GLOSSARY
ABDOMEN
The part of the body below the ribs and above the pelvic bone that contains organs like the intestines, the liver, the kidneys, the stomach, the bladder, and, in men, the prostate
ABLATION
Relating to the removal or destruction of tissue or a system; androgen ablation refers to blocking the effects of androgens by surgical or medical means
ACRONYM
An abbreviation word formed from the initial letters of a phrase or word name; e.g. see ARM
ADENOCARCINOMA
A form of cancer that develops from a malignant abnormality in the cells lining a glandular organ such as the prostate; almost all prostate cancers are adenocarcinomas
ADRENAL ANDROGEN (AA)
A male hormone produced by the adrenal glands; actually, the adrenal gland makes AA precursors such as DHEA and androstenedione that are metabolized to androgens within the prostate cell; AA may be used in some publications to indicate anti-androgens or arachidonic acid
ADJUVANT TREATMENT
An additional treatment used to increase the effectiveness of the primary therapy; radiation therapy is often used as an adjuvant treatment after a radical prostatectomy if the surgical margins are involved by prostate cancer
ADRENAL CORTICOTROPHIC HORMONE
A pituitary hormone that stimulates the outer portion of the adrenal glands to secrete various hormones including cortisol, DHEA, and androstenedione
ADRENAL GLANDS
Located above the kidneys; they produce a variety of different hormones, including cortisol, adrenal androgens, and hormones important in blood pressure control and electrolyte balance
ADRENALECTOMY
The surgical removal of one or both adrenal glands
AGE-ADJUSTED
Modified to take account of the age of an individual or group of individuals; for example, average normal PSA values can be adjusted according to age groupings of men; these are PSA levels that are considered “normal” based on the age of the man
Age-adjusted PSA “cutoff”
40-49 up to 2.5 ng/ml
50-59 up to 3.5
60-69 up to 4.5
70-79 up to 6.5
ALKALINE PHOSPHATASE (ALK PHOS)
An enzyme in blood, bone, kidney, spleen, and lungs; used to monitor bone or liver metastasis when elevated
ALPROSTADIL
A prostaglandin that relaxes the smooth muscles of the penis, enhancing blood flow, and producing erection; first produced as Caverject®, an injectable Prostaglandin E1
ALPHA-BLOCKERS
Pharmaceuticals that act on the prostate by relaxing certain types of muscle tissue; these pharmaceuticals are often used in the treatment of BPH; examples are Cardura® and Hytrin®
AMINOGLUTETHEMIDE (AG)
A drug that blocks the production of adrenal hormones such as DHEA, androstenedione, and cortisol
ANALOG
A synthetic chemical or pharmaceutical that behaves like a normal chemical in the body, e.g., LHRH analogs such as Lupron® or Zoladex®
ANANDRON®
Trade or brand name for Nilutamide, an anti-androgen; in the USA, this is called Nilandron®
ANDROCUR®
Trade name for cyproterone, an anti-androgen with progestational activity; also called CPA for cyproterone acetate
ANDROGEN
A hormone which is responsible for male characteristics and the development and function of male sexual organs (e.g., testosterone) produced mainly by the testicles but also in the cortex of the adrenal glands; androgens have far reaching effects on blood formation, muscle and bone mass, cognitive function, emotional lability, skin and hair, etc.
ANDROGEN ABLATION THERAPY (AAT)
See androgen deprivation therapy (ADT)
ANDROGEN-DEPENDENT PC (ADPC)
Prostate cancer cells that depend on androgens for continued cell growth and vitality
ANDROGEN DEPRIVATION THERAPY (ADT) (Otherwise known as TIP)
A prostate cancer treatment that is based on blocking the amount or availability of androgen to the prostate cancer cell; includes diverse mechanisms such as surgical or medical castration, anti-androgens, 5 AR inhibitors, estrogenic compounds, agents that interfere with adrenal androgen production, agents that decrease sensitivity of the androgen receptor (AR); it also includes monotherapy, CHT with two drugs, and triple therapy or beyond
ANDROGEN DEPRIVATION SYNDROME (ADS)
A constellation of findings associated with low levels of androgen associated with ADT
ANDROGEN-INDEPENDENT PROSTATE CANCER (AIPC)
Prostate cancer cells that do not depend on androgen for growth
ANDROGEN RECEPTOR (AR)
A structural entity that is the site of interaction of a chemical substance called a ligand, like a lock and key; a docking site for a ligand
ANDROGEN RECEPTOR MUTATION (ARM)
A mutation in the gene located on the androgen receptor that allows the anti-androgen to stimulate prostate cancer growth rather than block growth; a paradoxical effect usually occurring in about 30% of patients on long-term anti-androgen therapy in the setting of a rising PSA with a castrate testosterone level
ANDROSTENEDIONE
An adrenal androgen precursor that is transformed to testosterone by 3 beta hydroxysteroid dehydrogenase (enzyme) within the prostate cell; testosterone can also be oxidized to androstenedione by 17 beta hydroxysteroid dehydrogenase
ANESTHETIC
A drug that produces general or local loss of physical sensations, particularly pain; a “spinal” is the injection of a local anesthetic into the area surrounding the spinal cord
ANEUPLOID
Having an abnormal number of sets of chromosomes; aneuploid cancer cells tend not to respond well to androgen deprivation therapy; aneuploidy refers to the state of being aneuploid; see also diploid
ANGIOGENESIS
The growth of new blood vessels; a characteristic of tumors; angiogenesis is a normal biologic process that occurs in both healthy and diseased states; “angiogenesis factor” or “tumor angiogenesis factor” refers to a substance that tumors produce in order to grow new blood vessels
ANTERIOR
The front; for example, the anterior of the prostate is the part of the prostate that faces forward
ANTI-ANDROGEN
A compound (usually a synthetic pharmaceutical) that blocks or otherwise interferes with the normal action of androgens at cellular receptor sites
ANTI-ANDROGEN WITHDRAWAL RESPONSE (AAWR):
A decrease in PSA seen upon stopping treatment with an antiandrogen such as Flutamide or Casodex®; this occurs because the anti-androgen has induced a mutation in the androgen receptor (AR) which is allowing the anti-androgen to stimulate rather than inhibit prostate cancer growth
ANTIBIOTIC
A pharmaceutical that can kill certain types of bacteria
ANTIBODY
Protein produced by the immune system as a defense against an invading or “foreign” material or substance (an antigen); for example, when you get a cold, your body produces antibodies to the cold virus
ANTICOAGULANT
A pharmaceutical that helps to stop the blood from clotting
ANTIGEN
“Foreign” material introduced into the body (a virus or bacterium, for example) or other material which the immune system considers to be “foreign” because it is not part of the body’s normal biology (e.g., prostate cancer cells); a substance that elicits a cellular-level immune response or causes the formation of an antibody
ANTIGEN-PRESENTING CELL (APC)
A type of cell that provokes an immune response from T-cells by binding foreign antigens to its own surface and then interacting with the T-cells. Also known as antigen processing cell
ANUS
The opening at the end of the rectum
APEX
The tip or bottom of the prostate, e.g., the part of the prostate farthest away from the bladder; the top of the prostate is called the base
APOPTOSIS
Programmed cell death due to an alteration in a critical substance or chemical necessary for cell viability; the lack of male hormones causes this programmed cell death of androgen-dependent prostate cancer
ARACHIDONIC ACID
An omega-6 fatty acid that is shown to be a stimulator of prostate cancer growth; found in egg yolk, animal red meat, organ meats; has free-radical generating properties
AROMATASE
An enzyme that converts testosterone to estrogen (estradiol or estrone)
ASPIRATION
The use of suction to remove fluid or tissue, usually through a fine needle (e.g., aspiration biopsy)
ASYMPTOMATIC
Having no recognizable symptoms of a particular disorder
AMINO TERMINAL FRAGMENT (ATF)
Highly active part of the uPA molecule
AMERICAN UROLOGICAL ASSOCIATION (AUA):
The official society of American urologists
AUTOLOGOUS
One’s own; for example, autologous blood is a patient’s own blood which is removed prior to surgery in case a patient needs a transfusion during or after surgery
AZOTEMIA
Elevation in blood nitrogen level due to dehydration or kidney dysfunction; in laboratory tests this manifests as elevation in blood urea nitrogen (BUN) and/or creatinine
B
B-MODE ACQUISITION AND TARGETING
An ultrasound evaluation of the prostate, localizing it prior to each and every RT therapy treatment; currently used in conjunction with IMRT and mechanically integrated into the treatment program
BASE
The base of the prostate is the wide part at the top of the prostate closest to the bladder
BASELINE PSA (bPSA)
The PSA level before a new treatment has begun; used to establish efficacy of a therapy based on response of the PSA to the treatment; can also be used in principle with any other marker, radiologic imaging study or any finding that shows pathology relating to prostate cancer
BENIGN
Relatively harmless; not cancerous; not malignant
BENIGN PROSTATIC HYPERPLASIA (BPH)
A noncancerous condition of the prostate that results in the growth of both glandular and stromal (supporting connective) tumorous tissue, enlarging the prostate and obstructing urination; see prostatitis
BENIGN PROSTATIC HYPERTROPHY (BPH)
Similar to benign prostatic hyperplasia, but caused by an increase in the size of cells rather than the number of cells
BICALUTAMIDE
A nonsteroidal antiandrogen available in the USA and some European countries for the treatment of advanced prostate cancer; also known as Casodex®
BILATERAL
Having or relating to two sides; for example, a bilateral orchiectomy is an operation in which both testicles are removed and a bilateral adrenalectomy is an operation in which both adrenal glands are removed
BIOPSY
Sampling of tissue from a particular part of the body (e.g., the prostate) in order to check for abnormalities such as cancer; in the case of prostate cancer, biopsies are usually carried out under ultrasound guidance using a specially designed device known as a prostate biopsy gun; removed tissue is typically examined microscopically by a pathologist in order to make a precise diagnosis of the patient’s condition
BIOSYNTHESIS
The production of complex molecules within living organisms or cells
BLASTIC
Having a dense appearance on a plain x-ray; associated with increased density of bone
involved by prostate cancer and a whiter appearance on an ordinary x-ray; prostate cancer bone metastases are usually blastic; breast cancer metastases are usually lytic (showing evidence of less bone density in areas of cancer)
BLOOD CHEMISTRY
Measured concentrations of many chemicals in the blood; abnormal values can indicate spread of cancer or side effects of therapy
BLOOD COUNT
Analysis of blood cells and platelets; abnormal values can indicate cancer in the bone or side effects of therapy
BLOOD UREA NITROGEN (BUN)
A test which measures the amount of nitrogen in your blood that comes from the waste product urea.
