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Glossary
A
Ablation
Decrease or elimination of; For instance, in prostate cancer, hormonal ablation means using hormones (or hormonal withdrawal) to decrease or eliminate testosterone production
Active Surveillance
Closely following a patient diagnosed with prostate cancer prior to some future possible treatment. Typically involves yearly repeat biopsies and quarterly PSA blood tests. Treatment occurs when the biopsy results worsen, PSA rises or patient decides he wants to be treated.
Adjuvant
A treatment given in addition to another therapy. Adjuvant hormonal therapy for example, would be hormonal therapy that is given along with the radiation and seed treatment. Neo-adjuvant hormone therapy would be hormone therapy given before brachytherapy or IMRT.
Adrenal Glands
Two glands located above the kidneys (one above each kidney); they produce several kinds of hormones, including a small amount of testosterone.
Age-Adjusted PSA
A scale that some physicians use in assessing the normal amounts of PSA as a man ages; age-adjusted PSA is controversial and not all physicians use it.
AJCC
American Joint Committee on Cancer
Alpha-Blockers
Drugs used to improve urination by relaxing the internal sphincter of the urethra. Examples would be Hytrin (Terazosin), Flomax (,tamsulosin) Uroxatrol,(alfuzosin) or Cardura (Doxazosin).
Androgen
Any hormone responsible for the development of male sex characteristics and sexual organs. Testosterone and its derivatives are examples.
Anterior
The front or forward portion
Anti-Androgen
A drug that blocks the action of testosterone (e.g. Casodex).
Anus
The opening at the lower end of the rectum
Apex
The bottom portion of the prostate. Just beyond this part is the sphincter that voluntarily closes the urethra.
Apoptosis
Cell death
B
Benign
Not cancerous; harmless
Benign Prostatic Hyperplasia (BPH)
A non-cancerous condition of overgrowth of prostate tissue. This tissue may compress the urethra and bulge into the bladder causing slowing of the urinary stream. Also called benign prostatic hypertrophy or BPH.
Bilateral
Both sides; for instance, when a bilateral nerves-sparing prostatectomy is performed, it means that the nerve bundles on both sides of the prostate were left intact. If the pathologist describes disease as bilateral, it means that the cancer is on both the right and left sides of the prostate.
bRFS Biochemical Relapse Free Survival
As standard form of measuring results of treatment. It reports on whether a patient has failed by PSA criteria. It dose not indicate wheter a patient has live ( survived) or not. It is only reflects PSA. It means, Are you alive without evidence of a PSA relapse? Common methods use a rising PSA on 2 or three consecutive occasions to define a failure.
Biological Therapy
Treatment to stop cancer growth through interruption of various cell reproductive pathways.
Biopsy
The removal of a sample of tissue for examination under a microscope to check for cancer cells. Typically 6-12 biopsies are taken of the prostate gland.
Bladder
The hollow muscular organ that stores urine; it sits above the prostate.
Bone Density Study
Dual Energy X-ray Absorptometry; low energy x-rays and analysis to measure bone loss. Also may be referred to as a Dexa Scan.
Bone Scan
An entire picture of the skeletal bones with a radioactive substance. To create these pictures, a radioactive substance is injected into the bloodstream. The radioactive substance collects in any areas of bone growth. Cancer can be indirectly seen because the bone tries to repair the injury caused by the cancer at that location in the bone. However benign conditions, such as old fractures, infection, and arthritis can seen as bone growth, sometomes resulting in a false positive scan. A scanner can image these areas and must be carefully interpreted.
Board Certification
Upon completion of Residency, physicians are required to take both written and orals exams in order to be “Board Certified”. For radiaton onoclogists, the body administering the exams is the Americam Board of Radiology.
Brachytherapy
Any procedure in which a source of radioactive material is placed near a tumor. The implantation of radioactive seeds for prostate cancer is a form of brachytherapy in which the seeds emit low energy radiation in order to kill cancer cells inside and immediately surrounding the prostate.
C
Cancer
A general term for more than 100 diseases in which abnormal cells multiply without control. Cancer is best determined by microscopic evaluation by a pathologist.
Capsule
Describe an anatomic boundary between the prostate gland the tissue surrounding it. There is not a true capsule that encases the prostate gland. Extra-capsular extension means disease beyond the prostate.
