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Caring for mind and body

Glossary of Cancer Terms

Abdominoperineal resection (APR): Surgical removal of the anus, the rectum and the surrounding muscles of the anal canal. Because the muscles of the anal sphincter are removed, a permanent colostomy is required.

Accelerated radiation: Radiation schedule in which the total dose is given over a shorter period of time. (Compare to hyperfractionated radiation.)

Active Surveillance: Active observation and regular monitoring of a patient without actual treatment; also called watchful waiting.

Acupuncture: A Chinese therapy involving the use of thin needles placed in special pressure points on the body.

Adenoma: Glandular tumor. It is a benign (non-cancerous) lesion that is confined to the mucosa. However, adenomas are premalignant lesions and over time can degenerate into an invasive tumor.

Adenocarcinoma: Cancerous tumor arising from glandular cells.

Adjuvant therapy: Treatment that is added to increase the effectiveness of a primary therapy. It usually refers to hormonal therapy, chemotherapy, or radiation therapy added after surgery to kill any remaining cancer cells and increase the chances of curing the disease or keeping it in check.

Adrenal androgen suppression: blockade of residual androgen production by the adrenal glands, using such medications as aminoglutethimide and ketoconazole.

Advance Directive: Legal document that describes your wishes for treatment in the event you cannot communicate your wishes directly.

Advanced prostate cancer: prostate cancer which has extended locally beyond the borders of the prostate gland, or has metastasized to lymph nodes, bones, or other sites.

Adverse reaction: (Adverse Event) An unwanted effect caused by the administration of drugs. Onset may be sudden or develop over time

Advocacy and support groups: Organizations and groups that actively support participants and their families with valuable resources, including self-empowerment and survival tools.

Alopecia: hair loss

Amsterdam criteria: Screening guidelines used to identify families with hereditary nonpolyposis colon cancer (HNPCC)

Anal Canal: The end of the gastrointestinal tract where the rectum is surrounded by the muscles of the anal sphincter.

Anal sphincter: Muscular band that allows us to maintain fecal continence.

Anastomosis: Surgical connection between the ends of the bowel.

Androgen: male sex hormone, including testosterone and DHT, necessary for prostate survival.

Androgen deprivation therapy (ADT): A treatment for advanced prostate cancer based on the reduction of androgen production, or the blockade of androgens’ effects on the prostate gland.

Anemia: Decreased number of red blood cells.

Anesthesia: loss of feeling, sensation, or consciousness resulting from the use of certain drugs or gases. Also used to describe the drug or gas used to cause this.

Anorexia: Loss of appetite leading to severe weight loss.

Anterior Resection: Surgical removal of the lower portion of the sigmoid colon or upper rectum that is performed through an incision in the lower abdomen.

Antiandrogen: A medication which directly blocks the pro-growth effects of androgens on the prostate gland.

Antibody: Molecule in the body’s immune system that identifies foreign substances on bacteria and cancer cells.

Anticoagulant (ant-i-ko-AG-ye-lent): Medication that inhibits blood from clotting.

Anti-emetic (an-tie-eh-MEH-tik): A medicine to prevent or treat nausea or vomiting.

Antiestrogen: A substance that blocks the effects of estrogen on tumors (e.g., the drug tamoxifen).

Antiestrogens are used to treat breast cancers that depend on estrogen for growth.

Antioxidants: A group of vitamins including vitamin C, vitamin E, selenium and carotenoids, (such as beta-carotene, lycopene, and lutein) that can stop the destructive effects of oxidation in the body. They can be found in most fruits and vegetables.

Approved drugs: In the U.S., the Food and Drug Administration (FDA) must approve a substance as a drug before it can be marketed. The approval process involves several steps including pre-clinical laboratory and animal studies, clinical trials for safety and efficacy, filing of a New Drug Application by the manufacturer of the drug, FDA review of the application and FDA approval/rejection of application Aromatase inhibitors - Drugs that block production of estrogens from hormones made by the adrenal gland. They are used to treat hormone sensitive breast cancer in postmenopausal women. Examples are anastrozole, letrozole, and exemestane.

Arm: Any of the treatment groups in a randomized trial. Most randomized trials have two “arms,” but some have three “arms” or even more.

Ashkenazi Jewish: One of two major ancestral groups of Jewish individuals, comprised of those whose ancestors lived in Eastern Europe (Germany, Poland, Russia). The other group is designated Sephardic
Jews and includes those whose ancestors lived in North Africa, the Middle East, and Spain. Most Jews living in the United States are of Ashkenazi descent (also called Eastern European Jews).

Axillary lymph node dissection: A surgical procedure in which the lymph nodes in the armpit (axillary nodes) are removed and examined to find out if breast cancer has spread to those nodes. This procedure is also done to remove any cancerous lymph nodes.

Barium enema: X-ray examination of the colon using contrast material to highlight areas of the colon.

Baseline: 1) Information gathered at the beginning of a study from which variations found in the study are measured. 2) A known value or quantity with which an unknown is compared when measured or assessed. 3) The initial time point in a clinical trial, just before a participant starts to receive the experimental treatment which is being tested. At this reference point, measurable values such as CD4 count are recorded. Safety and efficacy of a drug are often determined by monitoring changes from the baseline values.

Benign prostatic hyperplasia or hypertrophy (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.

Benign tumor: A tumor that is not cancerous. A tumor that lacks the ability to invade or spread.
Glossary

Bias: When a point of view prevents impartial judgment on issues relating to the subject of that point of view. In clinical studies, bias is controlled by blinding and randomization.

Biologic therapy: Treatment that uses the immune system to fight infection and disease. Also called immunotherapy or immune therapy.

Biopsy (Bx): The removal of a sample of tissue that is examined under a microscope to see if cancer cells are present.

Bisphosphonates: Drugs that help strengthen bones weakened by cancer by encouraging the deposition of calcium. Examples are pamidronate and zoledronate.

Blind study: A randomized trial is “Blind” if the participant is not told which arm of the trial he is on. A clinical trial is “Blind” if participants are unaware of whether they are in the experimental or control arm of the study. This is also called masked.

Bolus: Dose of drug given intravenously all at once, rather than by slow infusion.

Brachytherapy: internal radiation treatment achieved by implanting radioactive material (seeds) directly into the tumor or close to it. Also called internal or interstitial radiation therapy.

BRCAl/BRCA2 gene mutation: Genes are the “blueprint” of the cell; they are also units through which inherited characteristics are passed from parent to child. BRCAI and BRCA2 are names of two genes that are believed to be involved in protecting cells from changing into cancer cells. However, changes (mutations) in these genes increase a person’s chance of developing certain types of cancers, such as breast cancer. A test is available to determine if a woman has a BRCAI or BRCA2 gene mutation. Since the majority of women with breast cancer do not have a mutation in the BRCAI or BRCA2 gene, these tests are usually considered only for certain groups of women – for example, women who have a number of close blood relatives with breast cancer, women with breast cancer in both breasts, and women diagnosed with breast cancer at a young age.

