Prostate Cancer: Glossary

5-alpha-reductase inhibitors: a class of oral medications or pills that interfere with the conversion within the prostate of the male sex hormone testosterone (produced by the testicles) to a more potent form of the hormone (known as dihydrotestosterone). Proscar (finasteride) and Avodart (dutasteride) are two drugs within this class. These drugs are commonly prescribed to relieve voiding (urination) symptoms in men with an enlarged prostate. There is evidence that taking these drugs may reduce a man's risk of developing prostate cancer, though they may increase a man's risk of developing an aggressive form of prostate cancer. These are the only medications that can alter the PSA blood test by causing a false low reading. If you have a PSA blood test done while taking either of these medications, be sure to tell your doctor. To determine an accurate reading, your PSA blood test value should be multiplied by 2 when taking these medications.

Abscess: a localized (limited to a small area) collection of pus caused by a bacterial infection

Acute bacterial prostatitis: also called infectious prostatitis; a bacterial infection of the prostate gland that causes inflammation and swelling of the prostate. Acute bacterial prostatitis should be treated right away, as the condition can lead to cystitis, abscesses in the prostate, or blocked urine flow in extreme cases.

Active surveillance: A treatment approach in men with low-risk prostate cancer that involves closely watching the man's disease with regular clinical assessments, laboratory tests, radiology imaging, and/or prostate biopsy to determine if his cancer is stable or growing. Treatment is usually recommended to men whose cancers are growing or becoming a higher risk cancer.

Adjuvant therapy: treatment provided in addition to the primary treatment to prevent cancer recurrence

Adrenal glands: glands that sit on top of the kidneys. The adrenal glands make and release hormones such as epinephrine (adrenaline), which raises heart rate and blood pressure; norepinephrine, which causes tightening of blood vessels; and steroid hormones, which help reduce inflammation and control how the body utilizes fat, protein, carbohydrates, and minerals. Other steroid hormones produced in the adrenal gland are called androgens, or male sex hormones.

Alpha-adrenergic blocker: a class of drugs used to treat benign (noncancerous) prostate enlargement. These medications tend to relax the prostate muscles and improve urine flow. They are also used to treat hypertension (high blood pressure).

Androgen: a hormone, such as testosterone, dihydrotestosterone, 5-dehydroepiandrosterone, and androstenedione, responsible for the development of male sex characteristics

Antegrade ejaculation: normal forward ejaculation

Antiandrogen drug: any medication that reduces or blocks the normal activity of an androgen hormone

Antibiotic: medication used to treat bacterial infection

Anti-inflammatory: medication used to reduce pain, swelling, or other irritation that is often caused by prostatitis

Antimicrobial: a drug that kills bacteria or prevents them from multiplying. Antibiotics are naturally occurring antimicrobials. Antimicrobial medications are used to treat acute (sudden) infectious and chronic (long-term) prostatitis.

Antibodies: proteins produced by the body to protect itself from foreign substances (such as bacteria or viruses)

Antigens: Foreign substances that cause an immune response in the body. The body produces antibodies to fight antigens.

Antispasmodics: drugs that help decrease involuntary muscle spasms that may occur in the bladder

Atrophy: wasting of tissue or organ, caused by disease, lack of blood flow, or lack of use (as in muscle atrophy). The testicles can become atrophic due to disease, cancer, or abnormal development.

Azoospermia: the absence of sperm in the ejaculate

Benign prostatic hyperplasia (BPH): also known as benign (noncancerous) enlargement of the prostate. Almost all men with normal hormonal function (those who produce the male hormone testosterone) will develop some enlargement of the prostate as they age.

Benign tumor: a noncancerous growth that does not spread to nearby tissues or other parts of the body

Biopsy: removal of a sample of tissue for study, usually under a microscope. A prostate biopsy is a procedure in which a physician uses ultrasound to guide a small needle into areas of the prostate where abnormalities are found. The needle is used to collect cells or tissue samples of the prostate. Usually 10 to 18 biopsies are taken to sample various areas of the prostate. The tissue samples are then analyzed in a laboratory to help physicians diagnose a variety of disorders and diseases in the prostate.

Brachytherapy: a form of radiation therapy for prostate cancer. During the procedure, radioactive seeds (iodine-125) are implanted into the prostate gland under ultrasound guidance. The number of seeds and their locations are determined by a computer-generated treatment plan for each patient. The seeds remain in place permanently and become inactive after about 10 months. This technique allows for delivery of a high dose of radiation to the prostate with limited damage to surrounding tissues.

