Talk:Colorectal cancer

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[edit] Question about asprin & BCG

Does anyone know why combination therapy using asprin and BCG isn't more popular? It seems safer and less expensive.

Well, start conducting trials whether it also decreases mortality. JFW | T@lk 22:50, 7 August 2005 (UTC)

[edit] Alternative explanation for epidemiology

The prevention section states: Lifestyle: The comparison of colorectal cancer incidence in various countries strongly suggests that sedentarity, overeating (= high caloric intake), and perhaps a diet high in meat (red or processed) could increase the risk of colorectal cancer.

The same epidemiology strongly suggests that the use of sitting toilets increases the risk. The dietary fiber theory has been tested for decades and has been shown to be invalid. See this link [1]

The use of squat toilets is a much more probable explanation since it is consistent throughout the developing world and pertains directly to colon hygiene. Does anyone mind if I do a brief edit on this subject?

--Jonathan108 16:46, 7 October 2005 (UTC)

I've seen your postings before. There is more evidence for a role of fiber than for your toilet theories. Please don't do a brief edit this subject. JFW | T@lk 21:39, 9 October 2005 (UTC)
Hear, hear. You (Jonathan108) keep saying there is evidence for your toilet theories but I have yet to read any that qualifies as good evidence. Besides, while the dietary fiber theory might be taking some hits, that does not mean that it implies that your theory is better. Just because A does not imply B, that does not mean that not A implies B. Alex.tan 20:33, 21 October 2005 (UTC)
Of course it doesn't mean that my theory is better. It only means that something new is needed. My theory is quite plausible from many different angles, and was even advocated by Dr. Denis Burkitt, the originator of the fiber theory. It deserves to be considered, and not dismissed out of hand as you both seem to have done.--Jonathan108 16:36, 2 April 2006 (UTC)

Proving causation is really difficult, and your ideas qualify as WP:NOR. How do you propose testing for your hypothesis? I can think of several methodological hurdles you'll have to jump before your opinion can be proven scientifically. Wikipedia is not the forum for this sort of delibrations. Please try a blog. Cheers. JFW | T@lk 23:57, 2 April 2006 (UTC)

I would like to offer piece of epidemiologic evidence for thought. There is a large immigration of Japanese to Hawaii. The incidence of colorectal cancer in Japan is low and the incidence in Hawaii is moderately high. Studies of immigrant populations demonstrate that the incidence of colorectal cancer in the Japanese rises to Hawaiian levels following immigration. For sporadic colorectal cancer, this demonstrates the importance of an environmental contributions. I will provide the relevant reference in this location when I have it.Jcromwell 14:52, 19 November 2006 (UTC)

[edit] Smoking

The article states "Smokers are more likely to die of colorectal cancer than non-smokers", but doesn't give any source for the fact or indication of how much of an increased risk smoking presents. I googled the info and came up with a study conducted by the American Cancer Society that supports the claim. I'll edit accordingly. -- ktaylor

Thanks, well done. Perhaps we should start using Wikipedia:Footnote4 here. JFW | T@lk 13:35, 12 October 2005 (UTC)

[edit] Third or fourth most common cancer

An anonymous editor 209.7.119.196 feels that colon cancer is the fourth most common form of cancer and the second leading cause of death among cancers in the Western world. However, at least in the U.S., it is the third most common form of cancer according to the American Cancer Society colorectal cancer facts & figures . Andrew73 20:35, 15 December 2005 (UTC)

[edit] Fiber, yes but

In last week's JAMA[2] it was found that dietary fiber intake was inversely associated with risk of colorectal cancer in age-adjusted analyses. However, after accounting for other dietary risk factors, high dietary fiber intake was not associated with a reduced risk of colorectal cancer. JFW | T@lk 14:26, 25 December 2005 (UTC)

[edit] Deleted alternative therapies

This may be controversial, but I deleted the alternative therapies section; therapies of unproven value such as mistletoe, etc. should not be given the same weight as therapies with proven benefit such as chemotherapy, etc. Thoughts? Andrew73 16:45, 26 December 2005 (UTC)

Since there were no references cited in that section of the article, it was probably best to remove it. It might be possible to have such a section if it described studies of the "alternatives". I'm not sure that any of the alternatives that were listed are really significant.

