Prostate Cancer-16

3DCRT (3-Dimensional Conformal Radiation Therapy):
An approach to radiation treatment planning that focuses on directing the radiation energy to the tumor target while sparing surrounding normal tissues.


5-ALPHA REDUCTASE (5-AR):
The enzyme that converts testosterone to dihydrotestosterone (DHT).


ADENOCARCINOMA:
A form of cancer that develops from a malignant abnormality in the cells comprising a glandular organ, such as the prostate. Almost all prostate cancers are adenocarcinomas.

ADVANCED PROSTATE CANCER:
Prostate cancer that is no longer organ-confined; systemic prostate cancer, sometimes with metastases to lymph nodes, seminal vesicles, bone, or vital organs of the body such as liver and/or lungs. Advanced prostate cancer is treated with systemic therapies currently in use such as androgen deprivation and chemotherapy.

AGONIST:
A chemical substance, such as a drug, capable of combining with a receptor on a cell and initiating a reaction or activity. In PC, the LHRH agonist is also called LHRH-A. The most commonly used LHRH-As are Lupron and Zoladex. Either of these agents interacts with the LHRH receptor and forms a complex that results in a decrease in the release of LH over a period of 2 weeks and hence a lowering in serum testosterone.

ALGORITHM:
In prostate cancer, one of a group of systems whereby the human experiences of a number of patients are statistically or numerically analyzed to produce data that can be generalized to predict the probable disease status of patients who have not yet been treated and therefore have no empirical data of their own on which to base judgments regarding their disease status. Examples include the Partin Tables, Narayan Stage, and Kattan Nomograms.

ALPHA-1 BLOCKERS:
Oral medications prescribed to improve urine flow by relaxing periurethral smooth muscle tissue; those of the quinazoline class (Hytrin and Cardura) have been shown to be synergistic with Proscar in causing programmed cell death in prostate cells, both benign and malignant.

ALPHA-TOCOPHEROL ISOMER:
A component of vitamin E.

AMERICAN UROLOGICAL ASSOCIATION (AUA) SYMPTOM INDEX SCORE:
A series of subjective questions used by physicians to evaluate the extent of existing lower urinary tract symptoms.

ANASTOMOSIS:
In prostate cancer, the surgical connection made between the bladder neck and the remaining urethra after the prostate is removed.

ANASTOMOTIC STRICTURE:
In prostate cancer, a narrowing at the site of the anastomosis between the bladder neck and urethra after radical prostatectomy.

ANDROGEN:
A hormone produced primarily by the testicles, but also in the cortex of the adrenal glands, that is responsible for male characteristics and the development and function of the male sexual organs and also affects muscle and bone mass, emotional stability, cognitive function, skin and hair, and so forth.

ANDROGEN-DEPENDENT PC (ADPC):
Prostate cancer cells that depend on androgens for continued growth and vitality.

ANDROGEN DEPRIVATION SYNDROME (ADS):
A constellation of symptoms directly or indirectly due to the drop in testosterone that occurs following surgical castration or the suppression of testicular and adrenal androgens by the use of medications.

ANDROGEN DEPRIVATION THERAPY (ADT):
A prostate cancer treatment that is based on blocking the amount of available androgen to the prostate cancer cell.

ANDROGEN-INDEPENDENT PC (AIPC):
Prostate cancer cells that do not depend on androgen for growth.

ANDROGEN RECEPTOR:
A structural entity that is essentially a docking site for androgen to communicate with the cell and affect cell function. The substance interacting with the receptor is called a ligand. The interaction of ligand and receptor is a major mode of biochemical communication in all life forms.

ANEUPLOID:
Cells that have an abnormal number of sets of chromosomes. Aneuploid cancer cells tend not to respond as well to androgen deprivation therapy.

ANGIOGENESIS:
Relating to the formation of blood vessels.

ANTAGONIST:
A chemical that acts within the body to reduce the physiological activity of another chemical substance.

ANTIGEN:
A substance that elicits a cellular-level immune response or causes the formation of an antibody.