Breast conserving treatment or therapy: Surgery to remove a breast cancer and a small amount of normal tissue around the cancer without removing any other part of the breast. This procedure is also called lumpectomy, segmental excision, or limited breast surgery. The surgery may require an axillary dissection and usually requires radiation therapy afterwards.

Breast coil for MRI: When viewing an area of the body using MRI, the best pictures are made when using coils (part of the MRI equipment) that are specifically made (dedicated) to evaluate that particular body part. For example, when a head MRI is performed, the head is surrounded by a head coil. MRI images of the breast can be generated when a general body coil is used, but much better images can be generated when a dedicated breast coil is used.

Breast Reconstruction: Surgery that rebuilds the breast’s contour after mastectomy. A breast implant or the woman’s own tissue provides the contour. If desired, the nipple and areola (the dark circle around the nipple) may also be re-created. Reconstruction can be done at the same time as the mastectomy or any time later.

Bronchoscopy: examination of the bronchi (large tubes branching off the trachea, sometimes called the windpipe) through the use of an instrument called a bronchoscope. This exam is conducted in order to find tumors.

Cachexia: Breakdown of muscle mass resulting from rapid weight loss.

Calorie: A measurement of the energy your body gets from food. Your body needs calories as “fuel” to perform all of its functions, such as breathing, circulating the blood and physical activity. When you are sick, your body needs extra calories to fight. Adequate calories from foods and fluids are required to maintain weight.

Cancer: A general term for more than 100 diseases that have uncontrolled, abnormal growth of cells that can invade and destroy healthy tissues.

Carcinoid tumor: Tumor consisting of neuroendocrine (hormone producing) cells

Carcinogenic: Able to induce cancer.

Carcinoma in situ: An early stage of cancer in which the tumor is still only in the structures of the organ where it first developed – the disease does not invade other parts of the organ or spread to distant sites. Most in situ carcinomas are highly curable.

Carcinoembryonic antigen (CEA): A test to detect a protein that is often created by colon cancers. Used primarily as a surveillance test for recurrent colorectal cancer.

Catheter: A thin, flexible tube through which fluids or other materials enter or leave the body.

Cecum: The pouch-like structure that is the first segment of the colon.

Cell: The smallest unit of a living organism.

Centigray (cGy): The preferred measurement of the amount of radiation dose absorbed by the body (1 cGy = 1 rad).

Chemoradiation: Therapy consisting of chemotherapy and radiation therapy

Chemotherapy: Treatment with drugs to destroy cancer cells, sometimes called “chemo”. Chemotherapy is often used in addition to surgery or radiation to treat cancer when spread (metastasis) is proven or suspected, when the cancer has come back (recurred), or when there is a strong likelihood that cancer could recur.

Chromosomes: Threadlike structures inside the nucleus of the cell that contain the genetic instructions for cell function.

Clinical Investigator: A medical researcher in charge of carrying out a clinical trial’s protocol.

Clinical stage: Clinical stage is the stage determined only by physical examination and X-ray or other imaging studies. This includes determination of the size of the cancer and evaluation of lymph nodes by the doctor’s examination of the armpit. Clinical stage is used for initial treatment planning. See stage and pathological stage.

Clinical trial: Research studies test new drugs or treatments and compare them to current, standard treatments. Before a new treatment is used on people it is studied in the lab. If lab studies suggest the treatment works, it is tested in patients. These human studies are called clinical trials. Carefully conducted clinical trials are the fastest and safest way to find treatments that work in people. Trials are in four phases: Phase I tests a new drug or treatment in a small group; Phase II expands the study to a larger group of people; Phase III expands the study to an even larger group of people; and Phase IV takes place after the drug or treatment has been licensed and marketed.

Cohort: In epidemiology, a group of individuals with some characteristics in common.

Colectomy: Surgical removal of all or part of the colon.

Colitis: Inflammation of the colon.

Colon: Part of the large intestine beginning at the cecum and continuing until the end of the sigmoid colon where the rectum begins.

Colonoscopy: Video-endoscopy of the entire colon.

Colorectal surgeons: Physicians who specialize in surgery of all diseases of the colon and rectum.

Colostomy: Stoma (a loop of bowel brought surgically out through the abdominal wall) created using the colon.

Combined androgen blockade (CAB): ADT using both an LHRH agonist or orchiectomy together with an antiandrogen.

Community Based Clinical Trial (CBCT): A clinical trial conducted primarily through primary care physicians rather than academic research facilities.

Compassionate Use: A method of providing experimental therapeutics prior to final FDA approval for use in humans. This procedure is used with very sick individuals who have no other treatment options. Often, case-by-case approval must be obtained from the FDA for “compassionate use” of a drug or therapy.

Complementary therapy: Broad range of healing philosophies, approaches, and therapies that Western (conventional) medicine does not commonly use to promote well-being or treat health conditions. Examples include acupuncture, herbs, etc.

Computed tomography (CT): Radiologic examination that utilizes X-rays to generate a two-dimensional computer image of the area scanned. In people diagnosed with colorectal cancer, CT Scanning is used primarily to evaluate the liver for metastatic spread.

Conformal radiation therapy: A newer type of radiation treatment that uses a special computer to help shape the beam of radiation to match the shape of the tumor and delivers the beam from different directions. This reduces the amount of exposure to nearby healthy tissues.

Contraindication: A specific circumstance when the use of certain treatments could be harmful.

Control: A control in randomized controlled trials refers to studying a group of treated patients not in isolation but in comparison to other groups of patients, the control groups, who by not receiving the treatment under study give investigators important clues to the effectiveness of the treatment, its side effects, and the parameters that modify these effects

Corticosteroids: Immune-modulating medication used in the treatment of inflammatory bowel disease.

Crohn’s Disease: An inflammatory bowel disease that can affect any part of the gastrointestinal tract.
Crohn’s disease of the colon is characterized by an inflammatory process that extends through the entire bowel wall and can cause strictures (narrowing) and fistulas (abnormal connections between two organs).
Cryoablation: An invasive technique that destroys tumor cells through the freezing and thawing of malignant tissue.

Cyst: A fluid filled mass that is usually not cancer (benign). The fluid can be removed for testing to be sure that cancer is not present.

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.

Cytology: a branch of biology dealing with the structure, function, multiplication, pathology, and life history of cells

Data Safety and Monitoring Board (DSMB): An independent committee composed of community representatives and clinical research experts, that reviews data while a clinical trial is in progress to ensure that participants are not exposed to undue risk. A DSMB may recommend that a trial be stopped if there are safety concerns or if the trial objectives have been achieved.