--JWSchmidt 17:39, 26 December 2005 (UTC)

Thanks for digging up the information. It seems that some of the information is for supportive therapies, i.e. to prevent nausea or vomiting, or preclinical testing. The clinical trials with curcumin may have potential, but overall, the information listed probably isn't notable enough to be in the article. Andrew73 17:45, 26 December 2005 (UTC)

I'm generally in favour of mentioning commonly used alternative remedies in a seperate section, but only if there is an indication that this is indeed commonly used, popular etc. Even those with a demonstrated benefit in trials may not necessarily be included if nobody uses them. JFW | T@lk 17:52, 26 December 2005 (UTC)

[edit] List of victims

Suddenly this page had a list of people with colorectal cancer. Many of them were of doubtful notability, and none have changed the public perception of colorectal cancer. I have removed the list and strongly discourage its recreation. Generally speaking, these lists are unnecessary, unencyclopedic, indiscriminate collections of information etc etc. Personally I would include only people of international fame whose illness has made a change in the public perception of the disease, such as Kylie Minogue and breast cancer or Michael J. Fox with Parkinson's disease. JFW | T@lk 18:11, 22 March 2006 (UTC)

[edit] Surveillance

This subject heading could be merged into prevention under the heading of secondary prevention. --Mansell 08:56, 9 June 2006 (UTC)

[edit] Liver mets

Gut this week: resection of liver mets. JFW | T@lk 19:32, 11 July 2006 (UTC)

[edit] Good Article nomination has failed

The Good article nomination for Colorectal cancer has failed, for the following reason(s):

More than half of this article consists of lists. These need to be re-written as prose. Also, very short sections should either be expanded or merged. Worldtraveller 14:45, 12 July 2006 (UTC)

[edit] Small error, but I'm a wiki newbie, not sure where to put this input-

In this article, FAP is said to have a 100% colon cancer association by age 40. I don’t think that is correct. Age 40 is significant in FAP because it is the mean age of cancer diagnosis, not the age by which they all have cancer. FAP has a near 100% progression to colon cancer, but the mean age is 39 (call it 40). I think that the sentence should read "FAP progresses to colon cancer in nearly 100% of all individuals, at a mean age of 39."

In fact, I am not aware of any specific age by which 100% have cancer, because I believe that 100% malignant progression is approached asymptotically with no specific associated age.

Here is the appropriate reference to clarify the issue- Bussey HJR. Familial polyposis coli. Baltimore: The Johns Hopkins University Press; 1975.

Here is a reference that discusses the median age of benign findings and some of the epidemiology of progression- Campbell WJ, Spence RAJ, Parks TG. Familial adenomatous polyposis. Br J Surg 1994;81:1722-33.

I hope that helps, I am new to this and not really sure whom to notify of an error. It isn't a big error, by any means.

Thanks.

[edit] Recent modifications

Hi I am a medical student in Hong Kong and I have modified the article to make it more comprehensive and (hopefully) easier to read.

  • symptoms: i have categorised it according to bowel symptoms, constitutional symptoms (due to catabolic effect of tumor) and also symptoms of systemic metastasis. Some new symptoms were added, e.g. tenesmus. Melena is not PR bleeding nor hematochezia (bloody stool). Anaemia is a diagnosis but not a symptom. Pallor and hepatomegaly are clinical presentations (signs) instead of symptoms.
  • Dukes classification: it is still commonly used among surgeons since it guides management and indicates prognosis
  • Surgery: I have further categorised it into curative, palliative, bypass, fecal diversion and open-and-close according to surgical principles. Please note the differences between surgical management in colon cancer and rectal cancer.
  • Radiation: also, I have summarised the paragraph, and please note the differences between colon and rectal cancer.

I think the format of the article can be improved, however I don't have time to do it at the same time. Maybe someone else would like to take up this job? sctonyling 16:43, 18 July 2006 (UTC)

added external links to nccn.org and also added other viable screening modalities currently implemented.--Vtak 03:49, 18 August 2006 (UTC)

[edit] Per rectal bleeding

Please kindly note that per rectal bleeding is not peri-rectal bleeding. Per rectal bleeding refers to bleeding through the rectum; "peri" is a prefix meaning surrounding, making the term "bleeding surrounding the rectum". sctonyling 05:08, 13 August 2006 (UTC)

Or it may read easier without "per." Andrew73 04:18, 14 August 2006 (UTC)
if we put it as rectal bleeding, it means "bleeding from the rectum", which is difficult from per rectal bleeding (bleeding through the rectum). To prompt easier reading, I have changed that into "bleeding through rectum (per rectal bleeding)". In the same essence, I have edited the passage so that medical terminologied precedes with layman explanation. I have as well categorised the symptoms for easier reading.sctonyling 04:41, 16 August 2006 (UTC)
I think bleeding through the rectum just confuses things. Doesn't make any sense -- Samir धर्म 04:46, 16 August 2006 (UTC)
"Rectal bleeding" is standard terminology. I haven't heard of anyone describing this as "bleeding through rectum," but this may reflect my American bias! Andrew73 12:42, 16 August 2006 (UTC)

[edit] reduction in calibre of feces

Newly added in section Symptoms.sctonyling 04:41, 16 August 2006 (UTC)

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