Wikipedia:Peer review/Melanoma/archive1

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[edit] Melanoma

It's been Medicine Collaboration of the Week, and has improved a lot. We'd like to hear comments about it. Thanks! NCurse _work 15:30, 12 August 2006 (UTC)

• Automated suggestions are provided here, that you may wish to refer for some useful style guidelines. - Mailer Diablo 17:29, 12 August 2006 (UTC)

• The lead is a little short - seems like it should include diagnostic methods and prevalence info at least. Also, the mention of resection before 1mm - I assume that's a statistical association, but it sounds rather arbitrary and probably needs a citation.

• I tried to fix it, found some references. Please have a look. NCurse _work 08:30, 13 August 2006 (UTC)

• Only one question: the first sentence says melanoma is a malignant tumor, but later in the lead there's a mention of "premalignant" melanoma. Is it necessarily malignant, and if so, is there a separate term for the early stages? Opabinia regalis 15:43, 13 August 2006 (UTC)

• I fixed it: "...suspicious of a malignant melanoma or a premalignant lesion" NCurse _work 18:21, 13 August 2006 (UTC)

• Many sections are quite listy. The staging section obviously should be a list, but even some of the prose sections - History and Epidemiology especially - read like a series of only somewhat related sentences rather than a coherent story. This may be because research hasn't told a very coherent story yet, but it should still be synthesized more clearly if possible. "Prevention" should definitely be prose, except the "mnemonic" (where did that come from anyway?)

• The ABCDE mnemonic comes from the Asymmetrical, Border, Color, Diameter, Evolution words. But the sections says "(see "ABCDE" mnemonic below.)" because in the list below these letters are bold too. NCurse _work 08:33, 13 August 2006 (UTC)

• Sorry, I wasn't clear - I meant what's the source for the mnemonic/who uses it. Opabinia regalis 15:43, 13 August 2006 (UTC)

• In fact, everybody (medical students, doctors, scientists). I can't show you exact reference for it, because there isn't any. But everybody uses it. NCurse _work 18:04, 13 August 2006 (UTC)

• I tried to fix Epidemiology section. In my opinion, History is correct, but we can wait for someone else to comment. NCurse _work 08:39, 13 August 2006 (UTC)

• I think epidemiology looks pretty good. On second glance my only real problem with the history section is the first sentence: "While there is little serious doubt that melanoma is not a relatively new disease..." is just too many double negatives and qualifiers in one place. Is there any serious doubt? Opabinia regalis 20:32, 13 August 2006 (UTC)

• What about it: 'While melanoma is not a relatively new disease'? NCurse _work 20:50, 13 August 2006 (UTC)

• I like that better, but do you really need "relatively"? Is there any intended comparison to the historicity (is that a word?) of other cancers? Opabinia regalis 04:46, 14 August 2006 (UTC)

• No, it is NOT a new disease, just we weren't so brave to write it like that. But I removed relatively and inserted a reference (which can't be found on the net, it's from 1966) - On the antiquity of melanoma. NCurse _work 07:08, 14 August 2006 (UTC)

• I tried to convert the Prevention section into prose. Please have a look. NCurse _work 18:37, 13 August 2006 (UTC)

• Looks better. Only suggestion would be an explanation of the difference between "primary" and "secondary" prevention (avoidance and vigilance?) - when I tried to look it up I discovered our prevention article is quite poor. Opabinia regalis 20:32, 13 August 2006 (UTC)

• To be honest, I really can't see why do we need this primary-secondary section names, without these the prevention section would be total too. Anyway I can put avoidance and vigilance next to the primary and secondary words. NCurse _work 20:56, 13 August 2006 (UTC)

• Are "avoidance" and "vigilance" really good restatements of the meanings? That was my guess from the context, but I'm sure you're more knowledgeable about medical usage than I am. I'd agree that the distinction isn't critical to the section's flow. Opabinia regalis 04:46, 14 August 2006 (UTC)

• In fact, there is no need for these subsections. I removed primary and secondary words. NCurse _work 07:03, 14 August 2006 (UTC)

• Is there a more dramatic image than Image:WB032021.JPG? Or maybe just touch up the color on this one?