Cancer: a general term for more than 100 diseases in which there is an uncontrolled, abnormal growth of cells. Cancer cells can spread through the bloodstream and lymphatic system to other parts of the body.

Cannulas: tubes that hold an instrument called a laparoscope (see below) and other instruments and allow access to the abdominal cavity for performance of laparoscopic surgery. These are also called "ports."

Carcinoma: malignant (cancerous) growth that begins in the lining or covering of an organ and tends to invade surrounding tissue and metastasize (spread) to other regions of the body

Carcinoma in situ: cancer that involves only the tissue in which it began; it has not spread to other tissues.

CAT scan: an X-ray technique using computer technology to produce a film showing a detailed cross-section of tissue. A CAT scan may be recommended so that your doctor can check for swollen or enlarged lymph nodes, which might mean the cancer has spread. Generally, a CAT scan is used only if the cancer is large, of a high grade, or associated with a very high PSA level.

Chemoprevention: a treatment approach that uses oral medications or pills to prevent the development of cancer in patients at risk.

Chemotherapy: in cancer treatment, the use of drugs whose main effect is either to kill or slow the growth of rapidly multiplying cells. Chemotherapy usually includes a combination of drugs, since this is more effective than a single drug given alone. There are many drug combinations used to treat prostate cancer.

Chronic prostatitis: Also known as chronic pelvic pain syndrome. There are many causes of this condition, including inflammation or infection from bacteria or other microorganisms. Men with this condition may complain of pelvic, perineal (the area between the scrotum and rectum) or penile pain, or pain with urination. They may also complain of voiding symptoms such as frequent urination or uncontrollable urge to urinate. Treatment is aimed at relieving the symptoms and/or the underlying cause.

Clear margins: areas of normal tissue that surround cancerous tissue, as seen during a microscopic examination

Clinical trial: a research program conducted with patients to evaluate a new medical treatment, drug, or device. The purpose of clinical trials is to find new and improved methods of treating different diseases and special conditions.

Combined hormonal therapy or maximal androgen deprivation: a medical treatment method that combines suppressing testosterone production and androgen production by the adrenal glands (see also: Hormone therapy) and a medication that reduces or blocks the normal activity of an androgen hormone (see also: Antiandrogen drug)

Cryobank: a place where cells, sperm, or embryos are frozen and stored

Cryopreservation: the process of freezing and storing sperm or embryos for later use

Cryotherapy: a treatment for men with prostate cancer (and those with recurrent prostate cancer after radiation therapy) that involves freezing and thawing of the prostate in a minor outpatient surgical procedure using prostate ultrasound. This technique enables freezing and thawing of the prostate to destroy prostate cancer cells and normal prostate tissue without affecting the vital body parts around the prostate gland, such as the bladder, rectum, and urinary sphincter muscle.

Cystectomy: removal of the bladder with surgery

Cystitis: inflammation of the bladder, which may be caused by infection

Cystoscopy: a procedure in which a tube is inserted into the urethra through the opening at the end of the penis. It allows the doctor to visually examine the complete length of the urethra and the bladder for polyps, strictures, abnormal growths, and other problems. Also called cystourethroscopy.

Cystoscope: tube-like device containing a light and a viewing lens. A cystoscope is inserted into the urethra to examine the urethra, bladder, and prostate.

Digital rectal exam (DRE): a screening test used to detect prostate cancer in its early stages. The prostate lies in front of the rectum, and the doctor can feel it by inserting a gloved, lubricated finger into the rectum. The doctor will feel the prostate for hard, lumpy, or abnormal areas and to determine whether the prostate is enlarged.

Dysuria: painful urination

Ejaculate: fluid and semen (which contains sperm) ejected from the penis during male orgasm

Ejaculatory duct: tube in the body where sperm are deposited into the urethra

Electrovaporation: a surgical procedure that uses electrical current to destroy excess benign (noncancerous) prostate tissue

Enuresis: involuntary urination. It is also termed "urinary incontinence."

Epididymis: a long, tube-like, coiled structure in which sperm collect, mature, and pass. The epididymis is located within the scrotum, above and behind the testicles. Mature sperm leave the epididymis through the vas deferens when they are ejaculated or reabsorbed by the body.