Defecation: The act of moving one’s bowels.

Dehydration: When the body loses too much water to work well. Severe diarrhea, vomiting or inability to consume enough liquids can cause dehydration.

Dietitian (also registered dietitian): A university-education health professional who plans well-balanced diet programs, including special diets to meet needs of people with various medical conditions.

Digestive tract: The parts of the body involved with eating, digesting and excreting food. It includes the mouth, esophagus, stomach and intestines.

Dihydrotestosterone (DHT): An androgen, produced from testosterone by 5a-reductase in the prostate, which is roughly ten times as powerful as testosterone at promoting prostate growth.
Glossary

Diuretics: Drugs that help the body get rid of water and salt.

Diverticulosis: Inflammation of a diverticulum.

Diverticulum: Abnormal out pouching of mucosa through the colonic wall.

Diverticulitis: Inflammation or infection of a diverticulum of the colon.

DNA: The building blocks of chromosomes.

Do-Not-Resuscitate (DNR) order: Dictates the steps if a patient is found to be minimally responsive with minimal life signs.

Dose-ranging Study: A clinical trial in which two or more doses of an agent (such as a drug) are tested against each other to determine which dose works best and is least harmful.

Dosimetrist: A person who plans and calculates the proper radiation dose for treatment.

Double-blind Study: A clinical trial design in which neither the participating individuals nor the study staff knows which participants are receiving the experimental drug and which are receiving a placebo (or another therapy). Double-blind trials are thought to produce objective results, since the expectations of the doctor and the participant about the experimental drug do not affect the outcome; also called double-masked study. Also called double-masked study.

Drug-Drug Interaction: A modification of the effect of a drug when administered with another drug. The effect may be an increase or a decrease in the action of either substance, or it may be an adverse effect that is not normally associated with either drug.

Ducts: Hollow passages for gland secretions. In the breast, a passage through which milk passes from the lobule (which makes the milk) to the nipple. These ducts are the starting point for most breast cancers.

Ductal carcinoma in situ: The most common type of noninvasive breast cancer. Cancer cells have not spread beyond the ducts.

Dysphagia: Difficulty with swallowing.

Dysplasia: Microscopic findings of abnormal cellular growth characterized by overcrowding of cells and irregularly shaped nuclei.

Edema: The buildup of excess fluid within the tissues, such as in ankles, legs, arms and abdomen.

Efficacy: (Of a drug or treatment). The maximum ability of a drug or treatment to produce a result regardless of dosage. A drug passes efficacy trials if it is effective at the dose tested and against the illness for which it is prescribed. In the procedure mandated by the FDA, Phase II clinical trials gauge efficacy and Phase III trials confirm it

Electric cautery or Electrocautery: Using electricity to destroy tissue.

Electron beam: a stream of high-energy particles called electrons used to treat cancer.

Empirical: Based on experimental data, not on a theory.

Endorectal ultrasound: Radiographic test using refracted sound waves to evaluate local tumor spread within the rectum.

Endoscope: A lighted instrument used to look inside a body cavity

Endoscopy: Using a lighted instrument to look inside a body cavity

Endpoint: Overall outcome that the protocol is designed to evaluate. Common endpoints are severe toxicity, disease progression or death.

Enterostomal specialist: Usually a nurse with special training in ostomy care, including coping with body charges after surgery.

Epidemiology: A branch of medical science that deals with the incidence, distribution, and control of disease in a population.

Epidermis: Outer most layer of skin.

Esophagus: Muscular tube joining the mouth and stomach

Estrogen: A female sex hormone produced primarily by the ovaries and in smaller amounts from hormones produced by the adrenal gland and fat cells. In some breast cancers, estrogen helps the breast cancer cells grow.

Excision: Surgical removal.

Expanded Access: Refers to any of the FDA procedures that distribute experimental drugs to participants who are failing on currently available treatments for their condition and also are unable to participate in ongoing clinical trials.

Experimental drugs: A drug that is not FDA licensed for use in humans, or as a treatment for a particular condition.

External radiation: Radiation therapy that uses a machine located outside of the body to aim high-energy rays at cancer cells. Also called external beam radiation.

Familial Adenomatous Polyposis (FAP): Disease characterized by the development of multiple adenomatous polyps throughout the colon usually at a young age.

Fecal Occult Blood Test (FOBT): Laboratory test that examines stool for blood.

Fiber: The part of plant foods that the body cannot digest. It helps to move food waste out of the body more quickly. Fiber is found in fruits, vegetables, dry beans and peas, nuts and seeds, and breads and cereals.
Fiber is not found in animal foods (meat, milk, eggs).

Fibroadenoma: A type of noncancerous breast tumor made of fibrous tissue and glandular tissue. On clinical examination or breast self-examination, it usually feels like a
finn, round, smooth lump. This usually occurs in young women.

Fibrocystic changes: A term that describes certain noncancerous changes in the breast, also called fibrocystic disease. Symptoms of this condition are breast swelling or pain. The breasts often feel lumpy or nodular. Because these signs sometimes mimic breast cancer, diagnostic mammography, ultrasound, or even a biopsy may be needed to show that this is not cancer.

Fibrosis: Formation of fibrous (scar like) tissue. This can occur anywhere in the body.
5α-reductase inhibitor: A medication which blocks conversion of testosterone to DHT in the prostate gland.

Food and Drug Administration (FDA): The government agency responsible for the approval of medications and new therapies in the United States.

Fistula: Abnormal connection between two hollow organs.

Fractionation: division of the total dose of radiation into smaller doses in order to reduce damage to healthy tissues.

Fractions: the smaller, divided doses of radiation that are given each day.

Free PSA %: Reports the percentage of free-PSA and usually expressed as a percentage based on free PSA divided by total PSA x 100; one study showed that men with free PSA % > 25% had low risk of PC while those with < 10% free PSA % were more likely to have PC.

Gamma rays: high-energy rays that come from a radioactive source such as cobalt-60.

Gardner’s syndrome: A variant of familial adenomatous polyposis that is associated with bone tumors, polyps and abdominal tumors.

Gastric: Related to the stomach.

Gastroenterologist: Medical doctor who specializes in disorders of the gastrointestinal tract.

Gastrointestinal (GI) tract: Group of organs involving the digestion and absorption of the food we eat.

Gastrostomy tube: A tube surgically placed through the skin into the stomach to deliver nutrition.

Gene: A segment of DNA that contains the information within a chromosome that contains the information to create a single protein. Passed from parents to offspring.

Genetic: Of, pertaining to, or produced by genes.

