Glossary of Key Prostate Terms
ablation: In medicine, the removal or destruction of a body part or tissue or its function. Ablation may be performed by surgery, hormones, drugs, radio frequency, heat or other methods.
adjuvant: An additional treatment used to increase the effectiveness of the primary therapy; radiation therapy and hormonal therapy are often used as adjuvant treatments following a radical prostatectomy.
adjuvant therapy: Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, or biological therapy.
adrenal gland: A small gland that produces steroid hormones, adrenaline, and noradrenaline, which help control heart rate, blood pressure, and other important body functions. There are two adrenal glands, one located on top of each kidney.
analog: In chemistry, a substance that is similar, but not identical, to another.
androgen: A type of hormone that promotes the development and maintenance of male sex characteristics.
anti-androgen: A drug used to block the production or interfere with the action of male sex hormones.
anti-androgen withdrawal response: A decrease in PSA caused by the withdrawal of an anti-androgen such as Casodex or flutamide after CHT begins to fail; occurs when there are PCa cells that have mutated to feed on the anti-androgen rather than T and DHT; withdrawal kills those cells
benign: Not cancerous. Benign tumors do not spread to tissues around them or to other parts of the body.
benign prostatic hyperplasia (or hypertrophy) (BPH): benign (non-cancerous) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine.
bilateral: Affecting both the right and left sides of the body.
biopsy: The removal of cells or tissues for examination under a microscope. When only a sample of tissue is removed, the procedure is called an incisional biopsy or core biopsy. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. When a sample of tissue or fluid is removed with a needle, the procedure is called a needle biopsy or fine-needle aspiration.
bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner.
BPH: see benign prostatic hyperplasia
brachytherapy: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called internal radiation, implant radiation, or interstitial radiation therapy.
deoxyribonucleic acid (DNA): The molecules inside cells that carry genetic information and pass it from one generation to the next.
DHT: (see dihydrotestosterone)
diethylstilbestrol (DES): A synthetic form of the hormone estrogen that was prescribed to pregnant women between about 1940 and 1971 because it was thought to prevent miscarriages. DES may increase the risk of uterine, ovarian, or breast cancer in women who took it. DES also has been linked to an increased risk of clear cell carcinoma of the vagina or cervix in daughters exposed to DES before birth.
differentiation: In cancer, refers to how mature (developed) the cancer cells are in a tumor. Differentiated tumor cells resemble normal cells and tend to grow and spread at a slower rate than undifferentiated or poorly differentiated tumor cells, which lack the structure and function of normal cells and grow uncontrollably.
digital rectal examination (DRE): An examination in which a doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities.
dihydrotestosterone (DHT): Also known as 5-alpha-dihydrotestosterone, it is the male hormone which is actually active in the prostate; it is made when an enzyme 5-alpha-reductase transforms testosterone to DHT which stimulates the growth of the prostate
Dose Rate: refers to the intensity at which radiation is delivered
double-blind, double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving.
downsizing, downstaging: The use of hormonal or other forms of management to reduce the volume of prostate cancer in and/or around the prostate prior to other attempted curative treatment.
DRE: (see digital rectal examination)
duct: In medicine, a tube or vessel of the body through which fluids pass.
dysplasia: Cells that look abnormal under a microscope but are not cancer.
EBR, EBRT: External beam radiation (therapy).
ejaculation: The release of semen through the penis during orgasm.
endorectal: Through the rectum; there are endorectal MRIs as well as ultrasound to visualize the area. See transrectal ultrasound (TRUS).
endorectal ultrasound (ERUS): A procedure in which a probe that sends out high-energy sound waves is inserted into the rectum. The sound waves are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissue called a sonogram. ERUS is used to look for abnormalities in the rectum and nearby structures, including the prostate. Also called transrectal ultrasound.
epithelium: A thin layer of tissue that covers organs, glands, and other structures within the body.
erectile dysfunction (ED): An inability to have an erection of the penis adequate for sexual intercourse. Also called impotence.
estrogen: A hormone that promotes the development and maintenance of female sex characteristics.
