Glossary of terms

A

Abdomen - The part of the body between the chest and the pelvis.

Abdominoperineal Resection (APR) [ab-dahm-in-oh-pur-IN-ee-ahl] - Surgical procedure in which some of the organs of the abdomen and pelvis are removed to prevent further spreading of the cancer, sometimes done for rectal cancer.

Ablation - In medicine, the removal or destruction of a body part or tissue or its function. Ablation may be performed by surgery, hormones, drugs, radiofrequency, heat, or other methods.

Abscess - An enclosed collection of pus in tissues, organs, or confined spaces in the body. An abscess is a sign of infection and is usually swollen and inflamed.

Adhesion - Scar tissue that binds connecting surfaces; often causes complications, such as pain or constipation, in a post-surgical patient.

Adenocarcinoma [add-no-car-suh-NO-muh] - Cancer that begins in cells that line certain internal organs and that have glandular (secretory) properties; 90% of all colorectal cancers are adenocarcinoma.

Adenoma - A usually benign (non-cancerous) tumor of glandular tissue that should be treated as precancerous.

Adjuvant Therapy - Medical treatment including chemotherapy, radiation, targeted or biologic therapy, provided to a patient in addition to the primary treatment to aid in the killing of cancer cells; adjuvant (meaning one that helps) chemotherapy and radiation therapy are both used in colorectal cancer treatment in an effort to eliminate all cancerous cells from the body, increasing the chances for a cure.

Advanced Directives - A legal document that states your wishes about health care choices or names someone else to make those choices if you become unable to do so. An advanced directive can be simple or complex. In other words, it can be general with little direction about care, or it can be very specific, detailing your wishes regarding acceptance or refusal of all types of life-sustaining treatments. The advance directive may also include a statement about organ and tissue donation.

Aflibercept - Also known was Zaltrap or Ziv-Aflibercept, this drug is a targeted biologic therapy for metastatic or stage IV colorectal cancer patients. Aflibercept works by blocking the blood supply to the tumor(s).

Alopecia [al-o-PEE-shuh] - Loss of hair or baldness, usually temporary, hair will usually re grow after treatment is finished.

Alternative Treatment - Treatments used in place of standard mainstream treatments; scientifically unproven therapies.

Anal Cancer - Cancer that forms in tissues of the anus. The anus is the opening of the rectum (last part of the large intestine) to the outside of the body.

Anastamosis [uh-nahs-ta-MOH-sis] - Surgically connecting two ends of bowel after resection, may be done at the time of resection or during an ostomy reversal.

Anemia - A condition in which there is a decrease in the number of red blood cell (RBC’s) or hemoglobin (Hg), may occur with chemotherapy or post-operatively, symptoms may include shortness of breath, pale skin (pallor), pale mucus membranes (gums etc.), heart palpitations and tiredness or fatigue.

Angiogenesis [an-jee-o-JEN-uh-sis] - Development of new blood vessels usually feeding a tumor; anti-angiogenesis drugs attempt to block the formation of these blood vessels.

Anti-angiogenesis - Anti-angiogenic drugs attempt to block the formation of new blood vessels needed for tumor growth and spread.

Antibody - A protein in the blood produced by immune cells to fight off diseases.

Antiemetic [anti-eh-MET-ic] - Remedies intended to control or reduce nausea and vomiting.

Antigen - A substance that induces antibody production.

Apoptosis [a-pop-toe-sis] - Programmed self-destruction of cells.

Arterial Access Device - Semi permanent device that allows a doctor or nurse direct access to an artery without having to put a needle in the artery (IV) every time treatment is given. Examples include chemo-port, port or picc-line.

Anxiety - State of intense apprehension, uncertainty, and fear resulting from the anticipation of an event or situation.

Arms (Clinical Trials) - Clinical trials can include multiple "arms." Each arm is a study group of patients receiving a specific treatment or combination of treatments that is being compared to other treatment arms as well as to the control arm. The "control arm" is the standard of care treatment.

