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Urologic Oncology Glossary of Terms

Active surveillance: Instead of active treatment for prostate cancer, the doctor may suggest close monitoring. This may be a reasonable choice for older men with small tumors that might grow very slowly. If the situation changes, active treatment can be started. Also called expectant management, watchful waiting, expectancy or observation.

Adjuvant therapy: Treatment used in addition to the main treatment. It usually refers to hormone therapy, chemotherapy, or radiation added after surgery to increase the chances of curing the disease or keeping it in check.

Alkaline phosphatase: An enzyme made by cells in the bones and liver. Levels of alkaline phosphatase in the blood often go up in men whose prostate cancer has spread to the bones or liver.

Androgen: Any male sex hormone. The major androgen is testosterone.

Androgen deprivation: The use of drugs to disrupt the actions of male hormones. See also hormone therapy.

Androgen-independent cancers: Prostate cancers that do not respond to hormone therapy. Often prostate cancers respond to hormone therapy for a few years before becoming androgen independent. Less often, prostate cancers may be androgen independent at the time they are diagnosed. Prostate cancer that starts off being androgen independent may be a different kind of prostate cancer called small cell or neuroendocrine.

Antiandrogens: Drugs that block the body's ability to use androgens. Several drugs of this type are currently available: flutamide (Eulexin), bicalutamide (Casodex), and nilutamide (Nilandron), which are taken as pills, once or three times a day. Antiandrogens are usually used combination with orchiectomy or LHRH analogs.

Benign prostatic hyperplasia (BPH): Noncancerous enlargement of the prostate that may cause problems with urination such as trouble starting and stopping the flow.

Bicalutamide: An anticancer drug that belongs to the family of drugs called anti-androgens.

Biopsy: The removal of a sample of tissue to see whether cancer cells are present.

Bone scan: A specialized nuclear medicine study that allows one to detect changes in the bone that may be related to metastatic prostate cancer.

Brachytherapy: Internal radiation treatment given by placing radioactive material directly into the tumor or close to it. Also called interstitial radiation therapy or seed implantation.

Castration: Surgery to remove the testicles; the medical term is orchiectomy.

Catheter (urinary): A thin, flexible tube through which fluids enter or leave the body; for example, a tube to drain urine.

Chemotherapy: Treatment with drugs to destroy cancer cells.

Clinical stage: Describes the extent of cancer present based on results of diagnostic tests and the physical examination.

Clinical trials: Studies of promising new or experimental treatments in patients. Clinical trials are only done when there is some reason to believe that the treatment being studied may be valuable to the patient.

Combination hormone therapy: Complete blockage of androgen production that may include orchiectomy (castration) or LHRH analogs, plus the use of antiandrogens; also called combined androgen blockade, total hormonal ablation, total androgen blockade or total androgen ablation.

Cryotherapy: Therapy in which the prostate gland is frozen to destroy the cancer cells.

Digital rectal examination (DRE): An examination in which a doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities in the prostate gland.

Early detection: Finding the disease at an early stage, before it has grown large or spread to other sites. Many forms of cancer can reach an advanced stage without causing symptoms. A PSA blood test can help to find early prostate cancer.

External beam radiation: A form of treatment in which radiation is focused from a source outside the body on the area affected by the cancer. It is much like getting a diagnostic X-ray, but for a longer time.

Finasteride: A drug used to reduce the amount of male hormone (testosterone) produced by the body.

Flutamide: An anticancer drug that belongs to the family of drugs called anti-androgens.

Gleason grade: A method of classifying how cells appear in cancerous tissues, the less the cancerous cells resemble normal cells, the more malignant the cancer. Two numbers, each from 1 to 5, are assigned to the two most predominant types of cells present. These two numbers are added together to produce a Gleason score between 2 and 10. Higher numbers indicate more aggressive cancers.

Hormone refractory: Resistant to hormone therapy.

