Former featured articleProstate cancer is a former featured article. Please see the links under Article milestones below for its original nomination page (for older articles, check the nomination archive) and why it was removed.
Good articleProstate cancer has been listed as one of the Natural sciences good articles under the good article criteria. If you can improve it further, please do so. If it no longer meets these criteria, you can reassess it.
Main Page trophyThis article appeared on Wikipedia's Main Page as Today's featured article on January 29, 2006.
Article milestones
DateProcessResult
November 29, 2005Peer reviewReviewed
December 16, 2005Featured article candidatePromoted
May 12, 2009Featured article reviewDemoted
March 20, 2024Good article nomineeListed
Current status: Former featured article, current good article

Unconfirmed risk factors[edit]

@Ajpolino I guess it's the question, if the systematic reviews systematically mention these studies, but also mention that they are unreliable, weak evidence, is it worth discussing them in the article? I think it's worth mentioning them, if only to say that the studies aren't worth much. Echoing this, WP:MEDDATE mentions "an older primary source that is seminal, replicated, and often-cited may be mentioned in the main text in a context established by reviews." At least for these studies, the replicability part is doubtful, although I guess we could consider multiple studies finding similar results to be replication, but they do have a fair number of citations, and the "seminal" part (what a pun) is suggested by the fact that they continue to appear in SR's. Mathnerd314159 (talk) 19:42, 21 June 2023 (UTC)[reply]

Hi Mathnerd314159, I'm sorry to be a pain, and I think my edit summary was so short as to be unclear. I think it's fine for our articles to cover areas with conflicting results. But I think some of the risk factors covered in that systematic review are so poorly covered that to dedicate text to them in an article on "Prostate cancer" is undue. Baldness is the extreme example: the 2021 Nature Reviews Diseases Primers article, 2021 Lancet article, and Harrison's Internal Medicine chapter which are all extensive mainstream articles on "Prostate cancer" don't mention baldness at all. Even articles specifically on epidemiology of prostate cancer rarely bring up baldness. The topic of prostate cancer risk factors is HUGE and the subject of immense study. More risk factors and detail would no doubt be due in an article on Risk factors for prostate cancer (we do have a Risk factors for breast cancer!) but here I think it muddles the reader's image for relatively little gain.
Somewhat similarly, I vaguely recall hearing on the radio 10+ years ago that men who masturbate more frequently are at reduced risk of developing prostate cancer. Recently I've been going through sources updating this article, and I'd sort of hoped to find great coverage either for or against the association that I could clarify here. But it seems to be similarly murky and has attracted relatively little coverage, and so I've decided it's probably undue as well :/ If you're interested in the topic and want to start Risk factors for prostate cancer, let me know and I'll happily help out and can send the sources I've been digging up for the Prostate cancer update (hey there's probably room there for the masturbation bit as well). Ajpolino (talk) 20:30, 21 June 2023 (UTC)[reply]
Oh and I don't know if this page has many watchers, you're the first person to substantially pop by in the few months I've been working on it. So if you vehemently disagree with me on this (totally fine!), perhaps we can post at WT:MED to try to solicit a few more opinions. Ajpolino (talk) 20:31, 21 June 2023 (UTC)[reply]
Yeah, I just clicked through to prostate cancer from masturbation a few days ago to see if there was more information and then I noticed the prostate cancer article didn't mention anything at all and it had been removed. It's like a lot of Wikipedia, someone writes it and then it never gets touched, and the resulting coverage is rather inconsistent. Page Info says 13 editors looked at recent edits in the past 30 days but I'm guessing they're mostly large-scale watchers worried about vandalism.
Splitting the risk factors out does seem like a good idea, the article did shrink a bit with your recent edits but it's good to have room for it to expand back up. I guess I can start it, or do you want to? I really haven't looked at much beyond the 2022 update article. Mathnerd314159 (talk) 00:12, 22 June 2023 (UTC)[reply]
You're most welcome to start it any time. I'd love to, but sadly I barely have the bandwidth to keep chugging through this update. I'm mostly working top-to-bottom updating the sources to high quality reviews and textbook chapters from the last five years. I'm at the top of the Prognosis section now. I'll do the images and lead last. I'm hoping to nominate the article at FAC later this summer (I did a big lung cancer update this spring. That's the most lethal cancer; this is the second most lethal. That's how I ended up here). You're of course most welcome to participate in any part of the process. If instead you want to dig deeper into risk factors, I'm happy to support however I can. If you see any sources in this article (or elsewhere) you'd like I can send you a copy. If there's any other way I can help just let me know. Ajpolino (talk) 02:21, 22 June 2023 (UTC)[reply]
Well, I was going to just write it, but I started and then I realized it was a lot of work, more than just a few days. So my current progress is in the draft Draft:Risk factors for prostate cancer. I should have time to come back to it in a week or two. I would say to discuss the draft on its talk page. I haven't had much problem with accessing sources so far, the issue is more that the statistics I want aren't published. Mathnerd314159 (talk) 04:39, 29 June 2023 (UTC)[reply]
@Ajpolino regarding epidemiology vs risk factors, I think I'll discuss both in the risk factors article, so I would say to try to combine those sections. Mathnerd314159 (talk) 03:36, 2 July 2023 (UTC)[reply]

