Talk:Bladder cancer

GA Review

This review is transcluded from Talk:Bladder cancer/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Tom (LT) (talk · contribs) 23:37, 26 April 2020 (UTC)

Wow, what an article @Astroketh, certainly looks good at first glance. Thanks for your edits to this article to bring it to this point. I've reviewed a number of medical and non medical articles and will be reviewing this article. I will review against the 6 good article criteria. On first glance I highly doubt there will be any major problems, this article looks appropriately cited, imaged, and comprehensive. I will spend a few days reading the article and then post a review. --Tom (LT) (talk) 23:37, 26 April 2020 (UTC)

Hey @Tom (LT) thank you for reviewing this article, I have started to work on your comments. --Astroketh (talk) 01:42, 28 May 2020 (UTC)

Hey @Astroketh. I've just closed the review, but seeing as you've become more active I'm happy to reopen it and complete this review if there is some editing on your part. Cheers --Tom (LT) (talk) 08:42, 28 May 2020 (UTC).

Hi @Tom (LT) yes that would be helpful. I have started to work on your comments.--Astroketh (talk) 06:50, 31 May 2020 (UTC)

•  Doing... --Tom (LT) (talk) 08:09, 28 April 2020 (UTC)
  • Stopping mid diagnosis section today.--Tom (LT) (talk) 22:50, 29 April 2020 (UTC)

Rate	Attribute	Review Comment
1. Well-written:
	1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct.	For the most part, highly understandable. See commentary below for a few issues.
	1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, and list incorporation.
2. Verifiable with no original research:
	2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline.	Several citations are older than recommended by the style guidelines (see WP:MEDRS), which I think is both achievable and important for a fairly common cancer like bladder cancer. Many citations are missing date of publication, which is important to help assess the currency of sources.
	2b. reliable sources are cited inline. All content that could reasonably be challenged, except for plot summaries and that which summarizes cited content elsewhere in the article, must be cited no later than the end of the paragraph (or line if the content is not in prose).
	2c. it contains no original research.
	2d. it contains no copyright violations or plagiarism.	Earwig's copyvio positives are general terms only.
3. Broad in its coverage:
	3a. it addresses the main aspects of the topic.	Absolutely
	3b. it stays focused on the topic without going into unnecessary detail (see summary style).
	4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each.
	5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute.
6. Illustrated, if possible, by media such as images, video, or audio:
	6a. media are tagged with their copyright statuses, and valid non-free use rationales are provided for non-free content.
	6b. media are relevant to the topic, and have suitable captions.	Many captions are lacking in some introductory information for general readers, or excessively complex. See below.
	7. Overall assessment.

Commentary

Readability

• "Higher levels of N-nitroso compounds(nitrate) " - not sure what (nitrate) means or if it really adds anything to the article... suggest remove it?
  • Removed --Astroketh (talk) 01:38, 28 May 2020 (UTC)
• "Aristolochic acid activates peroxidase in the urothelium and causes transversion mutation in the TP53 Tumor suppressor Gene. " - tumour suppressor gene shouldn't be in caps.
  • Changed as suggested--Astroketh (talk) 06:50, 31 May 2020 (UTC)
• Sometimes the word "specially" is used when I think "especially" is intended
• Diagnosis
  • Diagnosis - "urine cytology... There are newer non-invasive urine ". Suggest move the newer noninvasive urine tests to the end of the diagnosis section and split a separate paragraph, as the paragraph concludes with the fact these aren't to be used at present, so they are less important than the information about biopsies etc beneath them.
    • Changed as suggested--Astroketh (talk) 06:50, 31 May 2020 (UTC)
  • Diagnoss - "cancer is detected on TURBT, an MRI and/or CT scan (abdomen and pelvis or urogram) " suggest link MRI, and also reword "and/or CT scan" to "a CT scan of the abdomen and pelvis"
    • Changed as suggested--Astroketh (talk) 06:50, 31 May 2020 (UTC)
  • Diagnosis - "to look for metastasis" suggest explain metastasis, so that a lay reader can understand this concept.
    • Changed as suggested--Astroketh (talk) 00:45, 4 June 2020 (UTC)
  • Diagnosis - "Histologically, papillary transitional cell carcinoma can present in its typical form or with divergent differentiation (squamous, glandular differentiation or micropapillary variant). " will need to be simplified - eg "Under the microscope," instead of histology, and "in its different forms" or instead of "divergent differentiation"
    • Changed to read easier--Astroketh (talk) 00:45, 4 June 2020 (UTC)
  • I suggest the tables "Divergent histologies of non-papillary transitional cell carcinoma are listed below.", staging, grading, and the risk of recurrence, which are relevant to the article but quite long, be collapsed by default (see for example, Lymphoma). As it is, I think they are very long, bordering into WP:NOT territory and also unlikely to be of great use to most readers... but if they are included I think a collapsed table or a WP:FORK to an additional article may be preferable.
  • "Bladder cancer is staged (classified by the extent of spread of the cancer) and graded " - suggest link staging + grading
  • "WHO classification (2004/2016)[80][81] " - why is 2004 included?
    • 2016 is a extension of 2004, see section 1.3 --here--Astroketh (talk) 00:45, 4 June 2020 (UTC)

