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Glossary
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Adenocarcinoma
A cancer originating in glandular tissue. Prostate
cancer is most commonly classified as adenocarcinoma
of the prostate.
Adjuvant
An additional treatment which follows the definitive
(curative) treatment which is used to increase the
effectiveness of the primary therapy. For example,
radiation therapy and hormonal therapy are often
used as adjuvant treatments following a radical prostatectomy.
Algorithm
A step-by-step procedure for solving a problem or accomplishing
some end, especially by a computer.
Analog
A synthetic version of a drug or one of the body’s
chemicals.
Androgen deprivation therapy (ADT)
A therapy designed to inhibit the body’s production
of androgens.
Androgen-dependent cells
Prostate cancer cells which are nourished by male hormones
and therefore are capable of being destroyed by hormone
deprivation (also known as androgen-sensitive cells).
Androgen-independent cells
Prostate cancer cells which are not dependent on male
hormones and therefore do not respond to hormonal
therapy (also known as androgen-insensitive cells).
Angiogenesis
The body’s formation of new blood vessels. Some anti-cancer
drugs work by blocking angiogenesis, thus preventing
blood from reaching and nourishing a tumor.
Androgens
The male hormones, such as testosterone.
Anesthetic
A drug that produces general or local loss of physical
sensations, particularly pain. For example, a “spinal”
is the injection of a local anesthetic into the area
surrounding the spinal column.
Antioxidants
Any substances which delay the process of oxidation.
Anti-androgens
Drugs such as flutamide, that can block or neutralize
the effects of testosterone and DHT on prostate cancer
cells (by preventing testosterone and DHT from binding
to the androgen receptor).
Antibody
A protein produced by the body that counteracts the
toxic affects of a foreign substance, organism, or
disease within the body.
Apoptosis
The normal molecular mechanism which governs the life
span of cells so that they die in a very organized
way. Cancerous cells are resistant to normal apoptosis.
Avodart
A medication prescribed to alleviate the symptoms of
BPH (benign prostatic hyperplasia), but which also
has anti-neoplastic activity.
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Benign
A non-cancerous condition. See Benign Prostatic Hypertrophy.
Benign prostatic hypertrophy (BPH)
or benign prostatic hyperplasia
A non-cancerous condition of the prostate that results
in a growth of tumorous tissue and increase in the
size of the prostate gland.
Biopsy
A procedure involving the removal of tissue from the
body of a patient. Removed tissue is typically examined
microscopically by a pathologist in order to make
a precise diagnosis of the patient’s condition.
Bone scan
Diagnostic image of the skeleton, used for detecting
the spread of cancer.
BPH
See benign prostatic hypertrophy.
Brachytherapy (see implantation)
A form of radiation therapy in which radioactive seeds
are implanted into the prostate to deliver radiation
directly to the tumor.
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Cancer
A cellular malignancy typically forming tumors. Unlike
benign tumors, these tend to invade surrounding tissues
and spread to distant sites of the body.
Carcinoma
A malignant tumor made up chiefly of epithelial cells,
or those that form the lining of an organ or cavity.
See adenocarcinoma.
Castrate Range
The level of the body’s testosterone after orchiectomy
(removal of both testicles). This is the range or
level, which is used by physicians as a point of
comparison for those drugs, which attempt to decrease
the testosterone level.
CAT Scan
See computed tomography.
cGy
Abbreviation for centigray; a unit of radiation equivalent
to the older unit called a “rad.”
Chemotherapy
The treatment of cancer using chemicals that deter
the growth of cancer cells.
Combination Therapy
A form of hormonal therapy that surgically or chemically
blocks the production of testosterone by the testes,
and involves the additional use of an antiandrogen
to block the receptor sites from utilizing testosterone
produced by the adrenal glands.
Computerized Tomography
Computer generated cross-sectional images of a portion
of the body. Also called CT or CAT scan.
