PPML Glossary (N through Z) continued:
NADIR: the lowest point reached, e.g., in a series of PSA
values.
NECROSIS: destruction of cells through non-genetic
mechanisms; cells ordinarily die by genetic mechanisms;
see APOPTOSIS
NEGATIVE: the term used to describe a test result which does
not show the presence of the substance or material for
which the test was carried out; e.g., a negative
bone scan would show no sign of bone metastases
NEOADJUVANT: added before; e.g., neoadjuvant hormone
therapy is hormone therapy given prior to another form
of treatment such as a radical prostatectomy
NEOPLASIA: the growth of cells under conditions that would
tend to prevent the development of normal tissue (e.g.,
a cancer)
NERVE SPARING: term used to describe a type of prostatectomy
in which the surgeon saves the nerves that affect
sexual and related functions
NILUTAMIDE: an antiandrogen, still experimental in the USA,
but available in Canada and some other countries
NOCTURIA: the need to urinate frequently at night
NONINVASIVE: not requiring any incision or the insertion of
an instrument or substance into the body
NSE: neuron-specific enolase; a neuroendocrine marker
(see CGA)
ONCOLOGIST: a physician who specializes in the treatment of
various types of cancer
ONCOLOGY: the branch of medical science dealing with
tumors
ORCHIECTOMY: the surgical removal of the testicles
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)
OSTEOBLAST: cell that forms bone
OSTEOCLAST: cell that breaks down bone-cell grows in bone
tissue and apparently absorbs bone tissue, Pac-man
fashion
OSTEOLYSIS: destruction of bone
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
PALLIATIVE: designed to relieve a particular problem without
necessarily solving it; e.g., palliative therapy
is given in order to relieve symptoms and improve
quality of life, but does not cure the patient
PALPABLE: capable of being felt during a physical
examination by an experienced physician; in the case of
prostate cancer, this refers to some form of abnormality
of the prostate which can be felt during a DRE
PAP: PROSTATIC ACID PHOSPHATASE; an enzyme measured to help
decide whether prostate cancer has escaped from the
prostate
PARTIN TABLES: Tables that use PSA, Gleason's Score and
Clinical Stage to predict the likelihood of organ-
confinement, and capsule, seminal vesicle & lymph node
PCa involvement
PARTIN II TABLES: tables that use PSA velocity after RP to
distinguish local recurrence from distant metastases;
Alan Partin et al., Urology 43:649-659 (1994)
PATHOLOGIST: a physician who specializes in the examination
of tissues and blood samples to help decide what
diseases are present and therefore how they should be
treated
PC DIGEST: a summary of a patient's clinical information
that focuses on those medical issues that are
important to evaluation and treatment decisions; often
placed on messages after the signature line to remind
the reader; example:
Dx: 2/95, age 54, BPSA 8, G 6, CS T2a, PP=62-38-<1-1;
PAP 1.3(nl to 2.5), bone scan nl, Rx: CHB2 C+L 3/9; PSA
2/96 0.4, 4/96 0.35, non-detectable 6/95
PDQ: physicians data query; a NCI supported database
available to physicians, containing current information
on standard treatments and ongoing clinical trials
PENILE: of the penis
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
PIN: 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
PLACEBO: a form of safe but non-active treatment used as a
basis for comparison with medications in research studies
PLOIDY: a term used to describe the number of sets of
chromosomes in a cell; see also diploid and aneuploid
POSITIVE: the term used to describe a test result that
shows the presence of the substance or material for
which the test was carried out; e.g., a positive
bone scan would show signs of bone metastases
POSTERIOR: the rear; e.g., the posterior of the
prostate is the part of the prostate that faces a man's
back
PROGNOSIS: the patient's potential clinical outlook based on
the status and probable course of his disease; chance
of recovery
PROGRESSION: continuing growth or regrowth of the cancer
PROLACTIN: (PRL) a trophic hormone produced by the
pituitary that increases androgen receptors,
increases sensitivity to androgens, & regulates
production & secretion of citrate
PROSCAR: brand name of finasteride
PROSTASCINT SCAN: a monoclonal antibody with great affinity
for prostatic tissue (in particular malignant tumors)
is combined with a radioactive material (Indium 111)
and is injected intravenously and allowed to "settle"
for 3 days; the radiolabelled antibody preferentially
attaches itself to existing lesions, and when the body
is scanned these lesions are detected by the
radioactive emissions; not FDA approved yet, but has a
great potential to help determine how far a tumor has
spread
PROSTATE: the gland surrounding the urethra and immediately
below the bladder in males
PROSTATECTOMY: surgical removal of part or all of the
prostate gland
PROSTATE-SPECIFIC ANTIGEN: see PSA
PROSTATIC ACID PHOSPHATASE: see PAP
PROSTATITIS: infection or inflammation of the prostate gland
treatable by medication and/or manipulation; (BPH is a
more permanent laying down of fibroblasts and
connective tissue caused when the prostate tries to
contain a relatively silent chronic lower-grade
infection, often requiring a TURP to relieve the
symptoms)
PROSTHESIS: a man-made 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
PSA: PROSTATE-SPECIFIC ANTIGEN; 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 to follow the progress of Pca
