Glossary

ASYMPTOMATIC: Having no recognizable symptoms of a particular disorder.

BENIGN: Relatively harmless, not cancerous and not malignant. See malignancy and tumor.

BENIGN PROSTATIC HYPERPLASIA: Non-cancerous condition of the prostate that results in the growth of glandular and supporting connective tumorous tissue, enlarging the prostate and obstructing urination. See benign prostatic hypertrophy and prostatitis.

BENIGN PROSTATIC HYPERTROPHY (also BPH): Similar to benign prostatic hyperplasia, but caused by an increase in the size of cells rather than the growth of more cells. See benign prostatic hyperplasia and prostatitis.

BIOPSY: Sampling of tissue from a particular part of the body (e.g., the prostate) used to check for abnormalities such as cancer. In the case of prostate cancer, a biopsy is usually carried out under ultrasound guidance using a specially designed device known as a prostate biopsy gun. Removed tissue is typically examined microscopically by a pathologist in order to make a precise diagnosis of the patient’s condition.

BLADDER: Hollow organ in which urine is collected and stored in the body.

BONE SCAN: Technique more sensitive than conventional x-rays which uses a radiolabeled agent to identify abnormal or cancerous growths within or attached to bone. In the case of prostate cancer, a bone scan is used to identify bony metastases that indicate cancer has escaped from the prostate. Metastases appear as “hot spots” on the film, however, the absence of hot spots does not prove the absence of tiny metastases.

BPH (also BENIGN PROSTATIC HYPERTROPHY): Similar to benign prostatic hyperplasia, but caused by an increase in the size of cells rather than the growth of more cells. See benign prostatic hyperplasia and prostatitis.

BRACHYTHERAPY: Form of radiation therapy in which seeds or pellets, which emit radiation, are implanted to kill surrounding tissue (e.g., the prostate, including prostate cancer cells). See interstitial.

CANCER: Growth of abnormal cells in the body in an uncontrolled manner. Unlike benign tumors, these tend to invade surrounding tissues, and spread to distant sites of the body via the blood stream and lymphatic system.

CARCINOMA: Form of cancer that originates in tissues that line or cover a particular organ.

CAT SCAN (also COMPUTERIZED AXIAL TOMOGRAPHY or CT): Technology that uses computer-guided images from multiple x-rays to produce cross-sectional or three-dimensional pictures of internal organs to identify abnormalities. A CAT scan can identify prostate enlargement, yet is not always effective for assessing the stage of prostate cancer or for evaluating metastases of the lymph nodes or more distant soft tissue sites.

CATHETER: Hollow (usually flexible plastic) tube that can drain fluids from or inject fluids into the body. In the case of prostate cancer, it is common for patients to have a transurethral catheter to drain urine for some time after surgery or receiving some forms of radiation therapy.

CHEMOTHERAPY: Use of pharmaceuticals or chemicals to kill cancer cells. Chemotherapeutic agents may be potentially dangerous because they kill cancer cells, as well as healthy cells in the body.

COMPUTERIZED AXIAL TOMOGRAPHY (also CAT scan or CT): Technology that uses computer-guided images from multiple x-rays to produce cross-sectional or three-dimensional pictures of internal organs to identify abnormalities. A CAT scan can identify prostate enlargement, yet is not always effective for assessing the stage of prostate cancer or for evaluating metastases of the lymph nodes or more distant soft tissue sites.

CRYOSURGERY: Use of liquid nitrogen probes to freeze an organ to extremely low temperatures to kill the tissue, including any cancer cells. When used to treat prostate cancer, cryoprobes are guided by transrectal ultrasound.

CT (also CAT scan or COMPUTERIZED AXIAL TOMOGRAPHY): Technology that uses computer-guided images from multiple x-rays to produce cross-sectional or three-dimensional pictures of internal organs to identify abnormalities. A CAT scan can identify prostate enlargement, yet is not always effective for assessing the stage of prostate cancer or for evaluating metastases of the lymph nodes or more distant soft tissue sites.

