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3 dimensional conformal radiation therapy (3DCRT): an external radiation treatment approach that focuses on directing the radiation energy to the tumor target while sparing the surrounding normal tissues; see conformal

5-alpha-dihydrotestosterone: usually known as dihydrotestosterone or DHT

5-alpha reductase (5AR): enzymes that convert testosterone to dihydrotestosterone

5-alpha reductase inhibitor: A drug used to block the conversion of testosterone to dihydrotestosterone. Examples: finasteride (Proscar®) and dutasteride (Avodart®).

5-FU: 5-Fluorouracil; (Adrucil®); a drug in the group of cancer-fighting medicines known as antineoplastics, which interferes with the growth of cancer cells. It is approved for palliative management of colon, rectum, breast, stomach and pancreatic cancer

17,20 lyase: an enzyme important in the adrenal androgen pathways that converts 17 alpha hydroxyprogesterone to androstenedione and also converts 17 alpha hydroxypregneneolone to DHEA

a1-antichymotrypsin (ACT): one of the many serine protease inhibitors or serpins (short for serine protease inhibitor) which are proteins that inhibit peptidases (old name: proteases). Serine proteases are defined by the presence of a serine (an amino acid) residue in their active domain.

AAT: androgen ablation therapy; preferred terms might be androgen deprivation therapy (ADT) or hormone therapy.

AAWR: antiandrogen withdrawal response; a decrease in PSA seen upon stopping an antiandrogen such as Flutamide® or Casodex®; it is believed that this occurs because the antiandrogen has induced a mutation in the androgen receptor (AR) which is allowing the antiandrogen to stimulate PC growth rather than inhibit it

abdomen adj. abdominal: the part of the body below the ribs and above the pelvic bone that contains organs like the intestines, the liver, the kidneys, the stomach, the bladder, and the prostate

ablation: relating to the removal or destruction of tissue or a system; androgen ablation refers to blocking the effects of androgens by surgical or chemical means

abscopal effect: In cancer treatment, an abscopal effect occurs when a particular treatment has an impact on a tumor that was not treated – “ab-” being the Latin prefix for “away from”, and “scopus” the word for “target”. See our paper.

acinus: pl. ACINI: any of the small saclike structures that terminate the ducts of some glands, also called alveolus; ACINAR: of, relating to or comprising an acinus

acronym: an abbreviation formed from the initial letters of a name; e.g. see ARM

ACTH: adrenal corticotrophic hormone; a pituitary hormone that stimulates the outer portion of the adrenal glands to secrete various hormones including cortisol, DHEA and androstenedione

active objectified surveillance: active observation and regular monitoring of a patient without actual treatment ; also called watchful waiting

acute: beginning quickly and sharp or severe

acute urinary retention: the sudden inability to urinate, causing pain and discomfort. Causes can be related to an obstruction in the urinary system, stress, neurologic problems, or certain medications.

adenocarcinoma: a form of cancer that develops from a malignant abnormality in the cells lining a glandular  organ such as the prostate; almost all prostate cancers are adenocarcinomas

adenoma: a benign tumor of a glandular structure

adenovirus: a (20 sided) virus that contains DNA; there are over 40 different adenovirus varieties, some of which cause the common cold. Modified versions have shown some ability to cause apoptosis in laboratory testing

adhesion: a band of scar tissue abnormally joining two surfaces

adipose: tissue made of fat cells

adjuvant: an additional treatment used to increase the effectiveness of the primary therapy; radiation  therapy is often used as an adjuvant treatment after a radical prostatectomy if the surgical margins are involved by PC

ADPC (androgen-dependent PC): PC cells that depend on androgens for continued cell growth and vitality

adrenal androgen (AA): a male hormone produced by the adrenal glands; actually, the adrenal makes AA precursors such as DHEA and androstenedione that are metabolized to androgens within the prostate.

adrenal cortex: the outer portion of the adrenal gland; it secretes various hormones.

adrenal glands: the two adrenal glands are located above the kidneys; they produce a variety of different hormones, including cortisol, adrenal androgens and hormones important in blood pressure control and electrolyte balance

adrenalectomy: the surgical removal of one or both adrenal glands

Adriamycin® (doxorubicin): a genotoxic drug, a chemotherapy agent that affects DNA and alters its function

ADS (androgen deprivation syndrome): a number of side effects associated with low levels of androgen associated with ADTSee PCRI Paper on ADS.

