You are here: Glossary
Please also refer to the Prostate Cancer Charity Glossary
A program of active surveillance is based on the premise that prostate cancers at low risk of disease progression can be monitored regularly and if disease progression develops treatment can be instituted. The two goals of this approach to prostate cancer management are to reduce the risk of treatment related complications for men with cancers that are not likely to progress and to identify tumours that are progressing and institute therapy sufficiently early for disease control.
National professional society of radiation oncologists.
Medical therapy administered for the purpose of achieving castrate levelsof the male hormone.
One of several nonsteroidal antiandrogen drugs.
Length of time after treatment during which no detectable tumor marker (prostate-specific antigen; PSA) is found. Can be reported for an individual patient or for a study population.
The finding of an increasing amount of prostate-specific antigen, detected by comparison to its prior value, following initial treatment.
A distinctive biological or biologically derived indicator used to measure or indicate an event, effect or progress of a disease or condition. One example of a biomarker is prostate-specific antigen (PSA).
Procedure where a rectal ultrasound is used to image the prostate gland and then to remove small prostate tissue samples (cores) for pathology diagnosis.
A narrowing at the point where the bladder is reconnected to the urethra after prostate surgery.
see Interstitial (low dose rate) prostate brachytherapy (LDR)
A radioactive substance that can be permanently or temporarily inserted into a tissue site (e.g., prostate).
A type of observational epidemiologic investigation in which subjects are selected on the basis of whether they do (cases) or do not (controls) have a particular disease under study. The groups are then compared with respect to the proportion having a history of an exposure or characteristic of interest.
The case report is the most basic type of descriptive study of individuals, consisting of a careful, detailed report by one or more clinicians of the profile of a single patient. The individual case report can be expanded to a case series, which describes characteristics of a number of patients with a given disease.
The use of natural or synthetic substances to reduce the risk of developing disease.
The worsening of a disease characterised by increased tissue or organ damage, biochemical markers and/or worsening of symptoms.
May be viewed as a type of prospective cohort study because participants are identified on the basis of their exposure status and are followed to determine whether they develop the disease. The distinguishing feature is that the exposure status of each participant is assigned by the investigator.
Clinical staging is based on information gained up to the initial definitive treatment. Clinically localised prostate cancers are those that are presumed to be confined within the prostate based on pre-treatment findings such as physical exam, imaging, and biopsy findings. Clinically localised prostate cancers fall into the Tumor, Nodes and Metastasis (TNM) category of clinical T1 and T2 tumors.
Database that contains a comprehensive list of references for controlled trials and other healthcare interventions; includes citations not listed in other bibliographic databases (e.g., MEDLINE, EMBASE), such as conference proceedings, meeting abstracts, and ongoing trials.
Group of individuals or study subjects followed prospectively over a period of time in clinical research of various designs.
In a cohort study, subjects are classified on the basis of the presence or absence of exposure to a particular factor and are then followed for a specified period of time to determine the development of disease in each exposure group. Cohort studies can be prospective or retrospective. The feature that distinguishes a prospective from a retrospective cohort is whether the outcome of interest has occurred at the time the investigator initiates the study.
Medical conditions other than prostate cancer, within the same individual, with the potential to cause illness or death.
Imaging technology that captures radiographic images of crosssectional planes of the body.
Radiation therapy shaped to increase precision of the radiation beam.
Transperineal technique for cryoablation of prostate tissue. Employs transperineal probes or needles that deliver freeze/thaw cycles to prostate tissue using argon and helium gases. Treated tissues undergo coagulative necrosis from a combination of direct injury to cells caused by ice-crystal formation during freezing and ischemia from the microcirculatory occlusion that occurs during thawing. Treatment of the prostate is monitored in real time with a transrectal diagnostic ultrasound transducer.
Definitive treatment is intended to permanently eradicate prostate cancer, thus affording permanent freedom from disease, through either removal of the prostate or in situ therapy such as external beam radiotherapy or brachytherapy.
Government department committed to improving the quality and convenience of care provided by the NHS and social services. Its work includes setting national standards, shaping the direction of health and social care services and promoting healthier living.
Length of time after treatment during which the patient is alive and no cancer is found. Can be reported for an individual patient or for a study population.
