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Article 3: LET'S LEARN THE CANCER LANGUAGE FIRST There are over 100 different types of cancer. Each type of cancer can have different symptoms, diagnostic tests and treatment options. As a result, there are many terminologies and phrases that are used to describe the type, symptoms and diagnosis of cancer, and treatment methods. It is often very confusing as well as frustrating for the readers if too many medical jargons or terminologies are used in describing this condition. It is difficult for readers to understand the context of the topic or take any action, if required, after reading any article or book on cancers. As a result, the information is often misinterpreted or not fully understood or comprehended. In this 3rd article of my cancer series, I would like to explain in very simple terms all phrases and terminologies used in describing a cancer. This will help readers in understanding the cancer terms, types of cancer, common diagnosis and treatment terminologies, and the health personnel involved in management of cancer. These are described in alphabetical order here. Ablation: removal or destruction of body part or tissue. Radiofrequency Ablation (RFA) therapy involves destroying cancer tissue with heat. RFA is commonly used in the treatment of lung, liver and kidney tumors. Adenocarcinoma: cancer that begins from lining of internal organs or from skin Adenoma: a non-cancer tumor that starts from glands Adenopathy: swollen glands Adjunct or adjunctive therapy: another treatment used together with primary treatment. For example, radiotherapy is sometimes given after surgery to treat cancer as adjunctive treatment. Anal: of anus, anal cancer Anorexia: an abnormal loss of appetite for food. Asbestos: a group of minerals that are found in the form of tiny fibres. It is used as insulation against heat and fire in buildings. Asbestos dust when breathed into the lungs can lead to cancer of lungs and mesothelioma. Asthenia: feeling or weakness or lack of energy. This is common in late stage cancer. Astrocyte: this is a type of cell in the brain or spinal cord. Astrocytoma is a tumor that begins in


astrocytes. Asymptomatic: having no signs or symptoms of disease. Most cancers are asymptomatic in the early stages. Axillary lymph node dissection: removal of lymph nodes in the axilla. This may be done in the treatment of breast cancer. B-cell lymphoma: A type of cancer that forms in B cells. Barrett esophagus: this is a condition where the cells lining the lower part of the esophagus have changed or been replaced by abnormal cells that could lead to cancer of the esophagus. The regurgitation of the contents of stomach into the esophagus over time can lead to Barrett esophagus. Basal cells: they are small round cells found in the lower part of epidermis. The cancer that begins in the basal cells is called basal cell cancer or basal cell carcinoma. Benign: not cancerous, also called non-malignant. Malignant tumor is a cancerous growth.For example, fibroadenoma is a benign tumor of breast whereas as adenocarcinoma is a malignant tumor of the breast. Benign prostatic hyperplasia: this is a non-cancerous condition of prostate where there is overgrowth of prostate tissue. Biological therapy: this is a type of treatment that uses substances made from living organisms or its products to boost or restore the ability of the immune system to fight cancer. Examples of biological agents include vaccines, interleukins and monoclonal antibodies. Biopsy: the removal of cells or tissues from the cancer or suspected cancer area for examination by a pathologist. This is the most sure way of diagnosing cancer. Bone marrow ablation: This is a procedure that is used to destroy bone marrow using radiation or high doses of anticancer drugs. It is done before a bone marrow or blood stem cell transplant to kill cancer cells and bone marrow cells. This is a part of intensive treatment of some leukemias. Bone marrow aspiration: this is a procedure in which a small sample of bone marrow is removed with a wide needle and syringe and sent to laboratory to check for cancer cells. If a small sample of bone with bone marrow inside it is removed, it is called bone marrow biopsy. Bone marrow transplantation: A procedure that is used to replace bone marrow that has been destroyed by treatment with high doses of anticancer drugs or radiation. Bone metastasis: cancer that has spread to bone from the original (primary) site. Brachytherapy: it is also called internal radiotherapy. In this type of radiation therapy, radioactive materials sealed in needles, seeds, catheters or wires are placed directly into or near a tumor.