ADT: see androgen deprivation therapy

adverse reaction: a harmful or unexpected effect of a medication or treatment

aerobic: in biochemistry, reactions that need oxygen to happen or happen when oxygen is present

AG: aminogluthethimide; a drug that blocks the production of adrenal hormones such as DHEA, androstenedione and also cortisol

age-adjusted: modified to take account of the age of an individual or group of individuals; for example, it has been suggested that normal PSA values can be adjusted according to age groupings of men:
     Age        PSA "cutoff"
     40-49     up to 2.5 ng/ml
     50-59     up to 3.5
     60-69     up to 4.5
     70-79     up to 6.5

agonist: A drug or other chemical that can combine with a receptor on a cell to produce a physiologic reaction typical of a naturally occurring substance

AIPC (androgen-independent PC): PC cells that do not depend on androgen for growth

Akt: a protein kinase which is one of the key enzymes for regulating anti-apoptotic events

albumin: A class of simple, water-soluble proteins that can be coagulated by heat and precipitated by strong acids and are found in egg white, blood serum, milk, and many other animal and plant juices and tissues

alendronate sodium : a drug that affects bone metabolism used in treating osteoporosis and being studied in the treatment of hypercalcemia (abnormally high levels of calcium in the blood) and in treating and reducing the risk of bone pain caused by cancer; active ingredient in Fosamax®

algorithm: procedure or formula for solving a problem.

alkaline phosphatase (ALP): an enzyme in blood, bone, kidney, spleen, and lungs; used to monitor bone or liver  metastasis when elevated

alk phos: alkaline phosphatase

allopathy, allopathic: a system of medical practice that aims to combat disease by use of standard remedies such as drugs or surgery

alopecia: loss of hair

alpha-blockers: pharmaceuticals that act on the prostate by  relaxing certain types of muscle tissue; these pharmaceuticals are often used in the treatment of BPH; examples are Flomax®, Cardura® and Hytrin®

alpha receptors: a cell site that responds to adrenaline (epinephrine) or adrenaline-like substances, causing various physiological changes related to blood vessels getting smaller

alprostadil: a prostaglandin that relaxes the smooth muscles of the penis, enhancing blood flow, and producing erection; first produced as Caverject®, an injectable Prostaglandin E1

amino acid: a class of organic compounds that are the building blocks of peptides and proteins

aminoglutethimide (Cytadren®): an aromatase inhibitor that blocks the production of adrenal steroids. It also blocks the conversion of androgens to estrogens

amplicon: the DNA product of a PCR reaction, usually an amplified segment of a gene or DNA

anaerobic: an organism, such as a bacterium, that can live in the absence of atmospheric oxygen

analgesia: pain relief without loss of consciousness

analgesic: a drug that alleviates pain without causing loss of consciousness

analog: a synthetic chemical or pharmaceutical that behaves like a normal chemical in the body, e.g., LHRH analogs such as Lupron® or Zoladex®

Anandron®: trade or brand name for nilutamide, an antiandrogen; in the USA this is called Nilandron®.

anastomosis: (pl. anastomoses) – the connection of separate parts of a branching system to form a network, as of blood vessels; also the surgical connection of separate or severed tubular hollow organs to form a continuous channel, as the severed urethra in radical prostatectomy.

anastrozole (Arimidex®): an aromatase inhibitor that reduces the level of estrogen in the body

Androcur®: trade name for cyproterone, an antiandrogen with progestational activity; also called CPA for cyproterone acetate (not available in U.S.)