Carcinoma
Cancer
Cardura
This medication is used to improve urination flow. Doxazosin is an alpha blocker designed to relax the internal sphincter within the prostate and improve the flow of urine. See the website for further information.
Castration
Surgical castration is removal of the testicles via surgery. Medical castration uses medication to reduce testosterone temporarily to very low (castration) levels.
Catheter
A long narrow tube placed into the bladder which is used to allow urine to pass from the bladder to the penis (penile catheter) or out through the abdominal wall (suprapubic catheter).
Cesium 131 (CS-131)
An isotope used in prostate brachytherapy and other sites. Cs-131 emits low energy radiation, mostly beta and has a very short half life of 9 days. It therefore dissipates approximately 90% of it’s energy within 36 days.
Chemotherapy
Treatment with anti-cancer drugs, usually by attacking DNA or RNA. Both normal and cancer cells are affected, though typically normal cells can tolerate chemotherapy better than cancer cells.
CHT (Combined Hormonal Therapy)
Using multiple hormonal agents. An example would be the use of Lupron (an injected LHRH agonist) and Casodex (an oral anti-androgen) together.
Cialis
A medication used to improve erection ability. Tadalafil is a PDE-5 inhibitor. See website for details about side effects. Website
Clinical Trials
Studies conducted with cancer patients, usually to evaluate a new treatment, or to better evaluate and document the outcomes of existing standard treatments.
Complication
An unexpected effect of a treatment. This is different from a side effect which is an expected undesirable effect (temporary or permanent) of treatment.
Core
The small amount of tissue extracted during a needle biopsy.
Cryosurgery
The placement of super-cold liquids into the prostate or other organ to freeze and kill the tissue including cancerous tissue.
CT or CAT scan
Computerized Tomography: a series of detailed x-ray pictures of areas inside the body produced by a computer linked to a x-ray machine.
Cyberknife
A Robotic Linear Accelerator designed to give External beam radiation. In contrast to the traditional linear accelerator the robotic arm can move in multiple direction rather than simple arc such as with IMRT of other external radiation.
Cystoscope
A metal tube or small flexible rubber instrument used to look inside the bladder and the urethra.
D
DES
Diethylstilbestrol. This is a rarely used hormonal agent. Typically reserved for patients with metastatic cancer that are resistant to Lupron and Casodex. Commonly causes breast enlargement as a side effect.
DEXA Scan
Bone density study. Dual Energy X-ray Absorptiometry; low energy x-rays and analysis to measure bone loss Also know as a bone density study.
Diethylstilbestrol
A synthetic estrogen. Same as DES.
Differentiation
A description of cell progression or change versus normal cells. Pathologists grade the severity of cancer and determining the aggressiveness of prostate cancer cells as viewed under a microscope. Well differentiated cells grow slower, appear similar to normal cells and are less aggressive than poorly differentiated cells which look more abnormal and typically divide quicker and spread more easily. Most cancers are well to moderately differentiated.
Digital Rectal Examination (DRE)
A physical exam in which the prostate is examined by inserting a gloved finger into the rectum and palpating the posterior part of the gland.
Dosimetry
The process of calculating the radiation dose to a specific area of the body. With Prostate brachytherapy, this involves using sophisticated computers to determine seed placement, seed strength and needle placement.
Dosimetrist
A person who performs the computer calculations for a permanent seed implant or external beam radiation.
Dysuria
Painful urination
E
Ejaculatory Ducts
The tubes from the seminal vesicles and vas deferens in which semen travel. The ducts transverse through the prostate, ending in the urethra, within the middle of the prostate.
Erectile Dysfunction
Inability to achieve a full and sustained erection. Only refers to erection ability and not ability to achieve orgasm, climax or produce semen.
Estrogen
A female hormone. Estrogen is made in the ovaries, adrenal glands and fat tissues.
External Beam Radiation Therapy (EBRT)
Radiation targeted to a specified area and delivered by a special machine (e.g. a linear accelerator). Common forms of EBRT are IMRT, Protons, Cyberknife and Tomotherapy.