Ascites [ah-sites] - Abnormal build-up of fluid in the abdomen that may cause swelling or bloating. In late-stage cancer, tumor cells may be found in the fluid in the abdomen. Ascites also occurs in patients with liver disease.

B

Barium x-ray - Practice of using the metal barium in liquid form, in combination with x-rays, to create a picture of the intestines.

Benign [be-nine] - Not cancerous. Benign tumors do not spread to tissues around them or to other parts of the body.

Bile Duct - A tube through which bile passes in and out of the liver and is stored in the gallbladder.

Biocompatible resin - A substance that comes from plants or is made in the laboratory that does not dissolve in water.

Biologic agent - A substance made from a living organism or its products that is used in the prevention, diagnosis or treatment of cancer and other diseases.

Biological therapy - The use of substances that normally occur in the body in small amounts; used in larger doses to treat disease.

Biomarker - A biological molecule found in blood, other body fluids or tissues that is a sign of a normal or abnormal process, or of a condition or disease. A biomarker may be used to see how well the body responds to a treatment for a disease or condition. Also called molecular marker and signature molecule.

Biopsy - Removal of tissue to see if it is cancerous.

Blood Cells - These cells fight infection, help blood to clot, and carry oxygen to all parts of your body.

Bolus Infusion - A single dose of drug usually injected into a blood vessel over a short period of time. Also called a bolus.

Bowel obstruction - Blockage or clogging of the intestines.

BRAT diet - Bananas, Rice, Applesauce, and Toast diet; this combination of foods can sometimes be used to stop or slow down diarrhea.

C

Cachexia [ka-kek-see-uh] - General weight loss and muscle wasting that may occur during the course of a chronic illness such as cancer.

Calorie - A unit of measure that reflects how much energy is present in a food.

Cancer Center - See National Cancer Institute (NCI).

Carcinoembryonic antigen (CEA) [car-sin-o-em-bre-ON-ic an-tuh-jin] - A protein marker in the blood that may be present with some cancers and other diseases; may be used in some cases of colorectal cancer to monitor response to treatment or disease recurrence.

Carcinoma Cancer - derived from the cells lining organs or epithelial tissue.

CAT Scan - A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography, computed tomography (CT scan), or computerized tomography.

Catheter - A flexible tube used to deliver fluids into or withdraw fluids from the body.

Cecum [see-cum] - The first part of the large intestines, located on the right side of the abdomen. The appendix is attached to the cecum.

Cell - The smallest living unit capable of independent existence. Humans are made up of billions and billions of cells.

Chemoembolization [key-mo-em-bo-li-ZAY-shun] - A procedure in which the blood supply to the tumor is blocked surgically or mechanically and anticancer agents are administered directly into the tumor. This permits a higher concentration of drug to be in contact with the tumor for a longer period of time.

Chemotherapy - The treatment of disease by chemical agents.

Chronic - Persisting over a long period of time.

Coagulation - To change from a liquid or soft state to a thickened or solid state.

Colectomy Surgery - during which all or part of the colon is removed. Also called resection.

Colitis - Inflammation of the colon.

Colon - The part of the large intestine that extends from the end of the small intestine (cecum) to the rectum.

Colonoscope - Flexible, elongated tube that can be inserted through the anus and passed through the colon allowing visualization of the inside.

Colonoscopy - Visual examination of the inner surface of the colon by means of a colonoscope.

Colostomy - Procedure to create an opening of the colon through the skin of the abdomen to allow for the passage of feces; also the opening itself.

Compassionate Use Trial - A way to provide an investigational therapy to a patient who is not eligible to receive that therapy in a clinical trial, but who has a serious or life-threatening illness for which other treatments are not available. Also called expanded access trial.

Complementary Therapy - Treatments used along with standard mainstream treatments usually to help relieve symptoms or to help the patient feel better.

Continuous Infusion - The administration of a fluid into a blood vessel, usually over a prolonged period of time.

