Glossary S

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sagittal: a plane, slice or section of the body cutting from front to back through the sagittal suture of the skull, and continued down through the body in the same direction, dividing it into two parts

sagittal localizer: an anatomic image which is acquired quickly to provide information about how to select high resolution images of the organ of interest – specifically, the first imaging sequence acquired for a prostate MRI/MRSI exam to determine the proper placement of the endorectal coil and prescribe other images acquired during the exam. See our paper Magnetic Resonance Anatomic and Spectroscopic Imaging of Prostate Cancer

salvage: a procedure intended to "rescue" a patient  following the failure of a prior treatment; for example, a salvage prostatectomy would be the surgical removal of the prostate after the failure of prior radiation therapy or cryosurgery

Sandostatin®: trade name for octreotide

SARM (selective androgen receptor modulator): a drug that selectively inhibits androgen receptors of a specific tissue(s) while allowing the normal interaction of the androgen with androgen receptors at other sites (see SERM)

saturation biopsy: a systematic biopsy using 3-D mapping to obtain thorough coverage of a half or the full prostate involving as many as 30-80 samples, depending on gland volume

saw palmetto: The dwarf palm plant indigenous to Florida that is the source of Serenoa repens and its lipid extract (lipido-sterol extract of Serenoa repens or LSESr) that is sometimes used for treating BPH

SCF: stem cell factor

sclerotic: [tissue] hardened by causes like inflammation, mineral accumulation, etc.

screening: evaluating populations of people to diagnose disease early

scrotum: the pouch of skin containing a man's testicles

secondary to: derived from or consequent to a primary event or thing

secretion: 1. the process of secreting (releasing) a substance, especially one that is not a waste, from the blood or cells;
2. a substance, such as saliva, mucus, tears, bile, or a hormone, that is secreted

seed, seeding: brachytherapy; the implantation of radioactive seeds or pellets (may also be called "capsules") which emit low energy radiation in order to kill surrounding tissue, e.g., the prostate, including prostate cancer cells. Also known as "seed implantation" or "SI" – See our paper Prostate Seed Implantation for Prostate Cancer.

selenium: a relatively rare nonmetallic element found in food in small quantities that has some effect in prevention of prostate cancer

semen: the whitish, opaque fluid emitted by a male at ejaculation

seminal: related to the semen; for example, the seminal vesicles are structures at the base of the bladder and connected to the prostate  that provide nutrients for the semen

seminal vesicles (SV): glandular structures located above and behind the prostate that secrete and store seminal fluid; the seminal vesicles  connect with the ejaculatory ducts; the seminal fluid contains nutrients for the sperm that improves their viability and mobility

seminal vesicle invasion or involvement (SVI): prostate cancer cells are found in the seminal vesicle(s)

senescence: the state of being old the process of becoming old

sensitivity: the probability that a diagnostic test can correctly identify the presence of a particular disease assuming the proper conduct of the test; specifically, the number of true positive results divided by the sum of the true positive results and the false negative results; see specificity

sepsis: systemic response to infection with fever and elevated white blood cell count

sequential androgen blockade (SAB): a variation of ADT involving a two-medication (anti-androgen plus a 5 alpha reductase inhibitor) approach intended to stop PC growth using androgen deprivation focused at the level of the tumor cell, while at the same time maintaining normal serum testosterone levels so that the sexual function will hopefully be preserved

Serenoa repens: the dwarf palm and source of the active herb used in saw palmetto preparations such as permixon. Serenoa blocks various pathways in testosterone metabolism such as the conversion of testosterone to androstenedione as well as the conversion of testosterone to DHT. By itself, Serenoa repens is used in the treatment of LUTS.  See the July 99 issue of Insights (page 2-3) for details on Serenoa repens.

SERM (selective estrogen receptor modulator): a drug that selectively blocks one estrogen receptor but allows the other receptors at specific sites to function normally with estrogen; raloxifene is an example of a SERM- it blocks the ER in the breast and uterine tissue but allows the ER in bone tissue to be operative

seroma: a mass or swelling caused by the localized accumulation of serum within a tissue or organ

serotonin: neurotransmitter that relays impulses between nerve cells (neurons) in the central nervous system. Serotonin is involved in mood and behavior, physical coordination, appetite, body temperature, and sleep.

serous: of, relating to, producing, or resembling serum; especially : having a thin watery constitution

serum: any clear, watery fluid such as the pale yellow liquid that separates from the clot in the coagulation of blood

sex hormone binding globulin (SHBG): a protein that binds testosterone to make it unavailable for function; SHBG production is increased by estrogens such as DES. SHBG binds to DHT four times more avidly than to testosterone.

sextant: having six parts; thus, a sextant biopsy is a biopsy that takes six samples

SGOT: serum glutamic-oxaloacetic transaminase; a liver cell enzyme; elevation of SGOT is seen as an effect of liver cell injury by drugs, alcohol and viruses. Supplements such as silymarin, alpha lipoic acid and curcumin may protect and repair the liver cell and help reduce elevations of SGOT.