Conformal Radiation
A treatment utilizing external radiation and conforming
precisely to the size and shape of the prostate,
with the use of computerized planning and state-of-the-art
imaging techniques.
Cryosurgery
The freezing of tissue with the use of liquid nitrogen
probes. When used to treat prostate cancer, the cryoprobes
are guided by transrectal ultrasound.
CT scan
See computed tomography
Cytokine
Any of a class of immunoregulatory substances that
are secreted by cells of the immune system.
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DHT (dihydrotestosterone)
The active form of the male hormone, testosterone,
produced after testosterone is transformed by an
enzyme known as 5-alpha reductase.
Diagnosis
Evaluation of a patient’s symptoms and/or test results,
with the intent of identifying and verifying the
existence of any underlying disease or abnormal condition.
Digital rectal examination (DRE)
A procedure in which the physician inserts a gloved,
lubricated finger into the rectum to examine the
prostate gland for signs of cancer.
Doppler Ultrasound Technique
A machine that sends out ultrasonic waves that pick
up the velocity of blood flow through the veins and
are transmitted as sound to make an image.
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Endocrine
A term referring to the ductless glands, such as the
pituitary and the testes, which make an internal
secretion or hormone which passes into the bloodstream
and has an important influence on metabolic processes.
Ejaculatory Ducts
The tubular passages through which semen reaches the
prostatic urethra during orgasm.
Epidural Anesthesia
A painkilling method involving the injection of an
anesthetic into the base of the spine, temporarily
deadening the nerves running to the lower half of
the body.
Erectile Dysfunction
Also known as “E.D.,” the loss of the ability to produce
and/or sustain an erection (while desire for sex
remains unchanged).
Estrogen
Female hormones that block the luteinizing hormone
(LH) and can inhibit testosterone production to the
castrate range.
Extracapsular Extension
Used to describe prostate cancer, which has spread
into the tissue outside the prostate capsule.
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Flutamide
The generic name of Eulexin, an anti-androgen used
in hormonal therapy.
Foley Catheter
A catheter inserted in the penis and threaded through
the urethra to the bladder where it is held in place
with a tiny, inflated balloon. It removes urine from
the bladder and can be used to irrigate the urethra
and prevent blood clots.
Frozen Section
A technique in which removed tissue is frozen, cut
into very 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.
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Gene Therapy
The insertion of normal or genetically altered genes
into cells, usually to replace defective cells.
Gland
An aggregation of cells that secretes a substance for
use in or discharge from the body.
Gleason Score
A widely used method for classifying the cellular differentiation
of cancerous tissue. The less the cancerous cells
appear like normal cells, the more malignant the
cancer. Two grades of 1-5, identifying the two most
common degrees of differentiation present in the
examined tissue sample, are added together to produce
the Gleason score.
Globulin
Any of a number of simple proteins that occur widely
in plant and animal tissues.
Gray (Gy)
Unit of absorbed radiation dose.
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Half-Life
The time it takes for a radioactive isotope to deliver
half of its original energy.
Holistic Medicine
Medical care, which considers the patient as a whole,
including his physical, mental, emotional, spiritual,
social and economic needs.
Hormonal Therapy
Treatment that attempts to shut down the production
of hormones that nourish prostate cancer cells (also
known as hormone therapy, hormone ablation therapy,
hormone deprivation therapy, anti-androgen therapy
and anti-hormonal therapy). 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
A side effect of some forms of hormonal therapy, experienced
as a sudden rush of warmth to the face, neck, and
upper body.
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Implantation
The procedure by which radioactive seeds are inserted
into the prostate gland. See also brachytherapy.
Impotence
See Erectile Dysfunction
Incontinence
A 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 failure of ability to voluntarily exercise
control over the sphincters of the bladder neck and
urethra, resulting in total loss of retentive ability.
Inflammation
Redness or swelling caused by injury or infection.
