NOTE:  BE sure to do a "Site Search" (above right) for any word you might want additional information on.  A word may be missing here but used on the web site.

H

HC: hydrocortisone

HCT: hematocrit

HDCal: High Dose Calcitriol (i.e. The Beer protocol of HDCAL+Taxotere)

HDK: high dose ketoconazole (brand name Nizoral)

HDR: See High-Dose Rate Brachytherapy

HEREDITARY: Traits inherited from one's parents and from earlier generations via their DNA.

HESITANCY: Inability to initiate urination readily.

HIGH-DOSE RATE (HDR) BRACHYTHERAPY: Involves inserting iridium wires into the prostate gland through hollow plastic needles that are placed under transrectal ultrasound guidance. Once the radiation dose is delivered, the wires are withdrawn from the prostate.

HORMONE ABLATION THERAPY: Treatment that decreases or eliminates hormones. Example: surgical castration removes the testicles, the principle source of androgens. Actually should be Hormonal Ablation Therapy.

HORMONE DEPENDANT: Requiring hormones for survival. Examples include benign or cancerous prostate cells whose growth is supported by (and dependent on) androgens. Sometimes referred to as ADPC.

HORMONE THERAPY: Treatment that decreases or eliminates hormones. Example: surgical castration removes the testicles, the principle source of androgens. Actually should be Hormonal Ablation Therapy.

HORMONE: Substances that are produced in the body that act as messengers, communicating information between cells. Usually peptides or steroids, they are produced by one tissue and delivered via the bloodstream to another tissue to affect physiological activity such as growth or metabolism.

HOT FLASH: Sudden unexpected wave of body heat resulting in discomfort and sweating; a frequent side effect of certain forms of androgen deprivation therapy.

HRPC: hormone refractory prostate cancer

HT: hormone therapy

HYPERINSULINEMIA: A state of high insulin levels in the blood that can be caused by disproportionate consumption of simple or complex carbohydrates in the diet in proportion to dietary proteins and fats.

HYPOXIC CENTER: The center of a prostate cancer tumor in which a state of lower oxygen tension exists. This stimulates VEGF, a substance that stimulates the blood vessel growth necessary for the nourishment of the tumor.

I

ICHT: intermittent combined hormone therapy

IGRT:  IGRT is an advanced technology that allows radiation to be delivered to tumors with more precision than was traditionally possible. One of the challenges encountered when radiation is delivered to a tumor is that the tumor can move based on the patient's day to day position on the treatment table, as well as secondary to breathing. IGRT uses advanced imaging technology with on-board imaging (OBI).

IHT: intermittent hormone therapy

IMAGING: A radiology technique or method allowing a physician to see something that would not ordinarily be visible. Imaging studies include X-ray examinations, CT scans, bone or other nuclear medicine scans, and MRI and ProstaScint studies.

IMHO is in my humble opinion

IMMUNE SYSTEM: Natural defense mechanisms against infections and foreign materials.

IMO: is in my opinion

IMPLANT: Synthetic material or device that is inserted as treatment into the body, often permanently. Examples: radioactive seed implantation for prostate cancer; penile implants for erectile dysfunction.

IMPOTENCE: Inability to produce or maintain erection sufficient for intercourse.

IMRT: Intensity Modulated Radiation Therapy

INCISION: Surgical cut.

INCONTINENCE: Inability to control urination and urine flow.

INR: International Normalized Ratio: The INR is a conversion unit that takes into account the different sensitivities of thromboplastins. The INR is widely accepted as the standard unit for reporting PT (Prothrombin Time) results.

INTENSITY MODULATED RADIATION THERAPY (IMRT): An approach to external beam radiation therapy delivery using sophisticated computer planning to specify the tumor target dose and the amount of radiation allowable to nearby tissues and to modulate the intensity of the radiation as the delivery system rotates around the patient, thus minimizing damage to normal tissues.

INTERFERON: A molecule that is active against viruses and cancer cells.

INTERFERON-SIGNALING PATHWAY (ISP): One of the defensive pathways that healthy cells use against the development of malignancy and invasion by viruses involving the interaction of interferon, which is produced in response to an invader.

INTERLEUKIN-6 (IL-6): A cell product made by the primary tumor as well as by osteoblasts that facilitates bone resorption and promotes osteopenia and osteoporosis by stimulating mature osteoclasts to break down bone.

INTERSTITIAL RADIATION THERAPY: Radioactive seed implantation therapy. Synonyms: Brachytherapy, seed implantation.

INTRAMUSCULAR: Within muscle.

