Active Surveillance  

When a prostate cancer is monitored by the doctor using regular digital rectal examinations and blood tests to track its progress and initiate treatment when the disease begins to progress.

Activity 

Relative seed strength rate of decay of radiation- number of radioactive atoms decaying at any one time from within the source

Acute

Occurring suddenly or over a short period of time

Adenocarcinoma 

Glandular cancer

Adjuvant therapy 

Adjuvant therapy is a treatment method used in addition to the primary therapy to improve the chances of curing cancer – it is often given when it is not known for certain whether or not any cancer cells may still remain in the body – examples of adjuvant therapy include the use of chemotherapy, radiation therapy after surgery or hormone therapy depravation

Androgen deprivation 

Depriving the malignant tissue of androgenic hormone (any male sex hormone); specifically testosterone – also known as androgen blockade therapy

Androgen 

Any hormone that produces male physical characteristics (facial hair, deep voice) – the main androgen hormone is testosterone

Anesthesia 

A partial or total loss of sense of pain – there are two types of anesthesia – general (the whole body is put to sleep by an anesthetic agent) and local (a small area is made insensitive to pain)

Anesthesiologist 

An M.D. specializing in anesthesia

Anesthetic 

A drug which causes anesthesia

Anesthetist

One trained to give anesthetics (not an M.D.)

Anisotropy constant   

An average dose measured from end capsule to end capsule at 1cm from the center of the seed– butterfly effect

Anti-androgen drug 

A drug that blocks the activity of an androgen hormone-anticancer drug –  attacks cancer cells

Antiandrogen 

A compound used to block the production or inhibit the action of male sex hormones

Antibiotic

A drug that fights bacterial infections

Antibody
A special type of protein made by the body’s immune system – disarms or destroys a specific foreign agent (called an antigen) when it appears in the body

Anus
The opening at the lower end of the rectum through which solid body waste is eliminated

Aspiration
Withdrawing fluid by suction either with a tube and a suction machine or with a needle and syringe

ASTRO 
American Society for Therapeutic Radiology and Oncology

Bacteria
Microscopic organisms that can cause disease

BED – Biologically Equivalent Dose
When comparing isotopes for radiation delivery, BED provides a relative value for the amount of radiation delivered to the tissue

Benign
A term for a tumor that does not normally threaten a person’s life (that is, a tumor that is not cancerous and does not spread to other parts of the body)

Bilateral extracapsular extension
The spread of a tumor outside the tissue surrounding the prostate, on both sides

Bilateral
This term refers to both sides of the body

Biopsy
Removal of a small piece of tissue for examination under the microscope

BPH – Benign prostatic hyperplasia 
Non-cancerous overgrowth or enlargement of the prostate gland due to an increase in the number of its constituent cells

Brachytherapy 
The implantation of radioactive seeds or pellets that emit low-level radiation in an attempt to kill surrounding malignant tissue

CAB – Combined androgen blockade
Type of hormone therapy that involves combining an antiandrogen drug with an LHRH analog or with orchiectomy – also called total androgen blockade (TAB) or maximal androgen blockade (MAB)

Cancer
A tumor with abnormal cells that grow and divide without control – can spread through the blood and lymph to other parts of the body and pose a serious threat to a person’s life

CASODEX® tablets 
Oral non-steroidal antiandrogen structurally related to flutamide (Eulexin® capsules) used as an anti-hormonal agent in the treatment of metastatic prostatic carcinoma

CAT – Computer aided tomography 
Special radiographic technique that uses a computer to assemble multiple x-rays into a 2-dimensional cross-sectional image – this scan can uncover several soft tissue structures not found with conventional radiography

Ci – Curie
Unit of radioactivity, mCi:  1000mCi= 1 Ci

Clinical trials
Research studies to test new treatments, or approaches, which might provide better results than current methods – (strict rules are followed to make sure patients are well informed about the purpose, risks and benefits of any study before they agree to join a clinical trial)

Combination therapy
The use of two or more types of treatment on one cancer patient (e.g., surgery and radiation therapy)

Cryosurgery
A surgical procedure that uses extreme cold to destroy abnormal tissue

Cryotherapy 
The use of cold (i.e. liquid nitrogen) to limit progression of disease (e.g., hindering the spread of malignant cells by freezing the cancerous tissue)

