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1 Glossary of Terms Prostate Module Adenocarcinoma Cancer originating in glandular epithelium lining internal organs such as the prostate or pancreas. Brachytherapy Internal radiation treatment achieved by inserting radioactive sources directly into or near a tumour; also called internal radiation, implant radiation, or interstitial radiation therapy. Cancer A malignant and invasive growth or tumor caused by abnormal and uncontrolled cell division. Cancer has the potential to spread to other parts of the body via local extension, the lymphatic system, or the blood stream. Digital Rectal An examination for abnormalities of organs or other Exam (DRE) structures in the pelvis and lower abdomen. Etiology The cause or origin of disease. Gleason Score A system for grading prostate cancer. The Gleason grading system assigns a grade to each of the two largest areas of cancer in the tissue samples. Grades range from 1 to 5, with 1 being the least aggressive and 5 the most aggressive. Grade 3 tumours seldom have metastases, but metastases are common with grade 4 or grade 5. The two grades are then added together to produce a Gleason score. A score of 2 - 4 is considered low grade; 5 - 7, intermediate grade; and 8 - 10, high grade. A tumour with a low Gleason score typically grows slowly enough that it may not pose a significant threat to the patient in his lifetime. Hormone The removal or destruction of hormones or their ablation function. The goal of hormone therapy such as androgen deprivation therapy (ADT) or androgen suppression therapy is to lower levels of the male hormones (androgens, mainly testosterone) in the body. Androgens, produced mainly in the testicles, stimulate prostate cancer cells to grow. Lowering androgen levels often makes prostate cancers shrink or grow more slowly. Metastasis The spread of cancerous cells from the initial area to www.radiationoncology.ca Virtual Experience in Radiation Oncology © 2008 2 other parts of the body. A tumour formed by cells that have spread is called a “metastatic tumour” or a “metastasis”. A metastatic tumour contains cells that are like those in the original (primary) tumour. The plural form of metastasis is metastases. Nomogram The Prostate Nomogram is a computerized tool that helps physicians and patients decide which treatment approach will result in the greatest benefit. A combination of disease factors including stage of the cancer, prostate specific antigen (PSA) level, biopsy pathology, use of hormone therapy, and radiation dosage are incorporated into the nomogram. Prostatectomy Excision of part or all of the prostate gland. PSA (ProstateA protease secreted by the epithelial cells of the specific antigen) prostate; PSA is used in the diagnosis of prostate cancer since its concentration in the blood serum tends to be proportional to the clinical stage of the disease. Radiation The medical use of high energy ionizing radiation from therapy sources such as X rays, cobalt or radium to kill or shrink (Radiotherapy) malignant cells. Radical Removal of the entire prostate gland, as well as some prostatectomy surrounding tissues and structures; typically, this surgery is done if it appears the cancer has not spread outside the prostate. Side effects Symptoms directly related to treatment, such as nausea resulting from radiation treatment of the stomach. Side effects are considered acute if they occur within the first six months after treatment. Symptoms persisting over a longer period of time are considered chronic. Staging Assessing the extent of the primary tumour and whether there is spread of cancer to the draining lymph nodes or distant body sites. Transition zone The innermost part of the prostate gland surrounding the urethra. The transition zone, along with the central zone, tends to enlarge as men pass age 40. Because of the proximity, to the urethra, such enlargement can cause urination or ejaculation difficulties. The transition zone makes up about 5% of the glandular volume and is the site of about 10% of prostate cancers. Transrectal The use of sound waves to create a computerized image www.radiationoncology.ca Virtual Experience in Radiation Oncology © 2008 3 Ultrasound (TRUS) of the prostate in order to detect abnormal prostate growth, guide a biopsy of an abnormal prostate area, and facilitate prostate cancer staging. Also called endorectal ultrasound. www.radiationoncology.ca Virtual Experience in Radiation Oncology © 2008