therapy (see SCREENING)
PSA DOUBLING TIME (PSADT): the time it takes the PSA to
double in value; see method of finding PSADT in my
posting of 5/9/96 with Subject: PSA Doubling Time:
Table and Equation
PSA-II: prostate-specific antigen type II assay; reports the
percentage of free-PSA to total-PSA (total-PSA = free-
PSA + bound-PSA); helpful for screening purposes when
PSA values are above the normal threshold for an age
group and less than 10; one study showed that men with
PSA II > 25% had no PCa; those with < 10% were likely
to have PCa; not yet FDA approved (4/96), but
available
PSA RT-PCR: PSA reverse transcriptase-polymerase chain
reaction; 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
PCa; not FDA approved (4/96), but available at
locations where FDA approved clinical trials of the
test are being done; (see RT-PCR)
PSA VELOCITY (PSAV): the rate at which PSA values increase
assuming that the rate does not change;
PSM: prostate specific membrane; a membrane that surrounds
the protoplasm (cytoplasm) of prostate cells
PSM RT-PCR: an RT-PCR assay that tests for a PSM
glycoprotein derived from the cell membrane of the
human prostatic cancer cell line LNCaP; may give high
results for hormone-refractory disease; able to detect
one prostate cancer cell in one million blood cells
PSMA: prostate specific membrane antigen
QUALITY OF LIFE: an evaluation of health status relative to
the patient's age, expectations, and physical and
mental capabilities
RADIATION ONCOLOGIST: a physician who has received special
training regarding the treatment of cancers with
different types of radiation
RADIATION THERAPY (RT): the use of x-rays and other forms
of radiation to destroy malignant cells and tissue
RADICAL: (in a surgical sense) directed at the cause of a
disease; thus, radical prostatectomy is the surgical
removal of the prostate with the intent to cure the
problem believed to be caused by or within the prostate
RADICAL PROSTATECTOMY (RP): see RADICAL
RADIO SENSITIVITY: the degree to which a type of cancer
responds to radiation therapy
RADIOTHERAPY: see RADIATION THERAPY
RANDOMIZED: the process of assigning patients to different
forms of treatment in a research study in a random
manner
RECURRENCE: the reappearance of disease
REFRACTORY: resistant to therapy; e.g., hormone refractory
prostate cancer is resistant to forms of treatment
based on the use of hormones; see mutation.
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; 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: ability to fight off a disease as a result of
the effectiveness of the patient's immune system
RESPONSE: a decrease in disease that occurs because of
treatment
RETENTION: difficulty in initiation of urination or
inability to completely empty the bladder
RETROPUBIC PROSTATECTOMY: surgical removal of the prostate
through an incision in the abdomen
RISK: the chance or probability that a particular event will
or will not happen
RP: see RADICAL PROSTATECTOMY
RTPCR: see RT-PCR
RT-PCR: reverse transcriptase polymerase chain reaction; 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; because today's
reproducibility is poor, the test results are reported
in vague terms like "positive" or "negative" rather
than as numbers; see PSA RT-PCR
SCREENING: to separate patients with tumors from those
without tumors; multiple criteria are often used; the
following PSA screening "cutoff" levels for PCa are
replacing the older 4.0 value:
Age PSA "cutoff"
40-49 2.5 ng/ml
50-59 3.5
60-69 4.5
70-79 6.5
J.E. Oesterling, Cancer Supplement, Apr. 1, 1995,
75:1795-1804
SECONDARY TO: derived from or consequent to a primary event
or thing
SELENIUM: a relatively rare nonmetallic element found in
food in small quantities which may have some effect in
prevention of cancer
SEMINAL VESICLES (SV): glands at the base of the bladder and
connected to the prostate that provide nutrients for
the semen
SENSITIVITY: the probability that a diagnostic test can
correctly identify the presence of a disease;
specifically, the number of true positive results divided
by the sum of the true positive results and the false
negative results; see SPECIFICITY
SEXTANT: having six parts; a sextant biopsy 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;
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 Pca
cases is highly sensitive, but if it also falsely
indicates that 40% of those who do not have PCa do have
PCa then its specificity is 60%, rather poor
STAGE: a term used to define the size and physical extent of
a cancer
STAGING: the process of assigning a stage to a particular
cancer in a specific patient in light of all the
available information; it is used to help determine
appropriate therapy; there are two staging methods:
Whitmore-Jewett (1956) and the more detailed TNM
(tumor, nodes, metastases; 1992, American Joint
Committee on Cancer and the International Union Against
Cancer.)
Stage A (Whitmore-Jewett) becomes T1 (TNM)
Stage B becomes T2
Stage C becomes T3
A more detailed cross reference for TNM and Jewett-
Whitmore is in Jerry Bostick's posting of 6/11/96 10:27
am with Subject:"Re:2 Questions:CS+Prostasure"
Whitmore-Jewett stages:
Stage A is clinically undetectable tumor confined to
the gland and is an incidental finding at
prostate surgery.
A1: well-differentiated with focal involvement
A2: moderately or poorly differentiated or involves
multiple foci in the gland
Stage B is tumor confined to the prostate gland.