ExtracapsularExtension
Prostate cancer cells that have extended beyond the edge of the prostate into the tissue surrounding the prostate. This is usually microscopic and thus can typically only be seen by the pathologist looking at tissue under a microscope. It cannot typically be seen at surgery or by diagnostic scans (MRI, CT etc).
F
Flomax
A medication used to improve urination flow. Tamsulosin is a Alpha blocker which helps relax the internal sphincter within the prostate allowing for improvement of the emptying of the bladder. See website for details. Website
Free PSA
Most PSA binds to other proteins in the blood but free PSA is unbound and floating by itself. Generally, the lower the percentage of free PSA, the higher the likelihood of having prostate cancer.
Frequency
In regards to urination, this refers to the number of urinations per day or night.
G
Gleason Score (GS)
A method for categorizing cancerous tissues from least aggressive to most aggressive. It is prostate cancer specific. Prostate tumors sometimes are made of patterns ofof two or more grades of cells. Each of the patterns of cells are graded from 1-5;. The two numbers are added together to give the Gleason score. For example Gleason score 7/10 refers to a pattern of Gleason grade 3 cells and Gleason grade 4 cells. The most common cell pattern is recorded first. A Gleason 4+3=7 means that most of the cancer was Gleason pattern grade 4 and less was grade 3. A Gleason 4+3=7 is typically more aggressive than a Gleason 3+4=7. If all the cells are the same such as Gleason 3 then cancer becomes a Gleason score 6 (3 plus 3) Most cancers are Gleason score 6 or 7. GS 2-4 are very rare, and tend to come from the central aspect of the prostate that is removed at time of TURP. Over the years Gleason scores have evolved. In the late 1980’s and early 1990’s cancers were often called Gleason score 2-4. Those same biopsies reviewed today would typically be called Gleason score 6 or 7. This is another reason one cannot accurately compare results of patients treated from an older era to modern era patients.
Grade
A way to describe the possible severity of a cancer based on the appearance of cells under a microscope; Prostate cancer is graded from 1-5, see Gleason Score.
Gy – Gray
A unit of measuring radiation. Typical external doses are 75-80 Gy. Implant doses range from 90- 160 Gy. May also sometimes be recorded as cGY centigray which is a 1000 Grays.
Gynecomastia
Enlargement and/or tenderness of the male breasts or nipples; one potential side effect of hormonal therapy.
H
Hematospermia
Blood in the semen
Hematuria
Blood in the urine
Hormonal Therapy
Hormone therapy for prostate cancer stops production or the effect of testosterone. Hormone therapy may involve removing the testicles or drugs to prevent the production or effect of male hormones.
Hormone
A chemical substance that is formed in one part of the body, travels through the blood, and affects that function of cells elsewhere in the body. Male hormones such as testosterone produce male characteristics such as facial hair and baldness.
Hot Flash
A brief rush warmth in the face, neck and upper body, often a side effect of hormonal therapy.
I
Immune System
The body’s system that protects and fights foreign or abnormal agents such as viruses, bacteria, and cancer cells.
Implant
A procedure in which radioactive material is placed in the body; for instance radioactive implant is a procedure in which small seeds are inserted into the prostate to kill cancer cells.
Impotence
A general term to indicate a problem with sexual function. While it is most commonly associated with erectile dysfunction, it could include problems with climax,fertility or ejaculation. A good description of impotence should describe each of these specific issues separately.
IMRT (Intensity Modulated Radiation Therapy)
External beam radiation in which the beam strength (intensity) can be modified (modulated) for every beam; the linear accelerator beams are shaped and modulated using a computerized device known as a multi-leaf collimator (MLC). IMRT allows for higher doses than conformal or older conventional radiation to be delivered to the prostate while maintaining lower doses to nearby normal tissue.
Incision
A cut in the skin made during surgery. For example, during Robotic surgery 4 incisions are made in the abdominal wall to allow for the laparoscopic probes to be inserted.
Incontinence
Usually refers to the loss of urinary control or inability to control the flow of urine from the bladder, or requirement to wear a pad for any reason. Stress incontinence means leakage of urine during coughing, sex, exercise or sneezing. Complete or frank incontinence refers to lack of any control. Surgical incontinence is often reported only as complete incontinence. The total incontinence rate is the sum of both complete and stress incontinence. It is defined as the requirement to wears pads.