INTRAVENOUS PYELOGRAM (IVP): Imaging test to visualize the kidneys, ureters, bladder, and urethra by injecting a radio-opaque fluid intravenously. Synonym: Excretory urogram.

INTRAVENOUS: Within a vein.

IV: intravenous

J

K

KATTAN NOMOGRAMS: Various algorithms named after Michael Kattan that present probabilities of response to therapies, such as radical prostatectomy, external beam RT, and seed implantation based on a combination of biological inputs such as PSA, Gleason score, and clinical stage.

KEGELS: Exercise of pelvic muscles that assist urinary continence control.

KELOID: Excessive scar tissue at the site of a surgery or an internal procedure. A history of this type of scar tissue formation may indicate the probability of the development of anastomotic stricture after radical prostatectomy.

L

LACTIC DEHYDROGENASE (LDH): Elevated levels of this substance are associated with high Gleason score prostate cancer. LDH used to be routinely included in the standard chemistry panel and was considered an excellent overall tumor marker. For reasons unclear, LDH has been omitted from the standard panel.

LAPAROSCOPIC LYMPHADENECTOMY: Surgical removal of pelvic lymph nodes through multiple small incisions in the abdomen and use of fiberoptic-based tubal instrument.

LAPAROSCOPIC PROSTECTOMY: Surgical removal of the prostate gland through multiple small incisions in the abdomen. This can be manually or remotely done.

LEUTINIZING HORMONE (LH): Pituitary hormone that stimulates the testicles to produce testosterone.

LEUTINIZING HORMONE-RELEASING HORMONE (LHRH): Hypothalamic leutinizing hormone-releasing hormone that stimulates the pituitary to release leutinizing hormone.

LH: Leutinizing hormone, a pituitary hormone that stimulates the testicles to produce testosterone

LHRH AGONIST: Drug that affects hormone release by mimicking LHRH.

LHRH ANTAGONIST: An agent that blocks the LHRH receptor by pure antagonism without the initial release of LH, which is responsible for causing a testosterone surge seen with LHRH agonists; Abarelix (Plenaxis) is an example of an LHRH antagonist.

LHRH: Hypothalamic leutinizing hormone-releasing hormone that stimulates the pituitary to release leutinizing hormone.

LIBIDO: Sex drive.

LIGAND: A protein or an enzyme that combines with its appropriate binding site or receptor. The interaction of a ligand and its receptor initiates a biochemical reaction leading to the synthesis of other substances, often proteins, hormones, or enzymes. Almost all reactions in the human body involve ligands interacting with their appropriate receptors.

LINEAR ACCELERATOR: Device for creating high energy radiation used in some forms of external beam radiation therapy. Is used in both conventional, conformal, 3dEBRT, IMRT types of external beam

LN+: lymph node positive (pathology finding)

LNCaP: One of the many prostate cancer cell lines.

LNCaP is an androgen-dependent cell line.

LOCAL RECURRENCE: Return of cancer after treatment to the site of origin.

LOCALIZED CANCER: Cancer which has not spread beyond the organ of origin.

LOWER URINARY TRACT SYMPTOMS (LUTS): Urinary difficulties including slow stream, urinary urgency, difficulty in starting urination, and incomplete emptying of the bladder. These symptoms are quantified in the AUA Symptom Index or Score.

LUPRON: Brand name of one of the drugs acting as an LHRH agonist.

LUTEINIZING HORMONE (LH): A pituitary hormone that stimulates the Leydig cells within the testicles to produce testosterone.

LUTEINIZING HORMONE-RELEASING HORMONE (LHRH): Hormone from the hypothalamus that interacts with the LHRH receptor in the pituitary to release LH which in turn stimulates Leydig cells in the testicles to make testosterone.

LYCOPENE: Chemical found in high levels in cooked tomatoes that may reduce the risk of prostate cancer.

LYMPH NODES: Small glands occurring throughout the body that filter out bacteria and other toxins, including cancer cells. During the process of metastasis, they are one of the first sites of involvement when the cancer leaves the primary site of origin.

LYMPHADENECTOMY: Surgical removal of lymph nodes. Examples: Staging pelvic lymphadenectomy is removal of pelvic lymph nodes to determine the extent of spread of prostate cancer. Synonym: Lymph node dissection.

LYMPHANGIOGRAM: Imaging test that evaluates lymphatic vessels.

LYMPHATICS: Vascular channels for lymph fluid that is one of the natural defense mechanism against infection and other foreign substances. The lymph fluid percolates through tissue and is collected and circulates through lymphatic vessels, ultimately connecting to blood vessels.

M

MAGNETIC RESONANCE IMAGING (MRI): Use of magnetic resonance with atoms in the body tissues to produce distinct cross-sectional or three-dimensional images of internal structures.