Investigational
Describes a drug or procedure allowed by the FDA (Food
and Drug Administration) for use in clinical trials.
Insurance companies tend to deny coverage to procedures,
which are described as investigational.
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LH (luteinizing hormone)
A chemical signal originating in the pituitary gland
that causes the testes to make testosterone.
LHRH (luteinizing hormone releasing hormone)
A chemical signal originating in the hypothalamus that
causes the pituitary to make LH.
LHRH Analogs (LHRH Agonists)
Synthetic versions of the body’s chemical LHRH that
can inhibit pituitary production of the hormone LH.
Two LHRH analogs available in the U.S. are commercially
named Lupron and Zoladex.
Localized Prostate Cancer
Cancer that is confined to the prostate gland, and
therefore considered curable.
Lupron
See LHRH analogs
Lymph Node
A small bean-shaped mass of tissue along the vessels
of the lymphatic system. The lymph nodes filter out
bacteria and other toxins, as well as cancer cells.
Lymphadendectomy
The surgical removal and examination of lymph nodes
to precisely diagnose and stage cancer.
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Magnetic Resonance Imaging (MRI)
A painless, non-invasive technique using strong magnetic
fields to produce detailed images of internal body
structures. An MRI scan usually takes about 45 minutes.
Malignant
Having the invasive and metastatic properties of cancer.
Tending to become progressively worse.
Metalloprotease Inhibitors
Drugs used to suppress the body’s production of certain
enzymes.
Metastasis
The spread of cancer, by way of the blood stream or
lymphatic system, beyond the boundaries of the organ
or structure where the cancer originated. (Metastases
is plural.)
Metastatic Work-up
A group of tests including bone scans, x-rays and blood
tests, to ascertain whether cancer has spread throughout
the body, or metastasized.
Morbidity
Unhealthy consequences and complications resulting
from treatment.
MRI
See Magnetic Resonance Imaging.
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Nadir
The lowest point. Doctors sometimes use this as a verb
to describe return of cancer or treatment failure.
Neurovascular Bundles
Strands of interwoven nerves and veins that run down
the side of the prostate. The bundles contain microscopic
nerves that are essential for erection; they also
contain arteries and veins. Cutting the nerves in
the bundles during surgery, or otherwise harming
them in another procedure, usually renders the patient
impotent.
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Oncology
The branch of medical science dealing with tumors.
An oncologist is a specialist in the study of cancerous
tumors.
Orchiectomy
A surgical form of hormonal therapy that involves the
removal of all or part of the testes, thus shutting
down the production of testicular testosterone (also
known as surgical castration).
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Palladium 103 (Pd-103)
A radioactive isotope used in brachytherapy.
Palpatory
Capable of being examined by touch or manipulation.
PAP
See Prostatic Acid Phosphate
Pathologist
A doctor who specializes in the examination of cells
and tissues removed from the body.
Perineural Invasion
Describing cancer, which has spread from the prostate
to the nerve bundles.
Perineum
The area of the body between the anus and the scrotum.
A perineal procedure uses this area as the point
of entry into the body.
Placebo
A sugar pill often taken by participants in a medical
study. Patients taking a placebo are compared to
patients taking actual medications.
PIN
See Prostatic Intraepithelial Neoplasia.
Proctitis
Inflammation of the rectum.
Prognosis
The forecast of the course of a disease, and future
prospects of the patient.
Progression
A change in the status of the cancer indicating the
condition has progressed and worsened.
Pro-oxidant
Used to describe substances, which aid oxidation.
Proscar
A medication prescribed to alleviate the symptoms of
BPH (benign prostatic hyperplasia) but which also
has anti-neoplastic activity as well as preventative
effects.
Prostascint? Scan
A new method to determine whether or not cancer has
spread to distant sites by using monoclonal antibodies.
This is especially helpful with patients who have
been on hormonal therapy.
Prostate
A gland which surrounds the neck of the bladder and
the urethra in the male. The prostate secretes a
thin, opalescent, slightly alkaline fluid which forms
part of the semen.