CYSTOSCOPE: Instrument used by a physician to look inside the bladder and the urethra.

DIFFERENTIATION: Method to grade the severity of disease based on the differences between prostate cells examined microscopically. Well-differentiated cells are easily recognized as normal cells, while poorly differentiated cells are abnormal, cancerous and difficult to recognize as belonging to any particular type of cell group.

DIGITAL RECTAL EXAMINATION (also DRE): Conducted by a physician, during which a lubricated and gloved finger is inserted into a patient’s rectum to feel for abnormalities of the prostate and rectum.

DRE (also DIGITAL RECTAL EXAMINATION): Conducted by a physician, during which a lubricated and gloved finger is inserted into a patient’s rectum to feel for abnormalities of the prostate and rectum.

DYSURIA: Urination that is problematic or painful.

EBRT (also EXTERNAL BEAM THERAPY or EXTERNAL RADIATION THERAPY): Form of radiation therapy in which radiation is delivered by a machine pointed at the area of the body to be radiated.

EXTERNAL BEAM THERAPY (also EXTERNAL RADIATION THERAPY or EBRT): Form of radiation therapy in which radiation is delivered by a machine pointed at the area of the body to be radiated.

EXTERNAL RADIATION THERAPY (also EBRT or EXTERNAL RADIATION THERAPY)): Form of radiation therapy in which radiation is delivered by a machine pointed at the area of the body to be radiated.

FREE PSA (also PSA-II): Prostate-specific antigen type II assay that reports the percentage of free PSA compared to total PSA (Total PSA = free PSA + bound PSA). It is a helpful screening tool when PSA values are above the normal threshold for an age group and less than 10. One study showed men with PSA II greater than 25% had no prostate cancer, while those with less than 10% were likely to have prostate cancer

FREQUENCY: Need to urinate often.

GENITOURINARY SYSTEM: Combined genital and urinary systems; also known as the genitourinary tract.

GLEASON SCORE: Widely used method for classifying cellular differentiation of cancerous tissues; the less the cancerous cells appear like normal cells, the more malignant the cancer. Two numbers, each from 1-5, are assigned successively to the two most predominant patterns of differentiation present in the examined tissue sample and are added together to produce the Gleason score. High numbers indicate poor differentiation and cancer. See grade.

GRADE: Means of describing the potential degree of severity of a cancer based on the appearance of cancer cells examined microscopically. See Gleason score.

HORMONE THERAPY: Use of hormones, hormone analogs and surgical techniques to treat disease (e.g., advanced prostate cancer) either on their own, in combination with other hormones or in combination with other treatment methods. Although not a cure, and because prostate cancer is usually dependent on male hormones to grow, hormonal therapy can effectively alleviate symptoms and retard further development of disease.

HYPERPLASIA: Enlargement of an organ or tissue because of an increase in the number of cells in that organ or tissue. See benign prostatic hyperplasia.

IMPLANT: Device inserted into the body (e.g., a tiny container of radioactive material inserted in or near a tumor to kill cancer cells; also a device inserted to replace or substitute for an ability which has been lost, such as a penile implant to provide rigidity for intercourse).

IMPOTENCE: Inability to have or to maintain an erection.

IMRT (also INTENSITY MODULATED RADIATION THERAPY): A newer form of radiotherapy, enabling more precise external beam radiotherapy treatment. Instead of having a single, large radiation beam pass through the body, IMRT breaks it up into thousands of thin beams, improving accuracy and minimizing harm to surrounding tissue.

INCONTINENCE (also URINARY INCONTINENCE or URINARY URGENCY): Loss of urinary control. Various types and degrees of incontinence exist, including overflow incontinence in which the bladder retains urine after voiding and results in involuntary seepage of urine from the bladder. Stress incontinence is the involuntary discharge of urine when there is increased pressure upon the bladder, which may be caused by 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.

INTENSITY MODULATED RADIATION THERAPY (also IMRT): A newer form of radiotherapy, enabling more precise external beam radiotherapy treatment. Instead of having a single, large radiation beam pass through the body, IMRT breaks it up into thousands of thin beams, improving accuracy and minimizing harm to surrounding tissue.