Images

• I think captions could be improved in many images to provide either some context or a little more information. Most readers won't know what type of image or where things are.
  • "Transitional cell carcinoma of the bladder. The white in the bladder is contrast." could explain that the image is a CT scan in the pelvis, that the cancer is the blackened mass in the contrast.
  • "Location of bladder cancer" could explain that the bladder is an organ in the pelvis and the image shows the location of the cancer as in the lining of the bladder wall.
  • "Bladder wall thickening due to cancer" again, mentioning that this is a CT scan
  • "Bladder tumor in FDG PET due to the high physiological FDG-concentration in the bladder, furosemide was supplied together with 200 MBq FDG. The uptake cranial to the lesion is a physiological uptake in the colon." definitely needs to be simplied for the reader. I don't think the fact that furosemide or the FDG dose that was given is that important to this article.
• Some images need a bit more explanation
  • "Diagram showing the T stages of bladder cancer"
  • "Stage N1 bladder cancer" - eg "N1 is defined as involvement of local lymph node groups, shown here"
  • "Advanced bladder cancer (M1b)"

Verifiability

• Missing a citation:
  • "Blood in the urine may also be caused by other conditions, such as bladder or ureteric stones, infection, kidney disease, kidney cancers or vascular malformations, though these conditions (except kidney cancers) would typically be painful. "
  • "Aristolochic acid activates peroxidase in the urothelium and causes transversion mutation in the TP53 Tumor suppressor Gene. "
  • "Histologically, papillary transitional cell carcinoma can present in its typical form or with divergent differentiation (squamous, glandular differentiation or micropapillary variant). "
  • This table ("Divergent histologies of non-papillary transitional cell carcinoma are listed below.") lacks a citation for histology and prevalance.
  • "Staging usually follows the first transurethral resection of bladder tumor (TURBT). Papillary tumors confined to the mucosa or which invade the lamina propria are classified as Ta or T1. Flat lesion are classified as Tis. Both are grouped together as non-muscle invasive disease for therapeutic purposes. "

References

• Citation number 1: "National Cancer Institute. 1 January 1980. Archived from the original on 14 July 2017. Retrieved 18 July 2017". Two issues. Firstly, it's from 1980?!! That can't be right. Secondly, I can't access the archive to verify it. There is enough information about bladder scan going round I think most citations should be from the last 5 - 10 years to ensure that they are still current
  • Changed as suggested--Astroketh (talk) 01:16, 4 June 2020 (UTC)
• Citation 11 is missing a retrieval date ("Survival statistics for bladder cancer - Canadian Cancer Society". www.cancer.ca.")
• Not to be too picky but citation number 35: " Chaudhary KS, Lu QL, Abel PD, Khandan-Nia N, Shoma AM, el Baz M, et al. (January 1997). "Expression of bcl-2 and p53 oncoproteins in schistosomiasis-associated transitional and squamous cell carcinoma of urinary bladder". British Journal of Urology. 79 (1): 78–84."
• Citation number 36: " Shokeir AA (January 2004). "Squamous cell carcinoma of the bladder: pathology, diagnosis and treatment". BJU International. 93 (2): 216–20. doi:10.1111/j.1464-410x.2004.04588.x. PMID 14690486."
• #43 lacks retrieval date: "Online Mendelian Inheritance in Man (OMIM) 109800"
• #44 also lacks last updated and retrieval date: " "Bladder cancer". Genetics Home Reference. "
• #49 "Bladder Cancer Report" (PDF). World Cancer Research Fund : International. Retrieved 9 November 2019. lacks publication date
• #53 ""EAU Guidelines: Non-muscle-invasive Bladder Cancer Diagnosis". Uroweb. Retrieved 12 November 201" lacks publication date
• #54 " "EAU Guidelines: Muscle-invasive and Metastatic Bladder Cancer diagnosis". Uroweb. Retrieved 12 November 2019. " lacks publication date
• #55 " Lotan Y, Roehrborn CG (January 2003). "Sensitivity and specificity of commonly available bladder tumor markers versus cytology: results of a comprehensive literature review and meta-analyses". Urology. 61 (1): 109–18, discussion 118. doi:10.1016/S0090-4295(02)02136-2. PMID 12559279. " now 17 years old
• #63 " "Uroweb - European Association of Urology (EAU)". Uroweb. Retrieved 7 November 2019. " lacks publication date
• #64 " "Types of Bladder Cancer: TCC & Other Variants | CTCA". CancerCenter.com. Retrieved 10 August 2018. " lacks a publication date
• #71 "Urothelial Carcinoma Variants - American Urological Association". www.auanet.org" - no date or access time

Status query

Tom (LT), it doesn't appear that any action has been taken to address the issues, though bots coming through have made minor modifications to three of the references since your review. Nominator Astroketh has made only six edits in 2020: one in February, four on March 13, and the most recent on April 24, two days prior to the review being open. If Astroketh doesn't return in the next several days, probably the thing to do is to close the nomination as unsuccessful. They can always renominate once they've returned and worked on the issues you've noted above. BlueMoonset (talk) 17:12, 23 May 2020 (UTC)

• Thanks BlueMoonset, I did need a bit of a prompt to make a decision here. I have failed the review seeing as it's been open for a month with no change. I am failing this in two main domains:
  1. readability; this article is too difficult for general readers in certain areas, and
  2. verifiability, taking into account the need for references, appropriately recent for medical sources.
• I can definitely see it passing in the future with some work, and thank the nominator and main editors for the efforts they've put in to date. --Tom (LT) (talk) 01:44, 25 May 2020 (UTC)

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)

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 Exposure to ... or the flatworm Schistosoma haematobium, which infects the bladder, also increases the risk., 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.
• 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.
• Prognosis: how does this depend on the geography?
• 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.
• 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)
• 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)

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)