Inflammation
Swelling, pain, and/or irritation.
Invasive Procedure
Inserting an instrument or other substance into the body.
Invasive Cancer
Cancer that spreads (invades) into adjacent areas.
Iodine 125 (I-125)
An isotope used in prostate brachytherapy and other sites. I-125 emits low energy radiation mostly beta and has a half life of 60 days. It therefore dissipates approximately 90% of it’s energy within 6 months.
Isotope
An atom that emits radiation. Iodine 125, Palladium 103 and Cesium 131 are examples of isotopes. Isotopes used for permanent seed implantation degrade over a relatively short time to their natural element.
IPPS Score Sheet
This is a series of questions designed to assess your urination capabilities. It is used in Brachytherapy to determine tolerance and ultimate urination capabilities immediately after and long term. AUA score sheet is similar.
K
Kegel Exercises
Exercises to improve the strength of the voluntary muscles controlling urination. These muscles are located just beyond the prostate gland along the urethra.
L
Laparoscopy
Procedure using the laparoscope, a slender surgical optical instrument to see inside the abdomen. During robotic surgery 4 of these instruments are used.
Lateral
Any region to the left or right of the midline.
Levitra
A medication used to improve erection ability. Vardenafil is a PDE-5 inhibitor See website for details about side effects and usage. Website
Libido
Interest in sexual activity; sex drive.
Local Therapy
Treatment directed to the prostate and the area immediately surrounding the prostate. Regional therapy would indicate treatment of the pelvis and or seminal vesicles.
Luteinizing Hormone-Releasing Hormone (LHRH)
Chemicals originating in the brain that initiate the chain of events that result in testosterone production.
Lymph
Colorless fluid that travels through tiny vessels (lymphatic vessels) and lymphatic system (including the spleen and lymph nodes).
Lymph Nodes
Small bean-shaped organs that contain special cells that can filter out bacteria and other foreign particles and trap cancer cells. As the lymph passes through the lymph nodes the cells may be prevented from entering the bloodstream; also known as lymph glands. The first echelons of lymph nodes from the prostate are in the pelvis.
M
Magnetic Resonance Imaging (MRI)
A diagnostic imaging procedure in which a high powered magnet linked to a computer is able to create detailed images of internal organs. It has minimal diagnostic use in prostate cancer but is sometimes used to evaluate the seminal vesicles. MRI scans are sometimes fused with CT scans to help plan radiation therapy treatments. A SPECT MRI allows the computer to look at the chemical composition of the cells which in some occasions have a characteristic cancer pattern. The SPECT MRI has limited value in most patients.
Malignant
Cancerous cells which continue to divide without constraint and can spread to other parts of the body.
Margin
The area of normal tissue surrounding the prostate and encompassed by the treatment. This margin is designed to include the area beyond the prostate that the cancer can spread. A surgical margin is very tight to the gland if the surgeon spares the erectile nerves. With seed implantation or external beam radiation the margin treated (extra area of non-diseased tissue just beyond the prostate) is planned based on the grade, stage and PSA.
Medical Oncologist
A cancer physician specially trained in the use of medication or chemotherapy to treat cancer.
Medical Physicist
A PhD or Master trained physicist specialized in medical physics. These professionals oversee all of the equipment and planning issues related to the radiation treatments. For brachytherapy, the medical physicist reviews every plan for accuracy and correct seed strength.
Metastasis
The spread of cancer from one part of the body to another. Plural is metastasis.
Metastasize
A verb to indicate spread of cancer to other parts of the body. E.g. “The cancer has metastasized to the lymph nodes.”
N
Nadir
The lowest point; for instance, a PSA that has fallen to its lowest level after prostate cancer treatment has reached its nadir or low point.
Neoadjuvant
Meaning added before; for example, neoadjuvant hormone therapy is hormone therapy given before another form of treatment such as seeds and external beam radiation.
Nerve-sparing
A term describing a type of prostatectomy in which the surgeon saves the nerves that affect sexual and related functions. There is virtually no margin with this surgery.
Neutron Radiation
External beam radiation therapy which uses subatomic particles (neutrons) to treat cancer. Rarely used today.