BONE MINERAL DENSITY (BMD)
Bone mineral density; usually done by DEXA or qCT densitometry methods
BONE MARROW
Soft tissue in bone cavities that produces blood cells
BONE RESORPTION MARKER (BRM)
A laboratory test that quantifies the bone loss (resorption) occurring usually from ADT or prostate cancer; examples include Pyrilinks-D® (Dpd) and N-telopeptides
BONE SCAN
A technique more sensitive than conventional x-rays, it uses a radiolabeled agent to identify abnormal or cancerous growths within or attached to bone; in the case of prostate cancer, a bone scan is used to identify bony metastases which are definitive for cancer which has escaped from the prostate; metastases appear as “hot spots” on the film; however, the absence of hot spots does not prove the absence of tiny metastases
BOWEL PREPARATION
The cleaning of the bowels or intestines that is normal prior to abdominal surgery such as radical prostatectomy
BRACHYTHERAPY
A form of radiation therapy in which radioactive seeds or pellets which emit radiation are implanted within the prostate in order to destroy prostate cancer
C
CANCER
The growth of abnormal cells in the body in an uncontrolled manner; unlike benign tumors, these tend to invade surrounding tissues, and spread to distant sites of the body via the bloodstream and lymphatic system
CAPSULE
The fibrous tissue that acts as an outer lining of the prostate
CARBOXY-TERMINAL PROPEPTIDE TYPE I PROCOLLAGEN (PICP)
A bone formation marker
CARBOXY-TERMINAL TELOPEPTIDE TYPE I COLLAGEN (ICTP)
A bone resorption marker like DPD
CARCINOMA:
A form of cancer that originates in tissues that line or cover a particular organ; see also adenocarcinoma
CASODEX®
Brand or trade name of bicalutamide in the USA
CASTRATE
Medical status of castration; castrate testosterone is defined by most physicians as less than 20 ng/ml
CASTRATION
The use of surgical or medical (chemical) techniques to eliminate testosterone produced by the testes
CATHETER
A hollow (usually flexible plastic) tube which can be used to drain fluids from or inject fluids into the body; in the case of prostate cancer, it is common for patients to have a transurethral catheter to drain urine for some time after treatment by surgery or some forms of radiation therapy
CARCINOEMBRYONIC ANTIGEN (CEA)
A fetal antigen or protein that may be expressed by prostate cancer that is aggressive and often androgen-independent
CELL-MEDIATED IMMUNITY
Immunity dependent upon T-cells’ recognition of an antigen and their subsequent destruction of cells bearing the antigen
CHROMOGRANIN A (CGA)
A small cell prostate cancer or neuroendocrine cell marker; a progressive increase in CGA indicates an aggressive clone of prostate cancer cells that often metastasizes to nodes, liver, and lungs
CHEMOPREVENTION
The use of a pharmaceutical or other substance to prevent the development of cancer
CHEMOTHERAPY
The use of pharmaceuticals or other chemicals to kill cancer cells; in many cases chemotherapeutic agents kill not only cancer cells but also other cells in the body, which makes such agents potentially very dangerous
CHROMOSOME
A threadlike linear strand of DNA and associated proteins in the nucleus of cells that carry the genes and functions in the transmission of hereditary information
CLINICAL TARGET VOLUME
Describes the extent of microscopic, non-imageable tumor spread.
CLINICAL TRIAL
A carefully planned experiment to evaluate a treatment or a medication (often a new pharmaceutical) for an unproven use; Phase I trials are very preliminary short-term trials involving a few patients to see if drugs have any activity or any serious side effects; Phase II trials may involve 20 to 50 patients and are designed to estimate the most active dose of a new drug and determine its side effects; Phase III trials involve many patients and compare a new therapy against the current standard or best available therapy
COENZYME Q10 (COQ10)
Important in cardiac function; a substance that energizes the mitochondria within the heart cells and allows them to function better; an antioxidant that protects LDL cholesterol from oxidation
COLLIMATOR
A device used to define the size and shape of a radiation beam in radiation therapy treatment machines; a collimator typically consists of large blocks of heavy metals, such as steel or tungsten, moved by mechanical motors to define rectangular fields; see intensity-modulated radiation therapy and also multileaf collimator
COLOR-FLOW DOPPLER ULTRASOUND (CDUS)
An ultrasound method that more clearly images tumors by observing the Doppler shift in sound waves; high frequency sound waves bounce off of blood cells to determine blood flow; if tumor is present results will indicate so based on blood flow through tiny blood vessels characteristic of tumors.
COMBINATION HORMONE BLOCKADE (CHB)
Therapy usually involving an LHRH agonist and an anti-androgen; may involve other agents such as Proscar® or prolactin inhibitors such as Dostinex®; preferred term is ADT with number attached to show number of agents e.g. ADT3 (Flutamide, Lupron®, Proscar®) or ADT3 (FLP); also referred to as CHT, MAB, and TAB
COMBINED HORMONAL THERAPY (CHT)
The use of more than one hormone in therapy; especially the use of LHRH analogs (e.g., Lupron®, Zoladex®) to block the production of testosterone by the testes, plus anti-androgens (e.g., Casodex® (bicalutamide), Eulexin® (flutamide), Anandron® (Nilutamide), or Androcur® (Cyproterone) to compete with DHT and with T (testosterone) for cell sites thereby depriving cancer cells of DHT and T needed for growth; also referred to as CHB, MAB, and TAB; the preferred term is ADT
COMPLETE ANDROGEN BLOCKADE (CAB)
see combined hormonal therapy
COMPLETE BLOOD COUNT (CBC)
Blood panel including the white blood count (WBC), hematocrit (HCT) and the platelet count (PLT)
COMPLETE RESPONSE (CR)
Total disappearance of all evidence of disease using physical
examination, laboratory studies, and radiologic imaging; a criterion for evaluating the efficacy of a particular anticancer therapy; see also partial response
COMPLICATION
An unexpected or unwanted effect of a treatment, pharmaceutical or other procedure
COMPUTERIZED AXIAL TOMOGRAPHY (CAT) SCAN
Is a method of combining images from multiple x-rays under the control of a computer to produce cross-sectional or three-dimensional pictures of the internal organs which can be used to identify abnormalities; the CAT scan can identify prostate enlargement but is not always effective for assessing the stage of prostate cancer; the CAT scan is significantly more accurate at evaluating metastases of the lymph nodes or more distant soft tissue sites,
CONCORDANCE
The agreement in findings that support the accuracy of a particular investigation or treatment; concordance is a critical concept in studies to diagnose, stage, and treat prostate cancer
CONFORMAL THERAPY
The use of careful planning and delivery techniques designed to focus radiation on the areas of the prostate and surrounding tissue which need treatment and protect areas which do not need treatment; 3-dimensional conformal radiation therapy (3DCRT) is a sophisticated form of this method
CONTRACTURE
Scarring which can occur at the bladder neck after a radical prostatectomy or radiation therapy, and that results in narrowing of the passage between the bladder and the urethra; same as stricture
CORPORA CAVERNOSA
A part of a man’s penis that fills with blood when he is sexually excited, giving the organ the stiffness required for intercourse
CORPORA SPONGIOSUM
A mass of spongy tissue surrounding the male urethra ; function of the corpus spongiosum in erection is to prevent the urethra from pinching closed
COWPER’S GLANDS
A pair of pea-sized glands that lie beneath the prostate gland that secrete an alkaline fluid that forms part of the semen; this fluid neutralizes the acidic environment of the urethra, thereby protecting the sperm; named after the English surgeon William Cowper (1660-1709)
CRYOABLATION
see cryosurgery
CRYOSURGERY
The use of liquid nitrogen probes to freeze a particular organ to extremely low
temperatures to kill the tissue, including any cancerous tissue; when used to treat prostate cancer, the cryoprobes are guided by transrectal ultrasound
CRYOTHERAPY
see cryosurgery
CYCLIN-DEPENDENT KINASE INHIBITOR (CDK-1)
A regulator of cell growth; an enzyme inhibitor
CYPROTERONE
An anti-androgen with progestational activity
CYSTITIS
Inflammation of the bladder that may be caused by infection or chemical injury or radiation; characterized by increased urinary frequency, discomfort on urination and often red blood cells, white blood cells and/or bacteria in the urine
CYSTOSCOPE
An instrument used by physicians to look inside the bladder and the urethra
CYSTOSCOPY
The use of a cystoscope to look inside the bladder and the urethra
CYTOCHROME P-450 DEPENDENT 14-DEMETHYLATION
An enzyme system that is important in the endocrine pathways of hormone production and activation
CYTOKINES
Any of several regulatory proteins, such as the interleukins and lymphokines, that are released by cells of the immune system and act as intercellular mediators in the generation of an immune response
CYTOTOXIC EFFECTS
Cell-killing effects
D
D1 OR D2 DISEASE
Stage of cancer; see staging and Whitmore-Jewett Staging
DEBULKING
Reduction of the volume of cancer by one of several techniques; most frequently used to imply surgical debulking
DENDRITIC CELLS (DC)
Cells that process antigens (proteins) and present them to immune lymphocytes called T cells, playing a major role in the initiation of the immune response against tumor and other types of abnormal cells; antigen presenting cells; e.g. Provenge® is an investigational therapy employing DC
DEOXYRIBONUCLEIC ACID (DNA)
The basic biologically active chemical that defines the physical development and growth of nearly all living organisms; a complex protein that is the carrier of geneticinformation.
