Talk:Bladder cancer

Talk:Bladder cancer/GA1

Cochrane review edits for bladder cancer treatment

I added three short segments to this page using information from Cochrane review studies. - To the non-muscle invasive: added information about medications that are used to prevent recurrence of disease after surgery - To metastatic disease: added information on pembrolizumab vs chemotherapy for treating advanced bladder cancer that has recurred - To muscle-invasive disease: added information on the types of lymph node dissections that often accompany radical cystectomy and their impacts --Gsom12812 (talk) 19:17, 27 February 2021 (UTC)

Diagnosis through protein Mcm5 in the urine

Bladder cancer can be diagnosticated through the levels of protein Mcm5 in the urine. That protein Is exclusively produced by cancer cells. The related test has a precision of 97%. (sources: Il Corriere della Sera, Il Messaggero). 151.38.2.171 (talk) 17:22, 1 January 2023 (UTC)

Review (Gearing up for FAC)

Hi Femke and Draken Bowser, any chance one (dare I hope, both?) of you could spare some time to review this article? I've taken it through an overhaul update, with a mind to eventually bring it to FAC. First, I'm sure it could use some heavy editing. Your feedback would be much appreciated. Ajpolino (talk) 21:04, 12 December 2024 (UTC)

Adding that I haven't finished the images, and am not gifted in that realm. If you think of anything you'd like to see illustrated as you read, let me know and I'll do my best to make it so. Ajpolino (talk) 21:05, 12 December 2024 (UTC)

Femke

Great work on this. Get a busy period coming up with travel, so just some quick observations. Not sure when I can come back from more:

• I'm surprised a blocked bladder causes pain along the flank/side of the body between ribs and hips. Based on the picture, that's quite far from where the bladder is, right? Any reason why the pain is there?

• Great question; the source actually notes the pain is from hydronephrosis, i.e. urine backs up into the kidney and causes kidney swelling and pain. Clarified in the article, but happy to reword more dramatically if needed. Ajpolino (talk) 21:59, 13 December 2024 (UTC)

• I believe the term CT scan is more plain for non-experts and experts alike than computed tomography. I don't see a reason to spell it out. Same with MRI

• Done. Ajpolino (talk) 21:59, 13 December 2024 (UTC)

• The staging figure talks about CIS, the text next to it about Tis. Are these related?

• Yes, CIS tumors are staged Tis. I've made the smallest note in the text to clarify, but if you think it would help I can try to sort out how to edit the image (which is an SVG from Cancer Research UK). Ajpolino (talk) 21:59, 13 December 2024 (UTC)

• I find the treatment section on the technical side. For instance, acidosis feels like something that you can explain with a few words in plainer English? —Femke 🐦 (talk) 22:04, 12 December 2024 (UTC)

• I did some light clarifying – no doubt too light. If you point out other bits that read as overly technical, I can smooth them out (and become more self-sufficient at identifying those spots)

Thank you for taking a moment to look at the article. I hope you enjoy your travel. More comments are welcome any time, but certainly no rush to get to this. Best, Ajpolino (talk) 21:59, 13 December 2024 (UTC)

Continuing:

• To me, the word pathogen implies a virus or bacterium. I'm sure I'm wrong, but in the lead, can we say it's a parasite instead, rather than pathogen, for people equally unaware of the proper terminology.
  • Changed to Template:Tq, which hopefully suffices? I disfavor the label "parasite" since I think it comes off as vague and spooky (my PhD was in parasitology, probably hence my bias). Choosing "flatworm" over the more specific "fluke" because I assume the former would be more intuitively clear to a reader (who wouldn't know the taxon flatworm, but would correctly infer it's a type of worm that is flat). Ajpolino (talk) 15:20, 15 December 2024 (UTC)
    • Definitely clearer. —Femke 🐦 (talk) 20:32, 15 December 2024 (UTC)
• Can we say womb rather than uterus? The word is quite similar to uterer.
  • Sure. Done. Ajpolino (talk) 15:20, 15 December 2024 (UTC)
• Does the word cured not imply is permanent? "around two thirds of these people are permanently cured". —Femke 🐦 (talk) 09:44, 15 December 2024 (UTC)
  • Fair. Removed "permanently". Ajpolino (talk) 15:20, 15 December 2024 (UTC)
• If you want to update the WMO map, they do have newer data. The map function is interesting (last option, back to 2019 is as complete as you get), but it also has a trend from like 1979 in age-standardized mortality. I always find it interesting to see how/if healthcare is improving. Might be interesting to select a few large countries like South Africa, Germany, US, Brazil and see the trends in rich vs emerging countries.
  • Thinking about this (in red so I remember to return to it) Ajpolino (talk) 19:49, 13 February 2025 (UTC)
• Diet & lifestyle --> bit repetitive on the "several studies". Can we say some of this in Wikivoice? This may also improve the readability of the sentences.
  • Trimmed slightly. I'm resisting Wikivoice here because the evidence base is relatively poor and often contradictory. Open to suggestions Ajpolino (talk) 19:49, 13 February 2025 (UTC)
• Prognosis: how does this depend on the geography?
  • This may be hard to find; highlighting this so I remember to spend time on it. Ajpolino (talk) 19:49, 13 February 2025 (UTC)
• I would split the first para of staging in two after distant sites (M). I find it quite a dense paragraph. Similarly, I'd split the paragraph on the radical cystectomy from where the bladder recontruction starts.
  • Done. I also attempted to simplify the TNM paragraph slightly. Please let me know if I made it worse. Ajpolino (talk) 19:49, 13 February 2025 (UTC)
• It would be good if the image of the bladder reconstruction is linked in the caption to the correct procedure described in the main text. —Femke 🐦 (talk) 20:32, 15 December 2024 (UTC)
  • Clarified caption; sadly no article on the procedure, just a general one at urinary diversion (linked there for now). Ajpolino (talk) 19:49, 13 February 2025 (UTC)
• One of the images I think it missing is an photo of a tumor. There is one on Commons File:Papillary_urothelial_carcinoma_of_bladder.jpg, which might be useable? —Femke 🐦 (talk) 22:00, 15 December 2024 (UTC)

