Talk:Exercise and metabolic disease/prostate

REFLECTION ON PROSTATE ADT

1.	What parts of the resource were most useful in working with the "client" and why?

The exercise training and prescription pages would be most useful; it is clear and concise in the exercise prescription page regarding the correct exercise modality and the prescribed reps and sets and length of time. The diagnosis page was also useful in gaining an understanding of the diagnosis phase. There was an important point made regarding when prostate testing should take place; “Men over 40 with a family history are advised to get tested annually and so are all men over the age of 50. In the early stages of prostate cancer there can be no signs or symptoms in some cases, so getting tested is usually the only way to detect it. Early detection is vital as far as whether or not the cancer can be cured” the reference is useful, but it could have been linked to the actual statement for easier navigation, this is an important point that should stand out well in the wiki.

'''2.	Can you suggest improvements to the practical use of the resource? Rationalise any improvements and provide examples where possible.'''

The prevalence of prostate cancer was reported, but not against other diseases. Due to the amount of deaths from prostate cancer in relation to other diseases, it is an important point to make. Some information to alert EP’s on the size and importance of this disease and its lack of diagnosis and education could be made clearer in the wiki. The references below may be useful to back this statement up;

•	AIHW 2010. Cancer in Australia 2010: an overview. Cancer series no. 60. Cat. no. CAN 56. Canberra: AIHW. •	AIHW, CA (Cancer Australia) & AACR (Australasian Association of Cancer Registries) 2008. Cancer survival and prevalence in Australia: cancers diagnosed from 1982 to 2004. Cancer series no. 42. Cat. No. CAN 38. Canberra: AIHW.

A prevention page would also be helpful, as an EP we get clients who come to see us with a family history of prostate cancer and want to know about ways in which to prevent the likelihood of them getting it. There is quite a bit of information published on the prevention of prostate cancer, links to this would be very useful in this type of situation. Some examples below;

•	Brasky, T. M., Till, C., White, E., Neuhouser, M. L., Song, X., Goodman, P., et al. (2011). Serum phospholipid fatty acids and prostate cancer risk: Results from the prostate cancer prevention trial. American Journal of Epidemiology, 173(12), 1429-1439. •	Rota, M., Scotti, L., Turati, F., Tramacere, I., Islami, F., Bellocco, R., et al. (2011). Alcohol consumption and prostate cancer risk: A meta-analysis of the dose-risk relation. European Journal of Cancer Prevention, •	Schenk, J. M., Kristal, A. R., Arnold, K. B., Tangen, C. M., Neuhouser, M. L., Lin, D. W., et al. (2011). Association of symptomatic benign prostatic hyperplasia and prostate cancer: Results from the prostate cancer prevention trial. American Journal of Epidemiology, 173(12), 1419-1428.

A prognosis page would be beneficial for prostate cancer, most chronic disease wikis would benefit from this type of page. Clients will talk about this with their EP, having the information or links to prognosis would be beneficial and helpful in understanding the disease and its progression. I realise that prognosis is individualised, but even the latest generic information would be great. Some links below for prognosis;

•	Cima, I., Schiess, R., Wild, P., Kaelin, M., Schüffler, P., Lange, V., et al. (2011). Cancer genetics-guided discovery of serum biomarker signatures for diagnosis and prognosis of prostate cancer. Proceedings of the National Academy of Sciences, 108(8), 3342-3347. •	Donovan, M. J., Costa, J., & Cordon-Cardo, C. (2011). Personalized approach to prostate cancer prognosis. Archivos Espanoles De Urologia, 64(8), 783-791. •	Martin, N. E., Mucci, L. A., Loda, M., & DePinho, R. A. (2011). Prognostic determinants in prostate cancer. The Cancer Journal, 17(6), 429. •	Oleksowicz, L., Liu, Y., Bracken, R. B., Gaitonde, K., Burke, B., Succop, P., et al. (2011). Secretory phospholipase A2‐IIa is a target gene of the HER/HER2‐elicited pathway and a potential plasma biomarker for poor prognosis of prostate cancer. The Prostate,