The incidence of death directly attributable to the disease.
The percentage of subjects in a study who have survived for a defined period of time without cancer recurrence. Usually reported as time since diagnosis or treatment.
The spread of prostate cancer from the initial or primary site of disease to another part of the body; prostate cancer that has metastasized falls into the Tumor, Nodes, and Metastasis (TNM) category of M1 metastasis.
Radiation therapy delivered to doses that are higher than the conventional dose (e.g., >70Gy).
European Organisation for the Research and Treatment of Cancer.
Erections insufficient for penetration or intercourse. Old definition: Inability to achieve or sustain an erection for satisfactory sexual activity.
Term used to describe medical tests, procedures, and treatments that are based on sound medical scientific research studies.
Radiation therapy delivered from an external source of radiation.
Ablative hormonal therapy in a patient not previously treated with any hormonal therapy.
An ordinal scale that connotes the clinical behavior of a malignancy. Cancers with a high grade tend to have higher and more rapid rates of progression. Cancers with a low grade tend to have lower and slower rates of progression. The most common system of grading prostate cancer is the Gleason scoring system.
The impact of a disease and its treatment on a person's physical, emotional and social functioning and well-being, including the impact on daily functioning. HRQL is a subjective, patient-reported outcome and as such must be rated by the patient.
Blood in the urine.
A procedure in which catheters containing a radioactive source (e.g., iridium-192) are temporarily placed into the prostate gland under image guidance for the purpose of therapeutic radiation delivery.
Includes prostate cancers with a Gleason score of 8 to 10. Some prostate cancers with a Gleason score of 7 may demonstrate clinical behavior similar to cancers with a Gleason score of 8 to 10.
Transrectal, noninvasive technique for thermal ablation of prostate tissue. Employs piezoelectric transrectal ultrasound probes (therapeutic transducers) of varying focal depth to generate high frequency ultrasonic vibrations which are converged onto a small focal point resulting in focal hyperthermia and coagulative necrosis. Treatment of the prostate is monitored in real time with a diagnostic ultrasound transducer that is arranged confocally with the therapeutic transducer.
Prostate cancer that demonstrates progression (determined by rising prostate-specific antigen and/or clinical evidence of metastatic or local progression) in spite of castrate levels of androgens.
A form of radiation therapy where a higher dose of radiation is given each day in order to shorten the overall time course of the delivery of radiation therapy without decreasing the biological effect.
A measure based on the postimplant dosimetry that provides information on what proportion of the prostate gland received the intended radiation dose (i.e., prescription dose).
Inflammatory bowel disease includes two chronic diseases (Crohn's disease and ulcerative colitis) that cause inflammation of the intestines. Ulcerative colitis is a disorder of the large intestine and more commonly affects the rectum. Although Crohn's disease can affect any part of the digestive tract, it is more common in the last part of the small intestine.
Also referred to as tools, questionnaires, or surveys; these are measures used to evaluate the impact of a disease and/or its treatment on symptoms, complications and overall well-being. Instruments are typically completed by the patient alone but also may be administered by a third-party interviewer.
Radiation therapy that is modified in order to deliver a more conformal radiation treatment. The modification involves varying the intensity of the beam across the treatment volume providing the highly shaped (conformed) beam.
A procedure in which radioactive sources (125I seeds) are placed into the prostate permanently or temporarily using image guidance for the purpose of therapeutic radiation delivery.
Small radiopaque markers placed in the prostate gland for localisation purposes.
Symptoms that result in a limited capacity to store urine in the bladder. Symptoms include frequent and urgent urination.
Laparoscopic prostatectomy is the complete removal of the prostate using long, narrow instruments that are introduced through small skin incisions. During this procedure, a telescopic instrument called a laparoscope is inserted into the abdomen through a small incision. A camera attached to the laparoscope allows surgeons to view inside the abdomen and pelvis. Usually, four more small incisions are made in the abdomen to accommodate surgical instruments and the surgery is performed.
Sexual desire; sexual drive.
Measure of time, usually in years or months, to define the average survival of groups of people.
A machine capable of generating photons whose energy exceeds 4mV.