CT scan
Abbreviation for computerized (axial) tomography, a CT scan is a type of x-ray that uses a computer to produce a “3-D” picture of the exact size and location of a tumor

CT
Computed Tomography (CAT Scan)

Culture
Lab test used to find and identify the type of infection – bacteria in blood samples or other body samples are made to grow in special nutrients so that they can be studied

Cystoscopy
A diagnostic procedure in which an endoscope is introduced into the bladder via the urethra to check for abnormalities – it is also used to remove cells for a biopsy

Cytology
The microscopic study of cells that have been shed or scraped from the cervix,uterus, lungs, bladder, or skin

Dose rate constant   
Dose at 1cm from seed

Dose 
Energy absorbed per unit mass (energy absorbed into soft tissue or water)

DRE – Digital rectal examination
An examination using a lubricated and gloved finger inserted into the rectum to feel for abnormalities of the prostate and anus

EBRT – External beam radiation 
Radiation therapy that uses a machine to aim high-energy radiation beams at the cancerous area

Edema
Swelling of body tissue due to an abnormal build-up of fluid

Ejaculate
To eject sperm and seminal fluid from the penis

Erection
The state of the penis when it is enlarged due to increased blood flow; this most often occurs during sexual excitement

Estrogen
A female sex hormone

FDA – Food and Drug Administration
The US Government agency responsible of the review and maintenance of medical devices

Gleason score 
A classification of adenocarcinoma (glandular cancer) of the prostate by evaluation of the pattern of glandular differentiation – the score is the sum of the dominant and secondary patterns, each numbered on a scale of 2 (best) to 10 (worst)

Gleason’s grading system
The most commonly used prostate cancer grading system – involves assigning a score to cancerous prostate tissue, ranging from 1 to 5, based on how much the arrangement of the cancer cells mimics the way normal prostate cells form glands – two grades are assigned to the most common patterns of cells that appear; these two grades (they can be the same or different) are then added together to determine the Gleason score (a number from 2 to 10)

Gray (Gy) 
Basic unit for dose– measures radiation delivered over time

Half-life   
The time it takes for the activity in the group to decrease by half – varies based on the type of radioisotope

HDR – High-dose rate brachytherapy
A type of radiation therapy in which radioactive seeds are temporarily placed directly inside the prostate – the seeds contain more radioactivity than in standard brachytherapy, and can be removed in less than a day and may not require hospitalization

High energy
Typically refers to high dose rate (HDR) temporary seed implants

Hormonal therapy
Use of hormones (sometimes combined with other types of therapy) to treat breast, uterine, or prostate cancer

Hormone replacement therapy
Use of synthetic estrogen and progesterone after menopause to replace the natural hormones produced by women in their fertile years

Hormone therapy for prostate cancer
Prostate cancer, treatment that interferes with the production or activity of male hormones that promote prostate tumor growth

Hormones
Chemical substances that regulate such specific body functions as metabolism, growth, and reproduction

Implant
An implant is a small container of radioactive material that is placed in, or near, a cancerous tumor – referred to as internal radiation therapy or implant therapy– a device that is surgically placed in the body

Impotence
Inability to have an erection

Incision
An opening (cut) in skin created to allow access for surgery

Incontinence
Loss of urinary control

Infection
Invasion of the body tissues by microorganisms such as bacteria and viruses

Internal radiation therapy
Internal radiation therapy is one of the two types of radiation therapy – a radioactive substance is placed inside the body very close to, or right inside, the cancerous tumor, or in the place of a previously removed cancer(also called brachytherapy)

Interstitial radiation therapy
An interstitial implant is a radioactive source that is placed directly into a tumor in an organ such as the prostate or tongue (brachytherapy)

Interstitial 
Relates to spaces within a tissue or organ, but excluding potential space – interstitial brachytherapy is the placement of radioactive seeds within the area surrounding, but not including, the malignant neoplasm

Intravenous
When fluids or drugs are put directly into a vein – anti cancer drugs are often given by intravenous (IV) injection

IPSS Score
Assessment used to determine and track the severity of a patients prostate symptoms

Irradiation
Another term for radiation therapy

LDR – Low Dose Rate
Refers to permanent seed implants

Linear accelerator
A machine that creates and uses high-energy X-rays to deliver external radiation to a cancer tumor