'''3.	Was the resource factually accurate? Use references to support your response.''' Some references were not very recent for example in the prevalence page the following reference from 2002 was used;

•	Quinn, M, and Babb, P. Patterns and trends in prostate cancer incidence, survival, prevalence and mortality. Part I: international comparisons. British Journal of Urology 90(2): 162-173, 2002

More recent information regarding prevalence can be found by searching WHO or Australian government websites, for example;

•	http://www.who.int/mediacentre/news/releases/2003/pr27/en/ •	AIHW 2010. Cancer in Australia 2010: an overview. Cancer series no. 60. Cat. no. CAN 56. Canberra: AIHW. •	AIHW, CA (Cancer Australia) & AACR (Australasian Association of Cancer Registries) 2008. Cancer survival and prevalence in Australia: cancers diagnosed from 1982 to 2004. Cancer series no. 42. Cat. No. CAN 38. Canberra: AIHW.

'''4. What are your thoughts on the layout of the resource? Describe what changes you might make to improve ease of understanding of the resource. If you are aware of anything that may improve the resource (e.g. a video, reference to further reading etc) include them here.'''

The wiki was difficult to navigate and therefore read, some good information was reported though. Improvements could have been made by adding in subtitles, pictures and some links to other pages. Links to other pages means that you do not have to do the search yourself to find the information you need; it saves time if all the important points are linked to the actual page. For example right at the start of the wiki “prostate cancer” could have been linked to the prostate cancer page on Wikipedia, a link could also have been made to ADT for further information.

Below are some excellent links that could be included to add more information to the wiki. Wikipedia have some fantastic images of prostate cancer that are open access and can be used. See below; (to be able to see the prostate in images, would be a great benefit to an EP). http://en.wikipedia.org/wiki/Prostate_cancer http://en.wikipedia.org/wiki/File:Prostatelead.jpg

There is quite a lot of information on dietary links to prostate cancer; this was not included in the wiki. I thought that it would be an important add. Knowing the correct advice to give a client on dietary intake, including referral options would be relevant for the overall treatment of an individual with prostate cancer. Some references about dietary intake and prostate cancer are below;

•	Venkateswaran, V; Klotz, LH (2010 Aug). "Diet and prostate cancer: mechanisms of action and implications for chemoprevention". Nature reviews. Urology 7 (8): 442–53. •	Hébert, J. R., Hurley, T. G., Harmon, B. E., Heiney, S., Hebert, C. J., & Steck, S. E. (2011). A diet, physical activity, and stress reduction intervention in men with rising prostate-specific antigen after treatment for prostate cancer. Cancer Epidemiology, •	Hori, S., Butler, E., & McLoughlin, J. (2011). Prostate cancer and diet: Food for thought? BJU International, 107(9), 1348-1359. •	Marshall, J. R. (2012). Diet and prostate cancer prevention. World Journal of Urology,, 1-9.

5. Describe any personal experiences you have had, or anticipate, in professional life and how such a resource might be used in practice.

Personally, as a health professional I know that time is limited and to correctly treat a client you need to have the right information that is up to date and very relevant. This ensures the best outcome for a client. This resource is a quick and effective tool to use to navigate and build knowledge and understanding of a type of condition or disease state and the correct exercises to prescribe. It would be a great tool if it is continually updated (maybe each year) to include new and relevant information, statistics and research. The time needed to search for up to date research can be limited, it takes a great deal of time to look in all of the places needed (text books, on-line, scholar, Google, finding the correct search terms) to get the information required to stay up to date. To do a great job as an EP you need to spend the majority of your time with a client, so this type of resource could potentially cut down time, which may lead to more time for and with clients! This wikiversity resource, if developed further with more conditions, could also ensure that EP’s and other health professionals are all uniformed in the way in which they train people. This could potentially stop or cut down on any unnecessary injuries or incorrect training methods for these types of conditions. As suggested previously, to be most effective it would need to be kept up to date, made very easy to read and navigate and be accessible to everyone. Overall, the wiki is an excellent tool that I personally would use.