APOPTOSIS:
Programmed cell death due to an alteration in a critical substance or chemical necessary for cell viability. For example, the lack of male hormones causes apoptosis of androgen-dependent prostate cancer cells.

ARACHIDONIC ACID (AA):
An omega-6 fatty acid that is known to generate free radicals and is considered an unfavorable eicosanoid. AA is metabolized via enzymes of the COX and LOX family to generate prostaglandins, thromboxanes, leukotrienes, hydroxylated fatty acids, lipoxins, and 5-HETE compounds that are implicated in cancer, inflammatory disease, immune dysfunction, and degenerative disorders. Organ meats and egg yolk are rich in AA.

ARTIFICIAL NEURAL NET (ANN):
An approach to analyzing data that uses statistical analysis of historical data to produce systems that can predict probabilities of future outcomes based on inputted variables.


BASELINE PSA:
The PSA level before a new treatment has begun; used to establish the efficacy of a therapy based on response of the PSA to treatment.

BENIGN:
Not malignant; noncancerous.

BENIGN PROSTATE HYPERPLASIA OR HYPERTROPHY (BPH):
A noncancerous condition of the prostate that results in the growth of both glandular and stromal (supporting connective) tissue, enlarging the prostate and potentially leading to obstructive symptoms relating to urine flow (see American Urological Association Symptom Index Score).

BILATERAL:
Both sides; for example, a bilateral nerve-sparing radical prostatectomy is one in which the nerves on both sides of the prostate are left intact.

BIOMARKER:
An indicator of biological activity of cells or tissues that can be used as a means to monitor a state of health or disease. PSA is one of the most useful biomarkers in medicine.

BIOPSY:
Sampling of tissue from a specific part of the body in order to check for abnormalities such as cancer.

BISPHOSPHONATES:
A class of compounds that stops bone loss (resorption) by actions directed against the osteoclast.

BONE SCAN:
An imaging technique using a radioactive isotope that is selectively taken up by bone tissue to identify abnormal or cancerous growths within bone such as metastases.

BRACHYTHERAPY:
A form of radiation therapy in which radioactive seeds or wires are used to deliver the radiation dose close to the site of a tumor. Seeds can be permanently implanted or radioactive wires can be temporarily introduced and then withdrawn after the radiation dose is delivered.


CANCER:
The growth of abnormal cells in the body in an uncontrolled and disordered manner, invading surrounding tissues and sometimes spreading to distant sites within the body via the bloodstream and/or lymphatic system.

CARCINOEMBRYONIC ANTIGEN (CEA):
A biomarker of prostate cancer that may be expressed in prostate cancer variants associated with higher Gleason scores, for example, Gleason scores 8-10 may indicate that androgen-independent cells are present.

CASODEX:
Brand name of an antiandrogen medication that functions by occupying and therefore blocking the androgen receptor, thus preventing natural androgens from stimulating cell growth.

CAT or CT SCAN (COMPUTERIZED AXIAL TOMOGRAPHY):
An imaging method used to identify abnormalities by combining images from multiple X-rays under the control of a computer to produce cross-sectional or three-dimensional pictures of internal structures.

CBC (COMPLETE BLOOD COUNT):
Complete blood workup including white blood count, hematocrit, and platelet count.

cc (CUBIC CENTIMETERS):
Used as a measurement of prostate gland volume or amount of prostate cancer; cubic centimeters are equivalent to grams (g) in determinations of prostate gland volume.

cGy (centiGray):
A unit of measurement of radiation dose; 1 cGy equals the energy absorbed from ionizing radiation equal to 1 joule (a unit of energy) per kilogram.

CHEMOTHERAPY:
The use of pharmaceuticals or other chemicals to kill cancer cells. In many cases these agents may also damage normal cells in the process of killing cancer cells, resulting in various adverse side effects.