androgen: a hormone which is responsible for male characteristics and the development and function of  male sexual organs (e.g., testosterone) produced mainly by the testicles but also in the cortex of the adrenal glands; androgens have far reaching effects on blood formation, muscle and bone mass, cognitive function, emotional lability, skin and hair, etc

androgen dependent PC (ADPC): PC cells that depend on androgens for continued cell growth and vitality

androgen deprivation syndrome (ADS): a number of side effects associated with elimination or blockage of androgens from ADT; see PCRI paper on ADS.

androgen deprivation therapy (ADT): (also called hormone therapy) or testosterone inactivating pharmaceuticals (TIP)) a prostate cancer treatment that eliminates or blocks androgens to the PC cell; includes diverse mechanisms such as surgical or chemical castration, antiandrogens, 5 AR inhibitors, estrogenic compounds, agents that interfere with adrenal androgen production, agents that decrease sensitivity of the androgen receptor (AR)

androgen independent prostate cancer (AIPC): PC cells that do not depend on androgen for growth

androgen receptor (AR): A structural entity that is the site of interaction of a chemical substance called a ligand as is a lock and key; a docking site for a ligand

androgen receptor mutation (ARM): a mutation in the gene located on the androgen receptor that allows the antiandrogen to stimulate PC growth rather than block growth; a paradoxical effect usually occurring in about 30% of patients on long-term antiandrogen therapy in the setting of a rising PSA with a castrate testosterone level

androgen-sensitive prostate cancer: PC cells that depend on androgen for growth

androstenedione: an adrenal androgen precursor that is transformed to testosterone by 3 beta hydroxysteroid dehydrogenase within the prostate cell; testosterone can also be oxidized to androstenedione by 17 beta hydroxysteroid dehydrogenase

anemia: A disorder characterized by a decrease in hemoglobin in the blood to levels below the normal range. Symptoms include fatigue, weakness and difficulty breathing.

anesthetic, anesthesia: a drug that produces general or local loss of physical sensations, particularly pain; a “spinal” is the injection of a local anesthetic into the area surrounding the spinal cord

aneuploid: having an abnormal number of sets of chromosomes; for example, tetraploid means having two paired sets of chromosomes, which is twice as many as normal; aneuploid cancer cells tend not to respond well to androgen deprivation therapy; aneuploidy refers to the state of being aneuploid; (see also diploid)

angiogenesis: the growth of new blood vessels; a characteristic of tumors; angiogenesis is normal biologic process that occurs in both healthy and disease states; “angiogenesis factor” or “tumor angiogenesis factor” refers to a substance that tumors produce in order to grow new blood vessels

angiography: an X-ray study of the inside of the heart and/or blood vessels

anorexia: loss of appetite

antagonist: a drug that has an opposite reaction or competes for the same thing

anterior: the front; for example, the anterior of the prostate is the part of the prostate that faces forward

anterolateral: situated or occurring in front and to the side from the midpoint

antiandrogen: a compound (usually a synthetic pharmaceutical) that blocks or otherwise interferes with the normal action of androgens at cellular receptor sites

antiandrogen monotherapy (AAM): the use of an antiandrogen to block the androgen receptors of the cancer cells as a single therapy to reduce the side-effects normally associated with androgen deprivation therapy; See our paper on AAM

antiandrogen withdrawal response: see AAWR

antiangiogenesis: prevention of the growth of new blood vessels

antibiotic: a pharmaceutical that can kill certain types of  bacteria

antibody: protein produced by the immune system as a defense against an invading or "foreign" material or substance (an antigen); for example, when you get a cold, your body produces antibodies to the cold virus

anticholinergic: an agent that blocks certain receptors on the nerves, lessens muscle spasms and reduces release of liquids by the stomach, mouth, sweat glands, etc.