Crohn’s Disease - A chronic inflammatory disease that involves all layers of the intestinal wall. It primarily affects the lower part of the small intestine, called the ileum, but it can affect any part of the large or small intestine, stomach, or esophagus. Crohn’s disease can disrupt the normal function of the bowel in a number of ways.

Cryotherapy - Any method that uses cold temperature to treat disease.

Curative treatment - Treatment for a disease that is intended to cure the patient of the disease. Also called adjuvant therapy.

D

Dehydration - The loss of total body water; in colorectal cancer, this can occur because of vomiting, diarrhea, or low fluid intake.

Depression - A psychological disorder with symptoms such as sadness, inactivity, difficulty in thinking and concentration, significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes thoughts of suicide.

Differentiated - Refers to how specialized a cell is to perform a specific function; in cancer, the more specialized or differentiated the cancer cell is, the closer to normal it is. See histologic grade.

Digital rectal examination (DRE) - An exam in which the doctor inserts a lubricated, gloved finger into the rectum to feel for anything abnormal. This simple test, which is not painful, may detect many rectal cancers and some prostate cancers.

Double-contrast barium enema - An x-ray examination of the entire large intestine (colon) and rectum in which barium and air are introduced gradually into the colon by a rectal tube.

Drug eluting beads - Polymer embolisation microspheres designed to load and release drugs into a specific location.

Dysplasia [dis-play-zhuh] - Abnormal changes of groups of cells that may lead to cancer

E

EGFR (Epidermal Growth Factor Receptor) - A protein on the surface of skin cells and some tumor cells, which may increase growth and spread of the cancer.

Electrolyte - Any of various ions, such as sodium, potassium, or chloride, required by cells to regulate the electric charge and flow of water across the cell membranes.

Embolization - The introduction of materials into the bloodstream that lodge in place cutting off the blood flowing to a tumor.

Endocavitary irradiation - Use of radiation inside the body cavity, to reduce the size of a tumor; used in rectal cancer by placing a radioactive beam inside the rectum through a special scope.

Endoscopy [en-dahs-kuh-pee] - inspection of body organs or cavities using a flexible, lighted tube called an endoscope. This method is referred to by different names depending on the area of examination, such as: esophagoscopy (esophagus), gastroscopy (stomach), upper endoscopy (esophagus and stomach),sigmoidoscopy (lower third of the large intestine), and colonoscopy (entire large intestine).

Enema - Injection of fluid into the rectum and colon to cause a bowel movement

Enterostomal therapist [en-ter-es-STO-mal] - Nurse or therapist who specializes in the care and maintenance of a stoma or an ostomy.

Erbitux - A biological chemo agent that targets cells that express EGFR which increases cell growth.

Erythema [ear-uh-THEE-muh] - Redness of the skin.

External beam radiation therapy (EBRT) - The sending of radiation from outside the body toward a tumor or potential tumor site inside the body.

External Radiation - The radiation comes from a machine. The most common type of machine used for radiation therapy is called a linear accelerator. Most patients go to the hospital or clinic for their treatment, generally 5 days a week for several weeks.

F

Familial adenomatous polyposis (FAP) [fa-mil-e-uhl ad–no-muh-tus pa-lee-po-sis] - A syndrome in which a gene mutation that influences the development of colon, rectal, and other cancers is inherited. People with FAP usually have hundreds, and sometimes thousands of pre-cancerous polyps, or growths developing at a very early age. FAP is defined as the presence of more than 100 benign (adenomatous) polyps in the colon at one examination and confirmed through genetic testing.

Fecal immunochemical test (FIT) [(fee-kuhl im-you-no-KIM-uh-kuhl test] - A newer test to look for "hidden" blood in the stool, which could be a sign of cancer. The test is not affected by vitamins or foods, though it still requires 2 or 3 specimens.

Fecal occult blood test (FOBT) - A test for "hidden" blood in the stool. The presence of such blood could be a sign of cancer.

Feces - The matter discharged from the bowel during bowel movements consisting mostly of the waste material from food.