CHROMOGRANIN A (CGA):
A biomarker of prostate cancer that may be expressed in prostate cancer variants associated with higher Gleason scores, that is, Gleason scores 8-10. Progressive increases of CGA in the blood indicate an aggressive clone of prostate cancer is present that exhibits an increased tendency to metastasize to lymph nodes, liver, and lungs. CGA is produced by the neuroendocrine cells associated with androgen independent PC.

CLINICAL STAGE:
The TNM (tumor, nodes, metastases) system of classification for communicating extent of disease in a specific patient based on all available information. This system has largely replaced the older Whitmore-Jewett staging classification system.

CORE INVOLVEMENT:
Expressed as a percentage; indicates the amount of biopsy cores involved by prostate cancer divided by the total number of cores that have been sampled. If 12 cores of tissue were obtained and 6 showed PC, then the percentage core involvement would be 50%.

COX-2 (CYCLOOXYGENASE 2):
The enzyme that converts arachidonic acid to prostaglandin E2. Inhibition of COX-2 is now an important approach to reducing the production of unfavorable eicosanoids implicated in the cause and progression of malignancy and inflammatory disorders.

CRYOPROBES:
The hollow probes used to freeze tissue during a cryosurgery procedure.

CRYOSURGERY:
The use of liquid nitrogen or argon gas circulated through cryoprobes to freeze and kill tissue, including any cancerous tissue.


DEDIFFERENTIATION:
Relatively more primitive in appearance and function than well-differentiated cells that, by contrast, are mature and able to function properly. As the disease progresses, cancer cells become more dedifferentiated (i.e., primitive) than normal cells, losing the characteristics that normal cells possess.

DEXA SCAN:
An imaging procedure used to evaluate bone mineral density and evaluate the status of bone integrity as regards a diagnosis of osteopenia or osteoporosis. The DEXA may understate the true extent of abnormality by attributing unrelated conditions such as arthritis and vascular calcifications to normal bone density.

DIAGNOSIS:
The evaluation of signs, symptoms, and tests to determine physical and biological causes of these signs and symptoms and evaluate whether a specific disease or disorder is involved.

DIGITAL RECTAL EXAMINATION (DRE):
The use by a physician of a lubricated and gloved finger inserted into the rectum to feel for abnormalities of the prostate and rectum.

DIHYDROTESTOSTERONE (DHT):
A male hormone five times more potent than testosterone; DHT is converted from testosterone within the prostate and in other tissues by the enzyme 5-alpha-reductase.

DIPLOID:
Cells having one complete set of 46 normally paired chromosomes, that is, a normal amount of DNA. Diploid cancer cells grow relatively slowly and usually respond well to androgen deprivation therapy.

DNA (DEOXYRIBONUCLEIC ACID):
The basic biologically active chemical that defines the physical development and growth of nearly all living organisms; a complex protein that is the carrier of genetic information.

DOWNREGULATING (DOWNREGULATION):
Turning off a mechanism of action in the body at the biochemical level.

DUTASTERIDE (AVODART):
A 5-alpha-reductase inhibitor that prevents the conversion of testosterone to the five times more potent dihydrotestosterone (DHT). Unlike Proscar, which blocks only 5-alpha reductase Type II, dutasteride also blocks 5-alpha reductase Type I.


EICOSANOIDS:
Hormones made within the cell membrane of every living cell in the body controlling every physiological function. Eicosanoids have opposing actions operating as a check-and-balance system. Therefore, a balance of these opposing actions is essential for optimal health.

EICOSAPENTENOIC ACID (EPA):
An omega-3 fatty acid that has been shown to inhibit the formation of AA by inhibiting the enzyme delta-5 desaturase, which converts DGLA to AA.

EJACULATION:
The release of semen through the penis during orgasm.

ENDOCRINE GLAND:
Any of various glands producing hormonal secretions that pass directly into the bloodstream. Examples of endocrine glands include the thyroid, parathyroids, anterior and posterior pituitary, pancreas, adrenals, pineal, and gonads.

ENDORECTAL MRI:
Magnetic resonance imaging of the prostate using a probe inserted into the rectum.