Genetic counseling: A method to determine an individual’s risk of disease by examining the history and genetic material of the family. Genetic testing may involve giving a blood sample.

Germline mutation: Errors in the genetic code that are transferred between family members.

Gleason grade: A widely used method for classifying prostate cancer tissue for the degree of loss of the normal glandular architecture (size, shape and differentiation of glands); a grade from 1–5 is assigned successively to each the two most predominant tissue patterns present in the examined tissue sample and are added together to produce the Gleason score; high numbers indicate poor differentiation and therefore more aggressive cancer.

Gleason score: Two Gleason Grade numbers are added together to produce the Gleason Score. The first Gleason Grade number indicates the Gleason Grade of the cancer cells found most commonly within the sample, the second number the second most commonly found grade. For example, a Gleason Score of 4+3=7 means that Gleason Grade 4 is the most commonly found type of cell, Gleason Grade 3 the second most commonly found, producing a total Gleason Score of 7.

Grade: Cancer cells are graded by how much they look like normal cells. Grade 1
(also called well differentiated) means the cancer cells look like the normal cells. Grade 3 (poorly differentiated) cancer cells do not look like normal cells at all. Grade 1 cancers aren’t considered aggressive. In other words, they tend to grow and spread more slowly.
Grade 3 cancers are more likely to grow fast and metastasize. A cancer’s grade, along with its stage, is used to determine treatment.

Healthcare Proxy: Sometimes called the Durable Power of Attorney or health care agent; an officially designated medical decision maker (identified by a legal document or verbal identification) authorized to act if you become unable to make medical decisions on your own behalf.

Helical Tomography: a newer form of intensity modulated radiation therapy (IMRT) in which the radiation is directed from a donut-shaped machine that spirals around the body.

Hemoglobin: Protein in the blood responsible for carrying oxygen.

Hepatic: Relating to the liver.

Hepatic Artery infusion (HAI): A technique that uses a pump to administer high doses of chemotherapy directly into the blood supply of the liver.

HER1: A gene that produces a type of receptor that helps cells grow. Breast cancer cells with too many HER2 genes and/or receptors tend to be fast growing and may respond to treatment with certain drugs targeted to the HER2 receptor, such as trastuzumab and lapatinib.

Hereditary: Passing, or capable of passing, naturally from parent to offspring through the genes.
Hereditary nonpolyposis colon cancer (HNPCC): Syndrome of inherited colon cancer and other associated cancers that are not associated with the familial adenomatous polyposis syndrome. Often referred to as the Lynch Syndrome.

Hernia: A loop of bowel or an organ that protrudes through an abnormal opening in the body.
Glossary

High-dose-rate (HDR) brachytherapy: A type of internal radiation in which the radioactive source is in place only for a few minutes and then removed. This may be repeated several times over a few days to weeks. Also known as high-dose-rate remote afterloading radiation therapy.
Histology: The way the cancer cells look under the microscope (described as type and arrangement of tumor cells).

Hormone: A chemical substance released into the body by glands, such as the thyroid, pituitary, or ovaries. The substance travels through the bloodstream and sets in motion various body functions. For examples, prolactin, which is produced in the pituitary gland, begins and sustains the production of milk in the breast after childbirth.

Hormone receptor: These are the cell’s “welcome mat” for hormones circulating in the blood. The receptor is a protein located on a cell’s surface (or within the cell cytoplasm) that binds to a hormone. Tumors can be tested for hormone receptors to see if they can be treated with hormones or antihormones,

Hormone refractory prostate cancer: cancer which no longer responds to ADT.

Hormone therapy: Can be treatment with hormones, treatment with drugs that interfere with hormone production or hormone action, or surgical removal of hormone producing glands to kill cancer cells or slow their growth. The most common hormone therapy for breast cancer is the drug tamoxifen. Other hormonal therapies include aromatase inhibitors, androgens, and surgical removal of the ovaries (oophorectomy).

Hospice: A type of care focusing on improving quality of life as opposed to extending life as a person is no longer seeking treatment to cure his or her cancer.

Hot flashes: episodes of flushing, perception of rising temperature, and/or sweating associated with ADT use.

Hyperfractionated radiation: Radiation schedule in which it is given in smaller doses and more than once a day, but the overall length of treatment is the same. (Compare to accelerated radiation.)

Hyperproliferation: Abnormally high rate of cell division and reproduction.

Hypnosis or Hypnotherapy: A type of therapy, led by a trained professional, that helps people focus on a specific issue or sensation with the intention of treating a certain problem, such as pain or stress. People learn how to hypnotize themselves.

Hypopharynx: The bottom part of the throat. Cancer of the hypopharynx is also known as hypopharyngeal cancer.

Hypothesis: A supposition or assumption advanced as a basis for reasoning or argument, or as a guide to experimental investigation.

Ileocecal valve: Junction of the small and large intestine.

Ileostomy: Stoma created with small bowel.

Ileus: Delayed bowel function after abdominal surgery.

Immune therapy: Treatment that uses the immune system to fight infection and disease. Also called biologic therapy or immunotherapy.

Implant, radioactive: A small source or container of radioactive material placed in the body, either in or near a cancer. (See also brachytherapy.)

Imuran: Drug that suppresses the body’s immune system. Imuran is utilized in the treatment of inflammatory bowel disease.

Incidence: The number of new cases of a disease over a given time period, usually over a year.

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.

Inclusion / Exclusion Criteria: The medical or social standards determining whether a person may or may not be allowed to enter a clinical trial. These criteria are based on such factors as age, gender, the type and stage of a disease, previous treatment history, and other medical conditions. It is important to note that inclusion and exclusion criteria are not used to reject people personally, but rather to identify appropriate participants and keep them safe.

In situ: Cancer in situ is localized in its original place and confined to one area. This describes a very early stage of cancer.

Institutional Review Board (IRB): 1) A committee of physicians, statisticians, researchers, community advocates and others that ensures that a clinical trial is ethical and that the rights of study participants are protected. All clinical trials in the U.S. must be approved by an IRB before they begin. 2) Every institution that conducts or supports biomedical or behavioral research involving human participants must, by federal regulation, have an IRB that initially approves and periodically reviews the research in order to protect the rights of human participants.

Insufflation: The blowing of air into a body cavity.

Insulin: Hormone responsible for stabilizing blood sugar.

Intensity modulated radiation therapy (IMRT): An advanced method of conformal radiation therapy in which the beams are aimed from several directions and the intensity (strength) of the beams is controlled by computers. This allows more radiation to reach the treatment area while reducing the radiation to healthy tissues. (See also conformal radiation therapy.)

Intermittent androgen deprivation (IAD): Administration of ADT only until the PSA becomes undetectable, then cycling therapy to keep the PSA below a given threshold.