Fellow - Doctor who has completed his or her residency (general training), but is specializing in a field such as medical oncology or radiation oncology. A fellow is under the supervision of a senior physician.

Femoral artery - The major artery that supplies blood to the lower extremities.

Fiberoptic - Thin fibers of glass or plastic inside an instrument that allow the inside of the body to be seen.

5-FU - A drug that is used in the treatment of cancer. It belongs to the family of drugs called anti-metabolites. It is also called Fluorouracil, it interferes with DNA and RNA replication in cells.

Flexible sigmoidoscopy [sig-moid-AH-skuh-pee] - A routine outpatient procedure in which the inside of the lower large intestine (called the sigmoid colon) is examined. During the procedure, a physician inserts a sigmoidoscope through the rectum up into the colon. This allows the doctor to look at the inside of the rectum and part of the colon for cancer or for polyps. The sigmoidoscope is connected to a video camera and video display monitor so the doctor can look closely at the inside of your colon.

FOBT (Fecal Occult Blood Test) - Looks for blood in small amount of feces.

FOLFOX - An abbreviation for a type of combination chemotherapy that is used to treat colorectal cancer. It includes fluorouracil, leucovorin, and oxaliplatin.

Food and Drug Administration (FDA) - The FDA’s role is to oversee the pharmaceutical research conducted by drug companies, university research centers and physicians to make sure that federal regulations governing this research are followed.

FOLFIRI - An abbreviation for a type of combination chemotherapy that is used to treat colorectal cancer. It includes fluorouracil, leucovorin and irinotecan.

G

General anesthesia - A temporary loss of feeling and a complete loss of awareness that feels like a very deep sleep. It is caused by special drugs or other substances called anesthetics. General anesthesia keeps patients from feeling pain during surgery or other procedures.

Genetic testing - Blood or tissue tests that may be ordered to detect the presence of genetic abnormalities that place a person at risk for getting certain diseases, such as cancer. For patients and families suspected of having an inherited disease it may be possible to find the mutation causing the disease through genetic testing of blood.

Gluten - Wheat gum; the protein part of wheat and some other grains.

Gray - Unit of measure used by radiation oncologists to calculate the amount of radiation used in cancer treatments.

Guidewire - A thin wire used to guide the insertion of a catheter during a minimally invasive procedure.

H

Hepatic Arterial Infusion (HAI) - The delivery of chemotherapeutic agents to the liver through a catheter placed in the hepatic artery. This is most often done in the operating room with general anesthesia and an open procedure. A pump is implanted percutaneously (under the skin) for delivery of chemotherapy. The type and the schedule of chemotherapy delivered via the pump will depend on the physician. Generally, the pump is filled with chemotherapy once a month. Body temperature and the mechanism of the pump allow chemotherapy to be delivered continuously at a slow rate directly to the liver. The physician may choose to also give systemic chemotherapy in conjunction with HAI.

Hereditary non-polyposis colorectal cancer (HNPCC) - Also called Lynch syndrome, an inherited condition that greatly increases a person’s risk for developing colorectal cancer. People with this condition tend to develop cancer at a young age without first having many polyps. Colon and rectal cancer occur frequently in HNPCC families.

Histologic Grade - A microscopic measure of how aggressive a tumor is. Grade I-well differentiated, the least aggressive. Grade II-moderately differentiated, Grade III-poorly differentiated and Grade IV-undifferentiated.

Hospice - A special kind of care for people in the final phase of illness, their families and caregivers; the care may take place in the patient’s home or in a homelike facility.

I

Ileostomy [ill-ee-OSS-tuh-me] - Surgical creation of an artificial opening through which the last segment of the small intestine discharges digestive waste material directly to the outside of the body through the skin. 

Immune system - System of the body that is responsible for fighting off disease, includes B-cells that produce antibodies.

Immunomodulator [im-you-no mod-you-late-or] - Drug that alters, suppresses, or strengthens the body’s immune system.