anticoagulant: a pharmaceutical that helps to stop the blood from clotting

antiemetic: a medicine that prevents or alleviates nausea and vomiting

antiestrogen: a substance capable of preventing full expression of the biological effects of an estrogen

antigen: "foreign" material introduced into the body (a virus or bacterium, for example) or other material  which the immune system considers to be "foreign" because it is not part of the body's normal biology (e.g., prostate cancer cells); a substance that elicits a cellular-level immune response or causes the formation of an antibody

antigen-presenting cell (APC): A type of cell that provokes an immune response from T-cells by binding foreign antigens to its own surface and then interacting with the T-cells. Also known as antigen-processing cell

antineoplastic: Inhibiting or preventing the development of abnormal tissue growth, checking the maturation and proliferation of malignant cells

antioxidant: a substance that inhibits oxidation or reactions promoted by oxygen or peroxides. Antioxidant nutrients protect human cells from damage caused by "free radicals" (highly reactive oxygen compounds).

anus: the opening of the rectum through which solid waste leaves the body

apex, apical: the tip or bottom of the prostate, e.g., the part of the prostate farthest away from the bladder; the top of the prostate is called the base

apoptosis: programmed cell death due to an alteration in a critical substance or chemical necessary for cell viability; the lack of male hormones causes apoptosis of androgen dependent PC

arachidonic acid: an omega-6 fatty acid that has been shown to be a stimulator of PC growth; found in egg yolk, animal red meat, organ meats; has free-radical generating properties

arcus tendinous: a thickened whitish band of the pelvic fascia

Arimidex®: the trademarked name for anastrozole

ARM (androgen receptor mutation): a mutation in the gene located on the androgen receptor that allows the antiandrogen to stimulate PC growth rather than block growth; a paradoxical effect usually occurring in about 30% of patients on long-term antiandrogen therapy in the setting of a rising PSA with a castrate testosterone level

aromatase: an enzyme that converts testosterone to estrogen (estradiol or estrone)

arteriosclerosis: a chronic disease characterized by abnormal thickening and hardening of the arterial walls

ASCO: American Society of Clinical Oncology

aspiration: the use of suction to remove fluid or tissue, usually through a fine needle (e.g., aspiration biopsy)

assay: a method of performing a standard test for the quality or quantity of a substance (ex: PSA). Assay results may vary depending on the methods, reagents and equipment used.

ASTRO: American Society for Therapeutic Radiation and Oncology

asymptomatic: having no recognizable symptoms of a particular disorder

ATF (amino terminal fragment): highly active part of the uPA molecule

athermal: without heat

atherosclerosis: a disorder of the arteries leading to reduced blood flow caused by the narrowing of blood vessels due to the accumulation of plaques composed up of cholesterols and fats

atrophic: undergoing atrophy or shrinkage in size and usually function

atrophy: a wasting or decrease in size of a body organ, tissue, or part owing to disease, injury, or lack of use: muscular atrophy of a person affected with paralysis. a wasting away, deterioration, or diminution: intellectual atrophy.

attentive DRE: a DRE described for PCA3 test as “applying firm digital pressure to the prostate from base to apex and from the lateral to the median line for each lobe with exactly three strokes per lobe” ( Dr. Yves Fradet – AUA 2006) See PCRI Paper PCA3: A Genetic Marker of Prostate Cancer.

atypical hyperplasia (atypia): non typical enlargement of an organ or tissue

AUA (American Urological Association): the official society of American urologists

AUA Symptom Score: an evaluation of the lower urinary tract symptoms (LUTS) based on questions published by the American Urological Association

autocrine: of, relating to, promoted by, or being a substance secreted by a cell and acting on surface receptors of the same cell

autologous: one's own; for example, autologous blood is a patient's own blood which is removed prior to surgery in case a patient needs a transfusion during or after surgery

auxotroph, auxotrophic: mutant that differs from the wild-type (normal) in requiring a nutritional supplement beyond the minimum required for metabolism and reproduction

avascular: with few or no blood vessels

Avodart®: dutasteride

avulse: to pull off or tear away

axial: extending in a direction essentially perpendicular to the plane of a cyclic structure

axial spin-echo T1 weighted image: an image acquired in the axial plane using a pulse-sequence that weights the signal intensity of each pixel to the T1 (the time it takes for water protons to return to thermal equilibrium) relaxation of water

azotemia: elevation in blood nitrogen level due to dehydration or kidney dysfunction; in laboratory tests this manifests as elevation in BUN and/or creatinine

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