Internal mammary lymph nodes: Lymph nodes located inside the chest, next to where the sternum (breastbone) and the ribs come together.

Internal radiation: A type of therapy in which a radioactive substance is implanted into or close to the area needing treatment. Also called brachytherapy.

Interstitial fluid: Contains absorbed nutrients and cellular waste products that are recycled back into the bloodstream to be metabolized and detoxified.

Interstitial radiation: A type of internal radiation in which a radioactive source (implant) is placed directly into the tissue (not in a body cavity).

Intracavitary radiation: A type of internal radiation in which a radioactive source (implant) is placed in a body cavity, such as the vagina, as opposed to directly into a tumor.

Intraductal papillomas: Small, finger-like, polyp-like, noncancerous growths in the breast ducts that may cause a bloody nipple discharge. These are most often found in women 45 to 50 years of age. When many papillomas exist, breast cancer risk is slightly increased.

Intraoperative radiation: a type of external radiation therapy used to deliver a large dose of radiation to the tumor and surrounding tissue during surgery.

Intravenously: Medication given through the veins.
Ischemia: Insufficient blood flow resulting in inadequate tissue oxygenation.

Kegel exercises: A set of exercises designed to improve the strength of the muscles used in urinating.

Lactose: The sugar found in milk and milk products.

Laparoscopic prostatectomy: Surgery to remove all or part of the prostate with the aid of a laparoscope. A laparoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.

Large intestine (colon and rectum): The final organ in the gastrointestinal tract. Its role is the absorption of water and nutrients from digested waste.

Laryngectomy: An operation to remove all or part of the larynx (voice box).

Larynx: The area of the throat containing the vocal cords and used for breathing, swallowing, and talking. Also called voice box.

LHRH (luteinizing hormone releasing hormone) agonists or antagonists: Medications which block production of LH by the pituitary, by over stimulating the gland.

Linear accelerator: A machine that creates high-energy radiation to treat cancers, using electricity to form a beam of fast-moving subatomic particles. Also called mega-voltage (MeV) linear accelerator or a linac.

Living will: Document describing an individual’s wishes regarding specific supportive medical measures toward the end of life.

Lobectomy: a surgical procedure where a section or lobe of the lung is removed.

Lobular carcinoma in situ: Also called lobular neoplasia. Noninvasive cancer that has not spread beyond the lobules. The lobules are the milk producing parts of the breast at the distant end of the ducts.

Localized prostate cancer: A tumor confined to the prostate gland, which may be treated for cure with surgery, radiation, or other local treatments.

Lower Anterior Resection: Resection of the lower rectum through a lower midline abdominal incision.

Lumen: The area inside a hollow organ.

Lumpectomy: Surgery to remove the breast tumor and a small amount of surrounding normal tissue.

Luteinizing hormone (LH): A hormone produced by the pituitary gland which drives testosterone production by the testes.

Luteinizing hormone releasing hormone (LHRH): A hormone produced by the hypothalamus which drives production of LH by the pituitary.

Lymph nodes: Small, bean-shaped collections of immune system tissue located along
lymphatic vessels. They remove waste and fluids from lymph and help fight infections. Also called lymph glands.

Lymphedema: A possible complication after breast cancer treatment. Swelling in the arm is caused by excess fluid that collects after lymph nodes and vessels have been removed by surgery or treated with radiation.

Magnetic Resonance Imaging (MRI): A method of taking pictures of the inside of the body. Instead of using X-rays, MRI uses a powerful magnet and transmits radio waves through the body. The images appear on a computer screen as well as on film. The 3-D images of the body’s interior, delineating muscles, bone, blood vessels, nerves, organs and tumor tissue. Unlike conventional radiography or CT scanning, MRI does not expose patients to ionizing radiation.

Malignant: Cancerous. A tumor that can invade and spread. A tumor that can invade and spread.

Mammogram: An X-ray image of a breast. The procedure used to generate a mammogram is called mammography. Mammography uses low dose X-rays to evaluate the breast.

Margin: The edge of the tissue removed during surgery. A negative margin is a sign that no cancer was left behind. A positive margin indicates that cancer cells are found at the outer edge of the tissue that was removed and is usually a sign that some cancer remains in the body.

Mastectomy: Removal of the entire breast. In a simple or total mastectomy surgeons do not cut away any lymph nodes or muscle tissue. In a modified radical mastectomy, surgeons remove the breast and some armpit lymph nodes. In a radical mastectomy (now rarely performed), surgeons remove the breast, armpit lymph nodes, and chest wall muscles under the breast.

Mediastinoscopy: Examination of the mediastinum (the area between the two lungs) using a flexible tube inserted via a small incision in the chest in order to collect a tissue sample.

Medi-port: Permanent central venous catheter that is placed underneath the skin and usually used for long-term chemotherapy.

Menopause: The time a woman’s life when monthly cycles of menstruation stop forever and the level of hormones produced by the ovaries decreases. Menopause usually naturally occurs in a woman’s late 40s or early 50s, but it can also be caused by surgical removal of both ovaries (oophorectomy) or by chemotherapy, which often destroys ovarian function.

Medical oncologist: A doctor who is specially trained in the diagnosis and treatment of cancer and who specializes in the use of chemotherapy and other drugs to treat cancer.

Mesenteric vessels: The blood vessels that supply the large and small intestines. The lymph channels that drain the colon and rectum are adjacent to these vessels.

Mesentery: (MEZ-en-ter-E) The fatty tissue surrounding the blood vessels that supply the bowel.

Mesothelioma: A type of cancer associated with asbestos exposure.

Metastasis: The spread of cancer cells to distant areas of the body by way of the lymph system or bloodstream. Also used to describe the area to which cancer has spread. The plural is metastases.

Minerals: Nutrients needed by the body in small amounts to help it function properly and stay strong. Iron, calcium, potassium, and sodium are minerals.

Modality: Type or kind of treatment (e.g., surgery).

Monoclonal antibody: Monoclonal antibodies (MABs) are made in the lab and designed to target specific substances called antigens. MABs which have been attached to chemotherapy drugs or radioactive substances are being studied to see if they can seek out antigens unique to cancer cells and deliver these treatments directly to the cancer, thus killing the cancer cells without harming healthy tissue. Trastuzumab is the MAB used to treat HER2 positive breast cancers.

Mortality: The death rate from a specific disorder.

MRI: See magnetic resonance imaging.

Mucosa: The moist membrane lining the inside of the colon containing small glands that secrete mucus.

Mucositis: A complication of radiation or chemotherapy in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth and throat.

Muscularis: The muscle layer of the bowel wall.

Mutation: A genetic error.

Nasogastric (NG) tube: Suction tube placed through the nose down into the esophagus and the stomach to drain gastric contents.