Small rounded masses of tissue distributed along the lymphatic system that serve to filter impurities such as infection and cancerous cells. Lymph nodes associated with the prostate can be removed at the time of radical prostatectomy to see if the cancer has spread.
Surgical removal of the lymph nodes that drain the organ to be removed. During radical prostatectomy, the pelvic lymph nodes that drain the prostate can be removed for examination.
Doctor or physician who specializes in treating cancer patients with chemotherapy and other anticancer medicines.
Systematic statistical analysis that combines the results of several studies that address a given problem.
The percentage of subjects in a study who have survived without cancer spread for a defined period of time. Usually reported as time since diagnosis or treatment. Can be reported for an individual or a study population.
This term has two meanings. It can refer to complications of treatment, or alternatively, can refer to other medical problems that can impact on symptoms or life expectancy.
Use of only a single treatment modality (e.g., surgery alone or radiation alone) for the treatment of a medical condition.
A measure of the rate of death within a given population; may describe the population as a whole or a specific group within a population.
A radiation therapy modification device that provides the creation of a 3-dimensional conformal beam.
Prior to definitive therapy.
Hormonal therapy administered prior to definitive therapy.
Complete removal of the prostate performed with the intent to preserve the set of nerves to the penis that affect the man's ability to have an erection and that is in close proximity to the prostate gland. Some tumors can be removed using a nerve-sparing technique. Nervesparing surgery sometimes preserves the man's ability to have an erection after radical prostatectomy.
Prostate cancer that has not spread to lymph nodes or metastatic sites.
Symptoms arising from a compromised ability to empty the urinary bladder. This may result from inflammatory swelling that restricts the flow of urine through the urethra. Symptoms include pushing and straining to start urination and a weak urine stream.
The percentage of subjects in a study who have survived for a defined period of time. Usually reported as time since diagnosis or treatment. Also called the survival rate.
Palliative treatment is intended to relieve symptoms but is not expected to be a cure. Palliative treatment may be given in combination with other treatments intended to cure the disease or alone when a cure is not possible or indicated. The main purpose of palliative therapy is to improve the patient's comfort and quality-of-life.
Doctor or physician who is specially trained to examine tissues and to diagnose conditions.
The term used by the pathologist to describe the finding of cancer cells at the cut edge of the radical prostatectomy specimen. A finding of a positive surgical margin may place a patient at increased risk for cancer recurrence.
An imaging procedure performed following permanent interstitial prostate brachytherapy usually using computerized tomography to locate the radioactive sources with respect to the prostate gland permitting a calculation of the radioactive dose that is to be delivered as a result of the radioactive source implantation.
Inflammation of the mucous membranes of the rectum; may give rise to a range of bowel and gastrointestinal symptoms such as increased movement frequency, discomfort with bowel movements, rectal bleeding and tenesmus.
The duration that a patient is alive without any objective evidence of disease progression.
A change in the status indicating continuing growth or regrowth of the cancer, either within the prostate (local) or systemic spread (metastatic).
A study in which patients with a predefined condition are followed and information collected regarding their condition or other outcomes (e.g., qualityof- life). (See the definition of "clinical trial" or "randomized clinical trial.")
Removal of small cores of prostate tissue, usually with a spring-loaded biopsy needle usually obtained using transrectal ultrasound for guiding of the biopsy needle.
A measure of the rate of death attributable to the prostate cancer within a given population.
Calculation of PSA DT assumes first order kinetics for the increase in PSA over time. With this assumption, the increase in PSA follows an exponential growth curve, meaning a plot of log PSA over time would produce a linear slope that would remain constant. Most reports on PSA DT use a minimum of three consecutive PSA values, separated by a minimum of three months. Linear regression is used to calculate the slope of the log PSA line. The PSA DT is calculated as log x 2 divided by the slope of the log PSA line.
The state in which the serum level of PSA does not respond appropriately to therapy; this could be failure to drop or to stabilize or could be a continuous rising level.
The reappearance of a detectable and rising PSA following definitive treatment of localized and/or metastatic prostate cancer.
