Prostate Cancer-17

ENZYME:
Any of a group of chemical substances that are produced by living cells and cause particular chemical reactions to happen while not being changed themselves.

EPITHELIAL CELL:
A cell type in the prostate gland that lines the ducts and functionally secretes substances such as PSA into the bloodstream or into the duct openings or lumens.

EULEXIN:
The brand name of an antiandrogen that blocks the androgen receptor and prevents testosterone and/or DHT from stimulating cell growth.

EXTERNAL BEAM RADIATION THERAPY (EBRT):
A form of radiation therapy in which the radiation is delivered by a machine directed at the area to be radiated as opposed to radiation given within the target tissue, such as brachytherapy.

EXTRACAPSULAR EXTENSION:
A disease status in prostate cancer in which the cancer has penetrated the outer shell or capsule of the prostate and extends into the periprostatic tissue.


FINASTERIDE (PROSCAR):
An inhibitor of the 5-alpha-reductase Type II enzyme, which converts testosterone to the five times more potent dihydrotestosterone (DHT); used to treat BPH and PC.

FOLLICLE STIMULATING HORMONE (FSH):
A hormone produced in the pituitary gland that, in males, stimulates cells (Sertoli cells) in the testicles to make sperm; may be a factor in prostate cancer growth because FSH receptors have been identified on prostate cancer cells.

FREE PSA:
PSA unbound to any major protein; free PSA relates to benign prostate growth. The percentage of free PSA is one indicator of whether or not prostate cancer is likely present.

FREE RADICALS:
Substances that damage cell membranes and disrupt the integrity of the cell; reactive oxygen species (ROS).


GAMMA-LINOLENIC ACID (GLA):
One of the building blocks of eicosanoids that is metabolized to DGLA. The pathway that is taken after metabolism to DGLA is either toward AA and the unfavorable eicosanoids or toward the production of good eicosanoids such as PGA1 and PGA2.

GAMMA-TOCOPHEROL ISOMER:
A component of vitamin E.

GLAND:
A structure or organ that produces a substance that may be used in another part of the body.

GLAND VOLUME:
The volume of the prostate gland in cubic centimeters or grams. (Both units of measurement, cubic centimeters and grams, yield the same result.)

GLEASON GRADE:
After Donald Gleason, M.D. who developed the Gleason grading system as a tool to profile the aggressiveness of prostate cancer. A number from 1 to 5 that describes one of the two most predominant tissue patterns seen in the microscopic analysis of glandular architecture. The primary grade is the most predominant pattern, comprising 51% to 95% of the specimen, while the secondary grade comprises 5-49%.

GLEASON SCORE (GS):
The two Gleason grades, represented as (primary grade, secondary grade). An example of a high Gleason score would be (4,4) or (5,4) compared to a Gleason score of (3,3), the most common Gleason score at the time of diagnosis of PC.

GLYCEMIC INDEX (GI):
A measurement of the rate of carbohydrate entry into the bloodstream.

GLYCEMIC LOAD (GL):
The amount of insulin-stimulating carbohydrate multiplied by the glycemic index of the carbohydrate.


HDR:
See High-Dose Rate Brachytherapy

HEREDITARY:
Traits inherited from one's parents and from earlier generations via their DNA.

HIGH-DOSE RATE (HDR) BRACHYTHERAPY:
Involves inserting iridium wires into the prostate gland through hollow plastic needles that are placed under transrectal ultrasound guidance. Once the radiation dose is delivered, the wires are withdrawn from the prostate.

HORMONE:
Substances that are produced in the body that act as messengers, communicating information between cells. Usually peptides or steroids, they are produced by one tissue and delivered via the bloodstream to another tissue to affect physiological activity such as growth or metabolism.

HYPERINSULINEMIA:
A state of high insulin levels in the blood that can be caused by disproportionate consumption of simple or complex carbohydrates in the diet in proportion to dietary proteins and fats.

HYPOXIC CENTER:
The center of a prostate cancer tumor in which a state of lower oxygen tension exists. This stimulates VEGF, a substance that stimulates the blood vessel growth necessary for the nourishment of the tumor.


IMAGING:
A radiology technique or method allowing a physician to see something that would not ordinarily be visible. Imaging studies include X-ray examinations, CT scans, bone or other nuclear medicine scans, and MRI and ProstaScint studies.

INTENSITY MODULATED RADIATION THERAPY (IMRT):
An approach to external beam radiation therapy delivery using sophisticated computer planning to specify the tumor target dose and the amount of radiation allowable to nearby tissues and to modulate the intensity of the radiation as the delivery system rotates around the patient, thus minimizing damage to normal tissues.

INTERFERON:
A molecule that is active against viruses and cancer cells.

INTERLEUKIN-6 (IL-6):
A cell product made by the primary tumor as well as by osteoblasts that facilitates bone resorption and promotes osteopenia and osteoporosis by stimulating mature osteoclasts to break down bone.

INTERFERON-SIGNALING PATHWAY (ISP):
One of the defensive pathways that healthy cells use against the development of malignancy and invasion by viruses involving the interaction of interferon, which is produced in response to an invader.