Natural History Study: Study of the natural development of something (such as an organism or a disease) over a period of time.

Needle Biopsy: A procedure during which a hollow needle is used to obtain a core of tissue for study.

Neoadjuvant treatment: Used to describe systemic therapy, such as chemotherapy or hormone therapy, given before surgery. This type of therapy can shrink some tumors so that they are easier to remove.

Neoplasm: Abnormal growth of cells, a tumor.

Nerve-sparing radical prostatectomy: Surgery to remove the prostate in which an attempt is made to save the nerves that help cause penile erections.

Neuropathy: Disruption in a nerve’s function, sometimes caused by trauma, such as during surgery.

New Drug Application (NDA): An application submitted by the manufacturer of a drug to the FDA - after clinical trials have been completed - for a license to market the drug for a specified indication.

Nodal status: Indicates whether a breast cancer has spread (node positive) or has not spread (node negative) to lymph nodes in the armpit (axillary nodes). The number and
site of positive lymph nodes can help predict the risk of cancer recurrence.

Non-Small Cell Carcinoma: The more common form of lung cancer. Generally it includes the following cell types: squamous cell, adenocarcinomas, and large cell carcinoma.

Nonsteroidal anti-inflammatory drug (NSAID): Category of drugs that reduce inflammation; includes aspirin, ibuprofen and Sulindac.

Nutrient: Chemical compounds (water, protein, fat, carbohydrate, vitamins, minerals) that make up foods. These compounds are used in different ways by the body, i.e., to grow, function and stay alive.

Nutrition: A three-part process that gives the body the nutrients it needs. First, you eat or drink food. Second, the body breaks the food down into nutrients. Third, the nutrients travel through the bloodstream to different parts of the body where they are used as “fuel: and for many other purposes. To give your body proper nutrition, you have to eat and drink enough of the foods that contain key nutrients.

Neutropenia: Low white blood count which may indicate a suppressed immune system.

Oat Cell Carcinoma: Another name for small cell lung cancer. Occult: hidden: Not obvious to the naked eye.

Off-label Use: A drug prescribed for conditions other than those approved by the FDA.

Oncologist: A doctor who specializes in caring for people who have cancer.

Oncology (on-call-uh-jee): The branch of medicine devoted to the diagnosis and treatment of cancer.

Oophorectomy: Surgery to remove the ovaries.

Open-label Trial: A clinical trial in which doctors and participants know which drug or vaccine is being administered.

Orchiectomy: Removing the testes to remove the primary source of testosterone production.

Orphan Drugs: An FDA category that refers to medications used to treat diseases and conditions that occur rarely. There is little financial incentive for the pharmaceutical industry to develop medications for these diseases or conditions. Orphan drug status, however, gives a manufacturer specific financial incentives to develop and provide such medications.

Osteoporosis: Decrease in bone mineral density which may lead to fractures, worsened by ADT and by smoking, excessive alcohol consumption, and lack of exercise.

Ostomy: A surgically created opening from the inside of the body to the outside of the body.

Ovary: Reproductive organ in the female pelvis. Normally a woman has two ovaries.
They contain the eggs (ova) that, when joined with sperm, result in pregnancy.
Ovaries produce most of a premenopausal woman’s estrogen.

Palpation: Using the hands to examine something. A palpable mass in the breast is one that can be felt.

Palliative care: Treatment intended to relieve symptoms caused by cancer, rather than to cure it. Palliative care can help people live more comfortably.

Pancolitis: Colitis involving the entire colon.

Partial mastectomy: A type of breast conservation surgery that removes more breast tissue than a lumpectomy (up to 1/4 of the breast). It is also called a segmental mastectomy or a quadrantectomy.

Pathologic stage: Includes the findings of the pathologist after surgery. Most of the time, pathologic stage is the most important stage since involvement of the lymph nodes can only be accurately evaluated by examining them under a microscope.

Patient-controlled analgesia (PCA): Pump connected to an intravenous line that allows pain medication to be self-administered by a patient.

Pedunculated polyp: A polyp growing on a stack.

Percutaneously: Through the skin.

Peer Review: Review of a clinical trial by experts chosen by the study sponsor. These experts review the trials for scientific merit, participant safety, and ethical considerations.

Pericardial effusions: Fluid inside the membrane that surrounds the heart.

Perineum: The area of the skin around the anus and genital structures.

Perineal cavity: Abdominal cavity.

PET (positron emission tomography) scan: A total body scan that uses a radioactive form of glucose to detect cancer.

Pharmacokinetics: The processes (in a living organism) of absorption, distribution, metabolism and excretion of a drug or vaccine.

Pharyngeal cancer: Also called throat cancer. A cancer that forms in tissues of the pharynx (the hollow tube inside the neck that starts behind the nose and ends at the top of the windpipe and esophagus).

Pharyngeal cancer includes cancer of the nasopharynx (the upper part of the throat behind the nose), the oropharynx (the middle part of the pharynx), and the hypopharynx (the bottom part of the pharynx). Cancer of the larynx (voice box) may also be included as a type of pharyngeal cancer.

Phase I Trials: Initial studies to determine the metabolism and pharmacologic actions of drugs in humans, the side effects associated with increasing doses, and to gain early evidence of effectiveness; may include healthy participants and/or patients.

Phase II Trials: Controlled clinical studies conducted to evaluate the effectiveness of the drug for a particular indication or indications in patients with the disease or condition under study and to determine the common short-term side effects and risks.

Phase III Trials: Expanded controlled and uncontrolled trials after preliminary evidence suggesting effectiveness of the drug has been obtained, and are intended to gather additional information to evaluate the overall benefit-risk relationship of the drug and provide an adequate basis for physician labeling.

Phase IV Trials: Post-marketing studies to delineate additional information including the drug’s risks, benefits and optimal use.

Physical therapist: A health professional who helps patients use exercises and other methods to restore or maintain the body’s strength, mobility, and function.

Phytochemicals: A class of helpful chemical substances found in plants. Many of these chemicals are thought to reduce your risk of cancer.

Placebo: A placebo is an inactive pill, liquid or powder that has no treatment value. In clinical trials, experimental treatments are often compared with placebos to assess the treatment’s effectiveness.

Placebo Controlled Study: A method of investigation of drugs in which an inactive substance (the placebo) is given to one group of participants, while the drug being tested is given to another group. The results obtained in the two groups are then compared to see if the investigational treatment is more effective in treating the condition.

Placebo Effect: A physical or emotional change, occurring after a substance is taken or administered, that is not the result of any special property of the substance. The change may be beneficial, reflecting the expectations of the participant and, often, the expectations of the person giving the substance.

Platelets: Special blood cell fragments that help stop bleeding (responsible for blood clotting).