INTERSTITIAL: Within a particular organ. For example, interstitial prostate radiation therapy is radiation therapy applied within the prostate using implanted radioactive pellets or seeds. See brachytherapy.

LOCALIZED: Restricted to a well-defined area.

LYMPH (also LYMPHATIC FLUID): Clear fluid in which all cells in the body are constantly bathed; carries cells that help fight infection.

LYMPH NODES: Small glands which occur throughout the body and which filter the clear fluid known as lymph or lymphatic fluid; lymph nodes filter out bacteria and other toxins, as well as cancer cells.

LYMPHATIC FLUID (also LYMPH): Clear fluid in which all cells in the body are constantly bathed; carries cells that help fight infection.

MAGNETIC RESONANCE: Absorption of specific frequencies of radio and microwave radiation by atoms placed in a strong magnetic field. See magnetic resonance imaging or MRI.

MAGNETIC RESONANCE IMAGING (also MRI): Use of magnetic resonance with atoms in body tissues to produce distinct cross-sectional or three-dimensional images of internal organs. An MRI is primarily used in staging biopsy-proven prostate cancer. See magnetic resonance.

MALIGNANCY: Growth or tumor composed of cancerous cells. See benign and tumor.

MALIGNANT: Cancerous with a tendency to become progressively worse and to result in death; having the invasive and metastatic (spreading) properties of cancer.

MARGIN: Usually refers to the “surgical margin” which is the outer edge of the tissue removed during surgery. If the surgical margin shows no sign of cancer (“negative margins”), then the prognosis is good.

MEDICAL ONCOLOGIST: Oncologist primarily trained in the use of medicines (rather than surgery) to treat cancer.

METASTASIS (plural is METASTASES): Secondary tumor, resulting from a cancer cell or cells from a primary tumor site (e.g., the prostate) traveling through the body and growing in a new site. See metastasize.

METASTASIZE: Spread of a malignant tumor to other parts of the body. See metastasis.

MORBIDITY: Unhealthy consequences and complications resulting from treatment.

MRI (also MAGNETIC RESONANCE IMAGING): Use of magnetic resonance with atoms in body tissues to produce distinct cross-sectional or three-dimensional images of internal organs. An MRI is primarily used in staging biopsy-proven prostate cancer. See magnetic resonance.

NADIR: Lowest point reached, for example in a series of PSA values.

NERVE SPARING: Type of prostatectomy in which the surgeon spares the nerves that affect sexual and related functions.

NOCTURIA: Need to urinate frequently at night.

ONCOLOGIST: Physician who specializes in the treatment of various types of cancer; cancerous tumors. See oncology.

ONCOLOGY: Branch of medical science dealing with various types of cancer; cancerous tumors. See oncologist.

OVERSTAGING: Assignment of an overly high clinical stage at initial diagnosis because of the difficulty of accurately assessing available information (e.g., stage T3b as opposed to stage T2b).

PALLIATIVE: Designed to relieve a problem without necessarily solving it. For example, palliative therapy may relieve symptoms and improve quality of life, but it is not curative.

PALPABLE: Capable of being felt during a physical examination by an experienced physician. In the case of prostate cancer, this normally refers to an abnormality of the prostate that can be felt during a digital rectal examination or DRE.

PAP (also PROSTATIC ACID PHOSPHATASE): Rarely measured enzyme used to indicate whether prostate cancer has escaped from the prostate.

PATHOLOGIST: Physician who specializes in the examination of tissues and blood samples to help decide what diseases are present in a patient and how they should be treated.

PERINEUM: Area of the body between the scrotum and the rectum. A perineal procedure uses this area as the point of entry into the body.

PERIPHERAL: Outside the central region.

PROSTATE: Gland surrounding the urethra and immediately below the bladder in men.