EXBT, EXRT: external beam therapy; external radiation therapy.
external beam radiation: A form of radiation therapy in which the radiation is delivered by a machine pointed at the area to be radiated. May be known as external beam radiation (EBR, XBR), external beam radiation therapy (EBRT, XBRT). Compare to seed implantation.
Finasteride: A drug used to reduce the amount of male hormone (testosterone) produced by the body.
fine-needle aspiration: The removal of tissue or fluid with a needle for examination under a microscope. Also called needle biopsy.
flare: A sudden reaction to starting hormone therapy, sometimes characterized by severe increase in pre-hormone therapy symptoms, such as pain; does not occur in all men; some report it may be prevented by taking an anti-androgen (Casodex, Nilandron) several days before starting hormone therapy.
Flutamide: An anticancer drug that belongs to the family of drugs called anti-androgens.
free PSA (fPSA): PSA exists in two forms in the blood, either bound to protein or unbound (“free”). Measuring both the bound and free form can better predict risk.
Gantry: The frame that houses the equipment that generates and shapes the radiation. The gantry rotates around the patient to treat the targeted body area from different angles, to maximize the dose to the tumor while sparing as much as possible the surrounding tissue.
gastrointestinal (GI): Refers to the stomach and intestines.
gland: An organ that makes one or more substances, such as hormones, digestive juices, sweat, tears, saliva, or milk. Endocrine glands release the substances directly into the bloodstream. Exocrine glands release the substances into a duct or opening to the inside or outside of the body.
glandular: Pertaining to a gland.
Gleason Score (GS)- Gleason Grade: A system of grading prostate cancer cells based on how they look under a microscope. Gleason scores range from 2 to 10 and indicate how likely it is that a tumor will spread. A low Gleason score means the cancer cells are similar to normal prostate cells and are less likely to spread; a high Gleason score means the cancer cells are very different from normal and are more likely to spread.
gonads: The part of the reproductive system that produces and releases eggs (ovary) or sperm (testicle/testis).
gonadotropin-releasing hormone (GnRH): A hormone made by the hypothalamus (part of the brain). GnRH causes the pituitary gland to make luteinizing hormone (LH) and follicle stimulating hormone (FSH). These hormones are involved in reproduction.
Goserelin: A drug that belongs to the family of drugs called gonadotropin-releasing hormone analogs. Goserelin is used to block hormone production in the ovaries or testicles.
goserelin acetate: A luteinizing hormone-releasing hormone (LHRH) analog used in the palliative hormonal treatment of advanced prostate cancer and sometimes in the adjuvant and neoadjuvant hormonal treatment of earlier stages of prostate cancer. A U.S. brand name is Zoladex. See hormone therapy.
grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer.
grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions.
high-dose-rate (HDR): May be combined to be called high-dose-rate remote brachytherapy or high-dose-rate remote radiation. A type of internal radiation treatment in which the radioactive source is removed between treatments. (NCI bklt)
high-dose-rate remote brachytherapy: A type of internal radiation treatment in which the radioactive source is removed between treatments. Also called high-dose-rate remote radiation therapy or remote brachytherapy.
histology: The study of tissues and cells under a microscope.
hormone: A chemical made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in a laboratory.
hormone antagonists: Chemical substances which inhibit the function of the endocrine glands, the biosynthesis of their secreted hormones, or the action of hormones upon their specific sites, e.g., an anti-androgen.
hormone refractory prostate cancer: Prostate cancer that has become refractory, that is, it resists hormone therapy.
hormone therapy (HT): Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body’s natural hormones. Sometimes surgery is needed to remove the gland that makes hormones. Also called hormonal therapy, hormone treatment, or endocrine therapy.
HRPC: Hormone refractory prostate cancer; PCa that resists hormone therapy.
hyperplasia: An abnormal increase in the number of cells in an organ or tissue.
hypertrophy: The enlargement or overgrowth of an organ or part due to an increase in size of its constituent cells. Compare to hyperplasia; see benign prostatic hyperplasia (BPH).
IAS: Intermittent androgen suppression; the starting and stopping of the treatment. See hormone therapy.
ICHT: Intermittent combined hormone therapy; the starting and stopping of treatment. See hormone therapy.