KATTAN NOMOGRAMS:
Various algorithms named after Michael Kattan that present probabilities of response to therapies, such as radical prostatectomy, external beam RT, and seed implantation based on a combination of biological inputs such as PSA, Gleason score, and clinical stage.

KELOID:
Excessive scar tissue at the site of a surgery or an internal procedure. A history of this type of scar tissue formation may indicate the probability of the development of anastomotic stricture after radical prostatectomy.


LACTIC DEHYDROGENASE (LDH):
Elevated levels of this substance are associated with high Gleason score prostate cancer. LDH used to be routinely included in the standard chemistry panel and was considered an excellent overall tumor marker. For reasons unclear, LDH has been omitted from the standard panel.

LHRH ANTAGONIST:
An agent that blocks the LHRH receptor by pure antagonism without the initial release of LH, which is responsible for causing a testosterone surge seen with LHRH agonists; Abarelix (Plenaxis) is an example of an LHRH antagonist.

LIGAND:
A protein or an enzyme that combines with its appropriate binding site or receptor. The interaction of a ligand and its receptor initiates a biochemical reaction leading to the synthesis of other substances, often proteins, hormones, or enzymes. Almost all reactions in the human body involve ligands interacting with their appropriate receptors.

LNCaP:
One of the many prostate cancer cell lines. LNCaP is an androgen-dependent cell line.

LOWER URINARY TRACT SYMPTOMS (LUTS):
Urinary difficulties including slow stream, urinary urgency, difficulty in starting urination, and incomplete emptying of the bladder. These symptoms are quantified in the AUA Symptom Index or Score.

LUPRON:
Brand name of one of the drugs acting as an LHRH agonist.

LUTEINIZING HORMONE (LH):
A pituitary hormone that stimulates the Leydig cells within the testicles to produce testosterone.

LUTEINIZING HORMONE-RELEASING HORMONE (LHRH):
Hormone from the hypothalamus that interacts with the LHRH receptor in the pituitary to release LH which in turn stimulates Leydig cells in the testicles to make testosterone.

LYMPH NODES:
Small glands occurring throughout the body that filter out bacteria and other toxins, including cancer cells. During the process of metastasis, they are one of the first sites of involvement when the cancer leaves the primary site of origin.


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

MAGNETIC RESONANCE IMAGING (MRI):
Use of magnetic resonance with atoms in the body tissues to produce distinct cross-sectional or three-dimensional images of internal structures.

MALIGNANCY:
A growth or tumor composed of cancerous cells.

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

METASTASIS (pl. METASTASES):
Secondary tumor formed as a result of a cancer cell or cells from the primary tumor site traveling to a new site and growing there.

MICROVESSEL DENSITY:
An objectified measurement of angiogenesis.

mL (MILLILITER):
Unit of volume equal to one-thousandth of a liter.

NARAYAN STAGE:
Part of the algorithm developed by Perry Narayan that assesses if the microscopic findings of prostate cancer were limited to one side of the prostate (Narayan B1) or both sides (Narayan B2).


NERVE-SPARING:
A technique used in radical prostatectomy in which the erectile nerves are left intact by the surgeon.

NEURON-SPECIFIC ENOLASE (NSE):
A biomarker of prostate cancer that may be expressed in prostate cancer variants associated with higher Gleason scores, that is, Gleason scores 8-10.

ng (NANOGRAM):
Unit of measurement that is one-billionth of a gram.

NOMOGRAM:
A graphic representation, often used in analyzing data, consisting of several lines marked off to scale. Specific variables such as PSA, Gleason score, clinical stage, etc. are given point values. The sum of all the points equates with the prognostic outcome.


OBJECTIFIED ONGOING OBSERVATION:
A more appropriate term than watchful waiting that indicates that a patient not undergoing a definitive procedure using surgery or radiation or other treatments will be objectively monitoring his biological status in a consistent ongoing fashion.

ONCOGENES:
Genes relating to tumor growth.

ONCOLOGY:
The branch of medical science dealing with tumors. Oncologists study cancer and treat patients who are afflicted with cancer.

ONCOLYTIC VIRUS:
A virus that can kill tumor cells having defects in the interferon-signaling pathway or by other mechanisms.

ORGAN:
A group of tissues that work in concert to carry out a specific set of functions in the body.

ORGAN-CONFINED DISEASE:
Prostate cancer that is apparently confined to the prostate as determined either by clinical findings or, in the case of radical prostatectomy, by pathological findings; prostate cancer that has not penetrated the prostate capsule.

OSTEOBLAST:
A cell type within bone that promotes bone formation.

OSTEOCLAST:
A cell type within bone that promotes breakdown of bone or bone resorption.

OSTEOPENIA:
A condition of bone that indicates that an imbalance between bone formation and resorption is compromising bone integrity. Osteopenia indicates that the degree of bone loss is more than 1 standard deviation from the WHO definition of normal, but not more than 2.5 standard deviation below that level.

OSTEOPOROSIS: A reduction in bone mineral density that is more that 2.5 standard deviation below the normal level defined by the WHO.