Pre-FAC reviews[edit]

SandyGeorgia

Signs and symptoms

Pathophysiology

Screening

I've done some tweaking to hopefully make the section clearer to the reader. Let me know if you think we're improving here.
I struggled with how/where to describe digital rectal exams. Most sources I found/used describe them separately from screening, and I've mirrored that here. In a way they're more controversial than the PSA test -- the big screening trials didn't include DREs, USPSTF still recommends against them for prostate cancer screening, American Urological Association says "As a primary screening test, there is no evidence that DRE is beneficial, but DRE in men referred for an elevated PSA may be a useful secondary test", et al. That said I agree the old wording didn't make clear that the PSA test indicates prostate size rather than just cancer. I added a bit of wording to clarify that (I hope). Happy to add more, or swap things around if you still think it's not coming across clearly. Ajpolino (talk) 22:27, 14 July 2023 (UTC)[reply]
Here's what I'm trying to get at, strictly based on our personal experience, and I trust you to reflect the sources if you can find anything :) My husband had a PSA that was doubling every year. His physician ignored it because ... USPSTF. And me concurring based on bad information from ... ta da ... Wikipedia :) In the absence of an enlarged prostate, a PSA doubling every year for three exams should be investigated even if the PSA is still not at alarming levels. When he got to an NCCN urologist, after PSA went to 12, he said that since the DRE exam showed no other reason for growing PSA (eg, no enlarged prostate), then he certainly should have been looked at more closely and sooner. So, as you have now in the article -- the DRE gives good useful secondary information, to be weighted along with the PSA values if they are growing (assuming one has a baseline, which if USPSTF has its way, one doesn't). If you can find anything on that, grand :) What the urologist said, that the GP ignored, is that the normal DRE should have been an indication that the escalating PSA was an issue, before it got to 12 (back when it was doubling from 1 to 2, then 2 to 4, then 4 to 8 ... ) SandyGeorgia (Talk) 22:52, 15 July 2023 (UTC)[reply]
PS, I'm poking around to see if I still have Walsh's (Johns Hopkins) book, but I think I put it in storage or gave it to a charity book sale ... is it worth it for me to keep looking ? [2] SandyGeorgia (Talk) 22:55, 15 July 2023 (UTC)[reply]
Okay, that's helpful to hear. The sources tend to cover a situation like his by emphasizing that increasing PSA levels merit further investigation, and the rate of increase correlates with risk. But your urologists explanation makes a bucket of sense. Let me take another look through everything tomorrow with your experience in mind and I'm sure that'll help me interpret and write things more clearly.
Regarding the Walsh's book, I've actually not read it. I see my local library has a copy. I'll put a hold on it and will be able to take a look soon(ish). Ajpolino (talk) 02:46, 16 July 2023 (UTC)[reply]
One reason I ask is there's another bit we learned that I can't completely recall how to explain ... related to a surgery that avoids taking a nerve that surrounds the prostate, and when that is possible, leaves less lasting side effects than taking everything. Or something. And that's all I can remember :) Since, when looking at life expectancy charts, we ended up going for radiation anyway ... SandyGeorgia (Talk) 03:11, 16 July 2023 (UTC)[reply]