• I sent a letter to the American Academy of Dermatology to ask permission for their images. I'm waiting for the answer. NCurse _work 08:40, 13 August 2006 (UTC)

• There's a lot of emphasis on sun damage and sunburn as risk factors, but most people have had a peeling sunburn at some point in their lives - maybe flesh out the statistics on this, or find some relative-risk data?

• I found a reference for this sentence: "Occasional extreme sun exposure (resulting in "sunburn") is causally related to melanoma." The reference is a study: Sun exposure and risk of melanoma. Hope it will be enough. :) NCurse _work 18:32, 13 August 2006 (UTC)

• My concern here is that someone's going to read the article and think "Holy crap! I had a sunburn once; now I'm going to get skin cancer and die!" Is there some data to the effect of "x level of exposure to UV radiation increases melanoma risk by y%"?

• I haven't found any really relevant reference, maybe one, please have a look: [1]. NCurse _work 21:09, 13 August 2006 (UTC)
• I can't get the full text, but the abstract looks pretty statistical for reassuring the common hypochondriac. On the other hand, it's not Wikipedia's job to reassure hypochondriacs, so I don't think this is too critical. Opabinia regalis 04:46, 14 August 2006 (UTC)

• Most of the article is well-referenced, but there's a few statements in the epidemiology section especially that don't have citations - like the "Australia" data and the "British study".

• Done. NCurse _work 09:39, 13 August 2006 (UTC)

• The tissue slides are nice but could use a more descriptive caption.

• Done. NCurse _work 09:19, 13 August 2006 (UTC)

• I wonder if it's possible to get a slide of normal tissue for comparison? (Also, am I right in reading the image descriptions that these are all the same case?) Opabinia regalis 20:32, 13 August 2006 (UTC)

• Unfortunately, there is no normal skin histology image in Wikipedia, neither in Commons. Yes, these are the same case. NCurse _work 21:02, 13 August 2006 (UTC)

• "This radiation causes errors in the deoxyribonucleic acid (DNA) of cells, making them go through mitosis (cell division) at an unhealthy rate. " -- Not very clear. I assume the increased mitosis rate thing refers to inappropriate cell division after the tumor has formed, but the sentence implies that radiation damage itself accelerates mitosis rates, which as far as I know is not correct. It should be explicitly stated that radiation damage induces mutations, which can accumulate as cell division proceeds to create inappropriately-dividing cancerous cells.

• Done. NCurse _work 09:43, 13 August 2006 (UTC)

• I made a couple of minor clarifications to this section. Feel free to rewrite if you think it's too detailed. Opabinia regalis 20:32, 13 August 2006 (UTC)

• Is the something about melanoma metastases specifically that makes them more difficult to treat? Are they just difficult to detect, or are they more dangerous in some way than metastases from other types of cancers?

• It's very hard to detect metastasis, it sends cells into nearly every part of the body. NCurse _work 09:27, 13 August 2006 (UTC)

• To me it sounds like the article is saying metastases of melanoma specifically are more deadly than metastases of other cancers. Is that the case? (In either case, it's not critical but it might be interesting to see comparisons in prevalence and survival rates to other common cancers.) Opabinia regalis 15:43, 13 August 2006 (UTC)

• The metastasis of melanoma is one of the worst ones, but I couldn't find relevant reference. :( NCurse _work 18:06, 13 August 2006 (UTC)

Opabinia regalis 22:26, 12 August 2006 (UTC)

I've found uploaded 4 images. NCurse _work 09:33, 14 August 2006 (UTC)

• Some more info on familial melanoma and genetics of melanoma is probably needed. I suppose there has been some recent research in this area that is not fully reflected in the article. Kpjas 18:01, 14 August 2006 (UTC)