Pneumonectomy: a surgical procedure where an entire lung is removed.

Polyp: Abnormal mucosal growth.

Polypectomy: Surgical removal of polyps.

Polyposis: Condition in which multiple polyps form in an organ.

Port (also treatment field): the area of the body through which external beam radiation is directed to reach a tumor.

Potassium: A mineral the body needs for fluid balance and other essential functions

Pre-cancer: Abnormal cells that do not yet have the capacity to spread.

Preoperative chemotherapy: Chemotherapy given before surgery to shrink breast tumors so they can be removed with less extensive surgery than would otherwise be needed. Also called neoadjuvant chemotherapy.

Proctectomy: Surgical removal of the rectum.

Proctocolectomy: Surgical removal of the colon and the rectum.

Proctoscopy: Evaluation of the rectum using a rigid or flexible endoscope.

Progesterone: A female sex hormone released by ovaries during every menstrual cycle to prepare the uterus for pregnancy and the breasts for milk production (lactation).

Prognosis: A prediction of the course of disease – or the outlook for the cure of the patient. For example, women with breast cancer that is small, does not involve the lymph nodes, and is promptly treated have a good prognosis.

Prostate: A gland in the male reproductive system. The prostate surrounds the part of the urethra (the tube that empties the bladder) just below the bladder, and produces a fluid that forms part of the semen.

Prostate-specific antigen (PSA): A substance produced by the prostate that may be found in an increased amount in the blood of men who have prostate cancer, benign prostatic hyperplasia, or infection or inflammation of the prostate.

Prosthesis: an artificial replacement for a part of the body.

Protein: One of the three nutrients that supply calories to the body (the other two are carbohydrates and fats). The protein we eat becomes a part of our muscle, bones, skin and blood.

Protocol: A study plan on which all clinical trials are based. The plan is carefully designed to safeguard the health of the participants as well as answer specific research questions. A protocol describes what types of people may participate in the trial; the schedule of tests, procedures, medications and dosages; and the length of the study. While in a clinical trial, participants following a protocol are seen regularly by the research staff to monitor their health and to determine the safety and effectiveness of their treatment.

Pulmonologist: A physician who specializes in diseases of the lung and lung complications related to treatment. A pulmonologist is often the first to see and evaluate patients with a suspected lung cancer.

Quadrantectomy: A type of breast conservation surgery that removes more breast tissue than a lumpectomy (up to 1/4 of the breast). It is also called a partial or segmental
mastectomy.

Rad: Short form for “radiation absorbed dose”; an older term of measurement of the amount of radiation absorbed by the body (1 rad = 1 cGy).

Radiation: Energy carried by waves or a stream of particles. Types of radiation used to treat cancer include x-ray, electron beam, alpha and beta particle, and gamma ray. Radioactive substances include forms of cobalt, radium, iridium, cesium, iodine, strontium, samarium, phosphorus, and palladium. The radiation may come from outside of the body (external radiation) or from radioactive materials placed directly in the tumor (internal or implant radiation called brachytherapy), Radiation therapy may be used to reduce the size of a cancer before surgery, to destroy any cancer cells left behind after surgery, or, in some cases, as the main treatment.

Radiation oncologist: A doctor who specializes in using radiation to treat cancer.

Radiation physicist: A person trained to ensure that the radiation machine delivers the right amount of radiation to the treatment area. He or she works with the radiation oncologist and dosimetrist to design, plan, and calculate the proper dose for radiation treatment.

Radiation therapist: A person with special training to work the equipment that delivers the radiation.

Radiation therapy: The use of high-energy rays or subatomic particles that penetrate the body to treat disease.

Radiation therapy nurse: A registered nurse who has special training in oncology and radiation therapy.

Radical Surgery: Surgery designed to remove diseased areas and also areas that might have been affected by the disease.

Radiofrequency Ablation: Cancer treatment that uses heat to kill tumor.

Radiologist: a doctor with special training in reading and interpreting diagnostic x-rays and performing specialized x-ray procedures.

Radiopharmaceuticals: radioactive substances that are taken by mouth or injected. They collect in the area of the tumor and help stop its growth. Also called radionuclides.

Radio-resistance: The ability of cells not to be affected by radiation.

Radio-sensitivity: How susceptible a cell, cancerous or healthy, is to radiation. Cells that divide frequently are especially radiosensitive and are more affected by radiation.

Randomization: A method based on chance by which study participants are assigned to a treatment group.

Randomization minimizes the differences among groups by equally distributing people with particular characteristics among all the trial arms. The researchers do not know which treatment is better. From what is known at the time, any one of the treatments chosen could be of benefit to the participant.

Recurrent breast cancer: Breast cancer that has come back after treatment. Local
recurrence means that the cancer has come back in the same place as the original cancer. Regional recurrence means that the cancer has come back in the lymph nodes near the primary (original) site.
Distant recurrence is when cancer spreads to distant organs or tissues (such as the lungs, liver, bone or brain) after treatment.

Rectum: Pouch-like structure within the lower part of the large intestine that stores fecal waste before defecation.

Retrograde ejaculation: The flow of semen backward into the bladder rather than out the penis.

Restorative proctocolectomy: A surgical procedure in which the entire colon and rectum are removed, but a rectum is created using a pouch constructed from the small intestine (J Pouch).

Risk-Benefit Ratio: The risk to individual participants versus the potential benefits. The risk/benefit ratio may differ depending on the condition being treated.

Salvage resection: Surgical removal of a cancer after less radical initial treatments have failed.

Sarcoma: A cancerous (malignant) tumor that is highly likely to spread.

Screening mammogram: A screening mammogram is performed on women with no evidence of lumps or other symptoms. This includes 2 X-ray views of each breast (top to bottom; side-to-side). Diagnostic mammography includes additional X-ray views of area of concern (found on physical examination or on the screening mammogram) to provide more information about the size and character of the abnormality.

Sentinel lymph node mapping and biopsy: In a sentinel lymph node mapping and biopsy, the surgeon injects a radioactive substance and/or a blue dye into the area around the tumor. Lymphatic vessels carry these materials to the sentinel lymph node (also called the sentinel node). The doctor can see the blue dye or detect the radioactivity (with a Geiger counter) in the sentinel node, which is cut out and examined under a microscope. If the sentinel node contains cancer, more axillary lymph nodes are removed. But if it is free of cancer, the patient can avoid additional axillary surgery and potential side effects.

Segmental mastectomy: A type of breast conservation surgery that removes more breast tissue than a lumpectomy (up to1/4 of the breast). It is also called a partial mastectomy or a quadrantectomy.

Sensitivity: The ability of a screening test to identify patients with the disease.
Glossary

Serosa: Thin external lining of the bowel surface.

