The Prostate Dictionary Last Revised February 19, 1996. The Prostate Dictionary provides definitions of terms used by health professionals in the management of prostate cancer and related conditions. If you can't find a term here and you want a definition, please leave your question with Ask Arthur. A abdomen: the part of the body below the chest that contains organs like the intestines, the liver, the kidneys, the stomach, the bladder, and the prostate ablation: reduction of; for example, in the management of prostate cancer, hormonal ablation means the use of hormonal techniques to reduce the spread of prostate cancer cells and cryoablation means the use of deep freezing techniques to reduce the number of live prostate and prostate cancer cells adjuvant: added on; for example, adjuvant hormonal therapy is hormonal therapy added on to another form of therapy adenocarcinoma: a form of cancer that develops from a malignant abnormality in the cells lining an organ such as the prostate; almost all prostate cancers are adenocarcinomas adrenal: the two adrenal glands are located above the kidneys; they produce a variety of different hormones, including sex hormones -- the adrenal androgens adrenalectomy: the surgical removal of one or both adrenal glands age-adjusted: modified to take account of the age of an individual or group of individuals; for example, prostate cancer survival data and average normal PSA values can be adjusted according to the ages of groups of men 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 analog: a synthetic chemical or pharmaceutical that behaves very like a normal chemical in the body Anandron: trade or brand name for nilutamide androgen: a hormone which is responsible for male characteristics and the development and function of male sexual organs (e.g., testosterone) 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 (see also diploid) anterior: the front; for example, the anterior of the prostate is the part of the prostate that faces forward antiandrogen: a compound (usually a synthetic pharmaceutical) which blocks or otherwise interferes with the normal action of androgens 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 anticoagulant: a pharmaceutical that helps to stop the blood from clotting 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) anus: the opening of the rectum apex: the tip or bottom of the prostate, e.g., the part of the prostate farthest away from the bladder aspiration: the use of suction to remove fluid or tissue, usually through a fine needle (e.g., aspiration biopsy) asymptomatic: having no recognizable symptoms of a particular disorder 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 B base: the base of the prostate is the wide part at the top of the prostate closest to the bladder benign: relatively harmless; not cancerous; not malignant; not potentially fatal benign prostatic hyperplasia: see BPH bicalutamide: a nonsteroidal antiandrogen available in the US and some European countries for the treatment of advanced prostate cancer bilateral: both sides; for example, a bilateral orchiectomy is an orchiectomy in which both testicles are removed and a bilateral adrenalectomy is an operation in which both adrenal glands are removed biopsy: sampling of tissue from a particular part of the body (e.g., the prostate) in order to check for abnormalities such as cancer; in the case of prostate cancer, biopsies are usually carried out under ultrasound guidance using a specially designed device known as a prostate biopsy gun bladder: the hollow organ in which urine is collected and stored in the body bone scan: a sensitive technique which uses radiolabeled agents to identify abnormal or cancerous growths within or attached to bone; in the case of prostate cancer, a bone scan is used to identify bony metastases which are definitive for cancer which has escaped from the prostate bowel preparation: the cleaning of the bowels or intestines which is normal prior to abdominal surgery such as radical prostatectomy BPH: benign prostatic hyperplasia or enlargement of the prostate occurs in most men as they age; it can cause difficulties for many men (such as the frequent need to urinate at night), which can become severe for some individuals brachytherapy: the implantation of radioactive seeds or pellets which emit low energy radiation in order to kill surrounding tissue (e.g., the prostate, including prostate cancer cells) C CAB: complete androgen blockade (see maximal androgen deprivation) cancer: the growth of abnormal cells in the body in an uncontrolled manner capsule: the fibrous tissue which acts as an outer lining of the prostate carcinoma: a form of cancer that originates in tissues which line or cover a particular organ Casodex: brand or trade name of bicalutamide castration: the use of surgical or medical techniques to lower the level of testosterone in the male to zero or near zero catheter: a hollow (usually plastic) tube which can be used to drain fluids from or inject fluids into the body; in the case of prostate cancer, it is common for patients to have a transurethral catheter to drain urine for some time after treatment by surgery or some forms of radiation therapy chemoprevention: the use of a pharmaceutical or other substance to prevent the development of cancer chemotherapy: the use of pharmaceuticals to kill cancer cells; in many cases chemotherapeutic agents kill not only cancer cells but also other cells in the body, which makes such agents potentially very