Inflammatory bowel disease (IBD) - Diseases that cause inflammation of the bowel. IBD includes Crohn’s disease and ulcerative colitis.

Informed Consent - The principle of informed consent means that patients have the right to be fully informed about a trial before agreeing to participate in that trial. The patient receives complete trial information, including treatment specifics, potential risks, benefits and side effects. The patient must sign an "informed consent form" before he or she is allowed to participate. If the protocol changes during the trial, the informed consent process is repeated.

Infusion - Introduction of fluid or medicines (such as saline solution or chemotherapy drugs) into an artery or vein. May be given over several hours or days.

Inoperable - Describes a condition that cannot be treated by surgery.

Institutional Review Board (IRB) - Each research institution has an Institutional Review Board. The IRB, which includes non-medical and medical people, reviews all protocols for patient safety. The board also reviews the consent information given to patients who are thinking about participating in the trial, to make sure that it is written in clear, understandable language.

Intern - Doctor in his or her first year of training after graduating from medical school; an intern is under the supervision of other doctors.

Internal Radiation - Also referred to as implant radiation or brachytherapy. The radiation comes from radioactive material placed in thin tubes put directly into or near the tumor. The patient stays in the hospital, and the implants generally remain in place for several days. Usually they are removed before the patient goes home.

Interventional radiologist - A radiologist who specializes in different techniques that are used to guide the passage through the skin of wires and catheters for various procedures.

Intraoperative radiotherapy (IORT) - Radiation treatment given during an operation that takes place inside the body.

Irinotecan - A chemotherapeutic drug used alone or with other drugs to treat colorectal cancer or rectal cancer that has spread to other parts of the body or has come back after treatment with fluorouracil. Irinotecan blocks certain enzymes needed for cell division and DNA repair, and it may kill cancer cells.

K

Kegel exercises - Named for a 20th century U.S. gynecologist, these exercises consist of alternately contracting and relaxing the perineal muscles in order to gain more control over their movement. These exercises can be used to counteract urinary incontinence, decrease painful intercourse, or gain active control of the perineum.

L

Laxative - Medications that increase the action of the intestines or stimulate the addition of water to the stool to increase its bulk and ease its passage. Laxatives often are prescribed to treat constipation.

Lesion [lee-zhun] - A change in body tissue; sometimes used as another word for tumor. May also be used to describe a change in the appearance or texture of skin, such as an open sore, scab, or discolored area.

Local Anesthesia - A temporary loss of feeling in one small area of the body caused by special drugs or other substances called anesthetics. The patient stays awake but has no feeling in the area of the body treated with the anesthetic.

Local excision - Act or procedure of removing a diseased part by surgical means; local excision is the removal of the diseased tissue close to the affected organ.

Local Therapy - Surgery and radiation therapy are local therapies. They remove or destroy cancer in or near the colon or rectum. When colorectal cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.

Low anterior resection (LAR) - Surgical procedure used to remove the cancerous tissue in colorectal cancer.

Lymph nodes - Bean-like structures throughout the body that are part of the immune system that helps the body fight off infection by producing white blood cells (lymphocytes).

Lynch Syndrome - Also called HNPCC, an inherited condition that greatly increases a person’s risk for developing colorectal cancer. People with this condition tend to develop cancer at a young age without first having many polyps. Colon and rectal cancer occur frequently in HNPCC families.

M

Malignant - Cancerous

Medical oncologist - Medical doctor who specializes in the treatment of cancer.

Metastasis [meh-tas-tuh-sis] - Spread of a disease from the part of the body where it started to another part of the body beyond the regional lymph nodes.

Metastasize [meh-tas-tuh-size] - To pass into or invade by metastasis. (see above)

Microsphere - A very tiny, hollow, round particle made from glass, ceramic, plastic, or other materials. Microspheres injected into blood vessels that feed a tumor may kill the tumor by blocking its blood supply. They can also be filled with a substance that may help kill more tumor cells.

