
Put in Info-Box as to AT/RT Diagnostic Categories  -  DONE
Add Work-Up data from Dr. Kieran's article.  Plus sort out and list the treatment trends he notes. - DONE
Get Ref. on RIII study and add. - DONE
Check with Kieran and Zimerman on updates, also ask if IRS III LT surviors are just a result of increased age.  This was not the case with the Olsen Paper.
More information on pallative care
Note details on Rhabdoid tumors, changing definition of this cancer
Link to Renal Cancer (if any)  -  Think and REDO This Material.  It appears that around 25% of other CNS cancers are actually AT/RT.  Wonder if many AT/RT cancers are actually other types.
Rethink list of treatment options.
Test Cancer in vitrio to select Chemotherapy, what drug combinations work best.
Better discussion on Stem Cell Rescue.
Add graphic on AT/RT mortality from govt.
WHO Classification of Brain Tumours find and Use. Circa 2000
Better Chemo Discussion - cite studies, to link on each Drug Type.  Note Global vs. Local Chemo.
Eventually want to list each drug combination and the results achieved.
Better discusion of Treatment Alternatives, include Salvage Surgery.
Gross and Sub Resections on Surgery.
Size of Tumor
Metatisis
Induction vs. Maintenance
Stem Cell Transplant
Add Reference to Cerebellar Mutism/Posterior Fossa Syndrome Resource Center
Add subsection on Polyclonal PolyPhenotypic
Add Doctor Doctor link to Pathology Section.  Send the links to this Pathologist.
Add Section on Histology, list proteins found in Staining and how they characterize AT/RT.  Define each protein from the IHOP  (http://www.ihop-net.org/UniPub/iHOP/gs/90100.html ) Web Site.  Link to Proteomics Lab and work.
Break out section on Clinical Trials into a separate Section with a Link Back.  Link to other Clinical Trial Wiki pages
Discusse Phases and Legal Issues with Trials.  Note Off-Label.
Also note cell line and animal models prior to Phase I; think about how to speed research and integrate Trials with HealthCare E-Records  Note tie into general Cancer Statistics Registries.
For each Citation, add the URL where it is available.  Try to add in a small Abstract.
Pick up all the Journal References in Rhaboid Kids Web site.
Also check papers published by Major Authors
Cite on Wired article on clinical trials - make in formal
Fix links to Yahoo List Servers
DO a Section on Standard(s) of Care for X Disease, relate to Clinical Trials, ERecords/Registry, and Mal-practice.  Each Standard of Care should have a Time Box (e.g., as of 2007 X was the Standard of Care of AT/RT).
Add More WIKI Categories.
Add the Diagnostic Categories from the Code Books for AT/RT to the Article.  Ask if insurance provides any coverage where there is to Std. of treatmente.
Ideal would be to get with Medical Wiki and get a similar write-up on each of the 120 or so Pediatric Cancers.  Need a general section  on CNS cancers.
As a separate matter it would be nice to get an integrated Single Registry for all these AT/RT cancers.
ITBlair 04:31, 11 June 2007 (UTC)
thread_title: Futures

message: The Genetics section needs an introduction, stating the extent to which the suspected genetic error occurs;  at present, the article enumerates only cases in which it does occur.  But is that the norm or the exception?  --Una Smith (talk) 04:11, 18 April 2008 (UTC)
thread_title: Genetics

message: Most of the Diagnosis section applies to any suspected brain tumor, not specifically to AT/RT;  that content belongs in Brain tumor.  Explanations of the diagnostic tests should be pared back and/or moved to the relevant articles, wikilinked. --Una Smith (talk) 04:11, 18 April 2008 (UTC)
thread_title: Diagnosis

message: The Pathology section introduces the idea that AT/RT resembles several other tumor types, but does not explain (clearly) how they can be distinguished.  The Immunohistochemistry section has tangential content about the technique, and otherwise consists of a list of proteins that may be present in an AT/RT, but again lacks any information (and citations) re how these proteins help (if they do) to distinguish this tumor from others. --Una Smith (talk) 04:11, 18 April 2008 (UTC)
thread_title: Pathology

message: Much of the content in this section is not specific to AT/RT, nor is the application of these treatments to AT/RT fully explained. --Una Smith (talk) 04:11, 18 April 2008 (UTC)
thread_title: Treatment

message: The Prognosis section, and elsewhere in the article, statements about younger children having a worse prognosis are unclear.  These statements need careful explanation and qualification.  In general, early diagnosis is better than late diagnosis because, all else being equal, tumor size and risk of metastasis increase with time.  On the other hand, a very aggressive tumor may be diagnosed earlier because of its aggressiveness.  Also, the diagnostic landscape is changing rapidly, so that statements re prognosis in the older literature may no longer apply.  An example is sacrococcygeal teratoma;  before prenatal ultrasound exams were routine in wealthier countries, the cases of these tumors that were found prenatally were the worst cases:  already massive and/or causing "mirror syndrome" in the mother.  --Una Smith (talk) 04:11, 18 April 2008 (UTC)
thread_title: Prognosis

message: Hi, on a first reading of the statement about "most common solid cancer in children" this seemed to refer specifically to ATRT which is, of course not true. Central nervous system (CNS) cancers are, collectively, the most commmon solid tumours in childhood and are second only to leukaemia - see the very useful references below.Leukaemia-ken (talk) 09:07, 26 June 2012 (UTC)
replies: text: Thanks for that leg-work, WhatamIdoing!  I regard SEER as the US authority on epidemiological data, especially for rare cancers, but there is no "one true source", especially not for the rarest of the rare pediatric cancers.  Doesn't this context info belong in Brain tumor rather than here? --Una Smith (talk) 04:31, 20 April 2008 (UTC)
replies: text: I'm happy to help.  This stuff does seem a little out of place here.  In particular, I don't think that the ATRT's introduction needs to spend so much time on brain tumors in general.  Part of it might be okay under ==Epidemiology==.  WhatamIdoing (talk) 20:49, 20 April 2008 (UTC)
replies: text: Apparently the original article was written for parents of kids diagnosed with AT/RT, so it started from ground zero and touched on everything remotely relevant.  --Una Smith (talk) 03:50, 21 April 2008 (UTC)
thread_title:  17% of all pediatric cancers involve the CNS 

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