Talk:Adenocarcinoma of the lung

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 19 November 2018 and 14 December 2018. Further details are available on the course page. Student editor(s): Cec206. Peer reviewers: Neiceylyn.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 13:25, 16 January 2022 (UTC)

Reading
Reading this page was painful. First, it repeats the same facts as if repeating them multiple times will legitimize the article. As a result it is confusing. Furthermore, it appears to have been written by two people with different voices and it stutters between unrelated sentences. It is like someone came in and added the fact about this being the most common cancer in non-smokers haphazardly. It needs a rewrite and more information. Additional information would either be a link to cancer treatments or details on specific complications and treatments for this type of cancer. For example, it often ends up wrapping around the primary vein in the lungs, causing head and hand swelling. Luckily, it is slow growing and slow spreading, so someone can have it for years.

More details, less repetition, please. Maztec (talk) 21:23, 21 July 2010 (UTC)

Classification > Redundancy with "lung cancer"
Lung cancer is an extremely heterogeneous family of malignant neoplasms, with over 50 different histological variants recognized in the 4th revision of the World Health Organization (WHO) typing system, currently the most widely used lung cancer classification scheme. Because these variants have differing genetic, biological, and clinical properties, including response to treatment, correct classification of lung cancer cases are necessary to assure that lung cancer patients receive optimum management. While a small percentage of lung cancers are mainly sarcoma or tumors of hematopoietic or germ cell origin, approximately 98% of lung cancers are carcinoma, which are tumors composed of cells with epithelial characteristics. Adenocarcinomas (AdC's) are one of 8 major groups of lung carcinomas recognized in WHO-2004:


 * Squamous cell carcinoma
 * Small cell carcinoma
 * Adenocarcinoma
 * Large cell carcinoma
 * Adenosquamous carcinoma
 * Sarcomatoid carcinoma
 * Carcinoid tumor
 * Salivary gland-like carcinoma

Removed > Redundancy with "lung cancer" patho (talk) 13:05, 25 February 2014 (UTC)

Article Organization
, I noticed that you moved the Classification section down as sub-section of Diagnosis. After referring to MEDMOS, I noted that Classification sections may be positioned either early in the article or as a subset of Diagnosis. What was your rational for relocating the section in this case? Is there an accepted standard way to decide? Thanks! Dr G (talk) 00:02, 15 March 2018 (UTC)
 * there isn't a standard per Manual_of_Style/Medicine-related_articles, should you feel otherwise feel free to return it(classification) to the start of the article.--Ozzie10aaaa (talk) 02:02, 15 March 2018 (UTC)
 * Ah. I think if this were a more "catch all" topic (e.g. Lung cancer) of general public interest, disease classification would probably be less important than information about clinical presentation. However, in this case the topic is already a disease sub-type, and so I imagine it attracting a more focused readership whom might be interested in sub-classifications (particularly since it has been recent flux). But either way.  I may re-arrange if I add more to the article. Thanks again. Dr G (talk) 02:52, 15 March 2018 (UTC)

I agree with Classification section being so relevant here to deserve a main heading. Indeed, I note now it is placed under Epidemiology, and I think it is incorrect. Following the MED MOS guidelines I will upgrade Classification as a main heading, move Epidemiology to the bottom and rename Management into Treatment Tave15 (talk) 15:11, 10 February 2019 (UTC)

Work Plan
After initially evaluating this article, it is evident that a lot of work needs to be done to expand each section. There is a paucity of details that are vital to understanding the pathophysiology, presenting symptoms, and management of this disease. In addition, there is grossly misleading information that should be corrected and explained further.