Monoclonal antibodies [ma-nuh-KLO-nuhl] - A laboratory-produced biologic substance that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor.

MRI - Magnetic resonance imaging – specialized way to look at the organs of the body using magnetic energy and a computer.

N

Nasogastric (NG) tube - A tube that is passed through the nose and down through the nasopharynx and esophagus into the stomach. It is a flexible tube made of rubber or plastic, and it has bidirectional potential. It can be used to remove the contents of the stomach, including air, to decompress the stomach, or to remove small solid objects and fluid, such as poison, from the stomach. An NG tube can also be used to put substances into the stomach, and so it may be used to place nutrients directly into the stomach when a patient cannot take food or drink by mouth.

National Cancer Institute (NCI) - NCI is a federal agency that oversees the nation’s cancer research programs. Many clinical trials are funded by and/or conducted with NCI. There are also NCI Cancer Centers around the country; these are clinical and research facilities that meet NCI criteria and standards for cancer research. Find the criteria and list of the centers.

Nausea - A symptom resulting from the inclination to vomit.

NED - No evidence of disease.

Neutropenia [new-trow-PEEN-ee-uh] - Presence of abnormally low numbers of white blood cells (neutrophils) in the circulating blood lowering the body’s ability to fight off infection.

Nurse Practitioner (NP) - A nurse who has a Master’s or doctorate who is able to diagnose, prescribe medications and order diagnostic tests.

O

Off-Label - Use of a drug for a disease or condition other than the indication for which it was approved by the FDA.

Open surgical procedure - An operation that is performed through a large incision in the abdomen.

Ostomy - Artificial stoma, or opening, from the urinary or digestive system to the skin, may be permanent or reversed. See anastomosis.

P

Palliative care - The definition of Palliative Care from WHO (World Health Organization) says:
Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual. Palliative care is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy.

Pancolitis - Ulcerative colitis that involves the whole colon.

Parametrium [pair-uh-mee-tree-um] - Area around the uterus or womb in women.

Partial response - A result of cancer treatment that was not able to completely rid the body of the cancer, but did result in either stopping the growth of tumor(s) or caused shrinkage in the tumor(s).

Pathologist - A doctor who examines the cells and tissues removed during surgery.

Pelvic exenteration - Surgical removal of all of the organs of the pelvis; performed to treat cancers of the rectum or other pelvic organs.

Pelvis - Area of the body surrounded by the hips; includes the bladder, prostate, uterus, and other organs.

Penile implant - A flexible and/or inflatable device surgically placed along the length of the penis in order to provide penile rigidity; used for men who have problems either getting or maintaining an erection, to enable them to have sexual intercourse.

Penile injection - Process in which medication is injected into the penis to allow the production and maintenance of an erection; used for men who have problems either getting or maintaining an erection, to enable them to have sexual intercourse.

Percutaneous - Passing through the skin, as an injection or a topical medicine.

Perforation - Tearing or puncturing.

Peritonitis [pair-uh-tuhn-ITE-is] - Inflammation of the lining of the abdomen.

PET scan - Positron emission tomography is a specialized way to look at the organs of the body according to how fast they use sugar; can be used to detect cancerous cells. Cancer cells have a high metabolism and use sugar faster than non-cancerous cells.

Phases (for cancer trials) - A trial’s phase defines the type of testing occurring at a specific point. Clinical trials for anti-cancer drugs are conducted in three phases:

• Phase 1 trials 10 – 80 patients are enrolled to test dosage levels and the best way to apply the treatment (pills or injections; daily, hourly, weekly or continuously); side effects are monitored and used to determine the appropriate dosage levels for Phase 2 testing
• Phase 2 trials 40 – 300 patients to examine the effectiveness and safety of the treatment for selected types of cancers
• Phase 3 trials 300 – 5,000 patients, systematically compares the outcomes - the effectiveness and side effects - of the best available standard treatment and the experimental treatment(s).

The phase of the trial is not necessarily related to the stage of the cancer being studied. There are Phase 1 trials for all stages of cancer.