DEOXYPYRIDINOLINE (DPD)
(Pyrilinks-D®); a bone resorption marker reflecting breakdown of bone collagen
DIAGNOSIS (DX)
The evaluation of signs, symptoms, and selected test results by a physician to determine the physical and biological causes and whether a specific disease or disorder is involved
DIETHYLSTILBESTROL
A female hormone commonly used intreatment of prostate cancer with activity against AIPC as well as ADPC
DIFFERENTIATION
How mature (developed) the cancer cells are in a tumor when viewed under the microscope; differentiated tumor cells resemble normal cells and grow at a slower rate than undifferentiated tumor cells, which lack the structure and function of normal cells and grow more aggressively; a method of grading the severity of disease
DIGITAL RECTAL EXAMINATION (DRE)
The test in which a physician inserts a lubricated and gloved finger into the rectum to feel for abnormalities of the prostate and rectum
DEHYDROEPIANDROSTERONE (DHEA)
An adrenal androgen precursor produced in the adrenal cortex and transformed into testosterone within prostate cells
DEHYDROEPIANDROSTERONE-SULFATE (DHEA-S)
The sulfated form of dihydroepiandrosterone; sulfation is a chemical process that alters the molecule by adding a sulfur-type group; sulfation occurs in the liver; DHEA-S is a more reliable laboratory test than DHEA
DIHYDROTESTOSTERONE (DHT OR 5 ALPHA-DIHYDROTESTOSTERONE)
A male hormone 5 times more potent than testosterone that is converted from testosterone within the prostate by 5-alpha reductase;
DIPLOID
Having one complete set of normally paired chromosomes, i.e., a normal amount of DNA; diploid cancer cells tend to grow slowly and respond well to hormone therapy; a diploid number of chromosomes would equal 46, a haploid set would equal 23; see also haploid
DISTENSIBILITY
The ability to enlarge or distend
DIURNAL
Pertaining to the day; having a cyclic nature involving the 24-hour day; prolactin levels are at their peak in the early morning–they have a diurnal variation; calcium utilization appears highest in the evening close to bedtime
DOSE VOLUME HISTOGRAM (DVH)
A graph that displays the distribution of the absorbed dose in tissue resulting from the delivery of a particular treatment plan.
DOSIMETRY
Relating to the doses of radiation employed in treating a tumor
DOUBLE-BLIND
A form of clinical trial in which neither the physician nor the patient knows the actual treatment which any individual patient is receiving; double-blind trials are a way of minimizing the effects of the personal opinions of patients and physicians on the results of the trial
DOUBLING TIME
The time that it takes a particular focus of cancer to double in size
DOWNSIZING
The use of hormonal or other forms of management to reduce the volume of prostate cancer in and/or around the prostate prior to attempted curative treatment
DOWNSTAGING
The use of hormonal or other forms of management in the attempt to lower the clinical stage of prostate cancer prior to attempted curative treatment (e.g., from stage T3a to stage T2b); this technique is highly controversial
DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA)
A type of bone mineral density radiologic examination using x-ray absorption; see also qCT
DYSPLASIA
See prostatic intraepithelial (or intraductal) neoplasia PIN
DYSURIA
Urination that is problematic or painful
E
EASTERN COOPERATIVE ONCOLOGY GROUP (ECOG)
One of the clinical trials groups; also a measurement of patient level of activity and well-being
EDEMA
Swelling or accumulation of fluid in some part of the body
EICOSAPENTAENOIC ACID (EPA)
A fish oil supplement, an omega 3 fatty acid (having the first double bond at the carbon 3 position from the omega end of the molecule) that inhibits the delta 5 desaturase enzyme that converts DGLA to arachidonic acid
EJACULATION
The release of semen through the penis during orgasm; ejaculation may be termed “dry” if there is scanty or no fluid component to the ejaculate as a result of radiation therapy or surgery
EJACULATORY DUCTS
The tubular passages through which semen reaches the prostatic urethra during orgasm
ELECTROCARDIOGRAM (EKG)
A test to examine electrical activity of the heart
EMCYT®:
See estramustine phosphate
ENDOTHELIN-1 (ET-1)
A prostate cell product that stimulates osteoblasts, acts as a vasoconstrictor and may be responsible for bone pain in metastatic prostate cancer; blockers of the receptor for ET-1 are in clinical trials and showing promise, e.g. Atrasentan
ENZYME
Any of a group of chemical substances which are produced by living cells and which cause particular chemical reactions to happen while not being changed themselves
ENZYME-LINKED IMMUNOSORBENT ASSAY
A sensitive immunoassay that uses an enzyme linked to an antibody or antigen as a marker for the detection of a specific protein, especially an antigen or antibody; often used as a diagnostic test to determine exposure to a particular infectious agent, such as the AIDS virus, by identifying antibodies present in a blood sample; see immunoassay
ENDOGENOUS
Inherent naturally to the organism
ENDORECTAL MRI
MRI of the prostate done via a probe inserted into the rectum; may be combined with endorectal magnetic resonance spectroscopy (currently only being done at UCSF and Memorial Sloan Kettering)
EPIDERMAL GROWTH FACTOR (EGF)
A growth factor that stimulates cell growth, proliferation, and differentiation
EPIDIDYMIS
Tightly coiled, thin-walled tube that conducts sperm from the testes to the vas deferens and provides for the storage, transmission, and maturation of sperm; inflammation of the epididymis is called epididymitis
EPIGALLOCATECHIN GALLATE (EGCG)
The active ingredient of green tea that patients should check to gauge potency
EPITHELIAL CELL
In prostate cancer, the cells within the prostate that line the ducts and functionally secrete chemicals such as PSA into the bloodstream or into the duct openings or lumen
ERECTILE DYSFUNCTION (ED)
see impotence
ESTRAMUSTINE PHOSPHATE (EMCYT®)
A chemotherapeutic agent; a hybrid drug combination of nitrogen mustard and estrogen that disrupts cytoplasmic microtubules
ESTROGEN
A female hormone used in the treatment of prostate cancer
ESTROGEN RECEPTOR (ER)
The docking site on the cell or in the cell for estrogen
EULEXIN®:
The brand name of flutamide in the USA
EXPERIMENTAL
An unproven (or even untested) technique or procedure; note that certain
experimental treatments are commonly used in the management of prostate cancer
EXTENT OF DISEASE (EOD)
One of the considerations when staging the bone scan; The use of EOD grade on initial bone scan is useful for prognostic prediction; based on work by Mark Soloway, MD
EXTERNAL BEAM RADIATION THERAPY (EBRT)
A form of radiation therapy in which the radiation is delivered by a machine directed at the area to be radiated, as opposed to radiation given within the target tissue such as brachytherapy; includes conventional photons, protons, neutrons, or electrons; may be given conventionally or with 3D conformal techniques
EXTRACAPSULAR EXTENSION (ECE)
When prostate cancer extends beyond the prostate capsule
F
FALSE NEGATIVE
An erroneous negative test result; for example, an imaging test that fails to show the presence of a cancer tumor, later found by biopsy to be present in the patient, is said to have returned a false negative result
FALSE POSITIVE
A positive test result mistakenly identifying a state or condition that does not in fact exist
FEULGEN STAIN
A histology stain used in microscopy to identify chromosomal material or DNA
FERRITIN
An iron-containing protein complex, found principally in the intestinal mucosa, spleen, and liver, that functions as the primary form of iron storage in the body
FIBROBLAST GROWTH FACTOR (FGF)
Growth factors involved in the proliferation and differentiation of cells
FINASTERIDE
An inhibitor of the enzyme 5-alpha reductase, that stimulates the conversion of testosterone to DHT; used to treat BPH and prostate cancer
FLARE REACTION
A temporary increase in tumor growth and symptoms caused by LHRH agonists; can be mild to dangerous; may be prevented by taking an anti-androgen (Casodex®) several days before starting an LHRH agonist (Lupron® or Zoladex®) or by the use of an LHRH antagonist such as Abarelix (Plenaxis®)
FLOW CYTOMETRY
A measurement method that determines the fraction of cells that are diploid, tetraploid, aneuploid, etc.