IHT: Intermittent hormone therapy; the starting and stopping of treatment. See hormone therapy.
immunoassay: A test that uses the binding of antibodies to antigens to identify and measure certain substances. Immunoassays may be used to diagnose disease. Also, test results can provide information about a disease that may help in planning treatment (for example, when estrogen receptors are measured in breast cancer).
impotency: In medicine, refers to the inability to have an erection of the penis adequate for sexual intercourse. Also called erectile dysfunction.
incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence).
insulin: A hormone made by the islet cells of the pancreas. Insulin controls the amount of sugar in the blood by moving it into the cells, where it can be used by the body for energy.
intensity modulated radiation therapy (IMRT): A type of 3-dimensional radiation therapy that uses computer-generated images to show the size and shape of the tumor. Thin beams of radiation of different intensities are aimed at the tumor from many angles. This type of radiation therapy reduces the damage to healthy tissue near the tumor.
interstitial: Pertaining to or situated between parts or in the interspaces of a tissue.
interstitial radiation therapy (IRT): A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, internal radiation, or implant radiation.
intraductal carcinoma: A noninvasive, precancerous condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, intraductal carcinoma may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive. Also called ductal carcinoma in situ.
intraepithelial: Within the layer of cells that form the surface or lining of an organ.
Jewett staging system: A staging system for prostate cancer that uses ABCD. “A” and “B” refer to cancer that is confined to the prostate. “C” refers to cancer that has grown out of the prostate but has not spread to lymph nodes or other places in the body. “D” refers to cancer that has spread to lymph nodes or to other places in the body. Also called the ABCD rating or the Whitmore-Jewett staging system.
laparoscopy: The insertion of a thin, lighted tube (called a laparoscope) through the abdominal wall to inspect the inside of the abdomen and remove tissue samples.
leuprolide: A drug that belongs to a family of drugs called gonadotropin-releasing hormone analogs. It is used to block hormone production in the ovaries or testicles.
libido: Interest in sexual activity; compare to impotency.
Lupron: A U.S. trade or brand name of leuprolide acetate; an LHRH.
luteinizing hormone (LH): The pituitary hormone that causes the testicles in men and ovaries in women to manufacture hormones; also called a luteinizing hormone-releasing hormone or LHRH.
luteinizing hormone-releasing hormone (LHRH): A hormone that stimulates the production of sex hormones in men and women.
lymph: The clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases. Also called lymphatic fluid.
lymph gland: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph glands filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called a lymph node.
lymph nodes: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called a lymph gland.
lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes, and lymphatic vessels (a network of thin tubes that carry lymph and white blood cells). Lymphatic vessels branch, like blood vessels, into all the tissues of the body.
lymphocyte: A type of white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases.
magnetic resonance imaging (MRI): A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as CT or X-ray. MRI is especially useful for imaging the brain, spine, the soft tissue of joints, and the inside of bones. Also called nuclear magnetic resonance imaging.
malignant: Cancerous. Malignant tumors can invade and destroy nearby tissue and spread to other parts of the body.
marker: A diagnostic indication that disease may develop.
metastasis: The spread of cancer from one part of the body to another. A tumor formed by cells that have spread is called a “metastatic tumor” or a “metastasis.” The metastatic tumor contains cells that are like those in the original (primary) tumor. The plural form of metastasis is metastases (meh-TAS-ta-seez).
morbidity: A disease or the incidence of disease within a population. Morbidity also refers to adverse effects caused by a treatment.
Multi-Leaf Collimator: A device within a linear accelarator made up of tungsten leaves that can move independently to provide conformal shaping of radiation beams.
neoadjuvant: Done or added before the primary treatment; for example, neoadjuvant hormone therapy could be given prior to another form of treatment such as a radical prostatectomy; compare to adjuvant.
neoadjuvant therapy: Treatment given before the primary treatment. Examples of neoadjuvant therapy include chemotherapy, radiation therapy, and hormone therapy.
neoplasia: Abnormal and uncontrolled cell growth.
nerve sparing: A surgical technique during a prostatectomy where one or both of the neurovascular bundles controlling erections are spared. The utilization of this procedure is governed by the extent of the cancer and the skill of the surgeon.