Diagnosis

Management

Epidemiology (2)

Research

External links

Lead

The lead is a bit rough and perhaps too long, and there is some underlinking in the article, but these can be revisited after others have been through. That's enough for me for now. After Colin or Spicy have been through, you might want to also ping Johnbod. SandyGeorgia (Talk) 23:20, 12 July 2023 (UTC)[reply]

Ajpolino, I haven't been able to catch up here because of two funerals ... I may not be able to weigh in until after Christmas, but I do plan to ... Bst, SandyGeorgia (Talk) 18:47, 14 December 2023 (UTC)[reply]
Take your time SandyGeorgia. This can always wait. Let me know if there's anything I can take off your plate here on WP. Otherwise, sending warm wishes as you navigate challenging times. Ajpolino (talk) 19:58, 14 December 2023 (UTC)[reply]
Thank you, Ajpolino; kind thoughts help in difficult times. I only had time ot glance quickly at the lead, and wonder if you have yet worked on it? There seems to be a bit too much emphasis on the least likely scenarios. For example, in the first paragraph of the lead, we have "Some tumors eventually spread to other areas of the body, particularly the bones and lymph nodes. There, tumors cause severe bone pain, leg weakness or paralysis, and eventually death." I suspect you haven't yet tackled the lead, but when you do, it may need re-orientation to reflect the more likely outcomes, with less emphasis on the catastrophic. Or the old adage, "most men die with prostrate cancer, not because of it". I hope to have some time after Christmas, and before the two January funerals, to be able to catch up here. SandyGeorgia (Talk) 13:37, 17 December 2023 (UTC)[reply]
Hm. I see your concern about emphasis. I had already reworked the lead, but I'd mostly summarized the sections in the order they appear – apparently not a surefire recipe for an artful lead. I've tried some rearranging to have the clinical information flow more chronologically, which hopefully puts the emphasis closer to where it belongs. Let me know if we're moving forward or backward. Ajpolino (talk) 20:38, 19 December 2023 (UTC)[reply]

Colin

Sorry I haven't done much. Sat down to look at it yesterday and then got dragged away. I realise the prostate cancer screening stuff is controversial. When I read the lead "Most cases of prostate cancer are detected by prostate cancer screening programs" I thought, well that's not true in the UK. We don't have a prostate cancer screening program. So none of our prostate cancer is diagnosed through a screening program. You have to actually visit your GP, be aged over 50, have read and discussed the pros and cons and decided it is still for you, and then the GP can request/do it. They don't advertise it or encourage it. I don't know what portion wait for symptoms before going.

I'm back, and easing back into this... "programs" was a poor choice of words. Your description mirrors the situation in the US exactly (... except for the recommendation starting at age 55). I've tweaked the wording of the lead, but I may have mangled the sentence. If you have suggested wording I'm happy to hear it. Otherwise I'll revisit in a few days once I've knocked some of my rust off. Ajpolino (talk) 20:09, 11 September 2023 (UTC)[reply]

Also, if screening is about checking people with no symptoms, otherwise healthy, how does that fit in with the symptoms overlapping with enlarged prostate. If you go to your GP with urination problems age 60, say, you might end up going down the path of these tests. But then isn't it just plain old "diagnosis" rather than screening? And an enlarged prostate is common. So how do we separate screening from diagnosis?

Agreed, it's a fine line, and the difference is somewhat arbitrary. I split out "screening" as a section here because sources tend to discuss it this way, with "screening" referring to PSA tests and occasionally the digital rectal exam, and "diagnosis" referring to "what we do next to folks who have high PSA values". Ajpolino (talk) 20:09, 11 September 2023 (UTC)[reply]

Another UK difference I spotted was that the article referred to "African-American men". But the UK NHS talks about increased risk to "black" men (and lower risk for "Asian" men). Bear in mind "black" and "Asian" in the NHS page might be reflecting the black and Asian populations that live in the UK rather than globally (but might not, it doesn't give a source). Anyway, few black people in the UK are "African-American", nor are they in Europe, or .... in Africa. So I think that needs sorted to be a bit more globally-minded wrt point-of-view.