SGPT: serum glutamic pyruvic transaminase; a liver cell enzyme; elevation of SGOT is seen as an effect of liver cell injury by drugs, alcohol and viruses

SHIM score: (Sexual Health Inventory for Men) – a score which quantifies sexual function based on five specific questions.

SI: seed implantation; insertion of radioactive seeds, usually iodine 125 or palladium 103 into the prostate tissue to destroy prostate cancer (PC); see brachytherapy; see our paper Prostate Seed Implantation for Prostate Cancer.

side effect: a reaction to a medication or treatment (most commonly used to mean an unnecessary or undesirable effect)

sign: physical changes which can be observed as a consequence of an illness or disease

signal excitation: the excitation of signals using a strong magnetic field and radio frequency (RF) pulses to produce resonances or peaks due to water or other chemicals (metabolites) within tissue

sildenafil: the active ingredient of Viagra®, which may help to produce erections

sinusoidal: any of the venous cavities through which blood passes in various glands and organs, such as the adrenal gland and the liver

skeletal-related events: include bone fracture, spinal cord compression or the need for radiation or surgery for the treatment of bone metastasis

small cell PC: an aggressive variant of prostate cancer with a tendency to metastasize early due to rapidly dividing cells

sonogram, sonographic: an image of a structure that is produced by ultrasonography

spatial-resolution: a term that refers to the number of pixels utilized in construction of a digital image – images having higher spatial resolution have a greater number of pixels

specificity: the probability that a diagnostic test can correctly identify the absence of a particular disease assuming the proper conduct of the test; specifically, the number of true negative results divided by the sum of the true negative results and the false positive results; a method that detects 95% of true PC cases is highly sensitive, but if it also falsely indicates that 40% of those who do not have PC do have PC then its specificity is only 60%; see sensitivity.

SPECT: (single photon emission computed tomography) – Tomography using emissions from radionuclides and a computer algorithm to reconstruct the image. SPECT allows visualization of the body in slices from recalculated planar views of the patient.

spectroscopy: the science of measuring the emission and absorption of different wavelengths (spectra) of visible and non-visible light

sperm: a male reproductive cell

spermidine: A polyamine compound, C7H19N3, found in ribosomes and living tissues and having various metabolic functions. It was originally isolated from semen

spermine: A crystalline polyamine compound, C10H26N4, present in ribosomes and found widely in living tissues along with spermidine. It was originally isolated from semen

sphincter: a muscle which surrounds, and by its contraction tends to close, a natural opening; as, the sphincter of the bladder

stage: a term used to define the size and physical extent of a cancer

staging: the process of determining extent of disease in a specific patient in light of all available information; it is used to help determine appropriate therapy; there are two staging methods: the Whitmore-Jewett staging classification (1956) and the more detailed TNM (tumor, (lymph) nodes, metastases) classification (1992) of the American Joint Committee on Cancer and the International Union Against Cancer. Staging should be subcategorized as clinical staging and pathologic staging. Clinical stage is based on the digital rectal exam findings. Pathologic stage usually relates to what is found at the time of surgery. The TNM system is now most commonly used.

For diagrams, see our paper The Clinical Stage: Its Definition and Importance in Prostate Cancer.

- TNM stages:

