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Suggested Edits from QMed

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Hello, we are a group of medical students editing this page as part of our class assignment. We have compiled a list of suggestions to improve this article and would appreciate community feedback before we proceed with these edits. Here is a list of our suggestions:

Suggestions:

1) Add a wiki link to the following: PSA, prostate cancer, American Joint Committee on Cancer

2) TNM Staging Section should be updated with references to the 7th edition of AJCC and UICC.[1]. For the T1 description: we suggest that "tumor present, but not detectable clinically or with imaging" should be changed to "tumor present, but not palpable or detectable with imaging".[2]

3) We suggest an edit that will differentiate between clinical and pathological staging more clearly in the beginning by including the definition of each.

Replace: "imaging studies and blood tests (so-called "clinical stage"), or based on the extent of disease as revealed in a surgical specimen (so-called "pathological stage"),

Insert "The information considered in such a prognostic classification can be assessed by either clinical or pathological staging methods. Clinical staging usually occurs before the first treatment and tumour presence is determined through imaging and rectal examination, while pathological staging is done after treatment once a biopsy is performed or the prostate is removed by looking at the cell types within the sample".[3]

4)Change the sentence "Another scheme, now used less commonly for research, but often still used by clinicians, is the Whitmore-Jewett stage," to "Another scheme that was used in the past was Whitmore-Jewett staging, although TNM staging is more common in modern practice.[4] Under the Whitmore-Jewett staging section, remove: "The Whitmore-Jewett system is similar to the TNM system, with approximately equivalent stages." insert: "Although it is no longer commonly used in practice, the Whitmore-Jewett system is similar to the TNM system and has approximately equivalent stages".[4]

5) Clarify “risk” based on Gleason scale. Specifically, add: "A Gleason score of 6 is considered low risk, 3+4=7 is intermediate risk and 4+3=7, or 8-10 are considered high risk."[5]

6) Make Gleason Grade consistent throughout. i.e., In the article it mentions G score, cancer grade, histologic grade, etc. We suggest replacing those with "Gleason Grade". Replace: “G3-4: the tumor resembles normal tissue barely or not at all”, with: "G3-4: the tissue does not appear normal" or "G3-4: the tumor tissue does not resemble normal tissue."[5]

7) Add: "While the utility of absolute PSA values is still controversial (particularly for use in prostate cancer screening) the rate of rise and doubling time of PSA are useful indicators of the aggressiveness of a prostate cancer, and measuring PSA is also a widely accepted means of monitoring patients following their treatment.[6]

8) Addition of the image following images may help in visualization of the T staging - these images are not copyrighted

    a) https://upload.wikimedia.org/wikipedia/commons/thumb/5/5c/Diagram_showing_the_T_stages_of_bladder_cancer_CRUK_372.svg/2000px-Diagram_showing_the_T_stages_of_bladder_cancer_CRUK_372.svg.png
       --> For the T staging 
    b) https://upload.wikimedia.org/wikipedia/commons/thumb/6/65/Diagram_showing_a_transperineal_prostate_biopsy_CRUK_473.svg/1057px-Diagram_showing_a_transperineal_prostate_biopsy_CRUK_473.svg.png
       --> For showing how biopsy is done if wanted

9) The wikipage for "prostatic capsule" is no longer there, so instead of a hyperlink, we can define prostatic capule and have the term in brackets in the following manner: "In Stage III, the tumour has spread through a thin layer of connective tissue that envelopes the prostate gland (prostatic capsule) and the lump can be felt on the surface of the gland."[2]

Thank you so much, we appreciate any feedback you may have for us! Danielle, Meg, Madison, Louis, Wasim, Emma Drobi036 (talk) 20:04, 1 November 2017 (UTC)

References

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  1. ^ ...], American Joint Committee on Cancer. [Ed.: Stephen B. Edge (2010). AJCC cancer staging manual (7th ed. ed.). New York: Springer. ISBN 9780387884400. {{cite book}}: |edition= has extra text (help); |last1= has numeric name (help)
  2. ^ a b "TNM | UICC". www.uicc.org.
  3. ^ Cheng, Liang; Montironi, Rodolfo; Bostwick, David G.; Lopez-Beltran, Antonio; Berney, Daniel M. (January 2012). "Staging of prostate cancer". Histopathology. 60 (1): 87–117. doi:10.1111/j.1365-2559.2011.04025.x. ISSN 1365-2559. PMID 22212080.
  4. ^ a b Williamson, edited by Phillip Bennett, Catherine (2010). Basic science in obstetrics and gynaecology : a textbook for MRCOG Part I (4th ed. ed.). Edinburgh: Churchill Livingstone. p. 322. ISBN 978-0443102813. {{cite book}}: |edition= has extra text (help); |first1= has generic name (help)CS1 maint: multiple names: authors list (link)
  5. ^ a b Cosma, G; Acampora, G; Brown, D; Rees, RC; Khan, M; Pockley, AG (2016). "Prediction of Pathological Stage in Patients with Prostate Cancer: A Neuro-Fuzzy Model". PloS one. 11 (6): e0155856. doi:10.1371/journal.pone.0155856. PMID 27258119.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  6. ^ Laposata, [edited by] Michael (2014). Laboratory medicine (Second edition. ed.). ISBN 9780071805544. {{cite book}}: |first1= has generic name (help)