Nocturia
Urination at night
Noninvasive Treatment
No incision into the body is needed. External beam radiation is an example. Minimally invasive indicates that small incision (Robot laparoscopic) or needle insertion (seed implantation) is performed as part of the procedure.
O
Oncologist
A physician who specializes in treating cancer; for example, a radiation oncologist treats cancer with radiation and a medical oncologist treats the disease with drugs. A surgical oncologist treats cancer with surgery.
Orchiectomy
Surgery to remove the testicles
P
Palladium 103
An isotope used in prostate brachytherapy and other sites. Pd 103 emits low energy radiation mostly beta and has a half life of 17 days. It therefore dissipates approximately 90% of it’s energy within 2 months.
Palliative
Treatment to relieve a problem; palliative therapy is relieves symptoms of either treatment or the cancer but it is not curative. Radiation for a painful bone metastasis is an example of palliative treatment.
Palpable
Something that can be felt during a physical examination.
PAP (Prostatic Acid Phosphatase)
A rarely used blood test measuring a blood enzyme that was used to predict the aggressiveness of the cancer. Largely replaced by PSA, Stage and Gleason score.
Partin Tables
Tables that use a patient’s PSA, Gleason score and DRE stage to predict the likelihood of spread of disease beyond the prostate gland region. The tables report the predicted risk of cancer involving the edge of the gland (Extracapsular extension), the lymph nodes and the seminal vesicles.
Pathologist
A physician specializing in the examination of tissues and blood samples to help determine the presence of disease. The pathologist determines whether the cells are cancerous and also determines the Gleason score.
Pelvic Lymph Node Dissection
Removal of some pelvic lymph nodes to see if prostate cancer has spread, most often done during prostatectomy. The samples are obtained via an open operation or laparoscopically. Only some of the lymph nodes are removed, most remain behind unexamined in the pelvis.
Penile
Relating to the penis.
Penis
The male sex organ
Perineal
Relating to area from the scrotum to the anus (perineum).
Perineal Prostatectomy
A surgery to remove the prostate through an incision made between the scrotum and the anus.
Perineum
The area of skin and tissue between the scrotum and the rectum.
Peyronie’s Disease
Curvature of the penis is an abnormal bend in the penis that occurs during erection. Symptoms: Bend in the penis with erection; Narrowing of the penis with erection.
Photon Radiation
Also known as X-rays. Low-energy photon radiation, also known as x-rays, have just enough photon energy to penetrate the body for an x-ray film but cause minimal harm to the cells. High-energy photon radiation (IMRT radiation) is produced by a machine called a linear accelerator and is capable of killing cells particularly, cancer. One should note that Proton beam radiation is different from photon beam radiation in that the radiation is in the form of a proton particle. Each type of radiation beam therapy has advantages and disadvantages.
PIN
Prostatic Intraepithelial Neoplasia; Cells that are not quite normal yet also not cancer; The presence of PIN can alert the physician to increase surveillance as its presence may be associated with an increased risk of prostate cancer.
Placebo
A drug designed to look like a real drug but without any activity. In research studies the effects of placebos are compared with a real drug. Sugar pills are an example of a placebo. Studies that randomize patients between placebo and real drugs are attempting to see if the effect patients experience is due to the drug or simply the act of taking something that the patient thinks will help.
Posterior
Toward the back portion. The posterior portion of the prostate is the side near the rectum and is the portion palpated at the time of the digital rectal exam (DRE).
Post Operative Dosimetry
Following a permanent seed implant, the precise location of the seeds is determined by CT scan and a calculation of dose received to the prostate and adjacent areas is determined. The radiation oncologist (Brachytherapist) will review this and verify that a satisfactory dose has been received to the correct areas.
Prognosis
The potential clinical outlook based the probable course of disease.
Progression
Ongoing growth or the regrowth of the cancer. Progression in prostate cancer is measured typically by the PSA blood test, bone scans and CT scans.
Prostate
A male gland which supports the urethra and prostatic ducts. It produces a fluid that forms part of semen and is located between the bladder and the penis. It is anterior to the rectum.
Prostatectomy
An operation to remove part of, or the entire, prostate. An open prostatectomy requires an abdominal incision while a robot laparoscopic surgery requires 4 skin incisions and 4 probes be inserted into the abdomen.