My first goal would be to expand the lead section of this page. Two sentences is insufficient to summarize what will be outlined in a Wikipedia page. I will attempt to use plain language when giving an overview of the article. By giving a solid summary of what details are included, other readers may be able to quickly determine if the information that I plan to include is relevant/useful for their specific needs. It is likely that I will not finalize the lead section until all other sub-sections are completed. That way, I can ensure that the entire article is represented in the lead. I plan to structure my edited sections in the following order: -"classification" that will include incidence/prevalence and will provide a short explanation of how this particular cancer is different from other forms of lung cancers. I will likely delete the "epidemiology" section at the end of this page and include the information here. -"causes" Right now, the first sentence of this section is very misleading. Smokers are indeed at higher risk of developing this type of lung cancer in addition to small cell lung cancer, but it should be made clear that adenocarcinoma is the most common form of lung cancers in non-smokers. -"pathophysiology" with sub-section "molecular biology" Gross anatomy and physiology will be discussed to give adequate background of normal lung tissue function. I will attempt to give a basic explanation of cell change/malignant transformation and which molecular and genetic factors contribute to increased risk of this particular form of cancer. -"signs and symptoms" After the previous sections that outline the background of the disease are completed, I think that it makes sense to discuss presenting symptoms of this disease. It will be important for me to keep this section simple and straight forward. Many patients and non-medical readers will automatically jump to this section and those that follow. -"extra-pulmonary manifestations" I plan to discuss how this disease affects other organ systems. This includes distant metastases, paraneoplastic syndromes, cardiovascular complications, etc. I am not sure the exact location of this section in relation to other sections, but do believe it is important to include in describing the sequelae of this disease process. -"diagnosis" with sub-sections "imaging", "histology", "staging". I will include images of a chest xray and CT scan that shows typical location and characteristics of this lung cancer. -"management" with sub-sections "non-surgical", "surgical", and "surveillance" -"outcomes" I think that this section will be fairly short. Outcomes data including morbidity/mortality, cure rates, and recurrence rates will be included. -"prevention and screening"

Other comments: I plan to further develop the reference section. I will use access medicine and clinical key for the most part. Pulmonary pathology and oncology textbooks will likely make up the bulk of my references. I think the most challenging aspect of this assignment will be avoiding medical language that is too advanced. I think that I may find it hard to avoid jargon simply because I will want to adequately explain each topic to the best of my ability. I think I will embed other wikipedia links simply to avoid including too much detail in this particular page. There will definitely be a challenge in determining what information to include and which information to defer to other wiki pages.

Cec206 (talk) 20:24, 19 November 2018 (UTC)

Peer Review
Overall, this article is off to a great start. Everything within the article is very relevant to the article topic. Great job explaining the signs and symptoms, very easy to understand. Nothing in the article distracted me, per se, but the sections that went very deep into the science side of lung cancer a non-medical person would probably not understand. Parts of those sections are very well explained to the level of a non-medical person, but then other parts seem too complex. I would use less jargon throughout the whole article. The article is neutral and well balanced and utilizes great sources, though some parts need citing.

Here are some specific things I noted: In the lead and under diagnosis, commuted should be computed. I would also add the acronym CT in the lead since that is more widely known by non-medical people. The section 'Extra pulmonary manifestations' would go over many non-medical people's heads. I think it is a very important section, but maybe use less medical jargon. Relative risk is not a widely known term. Breaking that down into something simpler, for example just saying smokers are more than twice as likely to develop lung cancer instead of relative risk of 2.4. I would also use something other than peripheral(ly). The lead and the first part of epidemiology need citations.

Great article!

Neiceylyn (talk) 15:57, 10 December 2018 (UTC)

I have a minor suggestion, and as a novice thought I’d mention it here. In the 2nd paragraph it mentions smokers, and I think it might be a good spot to add the fact that this type of lung cancer is the most common form of lung cancer in the non-smoking population, rather than near the end of the article.

The myth that lung cancer is almost always caused by smoking is so entrenched, it might be useful to address this early on. As a lifelong non-smoker who lives with this type of cancer, it is almost always the first thing I have to explain. I figure a Wiki article might reflect that, disabuse folks of the myth fairly soon.

Also, there had been a flood of recent discoveries about the genetic mutations Adeno can have, and treatments based on them (the targeted chemo alluded to in the piece). This has drastically improved survivability rates. For instance, it used to be that people diagnosed with Stage 4 had about a 19% chance of living past one year. But now, if they are of the 5% who have a mutation in the ALK-1 gene - the targeted chemo designed for it can give you years, maybe decades (I am ALK-1 positive, and nearly 7 years since my diagnosis).

A word of caution, if someone adds the new info about mutations, I would steer clear of including much (if anything) about the death statistics - they would just freak everyone out (say, a relative looking up what their loved one has), and all cases are different, caught at different stages, tumors of different sizes, etc. My oncologists are even wary about the subject.

Anyway, sorry for the long ramble, but if any of this helps make the article better, that’d be great. It was quite good already, I thought, but I wanted to throw my two cent in. Pseudosadhu (talk) 20:17, 10 September 2021 (UTC)

Treatment
I plan to expand the Treatment section with the most recent advances and to reorganize it with the following "standard" subsections for cancer treatment: Tave15 (talk) 15:59, 10 February 2019 (UTC)
 * Surgery
 * Chemotherapy
 * Radiation therapy
 * Targeted therapy (that is now incorrectly under Chemotherapy)
 * Immunotherapy (with recent results of trials for immune checkpoint inhibitors)