dangerous CHT: combined hormonal therapy or treatment (see maximal androgen deprivation) clinical trial: a carefully planned experiment to evaluate a treatment or a medication (often a new pharmaceutical) for an unproven use complication: an unexpected or unwanted effect of a treatment, pharmaceutical, or other procedure conformational therapy: the use of careful planning and delivery techniques designed to focus radiation on the areas of the prostate and surrounding tissue which need treatment and protect areas which do not need treatment; three-dimensional conformational therapy is a more sophisticated form of this method contracture: scarring which can occur at the bladder neck after a radical prostatectomy and which results in narrowing of the passage between the bladder and the urethra corpora cavernosa: a part of a man's penis which fills with blood when he is sexually excited, giving the organ the stiffness required for intercourse corpora spongiosum: a spongy chamber in a man's penis which fills with blood when he is sexually excited, giving the organ the stiffness required for intercourse cryoablation: see cryosurgery cryosurgery: the use of liquid nitrogen to freeze a particular organ to extremely low temperatures to kill the tissue, including any cancerous tissue cryotherapy: see cryosurgery CT scan: computerized tomography (also known as computerized axial tomography or a CAT scan) is a method of combining images from multiple x-rays under the control of a computer to produce sophisticated cross-sectional or three-dimensional pictures of the internal organs which can be used to identify abnormalities cystoscope: an instrument used by physicians to look inside the bladder and the urethra cystoscopy: the use of a cystoscope to look inside the bladder and the urethra D debulking: reduction of the volume of cancer by one of several techniques; most frequently used to imply surgical debulking DES: see diethylstilbestrol DHT: see dihydrotestosterone diagnosis: the evaluation of signs, symptoms, and selected test results by a physician to determine the physical and biological causes of the signs and symptoms and whether a specific disease or disorder is involved diethylstilbestrol: a female hormone commonly used in the 1960s and 1970s for treatment of prostate cancer; for more information see the section on pharmaceuticals in the treatment of prostate cancer digital rectal examination: the use by a physician of a lubricated and gloved finger inserted into the rectum to feel for abnormalities of the prostate and rectum dihydrotestosterone: the male hormone which actually is active in the prostate; it is made when an enzyme in the prostate transforms testosterone differentiation: the use of the differences between prostate cancer cells when seen under the microscope as a method to grade the severity of the disease diploid: having one complete set of normally paired chromosomes, i.e., a normal amount of DNA DNA: deoxyribonucleic acid; the basic biologically active chemical which defines the physical development and growth of nearly all living organisms double-blind: a form of clinical trial in which neither the physician nor the patient knows the actual treatment which any individual patient is receiving; double-blind trials are a way of minimizing the effects of the personal opinions of patients and physicians on the results of the trial doubling time: the time that it takes a particular focus of cancer to double in size downsizing: the use of hormonal or other forms of management to reduce the volume of prostate cancer in and/or around the prostate prior to attempted curative treatment downstaging: the use of hormonal or other forms of management in the attempt to lower the clinical stage of prostate cancer prior to attempted curative treatment (e.g., from stage T3a to stage T2b); this technique is highly controversial DRE: see digital rectal examination dysplasia: see PIN dysuria: urination which is problematic or painful E Emcyt: the brand or trade name of estramustine phosphate in the US estramustine phosphate: a chemotherapeutic agent used in the treatment of some patients with late stage prostate cancer estrogen: a female hormone; certain estrogens (e.g., diethylstilbestrol) are used by some physicians in treatment of prostate cancer Eulexin: the brand or trade name of flutamide in the US experimental: an unproven (or even untested) technique or procedure; note that certain experimental treatments are commonly used in the management of prostate cancer external beam: a form of radiation therapy in which the radiation is delivered by a machine pointed at the area to be radiated F flutamide: an antiandrogen used in the palliative hormonal treatment of advanced prostate cancer and sometimes in the adjuvant and neoadjuvant hormonal treatment of earlier stages of prostate cancer frequency: the need to urinate often frozen section: method used by a pathologist to rapidly analyze tissue under a microscope in order to obtain a preliminary pathologic opinion of the presence or absence of prostate cancer (usually in the pelvic lymph nodes) G gastrointestinal: related to the digestive system and/or the intestines genital system: the biological system which, in males, includes the testicles, the vas deferens, the prostate, and the penis genitourinary system: the combined genital and urinary systems; also known as the genitourinary tract gland: a structure or organ which produces a substance which is used in another part of the body Gleason: name