PSA velocity usually is calculated from at least three measurements obtained over a 2-year period. PSA velocity is calculated by the equation [(PSA2 PSA1/time1 in years) = (PSA3 PSA2/time2 in years)] divided by 2. PSA1 equals the first, PSA2 equals the second and PSA3 equals the third serum PSA measurement. Time1 equals the time interval between the first and second PSA measurements, and time2 equals the time interval between the second and third PSA measurements.
A charged-particle form of conformal radiation therapy.
National Library of Medicine's search service that provides links to medical journals, medical databases, medical articles and other information. PubMed can be reached at www.pubmed.gov.
Doctor or physician who specializes in treating cancer patients with radiation.
National clinical trials group of radiation oncologists in the United States.
Radical perineal prostatectomy is the complete surgical removal of the entire prostate through an incision in the skin between the scrotum and the anus.
Radical prostatectomy is the complete surgical removal of the entire prostate gland that may be performed through an open incision or through a laparoscopic approach.
Radical retropubic prostatectomy is the complete surgical removal of the entire prostate through an incision in the lower abdomen.
A form of clinical trial or scientific procedure used in the testing of the efficacy of medicines or medical procedures. It is widely considered the most reliable form of scientific evidence because it is the best known design for eliminating the variety of biases that regularly compromise the validity of medical research. Randomization may be a simple allocation of treatment or it may be more complex or adaptive.
In the context of prostate cancer, refers to lymph nodes in the obturator fossa and along the external and internal iliac blood vessels.
Complete removal of the prostate using long, narrow instruments introduced through small skin incisions, guided with a telescope and assisted by a robotic instrument.
Testing for a disease prior to the development of symptoms using any combination of history, physical diagnosis, and laboratory and/or radiographic testing. The goal of screening is to identify a disease in its early stages to improve the likelihood of cure and/or prevention of complications from the disease. Screening for prostate cancer most commonly consists of a combination of digital exam of the prostate and the measurement of prostate-specific antigen in the blood.
Can include definitive and palliative treatments. Includes any treatment that is offered following evidence of disease recurrence or progression after initial treatment.
An internal structure in the male located behind the bladder and above the prostate gland that contributes fluid to the ejaculate.
Functions related to the skeletal or voluntary muscles (in contrast to the functions related to the visceral or involuntary muscles).
An outcome measure that is used in place of a primary endpoint (outcome). In clinical trials, a surrogate endpoint is a measure of effect of a certain treatment that may correlate with a real endpoint but has no guaranteed relationship.
The ratio of those who survive a disease per number of persons diagnosed with the disease in a given amount of time.
A painful spasm of the anal sphincter corresponding with a need to defecate. Ineffectual and painful straining of stool.
Imaging technology that utilizes the measurement of reflection or transmission of high frequency sound waves to obtain anatomical data of intra-abdominal structures.
One route and the most commonly used route through which catheters containing radioactive sources are placed for the purpose of performing prostate brachytherapy.
An ultrasonographic imaging procedure in which an ultrasound transducer is inserted into the rectum and used to image the prostate and adjacent structures. TRUS frequently is used to provide image guidance for prostate biopsies or radioactive seed placement.
Transurethral resection of the prostate is the partial removal of the inner portion of the prostate gland surrounding the urethra. The technique involves the insertion of a lighted instrument with an attached electrical loop called a resectoscope in the penile urethra, and is intended to relieve obstruction of urine flow due to enlargement of the prostate.
A rubber or silicone tube that is placed within the bladder through the opening at the tip of the penis to allow passage of urine from the bladder to a collection device such as a bag.
A narrowing of the urethra.
Involuntary loss of urine.
Doctor, physician, or surgeon who specializes in caring for people with diseases of the genital and urinary tract.
The vas deferens are muscular ducts that transport sperm from the epididymis (where sperm maturation occurs) to the ejaculatory duct located within the prostate gland. The ampulla of the vas is a dilated segment of the vas deferens located near the seminal vesicles.
A prostate cancer management strategy based on the premise that not all prostate cancers will develop symptoms or spread during a patient's lifetime. Patients managed with watchful waiting are generally followed until symptoms develop at which time treatment for symptoms is initiated. This strategy may differ from active surveillance in which treatment is generally initiated when there is evidence that a tumor thought to be small and slow growing appears to be increasing in size or in growth rate.