PROSTATE-SPECIFIC ANTIGEN (also PSA): Protein secreted by the epithelial cells of the prostate gland including cancer cells. An elevated level in the blood indicates an abnormal condition of the prostate gland, either benign or malignant. PSA is used to detect potential problems in the prostate gland and to follow the progress of cancer therapy. See screening.

PROSTATECTOMY: Surgical removal of part or all of the prostate gland.

PROSTATIC ACID PHOSPHATASE: (also PAP): Rarely measured enzyme used to indicate whether prostate cancer has escaped from the prostate.

PROSTATITIS: Infection or inflammation of the prostate gland treatable by medication and/or manipulation. (BPH is a more permanent layering of fibroblasts and connective tissue caused when the prostate contains a chronic lower-grade infection, often requiring a TURP to relieve symptoms.) See benign prostatic hyperplasia and benign prostatic hypertrophy.

PSA (also PROSTATE-SPECIFIC ANTIGEN): Protein secreted by the epithelial cells of the prostate gland including cancer cells. An elevated level in the blood indicates an abnormal condition of the prostate gland, either benign or malignant. PSA is used to detect potential problems in the prostate gland and to follow the progress of cancer therapy. See screening.

PSA-II (also FREE PSA): Prostate-specific antigen type II assay that reports the percentage of free PSA compared to total PSA (Total PSA = free PSA + bound PSA). It is a helpful screening tool when PSA values are above the normal threshold for an age group and less than 10. One study showed men with PSA II greater than 25% had no prostate cancer, while those with less than 10% were likely to have prostate cancer.

PSADT (also PSA DOUBLING TIME): Time it takes the PSA to double in value.

PSAV (also PSA VELOCITY): Rate at which PSA values increase assuming the rate does not change.

PSA DOUBLING TIME (also PSADT): Time it takes the PSA to double in value.

PSA REVERSE TRANSCRIPTASE-POLYMERASE CHAIN REACTION (also PSA RT-PCR): Blood test to detect micrometastatic cells in the blood stream. This screening tool may help avoid unnecessary invasive treatment (e.g., radical prostatectomy) for patients with metastasized prostate cancer.

PSA RT-PCR (also PSA reverse transcriptase-polymerase chain reaction): Blood test to detect micrometastatic cells in the blood stream. This screening tool may help avoid unnecessary invasive treatment (e.g., radical prostatectomy) for patients with metastasized prostate cancer.

PSA VELOCITY (also PSAV): Rate at which PSA values increase assuming the rate does not change.

QUALITY OF LIFE: Evaluation of health status relative to the patient’s age, expectations, and physical and mental capabilities.

RADIATION ONCOLOGIST: Physician who has received special training regarding the treatment of cancers with different types of radiation.

RADIATION THERAPY (also RT): Use of X-rays and other forms of radiation to destroy malignant cells and tissue.

RADICAL (in a surgical sense): Directed at the cause of a disease. In the case of prostate cancer, a radical prostatectomy is the surgical removal of the prostate with the intent to cure the problem caused by or within the prostate. See radical prostatectomy.

RADICAL PROSTATECTOMY: Operation to remove the entire prostate gland and seminal vesicles. See radical.

RADIOISOTOPE: Type of atom (or a chemical that is made with a type of atom) that emits radioactivity.

RECTUM: Final part of the intestines that ends at the anus.

RECURRENCE: Reappearance of disease.

REGRESSION: Reduction in the size of a single tumor or reduction in the number and/or size of several tumors.

REMISSION: Real or apparent disappearance of some or all of the signs and symptoms of cancer; the period (temporary or permanent) during which a disease remains under control, without progressing. Even complete remission does not necessarily indicate cure.

RESECTION: Surgical removal.

RETENTION: Difficulty in initiation of urination or the inability to completely empty the bladder.

RETROPUBIC PROSTATECTOMY: Surgical removal of the prostate through an incision in the abdomen.

RT (also RADIATION THERAPY): Use of X-rays and other forms of radiation to destroy malignant cells and tissue.