Hormonal therapy: Treatment to kill cancer cells or slow their growth by removing, blocking or adding hormones. In prostate cancer treatment, hormone therapy is sometimes called androgen deprivation.

Hyperplasia: Too much growth of cells or tissue in a specific area, such as the lining of the prostate; see also benign prostatic hyperplasia (BPH).

Impotence: Inability to have an erection adequate for sexual intercourse. Also called erectile dysfunction.

Incontinence, urinary: The inability to control the flow of urine from the bladder.

Kegel exercises: Exercises that help one strengthen muscles that aid in the control of urinary incontinence.

Luteinizing hormone-releasing hormone (LHRH): Hormone produced by the hypothalamus, a tiny gland in the brain, which indirectly affects testosterone levels.

LHRH analogs: Synthetically made hormones, chemically similar to LHRH. They block the production of the male hormone testosterone. Also called LHRH agonists.

LHRH antagonists: Drugs that block the release of hormones that stimulate testosterone production from the pituitary gland.

Luteinizing hormone: Pituitary hormone that stimulates the testicles too produce testosterone.

Lymph node: A rounded mass of lymphatic tissue found throughout the body. Lymph fluid passes through the lymph nodes, which filter out bacteria, cancer cells and toxic chemicals.

Lymph node dissection: In the case of prostate cancer, pelvic lymph node dissection, which is the surgical removal of the lymph nodes in the pelvis to determine if prostate cancer has spread outside of the prostate gland.

Metastasis: The spread of cancer cells to distant areas of the body by way of the lymph system or bloodstream.

Neuroendocrine prostate cancer: An uncommon cancer that arises from a specialized cell in the prostate gland called neuroendocrine. Some of these cancers are referred to as small cell cancer.

Nomogram: With regard to prostate cancer, these are tables, based on a large group of previous cases, used to predict the likelihood that cancer has spread to the lymph nodes or other organs. It takes into account the clinical stage and Gleason score of a man's cancer, as well as the PSA level.

Orchiectomy: Surgery to remove the testicles; castration.

Pathological stage: Describes the extent of cancer present based on surgical removal and examination of tissue.

Prognosis: A prediction of the course of disease; the outlook for the chances of survival.

Prostate-specific antigen (PSA): A protein made by the prostate gland. Levels of PSA in the blood often go up in men with prostate cancer but may increase because of some non-cancerous conditions as well. The PSA test is used to help find prostate cancer, as well as to monitor the results of treatment.

Prostatitis: Inflammation of the prostate. Prostatitis is not cancer.

Radical prostatectomy: Surgery to remove the entire prostate gland, the seminal vesicles and nearby tissue.

Seminal vesicles: Two small sacs next to the prostate that store semen.

Small cell prostate cancer: An uncommon form of prostate cancer. See also neuroendocrine prostate cancer.

Testicles: The male reproductive glands found in the scrotum. The testes (or testicles) produce sperm and the male hormone testosterone.

Testosterone: The main male hormone, made primarily in the testes. It stimulates blood flow, growth of certain tissues, and the secondary sexual characteristics. In men with prostate cancer, it can also encourage growth of the tumor.

Transurethral resection of the prostate (TURP): This operation removes part of the prostate gland that surrounds the urethra (the tube through which urine exits the bladder). This operation can be used to relieve symptoms caused by a tumor before other treatments begin. But it is not expected to cure this disease or remove all of the cancer. It is used even more often to relieve symptoms of non-cancerous prostate enlargement.

Tumor flare: Temporary growth of a prostate tumor, sometimes seen in men who are treated with an LHRH agonist alone, which is due to the brief rise in testosterone levels after starting therapy. It can cause pain, especially if cancer has already spread to the bones. It is often a few weeks before testosterone levels begin to fall. Taking an antiandrogen for the first few weeks of hormone therapy may prevent tumor flare.

Urologist: A doctor who specializes in treating problems of the urinary tract in men and women, and of the genital area in men. Urologists often perform surgery as well.

Watchful waiting: See active surveillance.