FLUTAMIDE
An anti-androgen used in the palliative hormonal treatment of advanced prostate cancer and in the adjuvant and neoadjuvant hormonal treatment of earlier stages of prostate cancer; normal dosage is two capsules three times a day
FOLLICLE STIMULATING HORMONE (FSH)
In the male, stimulates the Sertoli cells of the testicle to make sperm
FRACTION
The portion of a fractionated radiation treatment that is delivered in a single session
FREE PSA
PSA protein released into the blood that is not attached to other blood proteins; as opposed to a total PSA test which measures all PSA proteins in the blood, whether they’re “free” or attached; usually expressed as a percentage based on Free PSA divided by Total PSA times 100%; one study showed that men with Free PSA % > 25% had low risk of prostate cancer while those with <10% Free PSA % were likely to have prostate cancer
FREQUENCY
The need to urinate often
FROZEN SECTION
A technique in which removed tissue is frozen, cut into thin slices, and stained for microscopic examination; a pathologist can rapidly complete a frozen section analysis, and for this reason, it is commonly used during surgery to quickly provide the surgeon with vital information such as a preliminary pathologic opinion of the presence or absence of prostate cancer (usually in the pelvic lymph nodes)
FUSION
Combining two or more inputs of data so that they can be overlaid one upon another to provide a sense of agreement or concordance; fusion imaging studies such as ProstaScint-CT-PET are examples
G
G1 ARREST
Arrest or halt the cell cycle at the stage of G1; the normal sequence is G1-S-G2-M
GANTRY
Radiation therapy hardware from which the linear accelerator delivers its energy; the MLC is attached to the gantry and modulates the radiation beam as it exits
GASTROINTESTINAL
Related to the digestive system and/or the intestines
GENITAL SYSTEM
The biological system that, in males, includes the testicles, the vas deferens, the prostate, and the penis
GENITOURINARY SYSTEM (GU SYSTEM)
In the male, pertaining to the organs comprising the genital and urinary system. This includes the testicles, penis, seminal vesicles, urethra, bladder, ureters, and kidneys
GENOME
The total genetic content contained in a haploid set of chromosomes in single or multi-celled organisms, in a single chromosome in bacteria, or in the DNA or RNA of viruses; an organism’s genetic material
GENOMIC INSTABILITY
The instability of genetic material as a result of destructive chemical processes that lead to mutation
GLAND
A structure or organ that produces a substance which is used in another part of the body
GLAND VOLUME
The size in cubic centimeters or grams of the prostate gland
GLEASON SCORE
A widely used method for classifying the cellular differentiation of cancerous tissues; the less the cancerous cells appear like normal cells, the more malignant the cancer; two numbers, each from 1–5, are assigned successively to the two most predominant patterns of differentiation present in the examined tissue sample and are added together to produce the Gleason score; high numbers indicate poor differentiation and therefore cancer; named after Dr. Gleason who developed the grading system
GONADOTROPIN-RELEASING HORMONE (GNRH)
see LHRH
GOSERELIN ACETATE (ZOLADEX®
A luteinizing hormone-releasing hormone (LHRH) analog used in the hormonal treatment of advanced prostate cancer and in the adjuvant and neoadjuvant hormonal treatment of earlier stages of prostate cancer
GRADE
A means of describing the potential degree of severity of a cancer based on the appearance of cancer cells under a microscope; the Gleason grade is broken down into the primary and secondary grades; see Gleason Score
GRAY (GY)
The SI (Systeme International) unit of absorbed radiation dose: 1 Gy = 1 joule/kg = 100 rads
GREEN TEA POLYPHENOLS (GTP)
The active substances within green tea
GROSS TUMOR VOLUME (GTV)
Position and extent of the primary tumor.
GYNECOMASTIA
Enlargement or tenderness of the male breasts or nipples; a possible side effect of hormonal therapy which leads to increased levels of estrogens as seen with DES, PC SPES, monotherapy with anti-androgens (Flutamide or Casodex®) or the combination of the latter with Proscar®
H
H-2 BLOCKERS
Blockers of histamine, a substance responsible for gastric acidity among other functions
HAPLOID
Having the same number of sets of chromosomes as a germ cell (sperm or egg) or half as many as a somatic cell (all remaining cells having to do with the body); having a single set of chromosomes; see also diploid
HEALTH MAINTENANCE ORGANIZATION (HMO)
An insurance company that provides medical care to people
HEMATOSPERMIA
The occurrence of blood in the semen
HEMATURIA
The occurrence of blood in the urine
HEREDITY
The historical distribution of biological characteristics through a group of related
individuals via their DNA
HEREDITARY
Inherited from one’s parents and earlier generations
HETEROGENEOUS (HETEROGENEITY)
Non-uniform; composed of mixtures of different kinds; in reference to tumors meaning composed of different clones of cells
HIGH DENSITY LIPOPROTEIN CHOLESTEROL (HDL)
A beneficial cholesterol composed of a high proportion of protein (with little triglyceride and cholesterol) and that is associated with decreased probability of developing atherosclerosis
HIGH-DOSE KETOCONAZOLE (HDK)
Trade name is Nizoral®
HIGH MOLECULAR WEIGHT uPA
Urokinase-type plasminogen activator (uPA) system involved in cancer progression
HISTOLOGY
The study of the appearance and behavior of tissue, usually carried out under a microscope by a pathologist (a physician) or a histologist (not necessarily a physician)
HOMOGENEOUS (HOMOGENEITY)
Uniform; composed of the same element; in reference to a tumor cell population, meaning that the cells are of the same clone in contrast to a mixed cell population that would exhibit heterogeneity or be heterogeneous
HORMONE
Biologically active chemicals that are responsible for the development of secondary sexual characteristics
HORMONE REFRACTORY PC (HRPC)
A loosely used term that really should apply to progressive prostate cancer in the setting of a testosterone level less than 20 ng/dl and when an androgen receptor mutation has been excluded; the preferred term is androgen-independent prostate cancer
HORMONE THERAPY
The use of hormones, hormone analogs, and certain surgical techniques to treat disease (in this case prostate cancer) either on their own or in combination with other hormones or in combination with other methods of treatment; because prostate cancer is usually dependent on male hormones to grow, hormonal therapy can be an effective means of alleviating symptoms and retarding the development of the disease
HOT FLASH
The sudden sensation of warmth in the face, neck, and upper body; a side effect of many forms of hormone therapy
HYDROXYSTEROID DEHYDROGENASE (HSD)
The enzyme that oxidizes or reduces testosterone to androstenedione or vice versa
HYDROCORTISONE (HC)
A steroid compound synthesized in the adrenal cortex and vital to survival
HYPERCALCEMIA
Abnormally high concentrations of calcium in the blood, indicating leaching of
calcium from bone (tumors raise serum calcium levels by destroying bone or by releasing PTH or a PTH-like substance, osteoclast-activating factor, prostaglandins, and perhaps, a vitamin D-like sterol). Symptoms of hypercalcemia may include drowsiness, lethargy, headaches, depression or apathy, irritability, confusion; weakness, muscle flaccidity, bone pain, pathologic fractures; signs of heart block, cardiac arrest in systole, hypertension; anorexia, nausea, vomiting, constipation, dehydration, polydipsia; renal polyuria, flank pain, and eventually, azotemia (excess of urea or other nitrogenous substances in the blood)
HYPERPLASIA
Enlargement of an organ or tissue because of an increase in the number of cells in that organ or tissue; see also BPH
HYPERSENSITIVE PSA (ULTRASENSITIVE PSA)
A laboratory assay for PSA that is more sensitive to detection of low levels of PSA than a standard assay; these assays allow for earlier detection of recurrence and can distinguish an excellent response to ADT from a mediocre response; DPC Immulite 3rd generation and Tosoh are two examples of hypersensitive PSA assays available
HYPERTHERMIA
Treatment that uses heat; for example, heat produced by microwave radiation
I
IMAGING
A radiology technique or method allowing a physician to see something that would not normally be visible
IMMULITE
Laboratory console manufactured by Diagnostics Products Company (DPC) in Los Angeles that comprehensively evaluates the endocrine axis and biomarkers essential to prostate cancer management
IMMUNE SYSTEM
The biological system which protects a person or animal from the effects of foreign materials such as bacteria, viruses, cancer cells, and other things which might make that person or animal sick
IMMUNOASSAY
A laboratory technique that makes use of the binding between an antigen and its homologous antibody in order to identify and quantify the specific antigen or antibody in a sample; a procedure for detecting or measuring specific proteins or other substances through their properties as antigens or antibodies.