non-steroidal anti-inflammatory drug (NSAID): A drug that decreases fever, swelling, pain, and redness.
oncologist: A doctor who specializes in treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation.
orchiectomy: Surgery to remove one or both testicles.
osteoporosis: A condition that is characterized by a decrease in bone mass and density, causing bones to become fragile.
palliative: Designed to produce relief from symptoms without curing, e.g., aspirin for a headache is palliative.
palliative care: Care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of palliative care is to prevent or treat as early as possible the symptoms of the disease, side effects caused by treatment of the disease, and psychological, social, and spiritual problems related to the disease or its treatment. Also called comfort care, supportive care, and symptom management.
palpable: Capable of being felt during a physical examination by a physician; e.g., when the prostate which can be felt during a digital rectal examination.
palpable disease: A term used to describe cancer that can be felt by touch, usually present in lymph nodes, skin, or other organs of the body such as the liver or colon.
Partin Tables: These are tables constructed on the basis of the PSA, stage, grade and surgical findings of over 4,000 men. The tables are used to predict the probability that the prostate cancer has spread to the lymph nodes and/or seminal vesicles, penetrated the capsule, or remains confined to the prostate. They were initially developed by a group of urologists at the Brady Institute for Urology at Johns Hopkins University. They are called “Partin tables” after just one of the original contributors to this research.
pathologist: A doctor who identifies diseases by studying cells and tissues under a microscope.
patient-controlled analgesia (PCA): A method in which the patient controls the amount of pain medicine that is used. When pain relief is needed, the person can receive a preset dose of pain medicine by pressing a button on a computerized pump that is connected to a small tube in the body.
PCa: Abbreviation for prostate cancer; CaP is also used.
penis: An external male reproductive organ. It contains a tube called the urethra, which carries semen and urine to the outside of the body.
phase I trial: The first step in testing a new treatment in humans. These studies test the best way to give a new treatment (for example, by mouth, intravenous infusion, or injection) and the best dose. The dose is usually increased a little at a time in order to find the highest dose that does not cause harmful side effects. Because little is known about the possible risks and benefits of the treatments being tested, phase I trials usually include only a small number of patients who have not been helped by other treatments.
phase II trial: A study to test whether a new treatment has an anticancer effect (for example, whether it shrinks a tumor or improves blood test results) and whether it works against a certain type of cancer.
phase III trial: A study to compare the results of people taking a new treatment with the results of people taking the standard treatment (for example, which group has better survival rates or fewer side effects). In most cases, studies move into phase III only after a treatment seems to work in phases I and II. Phase III trials may include hundreds of people.
phase IV trial: After a treatment has been approved and is being marketed, it is studied in a phase IV trial to evaluate side effects that were not apparent in the phase III trial. Thousands of people are involved in a phase IV trial.
placebo: An inactive substance or treatment that looks the same as, and is given the same way as, an active drug or treatment being tested. The effects of the active drug or treatment are compared to the effects of the placebo.
positron emission tomography scan (PET Scan): A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body.
progesterone: A female hormone.
prognosis: The likely outcome or course of a disease; the chance of recovery or recurrence.
progression: Increase in the size of a tumor or spread of cancer in the body.
Proscar: Brand name of a drug using (finasteride) that reportedly shrinks the prostate gland in the treatment of BPH and PCa.
Prostascint scan: A scan involving the injection of a radiolabeled antibody that attaches itself to lesions and can then be visualized on the scan.
prostate gland: A gland in the male reproductive system just below the bladder. The prostate surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen.
prostatectomy: An operation to remove part or all of the prostate. Radical (or total) prostatectomy is the removal of the entire prostate and some of the tissue around it.
prostate-specific antigen (PSA): A substance produced by the prostate that may be found in an increased amount in the blood of men who have prostate cancer, benign prostatic hyperplasia, or infection or inflammation of the prostate.
prostatic: Of or pertaining to the prostate gland.
prostatic acid phosphatase (PAP): An enzyme produced by the prostate. It may be found in increased amounts in men who have prostate cancer.