Most sources say "African-American", though possibly just because the writer is American. Putting this at the top my to-do list. Ajpolino (talk) 20:09, 11 September 2023 (UTC)[reply]
Looked into this more and found a review that directly addresses the topic. Updated to what I believe is the mainstream view (men with "African or African Caribbean ancestry" are at increased risk) and added the review as a ref. Ajpolino (talk) 00:48, 27 September 2023 (UTC)[reply]

In the body section on screening, it leads with "Many national health bodies recommend prostate cancer screening in men aged at least 40..." But then when you look at the specifics, 40 is a really really low level, typically for exceptional sub-groups rather than everyone, and so that doesn't fit with "many". That sentence doesn't have its own source citation so not sure if it comes from the same place as the following sentence, or is unsourced. I think to be honest, the general statement would be that there is no agreement on what age, if any, to start a screening program. Since we have our own article on this, I think the reader isn't served by having a random selection of organisations and ages, at least not in prose format. I think for here we need a summary and from a source that does summarise the global (or at least Western) approaches. That summary might be to say there is a wide variation of opinion. -- Colin°Talk 08:28, 20 July 2023 (UTC)[reply]

Good point, I've had a go at trimming this back. Ajpolino (talk) 19:37, 27 September 2023 (UTC)[reply]

The staging text says "Prostate cancer is typically staged using the American Joint Committee on Cancer's (AJCC) three-component TNM system," But when I read TNM staging system it says it is maintained by the Union for International Cancer Control and describes a relationship with AJCC (different publications and slight difference in naming). So is our text a bit US focused and the TNM system is really an international one, and when the UK paragraph compares to "AJCC stage I" should it really by "UICC stage I"? -- Colin°Talk 17:01, 20 July 2023 (UTC)[reply]

Best I can tell, AJCC and UICC are supposed to be giving us unified TNM systems, but instead their systems differ slightly for some diseases (differences reviewed for urological cancers including prostate here). For prostate cancer Brits and Americans alike seem to be citing the AJCC's 8th edition manual. Even in the Cancer Research UK site if you scroll down to references you can see they reference the American version. I'm not sure if this preference is just because the AJCC manual came out more recently (2018) than the UICC one (2016) or if it's because of the differences mentioned in that review above. But if I can sort out why I'll add context if helpful. Ajpolino (talk) 19:11, 17 October 2023 (UTC)[reply]

The "Radical prostatectomy" paragraph describes four approaches. But the first two identify the location (above penis, below scrotum) and the latter two identify the instruments (Laparoscopy / Robots). Presumably the first two locations are big standard surgical approaches, though I can't see how you'd get a big hole in the area below the scrotum! It isn't clearly to me why the instrument methods shouldn't have the location of the incision mentioned or why either of the previous two locations wouldn't be used for them. I'm no surgeon. -- Colin°Talk 17:09, 20 July 2023 (UTC)[reply]

Found another review on the topic and updated the text to clarify. Apparently it's robot-assisted surgery for those who can afford it. In countries that can't afford the equipment, you'll get open surgery or a "traditional" laparoscopic approach (hand tools and a camera working through small holes in your abdomen) which is just as good for your cancer, but will leave you in bed a bit longer. Ajpolino (talk) 19:12, 19 October 2023 (UTC)[reply]
It'll take me a few days to find some time for this, just dropping by to say thank you (and SG above) for your feedback so far! The article will be much-improved for it. Ajpolino (talk) 16:37, 21 July 2023 (UTC)[reply]
Popping by to say I'm not dead, just away for regular life reasons. Still planning/hoping to return to this shortly. Hope all are well. Ajpolino (talk) 03:44, 22 August 2023 (UTC)[reply]
No problem. There's no rush. But I'm glad you are not dead. :-). -- Colin°Talk 07:26, 22 August 2023 (UTC)[reply]

Graham Beards

I have a few comments which I'll list here.