Sessile polyp: A flat-appearing polyp.

Side effects: Unwanted effects of treatment, such as headache, nausea, hair loss, skin irritation or other physical problems, caused by chemotherapy or fatigue caused by radiation therapy.

Single Blind Study: A study in which one party, either the investigator or participant, is unaware of what medication the participant is taking; also called single-masked study.

Sodium: A mineral required by the body to keep body fluids in balance. Sodium is found in table salt. Too much sodium can cause you to retain water.

Sonogram: During an ultrasound, the computer transforms the echoes into a picture called a sonogram. See ultrasound.

Sigmoidoscopy: Examination of the rectum and sigmoid colon by an endoscope.

Sigmoid colon: The “S” shaped loop of the colon before the rectum.

Simulation: A process involving special x-ray pictures that is used to plan radiation treatment so that the area to be treated is precisely located and marked.

Small Cell Carcinoma: A less common form of lung cancer also called oat cell carcinoma.

Small intestine: Tubular organ between the stomach and the large intestine. The function of the small intestine is the breakdown and absorption of the food we eat. Also called the small bowel.

Social worker: A mental health professional with a master’s degree in social work (MSW). A social worker can provide assistance in dealing with medical, psychological, social, and educational needs.

Soft diet: A diet consisting of bland, lower fat foods that you soften by cooking, mashing, pureeing or blending.

Sphincter (anal sphincter): Circular muscle around the anus that enables us to hold waste inside.

Sphincter-saving surgery: Surgery for the removal of a rectal cancer that is able to spare the sphincter muscles and therefore avoid a permanent colostomy.

Spiral CT: low-dose multidetector spiral computed tomography (CT) is an imaging technique that can screen asymptomatic, high-risk individuals for small lung nodules before they appear on traditional x-rays.

Sporadic Mutation: A genetic error that occurs randomly and is not an inherited flaw.

Squamous cell carcinoma (SCC): Cancer arising from the lining of the anal canal.

Stage: A method of describing the size and location of cancer based on characteristics of the tumor, the lymph nodes, and whether there is involvement of other organs. Stage I, II, III and IV are used, with I indicating early discovery, prior to spread, to Stage IV, describing cancer that has spread (metastasized) to lymph nodes near or far from the original tumor site.

Standard Treatment: A treatment currently in wide use and approved by the FDA, considered to be effective in the treatment of a specific disease or condition.

Standards of Care: Treatment regimen or medical management based on state of the art participant care.

Statistical Significance: The probability that an event or difference occurred by chance alone. In clinical trials, the level of statistical significance depends on the number of participants studied and the observations made, as well as the magnitude of differences observed.

Stereotactic needle biopsy: A method of needle biopsy that is useful in some cases in which calcifications or a mass can be seen on mammogram, but cannot be located by touch (palpation). Computerized equipment maps the location of the mass and this is used as a guide to place the needle.

Stoma: A loop of bowel brought out through the abdominal wall.

Stricture: Narrowing of the lumen of the bowel because of scarring, inflammation, or tumor.

Stromal Tumor: Rare tumor that starts in the muscular layers of the colon.

Study Endpoint: A primary or secondary outcome used to judge effectiveness of a treatment.

Study Type: The primary investigative techniques used in an observational protocol; types are Purpose, Duration, Selection and Timing.

Submucosa: The layer of the bowel wall between the granular lining (mucosa) and the muscle layer.

Sulindac: Example of a nonsteroidal anti-inflammatory drug that may help prevent formation of polyps.

Supportive care: Measures taken to relieve symptoms and improve quality of life but that are not expected to destroy the cancer. Pain medication is an example of supportive care.

Supraclavicular lymph nodes: Lymph nodes located in the area just above the collarbone.

Systemic therapy: Treatment that reaches and affects cells throughout the body; for example, chemotherapy.

Targeted therapy: Targeted therapy is a form of treatment that attacks specific sites and/or processes that are important to the function of cancer cells. In many cases of targeted therapy, higher levels of the target (for example, the HER2 receptor) in the cancer cells are associated with greater benefit for the patient when the therapy (such as, trastuzumab) is given.

Teletherapy: Treatment in which the radiation source is at a distance from the body (external radiation).

Testosterone: The major androgen or male sex hormone.

Therapeutic ratio: The dose required to treat the cancer divided by the tolerance dose of the surrounding organs.

Thoracic surgeon: A surgeon who specializes in the removal of tumors of the chest through surgery, including minimally invasive surgical techniques.

Total mesorectal excision (TME): Surgical removal of most of the rectum and its entire mesentery.

Total Parenteral Nutrition (TPN): When a person receives needed nutrients through a needle in a vein.

Toxicity: An adverse effect produced by a drug that is detrimental to the participant’s health. The level of toxicity associated with a drug will vary depending on the condition which the drug is used to treat.

Transanal excision (TAE): Sphincter-saving technique for removal of small tumors of the lower rectum. During transanal excision, an abdominal incision is avoided and the tumor is removed through the anus.

Transcription: The conversion of the DNA into its messenger RNA.

Treatment field (or port): The place on the body at which the radiation beam is aimed.

Treatment IND: IND stands for Investigational New Drug application, which is part of the process to get approval from the FDA for marketing a new prescription drug in the U.S. It makes promising new drugs available to desperately ill participants as early in the drug development process as possible. Treatment INDs are made available to participants before general marketing begins, typically during Phase III studies. To be considered for a treatment IND a participant cannot be eligible to be in the definitive clinical trial.

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 and guide prostate biopsy procedures.

Tumor: An abnormal lump or mass of tissue. Tumors are either benign (non-cancerous) or malignant (cancerous).

TURP (transurethral resection of the prostate): 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.

Ulcerative colitis: Inflammatory disease affecting the mucosa of the large intestine. Individuals with ulcerative colitis have a high risk of developing colorectal cancer.

Ultrasound: High frequency sound waves (far beyond the hearing range) with echoes bouncing off tissue to image internal organs.

Umbilicus: Belly button.

Unsealed radiation: internal radiation therapy given by injecting a radioactive substance into the bloodstream or a body cavity or swallowing it. This substance is not sealed in a container.

VATS (video assisted thoracoscopic surgery): A surgical procedure by which small incisions are made in the chest during surgery. A small camera is placed in one of these incisions and surgical instruments are used in the other incisions in order to retrieve tissue.

Vitamins: Key nutrients, such as vitamins A, C and E, that the body needs in small amounts to grow and stay strong.

Wedge resection: A surgical procedure to remove a section of one lobe of the lung.
Glossary

White blood cells: The blood cells that help defend the body against infection. Also called leukocytes.

X-ray: A form of radiation that can be used either at low levels to produce an image of the body on film or at high levels to destroy cancer cells.