SALVAGE PROSTATECTOMY: Procedure intended to “rescue” a patient following the failure of a prior treatment through the surgical removal of the prostate.

SCROTUM: Pouch of skin containing a man’s testicles.

SCREENING: Test to separate patients with tumors from those without tumors. See PSA.

SEMEN: Whitish, opaque fluid emitted by a male during ejaculation.

SEMINAL: Related to semen. For example, seminal vesicles are glands at the base of the bladder and connected to the prostate that provide nutrients for semen.

STAGE: Term used to define the size and physical extent of a cancer.

STAGING: Process of assigning a stage to a particular cancer in a patient to help determine appropriate therapy. Two common staging methods are the Whitmore-Jewett staging classification and, the more detailed, TNM (tumor, nodes and metastases) classification of the American Joint Committee on Cancer and the International Union Against Cancer.

SYMPTOM: Feeling, sensation or experience noticed by a patient and associated with or resulting from a physical or mental disorder.

SYSTEMIC: Throughout the whole body.

TESTIS: One of two male reproductive glands located inside the scrotum that are primary sources of the male hormone testosterone.

TESTOSTERONE: Male hormone in a man’s body, chiefly produced by the testicles, is essential to complete male sexual function and fertility.

TRANSPERINEAL: Through the perineum.

TRANSRECTAL: Through the rectum.

TRANSRECTAL ULTRASOUND (also TRUS): Imaging method to view the prostate that uses echoes of ultrasound waves, generated by an ultrasound probe inserted into the rectum. It is commonly used to visualize a prostate biopsy procedure.

TRANSURETHRAL: Through the urethra.

TRANSURETHRAL RESECTION OF THE PROSTATE (also TURP): Surgical procedure to remove tissue obstructing the urethra. It involves 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.

TRUS (also TRANSRECTAL ULTRASOUND): Imaging method to view the prostate that uses echoes of ultrasound waves, generated by an ultrasound probe inserted into the rectum. It is commonly used to visualize a prostate biopsy procedure.

TUMOR: Excessive growth of cells caused by uncontrolled and disorderly cell replacement. Abnormal tissue growth can be either benign or malignant. See benign and malignant.

TURP (also TRANSURETHRAL RESECTION OF THE PROSTATE): Surgical procedure to remove tissue obstructing the urethra. It involves 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.

ULTRASOUND: Sound waves, at a frequency far beyond the hearing range, whose echoes bouncing off tissue can be used to image internal organs or a baby in the womb.

UNDERSTAGING: Assignment of an overly low clinical stage at initial diagnosis because of the difficulty of accurately assessing available information (e.g., stage T2b as opposed to stage T3b).

URETHRA: Tube that drains urine from the bladder through the prostate and out through the penis.

URINARY INCONTINENCE (also INCONTINENCE or URINARY URGENCY): Loss of urinary control. Various types and degrees of incontinence exist, including overflow incontinence in which the bladder retains urine after voiding and results in involuntary seepage of urine from the bladder. Stress incontinence is the involuntary discharge of urine when there is increased pressure upon the bladder, which may be caused by 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.

URINARY TRACT INFECTION (also UTI): Infection identifiable by the presence of bacteria (or theoretically viruses) in the urine that may produce fever or a burning sensation upon urination.

URINARY URGENCY (also INCONTINENCE or URINARY INCONTINENCE): Loss of urinary control. Various types and degrees of incontinence exist, including overflow incontinence in which the bladder retains urine after voiding and results in involuntary seepage of urine from the bladder. Stress incontinence is the involuntary discharge of urine when there is increased pressure upon the bladder, which may be caused by 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.

UROLOGIST: Physician trained as a surgeon who specializes in disorders of the genitourinary system (combined genital and urinary systems). See genitourinary system.

UTI (also URINARY TRACT INFECTION): Infection identifiable by the presence of bacteria (or theoretically viruses) in the urine that may produce fever or a burning sensation upon urination.

VESICLE: Small sac containing a biologically important fluid.

WATCHFUL WAITING: Active observation and regular monitoring of a patient without actual treatment.