I have made few small edits regarding missing articles and fused participles That's all for now. Graham Beards (talk) 13:38, 11 December 2023 (UTC)[reply]

Made changes for your first 4 comments, let me know what you think. For #4 (PSA subtypes) I've tried to give the reader a brief sense of the post-PSA secondary testing world without too much jargon, and without getting into detail that's undue for an article on prostate cancer. I'm concerned I've left it either too detailed or not detailed enough. Would appreciate your thoughts. Will hit your last two bullet points, hopefully today. Ajpolino (talk) 15:49, 13 December 2023 (UTC)[reply]
To your last point, that first paragraph is my attempt to orient the reader with a quick summary intro. Since it's a summary, it's necessarily a bit repetitive. I think I've read the section too many times to see it clearly. A couple obvious options, I'd be happy to hear which you think is best: (1) Remove that paragraph altogether, (2) Keep it mostly as-is but remove the repeated definition of "active surveillance" (could be as simple as ... monitored regularly by active surveillance – repeat testing for a worsening of their disease), (3) Reducing repetition with some intervention between #1 and #2 in scope, (4) leave it as-is.
I've fiddled with a few variants of #2, but honestly I find myself now leaning towards #1. Wondering if you think the summary paragraph at the top is valuable orientation for the reader. Ajpolino (talk) 15:43, 14 December 2023 (UTC)[reply]
I think #2 is better. Graham Beards (talk) 17:20, 14 December 2023 (UTC)[reply]

Hi Colin and Graham Beards, I believe I've made it through your last round of comments. If you've got time, I'd be happy to hear any other comments/concerns you may have. Thank you for your feedback so far. I hope you both had restful holidays. Ajpolino (talk) 16:01, 3 January 2024 (UTC)[reply]

Happy New Year to you. I will try to get around to looking at this. -- Colin°Talk 18:15, 3 January 2024 (UTC)[reply]

2017 systematic review[edit]

Hi FULBERT, I'm sorry to revert your recent addition to Prostate_cancer#Supportive_care. I understand it's tempting to add everything new and useful to its relevant article, but here I don't think the text from that review really added any information for the reader to this article.

A 2017 systematic review of the literature found that while most studies focus on treatment options oriented toward survival, there was little evidence that assessed patient-centered outcomes concerned with comparative effectiveness of treatment.

First, I suppose this is more a conclusion about "Prostate cancer research" than "Prostate cancer supportive care" (i.e. the authors are concluding that prostate cancer researchers have understudied patient-centered outcomes beyond survival). But more importantly I think the authors' conclusion doesn't really merit a full sentence in our summary of prostate cancer care (codified at WP:PROPORTION). If you disagree, I'm happy to discuss further and we can reach out for more folks' opinions. Happy to hear any other thoughts/concerns you may have about the article as well. Cheers. Ajpolino (talk) 02:10, 1 December 2023 (UTC)[reply]

@Ajpolino Thank you for your feedback. FULBERT (talk) 02:20, 1 December 2023 (UTC)[reply]

GA Review[edit]

Passed. —Femke 🐦 (talk) 19:46, 20 March 2024 (UTC)[reply]

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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

Reviewer: Femke (talk · contribs) 09:24, 3 March 2024 (UTC)[reply]


Will be taking this on this week. I did a first read-through of the article, and in most places the prose is excellent. Are you planning to take the article to FAC? Happy to nit-pick a bit more if that's the plan. Initial thoughts:

—Femke 🐦 (talk) 09:24, 3 March 2024 (UTC)[reply]

Hi Femke, thank you for taking up the review. I'm traveling this weekend but should be back in business in a day or two. I am indeed hoping to bring this article through FAC, so any nitpicking you're willing to do is much appreciated. Thanks again! Ajpolino (talk) 12:57, 3 March 2024 (UTC)[reply]
Brilliant. I'll put optional where it's not needed for GA, but may be good for FA. —Femke 🐦 (talk) 14:30, 3 March 2024 (UTC)[reply]

Source check[edit]

I check sources when I'm surprised by the facts or when I don't understand the text fully, and supplement this with a few random searches if the text is clear.