The lead:

• Overall, I think the lead is too difficult. I usually try to ensure that 90-95% of readers will fully understand the lead, and I don't think we're close to that percentage. I'd guess we're under 5% now. We do have a culture of writing overly difficult medical articles (as for instance evidenced by a recent article on COVID info).
  • I would remove the new information about the urothelium from the lead. It's probably known by less than 5% of people
  • You explain what a cytoscopy is; can the word itself be omitted?
  • I wasn't familiar with urethra. Can it be omitted? This may be a ESL issue.
  • Do we need to mention pathologists in the lead? The sentence "Suspected tumors are removed and examined to determine if they are cancerous." also works for me.
  • To avoid the word "contain": "Those whose bladder tumors have not spread outside the bladder have the best prognoses."
  • Instead of "BCG vaccine", perhaps "a vaccine typically used for tuberculosis"?
  • That sentence can be easier too, for instance: "These tumours are usually removed with surgery, followed by chemotherapy or a treatment to boost the immune system, like the BCG vaccine.". This avoids complicated words like "immune stimulant".
  • These people are treated with chemotherapy and immune checkpoint inhibitors, followed by the antibody drug conjugate therapy enfortumab vedotin. --> A lot of complicated terminology. Can immune checkpoint inhibitors and ADC be described as "other forms of immunotherapy"? The NHS website on bladder cancer treatment seems to describe it so.
  • Can we avoid the genus name for the flatworm and instead tell the readers where it's from?

—Femke 🐦 (talk) 19:19, 2 January 2025 (UTC)

• • • I've implemented most of your suggestions. I've left some jargon that I feel is critical to introduce. Still thinking about a more artful way to reintroduce the BCG vaccine, as I do think it's a key concept in bladder cancer. Happy to hear more thoughts on how to improve the lead, and discuss particular points if you'd like. Ajpolino (talk) 20:46, 13 February 2025 (UTC)

Comments from Graham Beards

I have been invited to comment and I have taken the liberty of making a few edits, which I am happy to discuss. I think the Pathophysiology section might need more work as it focusses on genetics. This not my area of interest but I think the immune response perhaps should be discussed? (I was amazed by the use of the BCG vaccine).Graham Beards (talk) 09:18, 14 December 2024 (UTC)

Thank you. I'll look to add more meat to the Pathophysiology section asap (should have time in the next few days). Apologies, you tried to teach me the lesson on fused participles at prostate cancer too. I hope this time it will stick. Ajpolino (talk) 15:24, 15 December 2024 (UTC)

Draken Bowser

I plan to take a look at this within a week or two. Feel free to move on to FAC if you like and I'll join in there instead. Draken Bowser (talk) 19:38, 16 December 2024 (UTC)

I like how this article is very concise, and still I'm going to make a few suggestions that might end up making it a bit longer.

• We could use a sentence on screening, basically that there's insufficient evidence to support it at this time.
• Having discussed the limitations of cytology we could also mention its strenghts, i.e. that false positives are extremely rare.
• While "may undergo cystoscopy" is true, cystoscopy remains the gold standard in bladder cancer evaluation and I think the text could be slightly tweaked to stress its importance in the diagnostic approach. Perhaps we should even discuss cystoscopy first, before we mention cytology and cancer-related urine markes, which could both be considered adjuncts?
• I think the pathophysiology-section should introduce the "monoclonal hypothesis" and "field cancerization", and explain how they seem to be at odds with each other, yet co-occur.
• Is there anything on the use of COX2-inhibitors in human cancer treatment?
• Any thoughts on the potential for a history-section?

Regards. Draken Bowser (talk) 11:16, 23 December 2024 (UTC)

Pardon the radio silence. Hosting family for the holidays has taken my editing time. Will be back at this next week. Your comments and time are appreciated! Ajpolino (talk) 17:09, 29 December 2024 (UTC)

Recent additions from cancer.org

Hi TomStonehunter, I just reverted your recent additions to the article. I'm sorry to take such a drastic move. It's not my intention to be discouraging. Hopefully we can clarify things here, and restore those changes with a click if appropriate. My concern is that I checked several new sentences and saw that they were lifted directly from the cited source (mostly the American Cancer Society website) which would violate their copyright. Am I missing something? Further explanation at Wikipedia:Copying text from other sources if helpful. Happy to discuss here. Ajpolino (talk) 22:13, 16 January 2025 (UTC)

Tnx for heads up, explanation. Article submissions will be recrafted in same order as before, one topic area at a time.TomStonehunter (talk) 21:54, 17 January 2025 (UTC)

Thank you, the new addition looks better. Just a note the p16 loss doesn't seem to belong with the rest of the list. The other list items are genetic issues you are born with (which fits into the section). If I understand the source correctly on p16, it's saying 10-45% of bladder tumors evolve to lose the protein (i.e. the person was born with functioning p16, but the tumor lost it as it grew). Maybe that note would fit in better in the Pathophysiology section, which notes some other growth pathways that are altered during tumor growth? Ajpolino (talk) 16:48, 19 January 2025 (UTC)