of physician who developed the Gleason grading system commonly used to grade prostate cancer goserelin acetate: a luteinizing hormone releasing hormone analog used in the palliative hormonal treatment of advanced prostate cancer and sometimes in the adjuvant and neoadjuvant hormonal treatment of earlier stages of prostate cancer grade: a means of describing the potential degree of severity of a cancer based on the appearance of cancer cells under a microscope; see also Gleason gynecomastia: enlargement or tenderness of the male breasts or nipples H hematospermia: the occurrence of blood in the semen hematuria: the occurrence of blood in the urine heredity: the historical distribution of biological characteristics through a group of related individuals via their DNA hereditary: inherited from one's parents and earlier generations histology: the study of the appearance and behavior of tissue, usually carried out under a microscope by a pathologist (who is a physician) or a histologist (who is not necessarily a physician) hormone: biologically active chemicals that are responsible for the development of secondary sexual characteristics hormone therapy: the use of hormones, hormone analogs, and certain surgical techniques to treat disease (in this case advanced prostate cancer) either on their own or in combination with other hormones or in combination with other methods of treatment hot flash: the sudden sensation of warmth in the face, neck and upper body; a side effect of many forms of hormone therapy hyperplasia: enlargement of an organ or tissue because of an increase in the number of cells in that organ or tissue; see also BPH I imaging: a technique or method allowing a physician to see something which would not normally be visible immune system: the biological system which protects a person or animal from the effects of foreign materials such as bacteria, viruses, cancer cells, and other things which might make that person or animal sick implant: a device which is inserted into the body in order to replace or substitute for an ability which has been lost; for example, a penile implant is a device which can be surgically inserted into the penis to provide rigidity for intercourse impotence: the inability to have or to maintain an erection incidental: insignificant or irrelevant; for example, incidental prostate cancer (also known as latent prostate cancer) is a form of prostate cancer which is of no clinical significance to the patient in whom it is discovered incontinence: leaking of or inability to control any substance, but commonly the leaking of or inability to control urine (properly called urinary incontinence) indication: a reason for doing something or taking some action; also used to mean the approved clinical application of a pharmaceutical inflammation: any form of swelling or pain or irritation interstitial: within a particular organ; for example, interstitial prostate radiation therapy is radiation therapy applied within the prostate using implanted radioactive pellets or seeds (see also brachytherapy) intravenous: into a vein invasive: requiring an incision or the insertion of an instrument or substance into the body IVP: intravenous pyelogram, a procedure which introduces a radioactive substance into the urinary tract in order to allow the physician a superior image of the tract by taking an x-ray J K Kegel exercises: a set of exercises designed to improve the strength of the muscles used in urinating kidney: one of a pair of organs whose primary function is to filter the fluids passing through the body L laparoscopy: a technique which allows the physician to observe internal organs directly through a piece of optical equipment inserted directly into the body through a small surgical incision latent: insignificant or irrelevant; for example, latent prostate cancer (also known as incidental prostate cancer) is a form of prostate cancer which is of no clinical significance to the patient in whom it is discovered leuprolide acetate: a luteinizing hormone releasing hormone analog used in the palliative hormonal treatment of advanced prostate cancer and sometimes in the adjuvant and neoadjuvant hormonal treatment of earlier stages of prostate cancer LHRH: see luteinizing hormone releasing hormone libido: interest in sexual activity lobe: one of the two sides of an organ which clearly has two sides (e.g., the prostate or the brain) localized: restricted to a well defined area Lupron: the US trade or brand name of leuprolide acetate luteinizing hormone releasing hormone: a hormone responsible for stimulating the production of testosterone in the body lymph: the clear fluid in which all of the cells in the body are constantly bathed; also known as the lymphatic fluid lymph nodes: the small glands which occur throughout the body and which filter the clear fluid known as lymph or lymphatic fluid lymphadenectomy: a surgical procedure in which the lymph nodes are dissected M MAB: maximal androgen blockade (see maximal androgen deprivation) MAD: maximal androgen deprivation; the combined use of two forms of hormonal treatment to block the effects of testosterone and other androgens which are produced by the adrenal glands (also known by many other names and abbreviations) malignancy: a growth or tumor composed of cancerous cells malignant: cancerous margin: normally used to mean the "surgical margin," which is the outer edge of the tissue removed during surgery; if the surgical margin shows no sign of cancer ("negative margins"), then