IMPLANT
A device that is inserted into the body; e.g., a tiny container of radioactive material inserted in or near a tumor; also a device inserted in order to replace or substitute for an ability which has been lost; for example, a penile implant is a device which can be surgically inserted into the penis to provide rigidity for intercourse
IMPOTENCE
The inability to have or to maintain an erection; also known as erectile dysfunction (ED)
INCIDENTAL
Insignificant or irrelevant; for example, incidental prostate cancer (also known as latent prostate cancer) is a form of prostate cancer which is of no clinical significance to the patient in whom it is discovered
INCONTINENCE
(urinary incontinence) loss of urinary control; there are various kinds and degrees of incontinence; overflow incontinence is a condition in which the bladder retains urine after voiding; as a consequence, the bladder remains full most of the time, resulting in involuntary seepage of urine from the bladder; stress incontinence is the involuntary discharge of urine when there is increased pressure upon the bladder, as in coughing or straining to lift heavy objects; total incontinence is the inability to voluntarily exercise control over the sphincters of the bladder neck and urethra, resulting in total loss of retentive ability
INDICATION
The approved clinical application of a pharmaceutical
INFLAMMATION
Any form of swelling or pain or irritation
INFORMED CONSENT
Permission to proceed given by a patient after being fully informed of the
purposes and potential consequences of a medical procedure
INSULIN GROWTH FACTOR 1 (IGF-1)
A growth factor that stimulates prostate cancer cell growth and osteoblast growth
INSULIN GROWTH FACTOR BINDING PROTEIN 3 (IGFBP-3)
A tumor suppressor gene that decreases as prostate cancer progresses from benign to metastatic
INTENSITY-MODULATED RADIATION THERAPY (IMRT)
An approach to radiation delivery allowing the treatment team to specify the tumor target dose and the amount of radiation allowable to the nearby tissues, and uses sophisticated computer planning to arrive at acceptable equations; sophisticated hardware is also incorporated into this planning that allows the radiation intensity to be modulated up or down as the delivery system rotates around the patient
INTERFERON
A body protein that affects antibody production and can modulate (regulate) the immune system
INTERLEUKIN (IL)
Any of various compounds of low molecular weight that are produced by lymphocytes, macrophages, and monocytes and that function especially in regulation of the immune system and cell-mediated immunity
INTERLEUKIN 1 (IL-1)
A cell product involved in the immune response (cytokine) which facilitates osteoblast growth among its many functions; see Insights vol. 2, no. 4 for a more detailed description with illustrations
INTERLEUKIN 6 (IL-6)
A cytokine that stimulates osteoclast precursors and mature osteoclasts among its many functions; see Insights vol. 2, no. 4 for a more detailed description with illustrations
INTERMITTENT ANDROGEN DEPRIVATION (IAD):
ADT that stops testosterone lowering therapy with the intent to allow the patient to recover from symptoms of ADS as testosterone levels recover to normal; same as intermittent hormonal therapy or intermittent androgen suppression
INTERMITTENT ANDROGEN SUPPRESSION
see intermittent androgen deprivation
INTERMITTENT HORMONAL THERAPY (IHT) see intermittent androgen deprivation
INTERSTITIAL
Within a particular organ; for example, interstitial prostate radiation therapy is
radiation therapy applied within the prostate using implanted radioactive pellets or seeds; see also brachytherapy
INTRAVENOUS
Into a vein
INTRAVENOUS PYELOGRAM (IVP)
A procedure that introduces an x-ray absorbing dye into the urinary tract in order to allow the physician a superior image of the tract by taking an x-ray
INVASIVE
Requiring an incision or the insertion of an instrument or substance into the body
INVERSE PLANNING
Treatment planning for radiation therapy in which various aspects of the treatment plan are generated by a computer in order to achieve the dose distribution prescribed by a physician
INVESTIGATIONAL
A drug or procedure being tested in clinical trials in seeking FDA approval
ISOCENTER
The center of rotation of a treatment arc in radiation therapy
ISODOSE CONTOUR
A two or three-dimensional shape that contains the volume receiving a dose greater than or equal to a specified amount
ISODOSE LINE
A two-dimensional line that circumscribes an area receiving a dose greater than or equal to a specified amount
ITERATIONS
Repeated series of steps, performed either by the computer or by the user, implemented to develop a treatment plan
K
KEGEL EXERCISES
A set of exercises designed to improve the strength of the muscles used in urinating
KIDNEY
One of a pair of organs whose primary function is to filter the fluids passing through the body
L
LAPAROSCOP
A technique that allows the physician to observe internal organs directly through a piece of optical equipment inserted directly into the body through a small surgical incision
LATENT
Insignificant or irrelevant; for example, latent prostate cancer (also known as incidental prostate cancer) is a form of prostate cancer which is of no clinical significance to the patient in whom it is discovered
LEUPROLIDE ACETATE
A LHRH analog; trade name is Lupron®
LEYDIG CELLS
Cell population within the testicles that produces testosterone; the other main cell population are the Sertoli cells that make sperm
LHRH ANALOGS (or AGONISTS)
Synthetic compounds that mimic natural LHRH but then shut down LH production after continuous exposure; chemically similar to luteinizing hormone-releasing hormone (LHRH) but sufficiently different and suppress testicular production of testosterone by binding to the LHRH receptor in the pituitary gland; used in the hormonal treatment of advanced prostate cancer and in the adjuvant and neoadjuvant hormonal treatment of earlier stages of prostate cancer; leuprolide acetate (Lupron®) is an example
LHRH ANTAGONIST
An agent that blocks the LHRH receptor by pure antagonism without the initial release of LH seen with LHRH agonists; Abarelix (Plenaxis®) is an example
LIBIDO
Interest in sexual activity
LIGAND
An ion, a molecule, or a molecular group that binds to another chemical entity at a receptor to form a larger complex
LINEAR ACCELERATOR
A type of high energy x-ray machine that generates radiation fields for external beam radiation therapy. A linear accelerator is typically mounted with a collimator and/or a multileaf collimator in a gantry that revolves vertically around a treatment couch
LIPO-STEROLIC EXTRACT OF SERENOA REPENS (LSERr)
The lipid extracted portion of saw palmetto (an extract of the fruit of Serenoa repens. It is rich in fatty acids and phytosterols.)
LIPOPROTEIN
Any of a group of soluble proteins that combine with and transport fat or other lipids in the blood plasma.
LNCaP
A line of human prostate cancer cells used in laboratory studies; this cell line is hormonally dependent
LOBE
One of the two sides of an organ that has two sides or halves (e.g., the prostate or the brain)
LOCALIZED
Restricted to a well-defined area
LOW DENSITY LIPOPROTEIN (LDH) CHOLESTEROL
A lipoprotein of blood plasma that is composed of a moderate proportion of protein with little triglyceride and a high proportion of cholesterol and that is associated with increased probability of developing atherosclerosis
LUPRON®
The US trade or brand name of leuprolide acetate, a LHRH agonist
LUTEINIZING HORMONE (LH)
A pituitary hormone that stimulates the Leydig cells of the testicles to make the male hormone testosterone
LUTEINIZING HORMONE RELEASING HORMONE (LHRH)
A hormone responsible for stimulating the production of testosterone in the body by interacting with the LHRH receptor to release luteinizing hormone which in turn stimulates cells in the testicles (Leydig cells) to make testosterone; also known as gonadotropin-releasing hormone (GnRH)
LYMPH (ALSO LYMPHATIC FLUID)
The clear fluid in which all of the cells in the body are constantly bathed; carries cells that help fight infection
LYMPH NODES
The small glands which occur throughout the body and which filter the clear fluid known as lymph or lymphatic fluid; lymph nodes filter out bacteria and other toxins, as well as cancer cells
LYMPHADENECTOMY
The removal and microscopic examination of selected lymph nodes, a common site of metastatic disease with prostate cancer; this can be done during surgery prior to the removal of the prostate gland; a “laparoscopic lymphadenectomy” is an alternative using a small incision, requiring only an overnight stay in the hospital; also known as a pelvic lymph node dissection
LYMPHATIC SYSTEM
The tissue and organs that produce, store, and carry cells that fight infection; includes bone marrow, spleen, thymus, lymph nodes, and channels that carry lymph fluid
M
MAGNETIC RESONANCE
Absorption of specific frequencies of radio and microwave radiation by atoms placed in a strong magnetic field
MAGNETIC RESONANCE IMAGING (MRI)