Epididymitis: inflammation of the epididymis

Focal therapy: a treatment approach for men with localized prostate cancer that targets the cancerous regions of the prostate (usually with cryotherapy or brachytherapy) without treating the prostate regions that do not have cancer. It is still considered an experimental treatment for prostate cancer.

Flow study: a test that measures the flow of urine

Gleason score: a rating system that identifies the aggressiveness of a cancer. A Gleason score of less than 6 is considered less aggressive, and a score greater than 7 is considered more aggressive.

Grade: a labeling system that shows how quickly a cancer is growing

Hormones: chemicals produced by glands in the body. Hormones control the actions of certain cells or organs.

Hormone therapy (also hormonal therapy): the use of hormone medications to treat cancer by removing, blocking, or adding to the effects of a hormone on an organ or part of the body. Hormone therapy may also include surgery to remove the testicles to prevent male hormones from further stimulating the growth of prostate cancer.

Immune system: the body's natural defense system against infection or disease

Impotence: a man's inability to develop or sustain an erection satisfactory for sexual intercourse; also called erectile dysfunction. Though prostate cancer is not a cause of impotence, some treatments for the disease can cause impotence or erectile dysfunction.

Interstitial Laser Coagulation (ILC): a treatment technique that uses two lasers to deliver heat to the interior of an enlarged prostate using instruments placed in the urethra. The procedure is usually done in the operating room under local anesthesia to numb the area.

Intracavernous injection therapy: injection of medication into the penis to treat impotence. This type of therapy can be effective for patients who have undergone radical prostatectomy (removal of the prostate) or who have received radiation therapy to treat prostate cancer.

Intraurethral therapy (Muse): suppository medication placed in the urinary tube (urethra) to treat impotence. The medicine relaxes the muscle in the erection chamber, allowing improved blood flow into the penis.

Incontinence: loss of urinary control. Incontinence may be complete or partial and can result from prostate surgery or radiation therapy for prostate cancer, as well as other conditions.

Laparoscopic surgery (laparoscopy): a method of surgery that is less invasive than open surgery. Tiny incisions (cuts) are made to create a passageway for a special instrument called a laparoscope. This thin telescope-like instrument has a miniature video camera and light source to send images to a video monitor. The surgeon watches the video screen while performing the procedure with small instruments that pass through small tubes placed in the incisions.

Laser surgery: destruction of tissue using a small, powerful, highly focused beam of light

Local therapy: treatment that affects cells in the tumor and the area close to it

Localized cancer: cancer that hasn't spread to other parts of the body. Localized prostate cancer is confined to the prostate.

Luteinizing hormone releasing hormone (LHRH) analog: a drug that blocks the production of testosterone by the testes to help stop tumor growth

Male infertility: reduced ability to produce offspring (children)

Malignant: cancerous; can spread to other parts of the body

Metastasize: to spread from one part of the body to another

Nonbacterial chronic prostatitis: the type of chronic prostatitis that occurs when no definite infectious cause can be identified. Men with nonbacterial prostatitis often have a number of white blood cells (associated with infection) in their urine, but no bacteria are found.

Obstruction: a clog or blockage that prevents fluid from flowing easily

Oncologist: a physician or surgeon who specializes in the treatment of cancer. Oncologists have a thorough knowledge of how cancers behave and grow. This knowledge is used to calculate your risk of recurrence as well as the possible need for and benefits of additional or adjuvant therapy (such as chemotherapy, hormonal therapy, or radiation therapy). Your oncologist generally manages your overall medical care and monitors your general health during your course of treatment. He or she checks your progress frequently, reviews your lab and X-ray results, and coordinates your medical care before and after your course of treatment.

Oncologist, radiation: a doctor trained in cancer treatment using radiation therapy

Oncologist, surgical: a doctor who performs biopsies and other surgical procedures specifically related to cancer. A surgical oncologist who treats cancers of the prostate, bladder, kidney and testis is also known as a urologic oncologist. Surgical oncologists may also treat cancers with hormonal therapy and immunotherapy.

Orchiectomy: removal of the testes by surgery

Palpation: a technique in which a doctor presses on the surface of the body to feel the organs or tissues underneath

Pathologist: a doctor who specializes in analyzing tissue samples. In the case of prostate cancer, the doctor can examine prostate tissue samples under a microscope to detect the cellular makeup of the tumor, whether the cancer is localized or has the potential to spread, and how quickly it is growing. Pathologists can detect subtle differences in cancer cells that help your surgeon and oncologist confirm the diagnosis.