T Primary Tumor
TX: Primary tumor cannot be assessed
T0: No evidence of primary tumor
T1: Clinically inapparent tumor not palpable or visible by imaging
T1a: Tumor incidental histologic finding in > 5% of tissue resected via TURP
T1b: Tumor incidental histologic finding > 5% of tissue resected via TURP
T1c: Tumor identified by needle biopsy (e.g., because of elevated PSA)
T2: Tumor palpable but confined within the prostate
T2a: Tumor involves half of a lobe or less
T2b: Tumor involves more than half a lobe, but not both lobes
T2c: Tumor involves both lobes
T3: Tumor extends through the prostatic capsule
T3a: Unilateral extracapsular extension
T3b: Bilateral extracapsular extension
T3c: Tumor invades the seminal vesicle(s)
T4: Tumor is fixed or invades adjacent structures other than the seminal vesicles
T4a: Tumor invades any of bladder neck, external sphincter or rectum
T4b: Tumor invades levator muscles and/or is fixed to the pelvic wall
N Regional Lymph Nodes
NX: Regional lymph nodes cannot be assessed
N0: No regional lymph nodes metastasis
N1: Metastasis in a single lymph node, 2 cm or less in greatest dimension
N2: Metastasis in a single lymph node, more than 2 cm but not more than 5cm in greatest dimension; or multiple lymph node metastases, none more
than 5 cm in greatest dimension
N3: Metastasis in a lymph node more than 5 cm in greatest dimension

M Distant Metastases
MX: Presence of distant metastasis cannot be assessed
M0: No distant metastasis
M1: Distant metastasis
M1a: Nonregional lymph node(s)
M1b: Bone(s)
M1c: Other site(s)

- Whitmore-Jewett Stages:

Stage A is clinically undetectable tumor confined to the gland and is an incidental finding at prostate surgery.
A1: well-differentiated with focal involvement
A2: moderately or poorly differentiated or involves multiple foci in the gland

Stage B is tumor confined to the prostate gland.
BO: non-palpable, PSA-detected
B1: single nodule in one lobe of the prostate
B2: more extensive involvement of one lobe or involvement of both lobes

Stage C is a tumor clinically localized to the periprostatic area but extending through the prostatic capsule; seminal vesicles may be involved.
C1: clinical extracapsular extension
C2: extracapsular tumor producing bladder outlet or ureteral obstruction

Stage D is metastatic disease.
DO: clinically localized disease (prostate only) but persistently elevated enzymatic serum acid phosphatase
Dl: regional lymph nodes only
D2: distant lymph nodes, metastases to bone or visceral organs
D3: D2 prostate cancer patients who relapse after adequate endocrine therapy

stem cell: cell that has the ability to divide for indefinite periods in culture and to give rise to specialized cells; the ultimate stem cell might be a fertilized egg capable of producing the entire organism

stenosis: abnormal narrowing of a bodily canal or passageway

stent: a tube used by a surgeon to drain fluids

step-section histopathology: the sectioning of diseased tissues into ordered slices used for microscopic analysis

stepper: a motor (especially an electric motor) that moves or rotates in small discrete steps

steroid: any one of the hormones made in the outer layer of the adrenal glands (adrenal cortex)

stratified: In an analysis of data, a particular clinical or pathologic feature(s) is used as the basis for comparison, e.g. clinical stage, pathologic stage, PSA, Gleason score

stress incontinence: passing a small amount of urine when coughing, lifting, etc.

stricture: scarring as a result of a procedure or an injury that constricts the flow of a fluid; for example, a urethral stricture would restrict the flow of urine through the urethra

stroma, stromal: the supporting tissue of an organ

stromal BPH: a non-cancerous cause of prostate enlargement (BPH) within the connective tissue framework of the prostate

strontium-89: an injectable radioactive product that is used to relieve bone pain in some patients with prostate cancer that no longer responds to hormones or appropriate forms of chemotherapy

subcapsular: under the capsule; for example, a subcapsular orchiectomy is a form of castration in which the contents of each testicle is removed but the testicular capsules are then closed and remain in the scrotum

subcutaneous: located, found, or placed just beneath the skin

SUO: Society of Urologic Oncology

superficial : pertaining to or situated near the surface, especially relating to the skin

superolateral : situated above and toward the side (of the prostate)

suprapubic: above the pubic bone; a suprapubic tube is placed into the bladder by puncturing the skin and soft tissue above the pubic bone

surgical margins: the outer edge of the tissue removed during surgery

suture: surgical stitching used in the closure of a cut or incision

SVI: see seminal vesicle invasion.

SWOG: Southwest Oncology Group – One of the largest of the National Cancer Institute-supported cancer clinical trials cooperative groups in the United States.

symphysis pubis: the rather rigid articulation of the two pubic bones in the midline of the lower anterior part of the abdomen

symptom: a feeling, sensation or experience associated with or resulting from a physical or mental disorder and noticeable by the patient

symptomatic: having symptoms, evidence of disease

synergistic: assists or adds to the activity of another substance, such as a drug

systematic biopsy: sampling of various sectors of the prostate under ultrasound guidance

systemic: throughout the whole body; affecting the entire body

Sx: an abbreviation for symptoms