Physician Assistant (PA) - A person licensed to practice medicine under the supervision of a doctor.

Placebo - Compound with no real effect on the body (usually sugar) that is identical in appearance to the drug that is undergoing experimental research. Placebos are not used in colon or rectal cancer clinical trials.

Polyp [pah-luhp] - A growth from a mucous membrane commonly found in organs such as the rectum, the uterus, and the nose. Certain types of polyps, such as adenomas, may develop into cancer. Colorectal screening is important to detect polyps and early cancer.

Polypectomy - Surgical removal of a polyp.

Polyposis - The development of numerous polyps.

Port - Small, semi-permanent device that allows for the introduction of drugs (like chemotherapy) into a patient’s artery or vein without the need for repeated IVs.

Progression - In medicine, the course of a disease, such as cancer, as it becomes worse or spreads in the body.

Protocols (Clinical Trial Protocol)cA protocol is a blueprint for the trial, which describes how the trial will proceed, what types of patients will be eligible for the trial, the number of patients required, the type of care they will receive and so on. All protocols are reviewed by the sponsoring group (for example, the NCI or FDA) and the IRB (Institutional Review Board) of the institution where the research is being conducted to ensure patients are fully informed and that risks are minimized. See phases above.

R

Radiation Frequency Ablation (RFA) - Causes the cellular destruction of soft tissue by destroying them with heat. Heat is generated through agitation caused by alternating electrical current (radiofrequency energy) moving through tissue. The heat results in local cell coagulation: coagulated cells die and cannot continue to grow. The patient undergoing radiofrequency ablation receives IV sedation and grounding pads are placed on the legs. A thin needle is inserted into the tumor, visualized by CT scan or MRI, and electrical current is passed through the tip of the needle which becomes very hot and destroys the tumor. The procedure lasts 10 – 15 minutes and the patient goes home on the same day. The majority of patients do not experience side effects and resume normal activity the following day.

Radiation oncologist - Doctor who specializes in the treatment of cancer using radiation.

Radiation therapist - Person who assists the radiation oncologist and who usually delivers the daily radiation treatments.

Radiation therapy - Use of radiation (high energy x-rays) to eliminate or alleviate symptoms associated with tumors by shrinking or eliminating the tumors. In some cases used prior to surgery for rectal cancer.

Randomize - To arrange by chance usually associated with clinical trials.

Rectum - The last part of the large intestine where stool is stored prior to evacuation through the anus (external opening of the digestive system).

Recurrence - Cancer that has come back after treatment. Local recurrence means that the cancer has come back at the same place as the original cancer. Regional recurrence means that the cancer has come back in the lymph nodes near the first site. Distant recurrence is when cancer metastasizes after treatment to organs or tissues (such as the lungs, liver, bone marrow, or brain) farther from the original site than the regional lymph nodes.

Remission - In oncology, a period of time during which there is an apparent absence of cancer in the body.

Resection (colectomy) - Surgical removal of diseased tissue with a margin of normal tissue and regional (nearby) lymph nodes. Radical resection involves the above and includes the blood supply to the area. Resections may also be partial or limited depending on the extent of the disease.

Resident - Doctor who has completed his or her first year of training (internship) after graduating medical school, but who is still in the process of his or her general training; residents are supervised by other doctors.

S

Screening - The search for disease, such as cancer, in people without symptoms.

Sedation - To make sleepy, calm, or relaxed. Drugs to cause sedation are often used along with medicines to numb an area for a procedure like a colonoscopy.

Sexual dysfunction - Abnormal functioning of the sexual organs, or difficulty engaging in sexual activity.

Sigmoidoscope - A long, flexible instrument (about 1/2 inch in diameter) used in a sigmoidoscopy.

Sigmoidoscopy - Inspection, through a fiber optic scope, of the inside of the sigmoid colon which is the part of the large intestine that empties into the rectum.

Simulation - Process before radiation therapy in which the doctor and therapists measure the patient and decide how to direct the radiation.