Perineum: the area between the scrotum and anus

Permanent radioactive seed implants: a form of radiation therapy for prostate cancer in which radioactive implants (iodine-125) are implanted into the prostate gland using ultrasound guidance. The implants remain in place permanently, and become inactive after about 10 months. This technique allows for delivery of a high dose of radiation to the prostate with limited effect to surrounding tissues (see also: Brachytherapy).

Peyronie's disease: a condition that causes buildup of plaques and scarring along the walls of the erectile tissue of the penis. This condition causes curvature of the penis, especially when erect.

Post-void residual test (PVR): a test often performed with ultrasound imaging to detect how much urine is left in the bladder after the patient completes urination

Priapism: persistent, painful, and unwanted erection. This condition requires immediate medical attention if it last more than four hours.

Prostate: a muscular, walnut-sized gland that surrounds part of the urethra, the tube that carries urine and sperm out of the body. The prostate is part of the male reproductive system. It secretes seminal fluid, a milky substance that combines with sperm produced in the testicles to form semen. The muscles in the prostate push semen through the urethra and out of the penis during sexual climax (orgasm).

Prostate cancer: the most common form of cancer in American men and the second leading cause of cancer death in men. Cells in the body normally divide (reproduce) only when new cells are needed. Sometimes, cells will divide for no reason, creating a mass of tissue called a tumor. Tumors can be benign (noncancerous) or malignant (cancerous). Prostate cancer is a malignant tumor.

Prostate enlargement: See benign prostatic hyperplasia (BPH).

Prostate-specific antigen (PSA): a protein produced by the prostate. Higher levels of PSA, found during PSA testing, can indicate prostate cancer or other prostate diseases.

Prostate fusion MRI: special MRI imaging that is used to locate potential tumor sites in the prostate (see prostate fusion biopsy)

Prostate fusion biopsy: this is similar to the standard ultrasound-guided prostate biopsy; however, the MRI images from the fusion MRI are transposed onto the ultrasound machine. This aids the surgeon in taking more precise biopsies in suspicious areas.

Prostate massage: during a digital rectal examination, the doctor may massage, or "strip," the prostate to force prostatic fluid out of the gland and into the urethra. This fluid sample is then examined under a microscope for signs of inflammation and infection.

Prostatic acid phosphatase: an enzyme produced only in the prostate. High levels may indicate the spread of prostate cancer.

Prostatic ducts: a group of 20 to 30 tubes inside the prostate that collect and transport prostatic fluid to the ejaculatory ducts

Prostatic fluid: fluid produced by the prostate that is a part of the semen

Prostatitis, acute: a sudden bacterial infection of the prostate gland marked by inflammation of the prostate. Acute bacterial prostatitis must be treated immediately in order to prevent other health problems. (see also: Chronic Prostatitis).

Prostatodynia: pain in the prostate

Prostatectomy: See radical prostatectomy.

Radiation therapy: a form of cancer treatment that uses high levels of radiation energy to kill cancer cells or keep them from growing and dividing, while minimizing damage to healthy cells

Radical prostatectomy: surgery in which the entire prostate gland and some tissue around it are removed. Radical prostatectomy is used most often if the cancer is not believed to have spread outside the gland. Radical prostatectomy may be performed through an incision above the pubic bone (known as open or retropubic prostatectomy), through an incision in the perineum (known as perineal prostatectomy), and by using small incisions in the abdomen using a laparoscope (known as laparoscopic or robotic prostatectomy).

Radiology: a branch of medicine that uses radioactive substances and visual devices to diagnose and treat a wide variety of diseases

Radiologist: a doctor who reads and interprets X-rays and other radiographic images

Recurrence: the return of a disease after a period of remission

Remission: disappearance of any evidence of cancer. A remission can be temporary or permanent.

Renal: relating to the kidneys

Renal threshold: the point at which the blood is holding so much of a substance, such as glucose, that the kidneys allow the excess to "spill" into the urine. This is also called "kidney threshold," "kidney spilling point" or "leak point."

Retrograde ejaculation: ejaculation of semen backward into the bladder instead of through the urethra and out of the penis

Robotic surgery: a form of laparoscopic surgery that uses a robotic machine (known as the daVinci Surgical System) to help the surgeon. The laparoscope and the surgical instruments are attached to a robotic system that the surgeon controls at a video console in the operating room. Robotic surgery is commonly used to perform radical prostatectomy as well as operations to treat bladder and kidney cancer.