The use of magnetic resonance with atoms in body tissues to produce distinct cross-sectional, and even three-dimensional images of internal organs; MRI is primarily of use in staging biopsy-proven prostate cancer
MAGNETIC RESONANCE SPECTROSCOPY (MRS)
An imaging approach to measure biochemical changes in the brain, particularly to identify tumors
MALIGNANCY
A growth or tumor composed of cancerous cells
MALIGNANT
Cancerous; tending to become progressively worse and to result in death; having the invasive and metastatic (spreading) properties of cancer
MARGIN
Normally used to mean the “surgical margin”, which is the outer edge of the tissue removed during surgery; if the surgical margin shows no sign of cancer (“negative margins”), then the prognosis is good
MATRIX METALLOPROTEASE 2 (MMP-2)
Prostate cancer cell product involved in angiogenesis
MAXIMAL ANDROGEN BLOCKADE (MAB) or DEPRIVATION (MAD)
see ADT, CHB, CHT,
MAB, TAB
MCF-7
Human breast cancer cell line
MEDICAL ONCOLOGIST
A doctor primarily trained in the use of medicines (rather than surgery) to treat, diagnose, and prevent cancer
METASTASIS
(plural, METASTASES) a secondary tumor formed as a result of a cancer cell or cells from the primary tumor site (e.g., the prostate) traveling through the body to a new site and then growing there
METASTASIZE
Spread of a malignant tumor to other parts of the body
METASTATIC
Having the characteristics of a secondary tumor
METASTATIC WORKUP
Group of tests, including physical examination, bone scans, x-rays, other imaging studies, and blood tests to ascertain whether cancer has metastasized
METASTRON®
The brand name of strontium-89, a radioactive isotope used in the treatment of bone pain from metastatic prostate cancer
MICROGRAM (MCG or µG )
A unit of mass equal to one thousandth (10-3) of a milligram or one millionth (10-6) of a gram
MISSTAGING
The assignment of an incorrect clinical stage at initial diagnosis because of the difficulty of assessing the available information with accuracy
MODIFIED CITRUS PECTIN (MCP)
A substance that is able to interfere with prostate cancer growth by preventing cell-to-cell interaction and adhesiveness; It does soby binding to a carbohydrate substance called galectin-3 found on the surface of tumor cells
MONOCLONAL
Formed from a single group of identical cells
MORBIDITY
Unhealthy consequences and complications resulting from treatment
MUCOSA
Superficial lining cells involving body cavities like the mouth, rectum, bladder; a membrane
lining all body passages that communicate with the air, such as the respiratory and alimentary tracts, and having cells and associated glands that secrete mucus
MULTILEAF COLLIMATOR (MLC)
A type of collimator that can define irregularly shaped radiation fields. An MLC has two rows of narrow metal blocks (leaves) that can be independently driven in or out of the radiation beam from opposite sides under computer control
MULTILEAF INTENSITY-MODULATING COLLIMATOR (MIMiC)
A multileaf collimator designed specifically for intensity modulated radiotherapy. The MIMiC treats two slices, each 1 or 2 cm thick, with a fan beam of radiation, when the linear accelerator gantry rotates through an arc around the patient. The patient couch is moved to treat adjacent slices if the target is too large to treat with a single arc; see tomotherapy
N
NEGATIVE
The term used to describe a test result which does not show the presence of the substance or material being tested for; for example, a bone scan with no sign of bone metastases is negative
NEOADJUVANT
The use of a different kind of therapy before the use of the primary therapy, e.g. the use of androgen deprivation therapy (ADT) prior to radiation therapy (RT) of prostate cancer or the use of chemotherapy before surgery for breast cancer
NEOADJUVANT HORMONE BLOCKADE (NHB)
Use of androgen deprivation therapy prior to other therapies such as radiation therapy, surgery, or chemotherapy to reduce tumor volume and/or prostate gland volume. The goal is to allow these other therapies to work better; also called neoadjuvant hormonal therapy (NHT)
NEOPLASIA
The growth of cells under conditions that would tend to prevent the development of normal tissue (e.g., a cancer)
NERVE RADICLES
Small nerve roots that are seen microscopically within specific tissue, like the prostate
NERVE-SPARING
Term used to describe a type of prostatectomy in which the surgeon saves the nerves that affect sexual and related functions
NEUROENDOCRINE
Of or relating to the interactions between the nervous and endocrine systems, especially in relation to hormones.
NEURON-SPECIFIC ENOLASE (NSE)
A neuroendocrine marker; see chromogranin A
NILUTAMIDE (NILANDRON®)
A non-steroidal anti-androgen
NOCTURIA
The need to urinate frequently at night
NON-INVASIVE
Not requiring any incision or the insertion of an instrument or substance into the body
Nubeqa
As of 2020, the most recent second-generation hormonal agent to be FDA approved for the treatment of men with non-metastatic castrate-resistant prostate cancer. Preliminary studies suggest that Nubeqa has fewer side-effects than other second-generation agents.
O
ONCOLOGIST
A physician who specializes in the treatment of various types of cancer
ONCOLOGY
The branch of medical science dealing with the prevention, treatment, and diagnosis of cancer and tumors; onco- means “tumor”
ONCOLYTIC VIRUS
A virus that causes death of a tumor cell
ORCHIECTOMY (or ORCHIDECTOMY)
The surgical removal of the testicles; surgical castration
ORGAN
A group of tissues that work in concert to carry out a specific set of functions (e.g., the heart or the lungs or the prostate)
ORGAN-CONFINED DISEASE (OCD)
Prostate cancer that is apparently confined to the prostate
clinically or pathologically; not going beyond the confines of the prostatic capsule
ORNITHINE DECARBOXYLASE (ODC)
An enzyme essential for cell growth but also promotes growth of cancer cells
OSTEOBLAST
Cell that forms bone
OSTEOCLAST
Cell that breaks down bone; osteoclasts are in bone tissue and resorb bone leading to bone loss (osteopenia or osteoporosis)
OSTEOLYSIS
Destruction of bone
OSTEOPENIA
A reduction in the bone density that is more than one standard deviation from the normal bone density; using the T score it is T= -1.0 down to T= -2.4; once the T score is lower than -2.4, the patient is defined as having osteoporosis
OSTEOPOROSIS
A reduction in bone density resulting in a T score of -2.5 or lower; a loss of bone due to increased osteoclastic activity leading to bone resorption
OVERSTAGING
The assignment of an overly high clinical stage at initial diagnosis because of the difficulty of assessing the available information with accuracy (e.g., stage T3b as opposed to stage T2b)
P
PALLIATIVE
Describes a therapy given in order to relieve symptoms and improve quality of life, but does not cure the disease
PALPABLE
Able to be felt during a physical examination; in prostate cancer, this refers to some form of abnormality of the prostate which can be felt during a digital rectal examination
PARATHYROID HORMONE (PTH)
One of the principal calcium-regulating hormones in the body
PARATHYROID HORMONE-RELATED PROTEIN (PRHrP)
A protein involved in osteoblast
stimulation; a product also of the prostate cancer cell elaborated by neuroendocrine cells that make chromogranin A (CGA)
PARTIAL RESPONSE (PR)
A 50% or greater decline in parameters that are being used to measure anti-cancer activity; parameters include abnormalities involving physical exam findings, lab and radiologic studies; also see complete response (CR)
PARTIN TABLES
Tables used to predict the probability that the prostate cancer has spread to the lymph nodes or seminal vesicles, penetrated the capsule, or remains confined to the prostate; developed by a group of scientists at the Brady Institute for Urology at Johns Hopkins University, based on results of the PSA, clinical stage, and Gleason score involving thousands of men with prostate cancer
PATHOLOGIST
A physician who specializes in the examination of tissues and blood samples to help decide what diseases are present and how they should be treated
PC-3
Human prostate cancer cell line that is androgen-independent
PELVIS
The part of the skeleton that joins the lower limbs of the body together
PENILE
Of the penis
PERCUTANEOUS
Through the skin
PERINEAL
Of the perineum
PERINEUM
The area of the body between the scrotum and the rectum; a perineal procedure uses this area as the point of entry into the body
PERIPHERAL
Outside the central region
PERINEURAL INVASION
Prostate cancer invading the nerve sheath surrounding the nerves that enter the prostate
PERIPROSTATIC
Pertaining to the soft tissues immediately adjacent to the prostate
PHYSICIAN DATA QUERY (PDQ)
A NCI supported database available to physicians, containing
current information on standard cancer treatments and ongoing clinical trials
PITUITARY HORMONE
Hormones from the pituitary gland, a small gland at the base of the brain. Hormones secreted by the anterior pituitary influence growth, sexual development, skin pigmentation, thyroid function, and adrenocortical function.