radical prostatectomy: Surgery to remove the entire prostate. The two types of radical prostatectomy are retropubic prostatectomy and perineal prostatectomy.
radiography: Producing an image by radiation other than visible light, (e.g., X-rays of one’s teeth is done by radiography).
radiolabeled: Any compound that has been joined with a radioactive substance.
radiotherapy: The use of high-energy radiation from X-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiotherapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiation therapy.
rectum: The last several inches of the large intestine that ends at the anus.
red blood cell (RBC): A cell that carries oxygen to all parts of the body. Also called an erythrocyte.
refractory: In medicine, describes a disease or condition that does not respond to treatment.
regression: A decrease in the size of a tumor or in the extent of cancer in the body.
relapse: The return of signs and symptoms of cancer after a period of improvement.
remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body.
resection: Surgical removal of part or all of an organ.
resectoscope: Instrument inserted through the urethra and used by a urologist to cut out tissue (usually from the prostate) while the physician can actually see precisely where he is cutting.
retention of urine: Difficulty in urinating fully or the inability to completely empty the bladder.
screening: Checking for disease when there are no symptoms.
seed, seeding: Brachytherapy, the implantation of radioactive seeds or pellets (may also be called “capsules”) which emit low energy radiation in order to kill surrounding tissue, e.g., the prostate, including prostate cancer cells. Also known as “seed implantation” or “SI”.
SEER: The Surveillance, Epidemiology, and Ends Results Program that maintains statistics on cancer in the US. It is part of the National Cancer Institute.
semen: The fluid that is released through the penis during orgasm. Semen is made up of sperm from the testicles and fluid from the prostate and other sex glands.
seminal vesicle: A gland that helps produce semen.
side effect: A problem that occurs when treatment affects tissues or organs other than the ones being treated. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.
stage, staging: The extent of a cancer within the body. If the cancer has spread, the stage describes how far it has spread from the original site to other parts of the body.
steroid: A type of drug used to relieve swelling and inflammation.
testicle: One of two egg-shaped glands found inside the scrotum that produce sperm and male hormones. Also called a testis.
testis, testes: Medical term for testicle. One of two male reproductive glands located inside the scrotum behind and below the penis, which produce sperm and are the primary source of the male hormone testosterone. Plural is “testes.”
testosterone: A hormone that promotes the development and maintenance of male sex characteristics.
TNM staging system: A system for describing the extent of cancer in a patient’s body. T describes the size of the tumor and whether it has invaded nearby tissue, N describes any lymph nodes that are involved, and M describes metastasis (spread of cancer from one body part to another).
tomography: A series of detailed pictures of areas inside the body; the pictures are created by a computer linked to an x-ray machine.
transrectal ultrasound (TRUS): A procedure in which a probe that sends out high-energy sound waves is inserted into the rectum. The sound waves are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissue called a sonogram. TRUS is used to look for abnormalities in the rectum and nearby structures, including the prostate. Also called endorectal ultrasound.
transurethral prostatectomy: Also called a transurethral resection of the prostate or TURP.
transurethral resection (TUR): Surgery performed with a special instrument inserted through the urethra.
transurethral resection of the prostate (TURP): Surgical procedure to remove tissue from the prostate using an instrument inserted through the urethra.
tumor: A mass of excess tissue that results from abnormal cell division. Tumors perform no useful body function. They may be benign (not cancerous) or malignant (cancerous).
ultrasound (US): A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. Also called ultrasonography.
ureter: The tube that carries urine from the kidney to the bladder.
urethra: The tube through which urine leaves the body. It empties urine from the bladder.
watchful waiting (WW): Closely monitoring a patient’s condition but withholding treatment until symptoms appear or change. Also called observation.
Whitmore-Jewett staging system: A staging system for prostate cancer that uses ABCD. “A” and “B” refer to cancer that is confined to the prostate. “C” refers to cancer that has grown out of the prostate but has not spread to lymph nodes or other places in the body. “D” refers to cancer that has spread to lymph nodes or to other places in the body. Also called the ABCD rating or the Jewett staging system.
Zoladex: Trade or brand name for goserelin acetate, an LHRH used in hormone therapy.