Scrotum: the sac of skin that contains the testes

Semen: the fluid, containing sperm, that comes out of the penis during sexual arousal and climax (orgasm)

Semen analysis: test that provides information about the number and quality of the sperm

Seminal vesicles: small glands near the prostate that produce some of the fluid for semen

Sexually transmitted disease (STD): a disease that is spread by having sex with someone who has an STD. You can get an STD from sexual activity that involves the mouth, anus, or vagina. STDs are serious illnesses that require treatment. Some STDs, like AIDS, cannot be cured and are deadly. STDs can only be transmitted through direct physical contact.

Sildenafil: See Viagra.

Sperm: the microscopic cells produced in the testicles and carried by semen to aid in reproduction

Stage: a labeling system indicating how far the cancer has spread, or the extent of the cancer. The stage of prostate cancer depends on the size of the cancer and whether it has spread from its original site to other parts of the body.

Systemic therapy: treatment that reaches and affects cells all over the body

Testes (testicles): a pair of rounded glands that lie in the scrotum and produce male cells (sperm) for reproduction, and the hormone testosterone

Testosterone: the male sex hormone produced by the testes

Transurethral incision of the prostate (TUIP): surgical treatment for benign prostate enlargement. An instrument passed through the urethra makes cuts in the prostate to clear any blockages, but does not remove tissue.

Transurethral microwave thermotherapy (TUMT): a procedure (also called transurethral hyperthermia) for treating benign enlargement of the prostate. Microwave energy delivers temperatures above 113 degrees Fahrenheit to the prostate by way of an antenna positioned in the prostate with a special catheter. The high temperature kills the prostate tissue, which is later sloughed off and eliminated through urination.

Transrectal ultrasonography: See ultrasound, prostate.

Transurethral resection of the prostate (TURP): surgical removal of tissue blocking the urethra, with no external skin incision (cutting). This is the most common treatment for symptomatic benign enlargement of the prostate.

Trocar: sharp, pointed instrument used to make a puncture incision in the abdominal wall. Used for placement of cannulas or ports.

Tumor: an abnormal mass of tissue

Ultrasound: a test used to diagnose a wide range of diseases and conditions in which high-frequency sound waves are transmitted through body tissues. The echoes are recorded and translated into video or photographs that are displayed on a monitor.

Ultrasound, prostate (also called transrectal ultrasound): a procedure in which a probe about the size of a finger is inserted a short distance into the rectum. This probe produces harmless high-frequency sound waves that bounce off the surface of the prostate. The sound waves are recorded and transformed into video or photographs of the prostate gland. The probe can provide images at different angles to help the doctor estimate the size of the prostate and detect any abnormal growths or lesions.

Urethra: the tube that carries urine (from the bladder) and semen (from the prostate and other sex glands) out through the tip of the penis

Urethral stricture: a narrowing or blockage of the canal leading to the bladder, discharging the urine externally

Urethritis: inflammation of the urethra; may be caused by infection

Urinalysis: a test in which a urine sample is tested to detect abnormalities. Urinalysis is important for diagnosing prostatitis, urinary infections, bladder and kidney cancer, diabetes, and other conditions.

Urinary catheter: a thin, flexible, plastic tube that is inserted into the bladder to drain urine

Urinary tract: the path that urine takes as it leaves the body. It includes the kidneys, ureters, bladder, and urethra.

Urinary tract infection: an infection of the urinary tract, usually caused by bacteria. The infection most often occurs in the urethra and bladder. It can also travel from the bladder into the ureter and kidneys.

Urination: discharge of liquid waste from the body

Urologist: a doctor who specializes in treatment of the urinary tract for men and women, and the genital organs for males

Vacuum erection device: a cylinder that is placed over the penis to treat impotence. The air is pumped out of the cylinder, which draws blood into the penis and causes an erection. The erection is maintained by slipping a band off the base of the cylinder and onto the base of the penis.

Viagra: an oral drug or pill used to treat erectile dysfunction (also known as sildenafil). Other drugs like Viagra include Cialis (tadalafil) and Levitra (vardenafil).

Void: to urinate

Voiding dysfunction: difficulty urinating

Watchful waiting: an approach used for slow-growing prostate cancer that involves regular checkups instead of immediate treatment.