Situational anxiety - A painful or apprehensive uneasiness due to a stressful situation such as a long-term illness.

Stage - Period in the course of a disease; in cancer, a description of the extent of cancer involvement of the various parts of the body. See TNM.

Stoma - Artificial opening between a body cavity or canal (such as the colon) and the skin.

Stomatitis [sto-muh-TIE-tus] - Inflammation, redness or sores of the lining inside the lips and mouth, also called canker sores; may also refer to redness or irritation around the stoma of an ostomy site.

Stool - Discharge of the bowels, the digestive waste matter discharged at one movement of the bowels; also called feces.

Stool DNA (sDNA) test - Colorectal cancer screening test that checks for changes to the cells in the colon by looking at DNA cells in the stool. Certain kinds of changes in cell DNA happen when you have cancer. Like the other stool tests, if your test is positive, you may need to have a colonoscopy.

Support network - Friends, family, coworkers, and others who provide care during a person’s lifetime, but particularly when illness strikes.

Survivor - An individual is considered a cancer survivor from the time of diagnosis, through the balance of his or her life. Family members, friends, and caregivers are also impacted by the survivorship experience and are therefore included in this definition.

Systemic Therapy - Chemotherapy and biological therapy are systemic therapies. The drugs enter the bloodstream and destroy or control cancer throughout the body.

T

TACE - The administration of chemotherapy directly into the tumor via a catheter followed by embolization or cutting off the blood supply to the tumor.

TNM (Tumor Node Metastasis) classification - System to evaluate cancer based on the T – extent of tumor invasion, N – lymph node involvement, and M – metastasis observed (other than regional lymph nodes); the number following each letter represents the extent to which each area is involved.

Total Parenteral Nutrition (TPN) - Used for patients who cannot or should not get their nutrition through eating. TPN may include a combination of sugar and carbohydrates (for energy), proteins (for muscle strength), lipids (fat), electrolytes, and trace elements. An individual’s solution may contain all or some of these substances, depending on your condition.

Tumor - An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.

Tumor marker - A substance found in tissue, blood, or other body fluids that may be a sign of cancer or certain benign (noncancerous) conditions. Most tumor markers are made by both normal cells and cancer cells, but they are made in larger amounts by cancer cells. A tumor marker may help to diagnose cancer, plan treatment or find out how well treatment is working or if cancer has come back. An example of a tumor marker in colorectal cancer is CEA.

U

Ulcerative colitis - A disease that causes inflammation and sores, called ulcers, in the superficial layers of the lining of the large intestine. The inflammation usually occurs in the rectum and lower part of the colon, but it may affect the entire colon. Ulcerative colitis rarely affects the small intestine except for the lower section, called the ileum.

Ultrasound - A procedure in which high-energy sound waves are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasonography.

Urologist - A physician who specializes in urinary or urogenital tract diseases and disorders.

V

Vacuum constriction device - A device placed over the penis that, when pumped, creates a vacuum around the penis and causes it to become engorged with blood (become erect).

Venous access device - Semi-permanent device that allows direct access to a vein without having to place a needle in the vein each time an infusion is given.

Virtual Colonoscopy - Virtual colonoscopy, also called computerized tomography colonography (CTC), is a procedure that uses a combination of x-rays and computer technology to create images of the rectum and entire colon.

WXYZ

Wide surgical resection - Surgical procedure used to treat colorectal cancer in which the cancerous colon and an area of normal colon and lymph nodes are removed in an attempt to cure the patient of his or her cancer.

X-ray - One form of radiation that can be used at low levels to produce an image of the body on film or at high levels to destroy cancer cells.

Yttrium-90 microsphere - An artificial radioactive isotope of the element yttrium, used in radiotherapy.

Zaltrap (Ziv-Aflibercept) - A targeted therapy for metastatic or stage IV colorectal cancer patients. Zaltrap works by blocking the blood supply to the tumor(s).

Sources: WebMD, American Cancer Society, National Cancer Institute.