MALIGNANCY: A growth or tumor composed of cancerous cells.

MALIGNANT: Cancerous; tending to become progressively worse and to result in death; having the invasive and metastatic (spreading) properties of cancer.

METASTASIS, METASTASES, METASTASIZE: Spread beyond the organ of origin, usually through the blood channels or lymphatics. Example: prostate cancer metastasizes to pelvic lymph nodes and bone.

MICROVESSEL DENSITY: An objectified measurement of angiogenesis.

MICROVESSEL: Small blood vessel that nourishes cells. Example: the number and density of microvessels surrounding prostate cancer is increased when compared with benign prostatic tissue. mL (MILLILITER): Unit of volume equal to one-thousandth of a liter.

MRI: Imaging method using powerful magnetic energy to visualize internal organs of the body. Synonym: Magnetic resonance imaging.

N

N0M0: N(number 0), M(number 0) pathology finding of negative for lymph nodes, and metastases.

NARAYAN STAGE: Part of the algorithm developed by Perry Narayan that assesses if the microscopic findings of prostate cancer were limited to one side of the prostate (Narayan B1) or both sides (Narayan B2).

NEGATIVE MARGIN: Edge of a surgical specimen that is not involved with the disease process. Example: The apex of the prostate has a negative margin after radical prostatectomy (not involved with cancer).

NEOADJUVANT THERAPY: Additional therapy prior to the main therapy. Example: Some patients receive neoadjuvant therapy in the form of androgen deprivation therapy prior to radical prostatectomy.

NEOPLASM: Tumor. Example: Prostatic adenocarcinoma is a malignant neoplasm.

NERVE-SPARING: A technique used in radical prostatectomy in which the erectile nerves are left intact by the surgeon.

NEUROENDOCRINE CARCINOMA: Rare form of prostate cancer with poor prognosis. Synonym: Small Cell Carcinoma.

NEURON-SPECIFIC ENOLASE (NSE): A biomarker of prostate cancer that may be expressed in prostate cancer variants associated with higher Gleason scores, that is, Gleason scores 8-10.

NEUROVASCULAR BUNDLE: Collection of nerves and blood vessels at the edge of the prostate that assist with erectile function. This is an important pathway of extraprostatic cancer spread. ng (NANOGRAM): Unit of measurement that is one-billionth of a gram.

NHT: neoadjuvant hormone therapy

NOCTURIA: Urinary frequency at night.

NOMOGRAM: A graphic representation, often used in analyzing data, consisting of several lines marked off to scale. Specific variables such as: PSA, Gleason score, clinical stage, etc. are given point values. The sum of all the points equates with the prognostic outcome.

NSAID: Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation.  The most prominent members of this group of drugs are aspirin, ibuprofen, and naproxen partly because they are available over-the-counter in many areas.

NSE: neuron-specific Enolase. A specific marker for neuroendocrine tumors which express proteins or enzymes that are reflective of a de-differentiated tumor cell population such as small cell prostate cancer. When both CGA and NSE are elevated the prognosis is considered poor.

O

ONCOGENES: Genes relating to tumor growth.

ONCOLOGIST: Doctor who specializes in treatment of cancer. Examples: radiation oncologist, urologic oncologist, medical oncologist.

ONCOLOGY: The branch of medical science dealing with tumors. Oncologists study cancer and treat patients who are afflicted with cancer.

ONCOLYTIC VIRUS: A virus that can kill tumor cells having defects in the interferon-signaling pathway or by other mechanisms.

ORCH: orchiectomy

ORCHIECTOMY: Surgical removal of the testicles. Synonym: castration.

ORGAN: A group of tissues that work in concert to carry out a specific set of functions in the body.

ORGAN-CONFINED DISEASE: Prostate cancer that is apparently confined to the prostate as determined either by clinical findings or, in the case of radical prostatectomy, by pathological findings; prostate cancer that has not penetrated the prostate capsule.

OSTEOBLAST: A cell type within bone that promotes bone formation.

OSTEOCLAST: A cell type within bone that promotes breakdown of bone or bone resorption.

OSTEOPENIA: A condition of bone that indicates that an imbalance between bone formation and resorption is compromising bone integrity. Osteopenia indicates that the degree of bone loss is more than 1 standard deviation from the WHO definition of normal, but not more than 2.5 standard deviation below that level.

OSTEOPOROSIS: A reduction in bone mineral density that is more that 2.5 standard deviation below the normal level defined by the WHO.

OVERFLOW INCONTINENCE: Type of incontinence in which there is continuous urine dribbling despite a full bladder.