PLACEBO
A form of safe but non-active treatment frequently used as a basis for comparison with
pharmaceuticals in research studies
PLANNING TARGET VOLUME (PTV)
Equivalent to the clinical target volume plus a margin to
account for uncertainty in immobilization and localization of the patient anatomy during treatment
PLATELET-DERIVED GROWTH FACTOR (PDGF)
An important factor in tumor growth involving angiogenesis
PLOIDY
The number of sets of chromosomes in a cell; see also diploid and aneuploid
POSITIVE
The term used to describe a test result which shows the presence of the substance or material being tested for; a bone scan finding signs of bone metastases would be positive
POSITRON EMISSION TOMOGRAPHY (PET) SCAN
Imaging using a radioactive isotope that is taken up by tumor tissue to identify tumor activity
POSTERIOR
The rear; for example, the posterior of the prostate is the part of the prostate that faces a man’s back
PROCTITIS
Inflammation of the rectum; may be associated with radiation therapy for prostate cancer
PROGESTERONE
Used in the treatment of hot flashes in men having suppressions in LH and
testosterone; a specific steroid hormone in the family of progestins secreted by the corpus luteum of the ovary and by the placenta, that acts to prepare the uterus for implantation of the fertilized ovum, to maintain pregnancy, and to promote development of the mammary glands; many tumor cells contain progesterone receptors; examples of a progestin are Megace® or Depo-Provera®
PROGESTERONE RECEPTOR (PR)
The docking site on a cell that interacts with progestins
PROGNOSIS
Chance of recovery; the patient’s potential clinical outlook based on the status and probable course of his disease
PROGRESSION
Continuing growth or regrowth of cancer
PROLACTIN (PRL)
A trophic hormone produced by the pituitary that increases androgen receptors, increases sensitivity to androgens & regulates production & secretion of citrate
PROLIFERATING CELL NUCLEAR ANTIGEN (PCNA)
An index of cell division or proliferation
PROSCAR®
Brand name of finasteride, a 5AR inhibitor
PROSTAGLANDIN
Hormone-like substances that stimulate target cells into action; they differ from hormones in that they act locally, near their site of synthesis, and they are metabolized very rapidly; any of various oxygenated, unsaturated, cyclic fatty acids of animals that have a variety of hormone-like actions (as in controlling blood pressure or smooth muscle contraction)
PROSTAGLANDIN E2 (PGE2-+)
An unfavorable metabolite of arachidonic acid
PROSTASCINT
A monoclonal antibody test directed against the prostate specific membrane antigen (PSMA); seems to focus on androgen-independent tumor tissue
PROSTATE
The gland surrounding the urethra and immediately below the bladder in males
PROSTATE-SPECIFIC ANTIGEN (PSA)
A protein secreted by the epithelial cells of the prostate
gland including cancer cells; an elevated level in the blood indicates an abnormal condition of the prostate gland, either benign or malignant; it is used to detect potential problems in the prostate gland and tofollow the progress of PCA therapy (see screening)
PROSTATE-SPECIFIC MEMBRANE (PSM)
A membrane that surrounds the protoplasm (cytoplasm) of prostate cells
PROSTATE-SPECIFIC MEMBRANE ANTIGEN (PSMA)
A protein seen in many types of prostate
tissues, used for diagnostic purposes but also being researched for possible therapeutic purposes
PROSTATECTOMY
Surgical removal of part or all of the prostate gland
PROSTATIC ACID PHOSPHATASE (PAP)
An enzyme secreted by prostate cells associated with a higher probability of disease outside the prostate when levels are 3.0 or higher; PAP elevations connote that the disease is not an organ-confined disease
PROSTATIC INTRAEPITHELIAL (or INTRADUCTAL) NEOPLASIA
A pathologically identifiable condition believed to be a possible precursor of prostate cancer; also known more simply as dysplasia by many physicians; broken down into high-grade PIN (PIN 2 or PIN 3) and low-grade PIN (PIN 1); high-grade PIN is associated with having prostate cancer
PROSTATITIS
Infection or inflammation of the prostate gland treatable by medication and/or manipulation
PROSTHESIS
A manufactured device used to replace a normal body part or function
PROTOCOL
A precise set of methods by which a research study is to be carried out
PROTON PUMP INHIBITORS (PPI)
Drugs that reduce gastric acidity by inhibiting the proton pump within the gastric lining cells; examples include Prilosec® and Nexium®
PSA DENSITY (PSAD)
The amount of PSA per unit volume of the prostate gland, reflecting tumor density within the prostate; the quotient of PSA divided by gland volume
PSA NADIR (PSAN)
The lowest PSA value reached during or after a particular treatment; a progressive rise after a PSA nadir has been reached usually indicates biologic activity of prostate cancer
PSA RELAPSE-FREE SURVIVAL
Survival of the prostate cancer patient that demonstrates no evidence of biochemical relapse (a rising PSA as seen in 3 consecutive determinations); also called biochemical relapse-free survival (bRFS)
Prostate Specific Membrane Antigen (PSMA)
A type II membrane antigen which is present in most prostate tissue cells including prostate cancer cells. This antigen is used in PSMA/PET scans which are significantly more sensitive than anything previously available. Additionally, researchers are currently investigating the use of Lutetium-177 as targeted radiotherapy to treat metastases using PSMA as the target.
PSMA/PET Scan
A body scan used to look for prostate cancer metastases which, as of 2020, is under FDA investigation in the United States but has been approved and widely used in Germany, Australia, and elsewhere. This scan uses a radioactive element (e.g. Gallium-68) which attaches to prostate specific membrane antigen (PSMA)—which is expressed by most prostate cancer cells—and becomes visible on scans. As of 2020, it is significantly more sensitive than other body scan on the market.
PUBMED
An outstanding medical search website on the internet
PYRIDINOLINE (PD)
A bone resorption marker; a bone collagen breakdown product
PYRILINKS-D® (DPD)
A urine test that quantitates bone resorption; the second voided urine specimen is ideal to use; other markers of bone resorption are ICTP and N-telopeptide; deoxypyridinoline
Q
QUANTITATIVE COMPUTED TOMOGRAPHY (QCT) BONE DENSITOMETRY
A medical technique that measures bone mineral density; an alternate way to evaluate bone density besides the DEXA scan;
QUALITY OF LIFE
An evaluation of health status relative to the patient’s age, expectations, and physical and mental capabilities
R
RADIATION CYSTITIS
Inflammation of the bladder lining due to the ionizing effects of radiation therapy
RADIATION ONCOLOGIST
A physician specialized in the treatment of cancers with different types of radiation
RADIATION PROCTITIS
Inflammation of the rectal mucosa lining due to the ionizing effects of
radiation therapy
RADIATION THERAPY (RT)
The use of x-rays and other forms of radiation to destroy malignant cancer cells and tissue
RADICAL
(in a surgical sense) directed at the cause of a disease; see radical prostatectomy
RADICAL PROSTATECTOMY (RP)
An operation to remove the entire prostate gland and seminal vesicles with the intent to cure the problem believed to be caused by or within the prostate
RADIO SENSITIVITY
The degree to which a type of cancer responds to radiation therapy
RADIOISOTOPE
A type of atom (or a chemical which is made with a type of atom) that emits radioactivity
RADIOTHERAPY
see radiation therapy
RANDOMIZED
A research study which assigns patients to different treatments in a random manner to better compare results by preventing biases and confounding
RECEPTOR
A docking site which interacts with a ligand; receptors may be on the cell membrane or within the cell cytoplasm or nucleus; estrogen receptors and androgen receptors are examples; all cells have multiple receptors
RECTAL EXAM
see digital rectal exam
RECTUM
The final part of the intestines that ends at the anus
RECURRENCE
The reappearance of disease; this can be manifested clinically as findings on the physical examination (e.g. DRE) or as a laboratory recurrence only (e.g. rise in PSA)
REFRACTORY
Resistant to therapy; e.g., hormone refractory prostate cancer is resistant to forms of treatment involving hormone manipulation
REGRESSION
Reduction in the size of a single tumor or reduction in the number and/or size of several tumors
REMISSION
The real or apparent disappearance of some or all or the signs and symptoms of cancer; the period (temporary or permanent) during which a disease remains under control, without progressing; even complete remission does not necessarily indicate cure
RESECTION
Surgical removal
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
RESISTANCE
Medically, a patient’s ability to fight off a disease as a result of the effectiveness of the patient’s immune system
RESORPTION
loss of bone through increased breakdown via osteoclasts or other mechanism causing a reduction in bone mass
RESPONSE
A decrease in disease that occurs because of treatment; divided into complete response or partial response
RETENTION
Difficulty in initiation of urination or the inability to completely empty the bladder
RETROPUBIC PROSTATECTOMY
Surgical removal of the prostate through an incision in the abdomen above the pubic bones
REVERSE TRANSCRIPTASE-POLYMERASE CHAIN REACTION (RT-PCR)
A technique which allows a physician to search for tiny quantities of a protein, such as PSA, in the blood or other body fluids and tissues; see RT-PCR PSA
RISK
The chance or probability that a particular event will or will not happen
RT-PCR PSA
A blood test that detects micrometastatic cells circulating in the blood stream; may be useful as a screening tool to help avoid unnecessary, invasive treatments (RP, RT, etc.) on patients with metastasized prostate cancer
S
SALVAGE
A procedure intended to “rescue” a patient following the failure of a prior treatment; for example, a salvage prostatectomy would be the surgical removal of the prostate after the failure of prior radiation therapy or cryosurgery
SCROTUM
The pouch of skin containing a man’s testicles
SCREENING
Evaluating populations of people to diagnose disease early
SECONDARY TO
Derived from or consequent to a primary event or disease
SEED IMPLANTATION (SI)
Insertion of radioactive seeds, usually iodine-125 or palladium-103, into the prostate tissue to destroy prostate cancer
SELECTIVE ANDROGEN RECEPTOR MODULATOR (SARM)