—Femke 🐦 (talk) 17:51, 5 March 2024 (UTC)[reply]

The lead is missing citations. Each sentence in a medical article, including the lead, should have a citation. Readers should not have to search for relevant text or relevant citations within the document. Please see discussions about citations at WT:MED, WP:MEDMOS, WP:MEDRS, and WP:MEDCITE. -- Whywhenwhohow (talk) 19:12, 9 March 2024 (UTC)[reply]
Lead citations are optional, also for medical articles. Of the links you gave, only the essay WP:MEDCITE says it's adviseable to add citations to the lead in medical articles (as medical article's leads are more likely to be translated). A GAN is not the location to argue this. You probably want to create consensus in a guideline for this instead. —Femke 🐦 (talk) 09:20, 10 March 2024 (UTC)[reply]
I started a discussion at WT:MED#Citations --Whywhenwhohow (talk) 17:20, 10 March 2024 (UTC)[reply]

Second reading[edit]

Lead[edit]

Diagnosis[edit]

Management - Prognosis[edit]

Cause - Epidemiology[edit]

—Femke 🐦 (talk) 20:35, 7 March 2024 (UTC)[reply]

History - Research[edit]

Overall, I think the article is very close to meeting the FA criteria, and I will support a nomination there after the comments above are addressed :). —Femke 🐦 (talk) 16:09, 9 March 2024 (UTC)[reply]

Thanks very much for your time and effort. I've taken a swing at most of your comments. I have a few left to get to. Feel free to follow-up on anything you feel I've insufficiently resolved. Pardon my slowness this week. Just happened to catch me at a busy moment in real life. It should be letting up shortly. Ajpolino (talk) 20:36, 12 March 2024 (UTC)[reply]
Alright Femke I believe I've hit on all your points above. Please feel free to direct me to any outstanding deficiencies you see. Thanks again for your thoughtful feedback; the article is much improved for your efforts. Ajpolino (talk) 00:41, 20 March 2024 (UTC)[reply]
I'm very happy with how everything turned out! Learned a lot from the review, not only about prostate cancer, but also more generally about writing medical articles to FA, which will come in handy in the work on ME/CFS we're planning. —Femke 🐦 (talk) 19:45, 20 March 2024 (UTC)[reply]
The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Did you know nomination[edit]

(
)
Improved to Good Article status by Ajpolino (talk).

Number of QPQs required: 0. Nominator has less than 5 past nominations.

Post-promotion hook changes will be logged on the talk page; consider watching the nomination until the hook appears on the Main Page.

Mugtheboss (talk) 12:16, 23 March 2024 (UTC).[reply]

General eligibility:

Policy compliance:

Hook eligibility:

QPQ: None required.

Overall: No images, QPQ also unnecessary. Claim is properly cited, and mentioned multiple times throughout the article. No copy-vio issues upon spotchecks and the source is reliable. Article was recently promoted to GA after a lengthy review, so congratulation are in order for that.

The source's quote is specifically In addition, more than 1.2 million new cases are diagnosed and global prostate cancer-related deaths exceed 350,000 annually, making it one of the leading causes of cancer-associated death in men

I could maybe see a close paraphrasing issue here but I'll chalk it up to WP:LIMITED since these are simple facts that are hard to reword. I made a few minor tweaks to the lead and to the article to massage out an inconsistency, please review here: [4]. Passing DYK, congrats!! 🏵️Etrius ( Us) 00:45, 25 March 2024 (UTC)[reply]

Thank you for the swift review, this nom passed through much faster than my last.
Fun fact: I actually came up with the current hook early on in the GAN process after seeing the diagnosis and death rate in the infobox, without even seeing the actual paragraph until after the article was promoted to GA. — Mugtheboss (talk) 20:22, 25 March 2024 (UTC)[reply]
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