Prostate-Specific Antigen
An enzyme produced by normal and cancerous prostate cells. Normally present in small levels in a man’s blood. Infection, inflammation, prostate enlargement, and trauma to the prostate or cancer can increase PSA in the blood stream. Used also to measure results of prostate cancer treatment.
Prostatic Acid Phosphatase
PAP – a rarely used blood test measuring a blood enzyme that was used to predict the aggressiveness of the cancer. Largely replaced by PSA, stage and grade.
Prostatitis
Infection or inflammation of the prostate gland.
Prosthesis
A man-made device to replace a normal body part. A penile prosthesis consists of small tubes placed in the penis which can then be inflated to simulate/create an erection.
Proton Beam Radiation
This is particle (proton) external beam radiation. Protons slow and react with tissue at a specific depth in body. Protons have energy, mass and charge, thus do not travel as deeply into the body as photons which have just energy, but no mass or charge.
PSA (Prostatic Specific Antigen)
A protein produced by both normal and cancer cells of the prostate gland. PSA is present in small quantities in the serum of normal men, and is often elevated in the presence of prostate cancer and in other benign prostate disorders. A blood test to measure PSA is considered the most effective test currently available for the early detection of prostate cancer. Rising levels of PSA over time can be indicative of either localized and metastatic prostate cancer (CaP).
PSA Density
PSA density is the ratio of size of the prostate to the PSA level; Rarely used as it has little clinical value.
Q
Quality of Life
The health status after therapy compared to that prior to therapy. Quality of life (QOL) studies take into account the patient’s age, expectations, and physical functioning. Typical QOL studies look at erectile function, incontinence, bowel function and overall well being.
R
Radiation Proctitis
Inflammation and irritation of the area of the rectum immediately below (posterior to) the prostate, due to external beam or seed implantation.
RadiationProstatitis
Inflammation and irritation of the prostate due to external beam radiation therapy or seed implantation.
Radiation Therapy
Any treatment using radiation. Generally refers to external beam radiation; any treatment such as linear accelerator, proton beam, tomotherapy or seed implantation used to kill cancer cells are forms of radiation therapy. The radiation may come from a machine (external radiation therapy) or from radioactive materials (brachytherapy) placed inside the body as close as possible to the cancer.
Radical Prostatectomy
Surgery to remove the entire prostate and usually the seminal vesicles; the three types of radical prostatectomy are retropubic prostatectomy, perineal prostatectomy, and laparoscopic/robotic assisted prostatectomy.
Radiotherapy
See Radiation Therapy
Rectum
The last few inches of the large intestine leading to the outside of the body. The DRE involves inserting the finger into the rectum.
Recurrence
The reappearance of cancer by palpation, imaging or blood tests.
Refractory
Meaning resistant to therapy; for example, hormone refractory prostate cancer is cancer that is resistant to hormonal treatment and has returned.
Remission
Disappearance or lack of progression of the cancer either by blood tests or imaging. Remission can be temporary or permanent. Most often remission is used in reference to a response to chemotherapy or hormonal therapy.
Retention
Difficulty in starting urination or the inability to empty the bladder.
Retropubic Prostatectomy
Removal of the prostate through an abdominal incision.
Risk Group
Patients of similar prognosis. Patients can be grouped into Low, Intermediate and High risk groups based on stage, grade and PSA. Risk group classification can be helpful in designing treatment options and comparing different treatments. There are several types of risk groupings, D’Amico. NCCN, and Zelefsky but hey are very similar.
S
Salvage
A procedure following the failure of an earlier treatment. For example, salvage radiation would be treatment with radiation after an initial surgery failed. Arnold Palmer underwent salvage radiation therapy after his cancer returned after initial surgery.
Scrotum
The external pouch of skin containing the testicles.
Semen
Fluid that is released through the penis during orgasm. Semen is made of up of sperm from the testicles and fluid from the prostate and seminal vesicles.
Seminal
Related to semen. Generally refers to seminal vesicles, which are the small sacs outside the prostate which produce most of the ejaculate.
Seminal Vesicle
The small sacs outside the prostate which produce most of the ejaculate.