BO: nonpalpable, PSA-detected
B1: single nodule in one lobe of the prostate
B2: more extensive involvement of one lobe or
involvement of both lobes
Stage C is a tumor clinically localized to the
periprostatic area but extending through the
prostatic capsule; seminal vesicles may be
involved.
C1: clinical extracapsular extension
C2: extracapsular tumor producing bladder outlet
or ureteral obstruction
Stage D is metastatic disease.
DO: clinically localized disease (prostate only)
but persistently elevated enzymatic serum acid
phosphatase
Dl: regional lymph nodes only
D2: distant lymph nodes, metastases to bone or
visceral organs
D3: D2 prostate cancer patients who relapse after
adequate endocrine therapy
TNM stages:
Primary Tumor (T)
TX: Primary tumor cannot be assessed
T0: No evidence of primary tumor
T1: Clinically inapparent tumor not palpable or
visible by imaging
Tla: Tumor incidental histologic finding in 5% or
less or tissue resected
Tlb: Tumor incidental histologic finding in more
than 5% of tissue resected
T1c: Tumor identified by needle biopsy (e.g.,
because of elevated PSA)
T2: Tumor confined within the prostate
T2a: Tumor involves half of a lobe or less
T2b: Tumor involves more than half a lobe, but not
both lobes
T2c: Tumor involves both lobes; extends through the
prostatic capsule
T3a: Unilateral extracapsular extension
T3b: Bilateral extracapsular extension
T3c: Tumor invades the seminal vesicle(s)
T4: Tumor is fixed or invades adjacent structures
other than the seminal vesicles
T4a: Tumor invades any of bladder neck, external
sphincter, or rectum
T4b: Tumor invades levator muscles and/or is fixed
to the pelvic wall
Regional Lymph Nodes (N)
NX: Regional lymph nodes cannot be assessed
N0: No regional lymph nodes metastasis
N1: Metastasis in a single lymph node, 2 cm or less
in greatest dimension
N2: Metastasis in a single lymph node, more than
2 cm but not more than 5 cm in greatest
dimension; or multiple lymph node metastases,
none more than 5 cm in greatest dimension
N3: Metastasis in a lymph node more than 5 cm in
greatest dimension
Distant Metastases (M)
MX: Presence of distant metastasis cannot be
assessed
M0: No distant metastasis
M1: Distant metastasis
Mla: Nonregional lymph node(s)
Mlb: Bone(s)
M1c: Other site(s)
STENT: a tube used by a surgeon to drain fluids
STRICTURE: scarring as a result of a procedure or an injury
that constricts the flow of a fluid; e.g., a
urethral stricture restricts the flow of urine
STRONTIUM-89: an injectable radioactive product which is
used to relieve bone pain in some patients with
prostate cancer which no longer responds to hormones or
appropriate forms of chemotherapy
SUBCAPSULAR: under the capsule; e.g., 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
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
noticeable by the patient
SYSTEMIC: throughout the whole body
TESTIS: one of two male reproductive glands located inside
the scrotum which are the primary sources of the male
hormone testosterone
TESTICLE: 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
THERAPY: the treatment of disease or disability
TNM (tumor, nodes, metastases) see STAGING
TRANSITION: change; e.g., the transition zone of the
prostate is the area of the prostate closest to the
urethra and has features which distinguish it from the
much larger peripheral zone
TRANSPERINEAL: through the perineum
TRANSRECTAL: through the rectum
TRANSURETHRAL: through the urethra
TREATMENT: administration of remedies to a patient for
a disease
TRUS: TRANSRECTAL ULTRASOUND; 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 prostate
biopsy procedures
TRUS-P: see TRUS
TUMOR: 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
TURP: TRANSURETHRAL RESECTION OF THE PROSTATE; 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
TUR/P: see TURP
ULTRASOUND: sound waves at a particular frequency (far
beyond the hearing range) whose echoes bouncing off
tissue can be used to image internal organs
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 surgical term for a pint (usually of blood)
URETHRA: the tube that drains urine from the bladder through
the prostate and out through the penis
URGENCY: the need to urinate very soon
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
UROLOGIST: a doctor trained first as a surgeon who
specializes in disorders of the genitourinary system
UTI: URINARY TRACT INFECTION; 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
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
VESICLE: a small sac containing a biologically important
fluid
WATCHFUL WAITING: active observation and regular monitoring
of a patient without actual treatment
WHITMORE-JEWETT STAGING: see STAGING
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 at high levels for radiation therapy
ZOLADEX: trade or brand name for goserelin acetate, a LHRH
agonist
ZONE: part or area of an organ
Acknowledgments
Many entries were taken with the generous permission of the
following resources:
Prostate Cancer InfoLink Dictionary, by Mike Scott at
comed.com ;
the Prostate Cancer Library, by Ron Koster: Glossary of PC
Related Medical Terms, and Diagnostic and Staging Tests
originated on the Prostate Cancer Bulletin Board on Prodigy;
and Steve Strum, M.D.
Ed Piepmeier, June 1996
piepmeie@ccmail.orst.edu |