the prognosis is good metastasis: a secondary tumor formed as a result of a cancer cell or cells from the primary tumor site (e.g., the prostate) traveling through the body to a new site and then growing there metastatic: having the characteristics of a secondary tumor Metastron: the brand or trade name of strontium-89 in the US misstaging: the assignment of an incorrect clinical stage at initial diagnosis because of the difficulty of assessing the available information with accuracy monoclonal: formed from a single group of identical cells MRI: magnetic resonance imaging; a technique allowing sophisticated vertical, cross-sectional, and even three-dimensional images of organs inside the body based on the electromagnetic properties of different atomic particles as opposed to x-rays N negative: the term used to describe a test result which does not show the presence of the substance or material for which the test was carried out; for example, a negative bone scan would show no sign of bone metastases neoadjuvant: added before; for example, neoadjuvant hormone therapy is hormone therapy given prior to another form of treatment such as a radical prostatectomy neoplasia: the growth of cells under conditions that would tend to prevent the development of normal tissue (e.g., a cancer) nerve sparing: term used to describe a type of prostatectomy in which the surgeon saves the nerves that affect sexual and related functions nilutamide: an antiandrogen, still experimental in the US, but available in Canada and some other countries nocturia: the need to urinate frequently at night noninvasive: not requiring any incision nor the insertion of an instrument or substance into the body O oncologist: a physician who specializes in the treatment of various types of cancer orchiectomy: the surgical removal of the testicles organ: a group of tissues that work in concert to carry out a specific set of functions (e.g., the heart or the lungs or the prostate) overstaging: the assignment of an overly high clinical stage at initial diagnosis because of the difficulty of assessing the available information with accuracy (e.g., stage T3b as opposed to stage T2b) P palliative: designed to relieve a particular problem or problems without necessarily solving them; for example, palliative therapy is given in order to relieve symptoms and improve quality of life, but not to cure the patient palpable: capable of being felt during a physical examination by an experienced physician; in the case of prostate cancer, this normally refers to some form of abnormality of the prostate which can be felt during a digital rectal examination PAP: prostatic acid phosphatase; an enzyme test now used only rarely to decide whether prostate cancer has escaped from the prostate pathologist: a physician who specializes in the examination of tissues and blood samples to help decide what diseases are present and therefore how they should be treated pelvis: that part of the skeleton that joins the lower limbs of the body together penile: of the penis penis: the male organ used in urination and intercourse perineal: of the perineum perineum: the area of the body between the scrotum and the rectum peripheral: outside the central region PIN: prostatic intraepithelial (or intraductal) neoplasia; a pathologically identifiable condition believed to be a possible precursor of prostate cancer; also known more simply as dysplasia by many physicians placebo: a form of safe but non-active treatment frequently used as a basis for comparison with pharmaceuticals in research studies ploidy: a term used to describe the number of sets of chromosomes in a cell; see also diploid and aneuploid positive: the term used to describe a test result which shows the presence of the substance or material for which the test was carried out; for example, a positive bone scan would show signs of bone metastases posterior: the rear; for example, the posterior of the prostate is the part of the prostate that faces a man's back prognosis: the patient's potential clinical outlook based on the status and probable course of his disease progression: continuing growth or regrowth of the cancer prostate: the gland surrounding the urethra and immediately below the bladder in males prostatectomy: a surgical procedure for the removal of the prostate gland prostatitis: infection or inflammation of the prostate gland prosthesis: a man-made device used to replace a normal body part or function protocol: a precise set of methods by which a research study is to be carried out PSA: prostate specific antigen; a protein made by the prostate gland in response to the presence of foreign materials such as prostate cancer cells; it is used to detect potential problems in the prostate gland Q quality of life: an evaluation of health status relative to the patient's age, expectations, and physical and mental capabilities R radiation oncologist: a physician who has received special training regarding the treatment of cancers with different types of radiation radical: (in a surgical sense) directed at the cause of a disease; thus, radical prostatectomy is the surgical removal of the prostate with the intent to cure the problem believed to be caused by or within the prostate radioisotope: a type of atom (or a chemical which is made with a type of atom) which emits radioactivity radiotherapy: the use of x-rays and other forms of radiation in an attempt to destroy malignant cells and tissue randomized: the process of assigning patients to different