Glossary of Terms
CCA has compiled an online glossary of colorectal cancer-related terms to help you familiarize yourself with the language used on this site or used by your doctor; most of the definitions were obtained from the National Cancer Institute. For more information or questions about the glossary, please contact firstname.lastname@example.org.
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.
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 advance 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 know 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). Read our Zaltrap FAQ.
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.
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 anus, chemo-port, port or picc-line.
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.
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.
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.
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.
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.
Colitis Iinflammation of the colon.
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.
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.
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 not normal. This simple test, which is not painful, may detect many rectal cancers and some prostate cancers.
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 (small intestine), sigmoidoscopy (lower third of the large intestine), and colonoscopy (entire large intestine).
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.
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. Read more.
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.
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. Read more.
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.
General anaesthesia 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.
H I J K
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.
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.
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.
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.
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.
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 colon 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.
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.
Laparoscope A thin, tube-like instrument with a light and a lens used to look at tissues and organs inside the abdomen. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.
Large intestine The last part of the digestive tract; it is divided into sections: ascending beginning at the cecum on the right side, transverse which is horizontal and descending which is on the left side and includes the sigmoid and the rectum. The primary function is the absorption of water and the formation and collection of feces. Cancer can occur anywhere in the large intestines with 38% occurring in the ascending colon, 18% transverse, 18% descending and 35% in the rectum/sigmoid.
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 Anaesthesia 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 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.
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.
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.
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. The criteria and list of the centers can be found at http://cancercenters.cancer.gov.
O P Q
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.
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.
PET scan Positron emission tomography – 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.
- 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.
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. Read more.
Protocols (Clinical Trial Protocol) A 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.
Radiationfrequency 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 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.
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.
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.
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.
Sigmoidoscope A long, flexible instrument (about 1/2 inch in diameter) used in a sigmoidoscopy. Read more.
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 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.
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.
T U V W X Y Z
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 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 colon cancer is CEA.
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.
Virtual ColonoscopyVirtual 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.
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.
Zaltrap (Ziv-Aflibercept) – A target therapy for metastatic or stage IV colorectal cancer patients. Zaltrap works by blocking the blood supply to the tumor(s). Read our Zaltrap FAQ.
Sources: WebMD.com and ACS's Cancer.org