Sextant
Six sites which divide the gland for biopsy purposes; a sextant biopsy is a biopsy that takes cores of tissues from 6 different sites in the gland. Of note is that one or two cores may be taken from each of the “sextants”. Sextant terminology is typically associated with transrectal biopsies, not transperineal mapping biopsies.
Side Effect
An expected reaction to a therapy or a medication.
Stage
The definition of the size and extent of a cancer at a particular point in time. Usually cancers are staged using the T(tumor) N (nodes) M metastasis) staging system. T1a, b, c , T2a,b,c T3 are examples of stages. Older systems using A, B, C, D are rarely used and usually not helpful in deciding treatment. Current prostate cancer staging does not include PSA and Gleason scoring. Defining ones prognosis or recommending a particular course of therapy based on stage alone should not be done. Risk group classifications were developed which include stage, PSA and Gleason score information and are better at evaluating treatment outcomes.
Staging
An evaluation of the physical extent of the cancer. Stage primarily reflects the results of the digital rectal exam in most patients. Other tests such as bone scans lymph node dissections etc can affect the stage.
Stricture
Scarring or narrowing that restricts the flow of a fluid; for example, a urethral stricture is scar tissue in the urethra that constricts the flow of urine.
Systemic Therapy
Treatment affecting cancer cells throughout the body; hormonal therapy and chemotherapy are systemic treatments. Local therapy involves treating just the prostate and/or pelvis. Surgery and Brachytherapy are typical local therapies.The addition of external beam radiation generally refers to regional therapy.
T
Testicle
One of two male reproductive glands located inside the scrotum; they are the primary sources of the male hormone testosterone; sperm is also created in the testicles.
Testosterone
A male hormone responsible for male hair growth, libido, muscle strength, erection ability and bone density. The male hormone comprising most of the androgens in the male body; Testosterone is primarily produced by the testicles with lesser amounts coming from the adrenal glands.
Three-dimensional Conformational Therapy (3D-CRT)
A form of external beam radiation therapy that uses special software to plan and deliver tightly focused radiation.
Transperineal
Through the perineum
Transrectal
Through the rectum
Transurethral
Through the urethra
Transurethral Resection of the Prostate (TURP)
This is a procedure to relieve blockage in the urethra. A cystoscope is inserted into the penis and with the aid of a cutting cautery device, small amounts of prostate and urethra are removed until the obstruction is cleared.
TRUS (Transrectal Ultrasound)
Using ultrasound waves to create images the prostate.
TUIP
Transurethral incision of the prostate; a procedure that can be done to is to relieve urinary obstruction; less traumatic to the prostate than a TURP.
Tumor
An abnormal mass of tissue. Excessive, disorderly growth of cells. A tumor is not necessarily cancerous.
Tumor Flare
A short-lived increase in tumor growth and symptoms. In prostate cancer this is caused by an sudden increase in testosterone.
U
Ultrasonography
A technique that uses sound waves (that cannot be heard by humans) to produce pictures of areas inside the body. Pictures are created by a computer that analyses the echoes produced by the waves as they bounce off tissues.
Urethra
The slender tube that carries urine away from the bladder and out of the body through the tip of the penis.
Uroxatrol
This medication is used to improve urination flow. Alfuzosin is an alpha blocker designed to relax the internal sphincter within the prostate and improve the flow of urine See the website for further information. Website
Urgency
The need to urinate quickly.
Urologist
A doctor who specializes in diseases of the urinary organs in females and the urinary and sex organs in males.
V
Vas Deferens
The long tube through which sperm travel from the testes to the prostate prior to ejaculation.
Viagra
A medication used to improve erection ability Sildenafil is a PDE-5 inhibitor. See website for details about side effects. Website
Volume Study
A series of images of the prostate designed to determine the size and shape of the gland as well as to form an image for permanent seed planning. It is performed with a ultrasound inserted into the rectum and lasts approximately 10-15 minutes. It is minimally uncomfortable.
W
Watchful Waiting
Observation and regular monitoring of a patient without active treatment. Similar to active surveillance.
X
X-Ray
Radiation used at low levels to create images of the internal structures of the body.
Z
Zone
An area or a portion of an organ. The central zone is that region of the prostate in the middle surrounding the urethra.