Prostate Capsule
The outer membranous covering of the prostate gland.
Prostate Specific Antigen (PSA)
A blood test that measures a substance manufactured
solely by prostate gland cells. An elevated reading
indicates an abnormal condition of the prostate gland,
either benign or malignant. It is presently the most
sensitive tumor marker for the identification and
monitoring of prostate cancer.
Prostatic Acid Phosphatase (PAP)
An enzyme produced by the prostate that is elevated
in many patients when prostate cancer has spread
beyond the prostate. The PAP blood test has largely
been replaced by the PSA test.
Prostatic Intraepithelial Neoplasia (PIN)
A proliferative lesion composed of prostatic epithelial
cells that are dividing more rapidly than normal
epithelium. Although the cells have not yet become
cancerous, PIN is believed to be the most likely
precursor of prostate cancer. For example, up to
80% of patients who are identified to have PIN from
a biopsy progress to cancer.
PSA
See prostate specific antigen.
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Radiation Therapy
Use of high energy rays to kill cancer cells.
Radical Prostatectomy
An operation to remove the entire prostate gland and
seminal vesicles.
Radioactive
Capable of emitting radiant energy.
Recurrence
Return of the cancer following remission or treatment
intended as curative. Local recurrence indicates
a return of the cancer at the site of origin. Distant
recurrence indicates the appearance of one or more
metastases of the disease.
Refractory
No longer responsive to a certain therapy.
Resection
The surgical removal of a part of an organ or structure.
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“Salvage” Treatment
A medical tern for “Plan B.” It means a patient must
undergo another form of treatment because the first
therapy was not successful. Salvage therapy does
not always work and often has a greater degree of
complications.
Saw Palmetto
A nutrient extracted from the saw palmetto shrub, which
is considered by some to aid the body’s immune system.
Seeds
Radioactive, pencil-lead sized pellets used in brachytherapy.
For example, Palladium-103 + Iodine-I25 are commonly
used for the treatment of prostate cancer.
Selenium
A no-metallic element thought to be beneficial as a
nutrient; it is often included in multivitamin supplements.
Seminal Vesicles
Glands that, like the prostate, support male reproduction.
Fluid secreted by these glands regulates the consistency
of semen.
Simulation
The process of designing the radiation beam (or beamlets
with IMRT) configuration, simulating the actual treatments.
The optimal design of the beams (beamlets) is arrived
at jointly by the radiation oncologist and a medical
physicist.
Sphincter
A circular muscle which contracts to close an orifice.
The urethral sphincter squeezes the urethra shut,
providing urinary control.
Staging
The testing process by which the extent and severity
of a known cancer is evaluated according to an established
system of classification. It is used to help determine
appropriate therapy.
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Template
The needle guide template used during brachytherapy
to guide the brachytherapy needles into the prostate.
Radioactive seeds are then inserted through the hollow
needles.
Testosterone
The male hormone, or androgen, that is responsible
for sex drive and fertility. It also nourishes androgen-dependent
prostate cancer cells.
Total Androgen Blockage
A combined form of hormonal therapy that tries to achieve
a complete shutdown of the body’s testosterone production.
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 in the penile
urethra, and is intended to relieve obstruction of
urine flow due to enlargement of the prostate.
Tumor
An excessive growth of cells caused by uncontrolled
and disorderly cell replacement.
TURP
See Transurethral Resection of the Prostate
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Ultrasound
A painless, non-invasive diagnostic imaging technique
using sound waves to create an echo pattern that
reveals the structure of organs and tissues. It does
not use x-rays.
Urethra
The tube that carries urine from the bladder and semen
from the prostate out of the body through the penis.
Urologist
A physician who specializes in the diagnosis and in
the medical and surgical treatment of problems in
the urinary and male reproductive systems.
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Zoladex
See LHRH analogs
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