A drug that selectively inhibits androgen receptors of a specific tissue(s) while allowing the normal interaction of the androgen with androgen receptors at other sites; see also selective estrogen receptor modulator
SELECTIVE ESTROGEN RECEPTOR MODULATOR (SERM):
A drug that selectively blocks one estrogen receptor (ER) but allows the other receptors at specific sites to function normally with estrogen; Raloxifene® is an example of a SERM–it blocks the ER in the breast and uterine tissue but allows the ER in bone tissue to be operative
SELENIUM
A relatively rare nonmetallic element found in small quantities in food in, and that has some effect in prevention of prostate cancer
SEMEN
The whitish, opaque fluid emitted by a male at ejaculation
SEMINAL
Related to the semen; e.g. seminal vesicles
SEMINAL VESICLES (SV)
Glandular structures located above and behind the prostate that secrete and store seminal fluid; the seminal vesicles connect with the ejaculatory ducts; the seminal fluid contains nutrients for the sperm that improves their viability and mobility
SENSITIVITY
The probability that a diagnostic test can correctly identify the presence of a particular disease, assuming the proper conduct of the test; specifically, the number of true positive results divided by the sum of the true positive results and the false negative results; see also specificity
SERUM GLUTAMIC-OXALOACETIC TRANSAMINASE (SGOT)
A liver cell enzyme; elevation of SGOT is seen as an effect of liver cell injury by drugs, alcohol, and viruses
SERUM GLUTAMIC-PYRUVIC TRANSAMINASE (SGPT)
A liver cell enzyme; elevation of SGPT is seen as an effect of liver cell injury by drugs, alcohol, and viruses
SEXTANT
Having six parts; thus, a sextant biopsy is a biopsy that takes six samples
SIDE-EFFECT
A reaction to a medication or treatment (most commonly used to mean an unnecessary or undesirable effect)
SIGN
physical changes which can be observed as a consequence of an illness or disease
SPECIFICITY
The probability that a diagnostic test can correctly identify the absence of a particular disease, assuming the proper conduct of the test; specifically, the number of true negative results divided by the sum of the true negative results and the false positive results; a method that detects 95% of true prostate cancer cases are highly sensitive, but if it also falsely indicates that 40% of those who do not have prostate cancer do have prostate cancer then its specificity is 60%, rather poor; see sensitivity
SPHINCTER
A muscle which surrounds, and by its contraction tends to close; a natural opening; ex. the sphincter of the bladder
STAGE
A term used to define the size and physical extent of a cancer
STAGING
he process of determining extent of disease in a specific patient, in light of all available
information; it is used to help determine appropriate therapy; there are two staging methods: the Whitmore-Jewett staging classification (1956) and the more detailed TNM (tumor, nodes, metastases) classification (1992). Staging should be subcategorized as clinical staging and pathologic staging. Pathologic stage usually relates to what is found at the time of surgery. The TNM system is now most commonly used. Whitmore-Jewett Stage A becomes TNM T1, Stage B becomes T2, Stage C becomes T3
STENT
A tube used by a surgeon to drain fluids
STRATIFIED
In an analysis of research results, a particular clinical or pathologic feature is used as the basis for comparison, e.g. clinical stage, pathologic stage, PSA, or Gleason score
STRICTURE
Scarring as a result of a procedure or an injury that constricts the flow of a fluid; for example, a urethral stricture would restrict the flow of urine through the urethra
STRONTIUM-89
An injectable, radioactive product that is used to relieve bone pain in some patients with prostate cancer that no longer respond to hormones or appropriate forms of chemotherapy
SUBCAPSULAR
Under the capsule; for example, a subcapsular orchiectomy is a form of castration in which the contents of each testicle is removed but the testicular capsules are then closed and remain in the scrotum
SUPRAPUBIC
above the pubic bone; a suprapubic tube is placed into the bladder by puncturing the skin and soft tissue above the pubic bone
SUTURE
surgical stitching used in the closure of a cut or incision
SYMPTOM
a feeling, sensation, or experience associated with or resulting from a physical or mental disorder and is noticeable by the patient
SYSTEMIC
throughout the whole body; affecting the entire body
T
T-CELL
an immune-system cell that orchestrates an immune response to infected or malignant cells, sometimes by direct contact with the abnormal cells; T-cells are lymphocytes that develop in the thymus and circulate in the blood and lymphatic system; see dendritic cell
T-SCORE
The number of units — called standard deviations — that your bone density is above or below the average.
T1A, T1B, T1C, T2A, T2B, T2C, T3A, T3B, T3C, T4
see TNM stages
TARGETED CRYOABLATION of PROSTATE (TCAP) CANCER
Treatment of prostate cancer by freezing the tumor in order to kill it; see cryosurgery
TESTIS
Two male reproductive glands located inside the scrotum that are the primary sources of the male hormone testosterone
TESTICLE
Refers to one of two male reproductive glands;see testis
TESTOSTERONE (T)
The male hormone or androgen which comprises most of the androgens in a man’s body; chiefly produced by the testicles; may be produced in tissues from precursors such as androstenedione; T is essential to complete male sexual function and fertility
TETRAPLOID
having four times the amount of DNA or chromosomal material
THERAPY
The treatment of disease or disability
THERMOLUMINESCENT DOSIMETER
A device that registers the radiation dose (energy per unit mass) indicated by changes in color induced by temperature change. A device that directly measures absorbed dose
TOMOTHERAPY
Rotational radiotherapy delivery using an intensity-modulated fan beam. Intensity-modulated delivery is achieved by moving multiple collimator vanes into and out of the fan beam. The length of time that a leaf spends out of the beam is proportional to the intensity of radiation allowed through that particular portion of the beam
TRANSFORMING GROWTH FACTOR BETA (TGF-β)
A bone-derived growth factor that stimulates the prostate cancer cell and osteoblast, among many other functions
TRANSITION
Change; for example, the transition zone of the prostate is the area of the prostate closest to the urethra and has features that distinguish it from the much larger peripheral zone
TRANSPERINEAL
Through the perineum
TRANSRECTAL
Through the rectum
TRANSRECTAL ULTRASOUND (TRUS)
A method that uses echoes of ultrasound waves (far beyond the hearing range) to image the prostate by inserting an ultrasound probe into the rectum; commonly used to visualize and guide prostate biopsy procedures
TRANSURETHRAL
Through the urethra
TRANSURETHRAL RESECTION OF THE PROSTATE (TURP)
A surgical procedure to remove tissue obstructing the urethra; the technique involves the insertion of an instrument called a resectoscope into the penile urethra, and is intended to relieve obstruction of urine flow due to enlargement of the prostate
TREATMENT
administration of remediesto a patient for a disease; medical care given to treat a disease or illness
TUMOR
An excessive growth of cells caused by uncontrolled and disorderly cell replacement; an abnormal tissue growth that can be either benign or malignant; see benign, malignant
TUMOR, NODES, METASTASES (TNM) STAGING
see staging
TUMOR NECROSIS FACTOR ALPHA (TNFα)
A cell signaling protein responsible for regulation of immune cells
U
ULTRASOUND (US)
Sound waves at a particular frequency (far beyond the hearing range) whose echoes bouncing off tissue can be used to image internal organs (e.g., a baby in the womb)
UNDETECTABLE PSA (UDPSA)
defined in our research as a PSA of <0.05 using a hypersensitive assay such as DPC Immulite 3rd generation PSA or Tosoh assay
UNDERSTAGING
The assignment of an overly low clinical stage at initial diagnosis because of the difficulty of assessing the available information with accuracy (e.g., stage T2b as opposed to stage T3b)
UNIT
A blood-banking term for a pint of blood or plasma, but can be used to quantitate other blood products such as platelets
UREA
Made in the liver, when protein is broken down in your body; is passed out of the body through the urine
URETER
An anatomical tube that drains urine from one of the two kidneys to the bladder
URETHRA
The tube that drains urine from the bladder through the prostate and out through the penis
URINARY TRACT INFECTION (UTI)
An infection identifiable by the presence of bacteria (or theoretically, viruses) in the urine; may be associated with fever or a burning sensation on urination
URINARY SYSTEM
The group of organs and their interconnections that permits excess, filtered fluids to exit the body, including (in the male) the kidneys, the ureters, the bladder, the urethra and the penis
UROKINASE-LIKE PLASMINOGEN ACTIVATOR (uPA)
A protease or digestive enzyme that is made by the prostate cancer cell, stimulates prostate cancer cell and osteoblast growth, and is involved with invasion and metastasis
UROLOGIST
A doctor trained first as a surgeon, who specializes in disorders of the genitourinary system
V
VAS DEFERENS
Tube through which sperm travel from the testes to the prostate prior to ejaculation
VASECTOMY
Operation to make a man sterile by cutting the vas deferens, thus preventing passage of sperm from the testes to the prostate
VASCULAR ENDOTHELIAL GROWTH FACTOR (VEGF)
A substance known to stimulate blood vessel growth or angiogenesis and hence stimulate tumor growth
VESICLEA
A small sac containing a biologically important fluid
W
WATCHFUL WAITING
Active observation and regular monitoring of a patient without actual treatment
WHITMORE-JEWETT STAGING
see staging
X
X-RAY
A type of high energy radiation that can be used at low levels to make images of the internal structures of the body, and used at high levels for radiation therapy
Z
ZOLADEX®
Trade or brand name for goserelin acetate, an LHRH agonist or LHRH-A; drug used to suppress production of sex hormones
ZONE
Part or area of an organ
Zytiga
Also known by its generic name, abiraterone, Zytiga was the first second-generation hormonal agent developed for men whose cancer had become resistant to Lupron or other first-generation hormonal agents. Zytiga is approved for all men with metastatic disease, regardless of whether the cancer is resistant to first-generation disease.