Local control
Following a treatment, when there is no evidence of disease at the site of the initial treatment / tumor site

Localized cancer
A cancerous growth that has not spread to other parts of the body

Lymph nodes
Small bean-shaped structures scattered along the vessels of the lymphatic system – they filter out bacteria and cancer cells that may travel through the system

Lymph
A nearly clear fluid collected from tissues around the body and returned to the blood by the lymphatic system

Lymphatic system
Vessels that carry lymph are part of this system – other parts include lymph nodes and several organs that produce and store infection-fighting cells

Malignancy
A tumor consisting of cancer cells – from a malignant growth, these cells can break away and start secondary tumors elsewhere in the body

Malignant
A term for a tumor that is cancerous

mCi – Millicurie 
Another measure of activity (apparent) 1000mCi= 1 curie

Medical Oncologist
A doctor who specializes in chemotherapy for the treatment of cancer

Metastases
Secondary cancers, as a result of a primary tumor moving to a new location or body site.

Metastasis
The spread of cancer from its original site to distant areas via blood and lymph

Metastatic 
Spread of a disease from its origin to another part of the body; for prostate cancer, the formation of a secondary tumor caused by the primary (prostate) cancer or the spread of tumor cells to the surrounding lymphatic system

Morbidity
Side effects associated with a procedure

MRI – Magnetic resonance imaging
A diagnostic technique that uses a magnetic field to produce on a computer the image of an internal organ

Nadir 
The lowest point PSA figure attained after treatment

Needle aspiration
A type of biopsy in which a fine needle is inserted into the tumor and small amounts of fluid or cells are removed and tested for cancer

Needle core biopsy
A type of biopsy in which a small cutting needle is used to remove a core of tissue for examination under a microscope for the presence of cancer

Neoadjuvant hormonal treatment 
Prior addition; for example neoadjuvant hormonal therapy is hormonal therapy that is given prior to radical prostatectomy or radiation therapy

Nephrectomy
Surgical removal of a kidney

Nerve-sparing radical retro pubic prostatectomy
A prostatectomy technique that allows the surgeon to see the nerves on either side of the prostate so that they can be left alone during the surgery – preserving these nerves may allow some men to have a better chance of achieving erections after the prostatectomy

Nomogram 
Otherwise known as a nomograph, consists of three co-planar curves, usually parallel, each graduated for a different variable so that a straight line cutting all three curves intersects the related value of each variable

Obturator 
That which closes or stops an opening

Oncologist
An oncologist is a physician who specializes in diagnosing and treating cancer

Oncology
The study and treatment of cancer

Orchiectomy
The surgical removal of the testicles, the major source of male hormones(bi-lateral orchiectomy – both testes are removed

Overall survival
Following a treatment, the amount of time or number or patients who have remained alive

Palliative care
Emotional support and counseling as well as relief from pain and other physical discomforts for people who are critically ill – care may be provided either by a team associated with a hospice program or by a family doctor.  Intended to provide relief but unlikely to cure a disease

Pathologist
A doctor who specializes in the diagnosis of disease by studying cells and tissues with a microscope, trained in laboratory medicine and who examines biopsies and assesses the results of other laboratory tests

Pathology
The study of changes to body tissues and fluids caused by disease

Percent free PSA ratio
A blood test that can help a physician make a diagnosis of prostate cancer when other results are confusing by comparing the amount of PSA in the blood by itself and the amount that is bound or attached to other blood proteins

Perineal prostatectomy
An operation to remove the prostate gland through an incision made in the perineum

Perineum
The area between the scrotum and the anus

PET – Positron emission tomography
A computerized image of the metabolic activity of the body used to determine the presence of disease

Pituitary gland
A gland located at the base of the brain – produces hormones that stimulate the testicles (and other glands) to release hormones and produce sperm

Positive margins 
Indicates the presence of cancer at the surgical margin (the outer edge of tissue removed during surgery)

Prognosis
A prediction made as to the potential outcome of a disease

ProstaScint®scan 
Imaging using a radioactive labeled monoclonal antibody that has been shown to increase the detection of early disease spread in patients with prostate cancer

Prostate
A chestnut-shaped gland that surrounds the urethra in males that secretes chemicals into the semen (fluid that contains sperm)