forms of treatment in a research study in a random manner rectum: the final part of the intestines which ends at the anus recurrence: the reappearance of disease refractory: resistant to therapy; e.g., hormone refractory prostate cancer is resistant to forms of treatment based on the use of hormones. regression: reduction in the size of a single tumor or reduction in the number and/or size of several tumors remission: the real or apparent disappearance of some or all or the signs and symptoms of cancer resection: surgical removal resectoscope: instrument inserted through the urethra and used by a urologist to cut out tissue (usually from the prostate) while the physician can actually see precisely where he is cutting resistance: (in a medical sense) a patient's ability to fight off a disease as a result of the effectiveness of his (or her) immune system retention: difficulty in initiation of urination or the inability to completely empty the bladder retropubic: behind or posterior to the pubic arch risk: the chance or probability that a particular event will or will not happen RTPCR: reverse transcriptase polymerase chain reaction; a technique which allows a physician to search for tiny quantities of a protein, such as PSA, in the blood or other body fluids and tissues S 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 scrotum: the pouch of skin containing a man's testicles selenium: a relatively rare nonmetallic element found in food in small quantities which may have some effect in prevention of cancer semen: the whitish, opaque fluid emitted by a male at ejaculation seminal: related to the semen; for example, the seminal vesicles are glands at the base of the bladder and connected to the prostate that provide nutrients for the semen 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 sextant: having six parts; thus, a sextant biopsy is a biopsy requiring six samples 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 specitivity: 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 stage: a term used to define the size and physical extent of a cancer staging: the process of assigning a stage to a particular cancer in a specific patient in light of all the available information stent: a tube used by a surgeon to drain fluids 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 strontium-89: an injectable radioactive product which is used to relieve bone pain in some patients with prostate cancer which 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 suture: surgical stitching used in the closure of a cut or incision symptom: a feeling, sensation, or experience associated with or resulting from a physical or mental disorder and noticeable by the patient systemic: throughout the whole body T TAB: total androgen blockade; see maximal androgen deprivation testis: one of two male reproductive glands located inside the scrotum which are the primary source of the male hormone testosterone testicle: see testis testosterone: the male hormone or androgen which comprises about 90 percent of the androgens in a man's body; it is essential to complete male sexual function and fertility transition: change; for example, the transition zone of the prostate is the area of the prostate closest to the urethra and has features which distinguish it from the much larger peripheral zone transperineal: through the perineum transrectal: through the rectum transurethral: through the urethra TRUS: transrectal ultrasound; a method of imaging the prostate by inserting an ultrasound probe into the rectum; commonly used to visualize prostate biopsy procedures tumor: an abnormal tissue growth that can be either benign or malignant TURP: transurethral resection of the prostate; a surgical procedure in which tissue is cut from the prostate using a resectoscope U ultrasound: a set of sound waves at a particular frequency which can be used to image internal organs (e.g., a baby in the womb) understaging: the assignment of an overly low clinical stage at initial diagnosis because of the difficulty of assessing the available information with accuracy (e.g., stage T2b as opposed to stage T3b) unit: a surgical term for a pint (usually of blood) ureter: an anatomical tube which drains urine from one of the two kidneys to the bladder urethra: the tube that drains urine from the bladder through the prostate and out through the penis urgency: the need to urinate very soon urinary system: the group of organs and their interconnections that permits excess, filtered fluids to exit the body, including (in the male) the kidneys, the ureters, the bladder, the urethra, and the penis urologist: a doctor trained first as a surgeon who specializes in disorders of the genitourinary system UTI: urinary tract infection; an infection identifiable by the presence of bacteria (or theoretically viruses) in the urine; may be associated with fever or a burning sensation on urination V vas deferens: tube through which sperm travel from the testes to the prostate prior to ejaculation vasectomy: operation to make a man sterile by cutting the vas deferens, thus preventing passage of sperm from the testes to the prostate vesicle: a small sac containing a biologically important fluid W watchful waiting: active observation and regular monitoring of a patient without actual treatment X x-ray: a type of radiation used to make images of the internal structures of the body and in treatment of malignant diseases Y Z Zoladex: trade or brand name for goserelin acetate zone: part or area of an organ