Protocol
Standardized procedures established for treating different diseases

PSA – Prostate specific antigen
A test to detect prostate cancer –  measures the levels of a specific antigen (a protein that under certain conditions can trigger a specific immune response) secreted by the prostate that shows elevated levels due to the presence of prostate cancer or benign prostatic hyperplasia – found in normal seminal fluid and produced by prostatic epithelial cells, a rise in the enzyme may indicate cancer – an increase in the level of prostate specific antigen is also helpful to indicate the failure of treatment

PSAD – PSA density
A number determined by dividing the PSA value by the prostate volume

PSAV – PSA velocity
Measurement of how quickly PSA rises over time

QoL
Quality of Life

Radial dose function   
Dose at 1cm, 2cm, 3cm, etc. from the center of the seed- dose will weaken further away from the seed

Radiation Oncologist
A doctor who has had special training in using radiation to treat human disease

Radiation therapy
The use of gamma rays or high energy x-rays to damage or destroy cancer cells – a Registered Therapy Radiographer (R.T.) is the specialist who gives the radiation therapy prescribed by the doctor

Radioactive implant
Wires, seeds or needles containing radioactive chemicals which deliver a known amount of radiation – these implants are inserted into a tumor or previous tumor site for a specified period of time

Radioactive isotope 
An isotope of an element that has an unstable nucleus; it attempts to stabilize itself by giving off ionizing radiation

Rectum
The last 5 or 6 inches of the intestine leading to the outside of the body

Recurrence
The return of a cancerous growth or condition after treatment

Retropubic prostatectomy
An operation to remove the prostate gland through a cut made in the lower abdomen below the pubic symphysis

RP – Radical Prostatectomy
Surgical removal of the prostate in an attempt to cure the condition caused by or within the gland

Sagittal
In an orientation or direction from front to back in the median plane or in a plane parallel to the median

Salvage therapy 
Procedure performed following the failure of a prior treatment; for example, salvage prostatectomy (surgical removal of the prostate) or salvage radiotherapy (treatment of the malignant tissue using radiation)

Scrotum
The external sac, or pouch, containing the testicles

Seminal vesicles 
Glands located at the base of the bladder and connected to the prostate that provide nutrients for semen

Side effects
A symptom caused by certain drugs or treatments– generally unwanted or undesirable

Source 
A delivery device which emits radiation (seed)

SRS
Stereotactic Radiation Therapy

Staging
The classification of tumors according to the extent of their development – used to determine treatment methods and to predict the course of the disease

Testicles
Two egg-shaped glands that produce sperm and sex hormones

Testosterone
A male sex hormone produced chiefly by the testicles – stimulates a man’s sexual activity and the growth of other sex organs, including the prostate

Tissue
A group of cells organized to perform a specialized function

Trans rectal ultrasound (TRUS) 
Guided biopsy – procedure that uses an ultrasound probe, inserted into the rectum to acquire a live image of the prostate – the image is used to guide a biopsy needle for sample acquisition (technique that bounces high-frequency radio waves off a specified area, then gathers the echo pattern and converts it to a 2-dimensional image for diagnosis)

Transperineal 
Denotes a procedure entering through the perineum; the area of the body between the scrotum and anus

Transverse
In an orientation or direction from side to side to side across the median plane or in a plane perpendicular to the median

TRUS – TransRectal UltraSound
Using sound waves produced by a device inserted into the rectum to produce a picture of the prostate

Tumor
An excessive growth of cells resulting from uncontrolled and disorderly cell replacement

U – Air Kerma Strength
Measurement of radioactivity as it decays over time- adopted by AAPM 1995–one of two measurements of activity,  apparent activity (mCi) – millicuries  (mGym2/hr or U)

Ultrasound Imaging
A diagnostic technique that uses sound waves to detect abnormal bodily structures – the waves are bounced off internal organs; a computer picks up their echoes, processes the information, and forms a detailed picture of the area

Unilateral extracapsular extension 
A term sometimes used in TNM staging; it refers to the tumor spreading to outside of the prostate capsule on only one side

Watchful waiting 
When a prostate cancer is simply watched by the doctor using regular digital rectal examinations and blood tests to track its progress

WBRT
Whole Body Radiation Therapy

X-ray therapy 
High-energy radiation used in significant doses to treat cancer – used in a low-energy format for conventional radiographic imaging