BRCA1 and BRCA2: these are genes on chromosomes 17 and 13 respectively. A person who is born with changes (mutations) in BRCA1 and BRCA2 genes has higher risk of getting breast, ovaries and prostate cancer. Breast reconstruction: a surgery that is done to rebuild the shape of the breast after removing breast. Breast self-examination: a woman examines her breasts to check for lumps or other changes. Bronchogenic carcinoma: cancer that begins in the tissue that lines or covers the airways of the lungs. Cancer antigen 125 or CA-125: a substance that may be found in high amounts in the blood of patients with certain types of cancer, including ovarian cancer. Cachexia: loss of muscle mass and body weight. Cachexia is seen in patients in late stage cancer. Cancer: this is a condition where there is uncontrolled division of abnormal cells. Carcinogen: any substance that causes cancer, for example, tobacco smoke contains more than 50 carcinogens. Benzene is a carcinogen for leukemias. Carcinogenesis: it is a process whereby normal cells start changing into cancer cells. Carcinoma: it is a cancer that begins in the skin or in tissues that line the internal organs of the body. For example squamous cell carcinoma of skin or adenocarcinoma of gallbladder. Carcinoma in situ: these are abnormal cells (not cancer) but can become cancer cells and spread. They are also said to be in stage 0 of cancer for example, cervical carcinoma in situ. Carcinoma of unknown primary (cup): in this type of cancer, cancer cells are found in some parts of the body, but the place where the cancer cells first started to grow cannot be determined. Cervical: of cervix, cervical cancer Colostomy: colostomy is an operation that connects the colon to the outside of the body through the abdominal wall. Cryosurgery: this is a procedure in which tissue is frozen to destroy abnormal cells. Liquid nitrogen or liquid carbon dioxide is used to freeze the tissues. It is also called cryotherapy or cryosurgical ablation. Cyst: a sac in the body; cysts in the ovary are very common. Cytotoxic drugs: drugs that kill cells. Dilatation and curettage (D&C): this is a procedure where some tissues are removed from the lining of uterus or cervix. The cervix is first made larger (dilated) with a instrument called dilator


and another instrument called cutrette is inserted into the uterus to remove the tissue. The removed tissue sample may be sent to laboratory to check for abnormal or cancer cells. Debulking: this is the surgical removal of as much of a tumor as possible. This type of operation is usually done to relieve symptoms of cancer in the late stages of the disease. Dermal: of skin Duodenal: of duodenum, duodenal cancer Dysplastic nevi: it is also called atypical moles and have a tendency to develop into melanoma. Endometrial: of endometrium, endometrial cancer Esophageal: of esophagus, esophageal cancer Euthanasia: the intentional killing of a person to end his/her sufferings. It is also called mercy killing. Excision: removal by surgery, for example, excision of melanoma from skin. Familial adenomatous polyposis (FAP): this is an inherited condition in which many polyps form on the inside walls of the colon and rectum. FAP increases the risk of colorectal cancers. Familial atypical multiple mole melanoma syndrome (FAMMM): this is an inherited condition that increases the risk of melanoma and pancreatic cancer. Familial cancer: cancers that occur in families more often than in general population, for example, breast or colorectal cancer. Fecal occult blood test (FOBT): this is a test to check for blood in the stool. This is a screening test for bowel cancer. Fibroadenoma: this is a benign tumor of breast. Fibroid: a benign tumor that arises from smooth muscle, for example, uterine fibroid. First-degree relatives: this includes the parents, brothers, sisters, or children of an individual. Fistula: an abnormal opening or passage between two organs or between an organ and the surface of the body. Follow-up: monitoring a person's health condition over time after treatment. Gardasil: this is a vaccine to prevent infections by human papillomavirus (HPV) types 16, 18, 6 and 11. It is used to prevent cervical, vulvar, and vaginal cancers caused by these viruses. Gastrectomy: an operation to remove all or part of the stomach.


Gastric: of stomach, gastric cancer Gastric feeding tube: a tube that is inserted through the nose, down the throat and esophagus, and into the stomach to give liquid foods, liquids and drugs. Feeding tubes are often inserted in patients who have mouth, throat, neck and esophageal cancers, particularly when the surgery is extensive or combined with radiotherapy or chemotherapy. Gastrotomy or PEG tube: this type of tube is inserted directly into the stomach through an opening in the skin and abdominal wall. This type of tube can be used for long-term feeding. Gene: genes are pieces of DNA and contain the information for making a specific protein that is passed from parent to offspring. Genetic means related to genes. Genetic counselor: a health professional trained in counseling on the genetic risk of diseases. This may involve discussing the person's personal and family medical history and may lead to genetic testing. Genetic testing: this is analyzing DNA to look for genetic change (mutation) that may indicate increased risk for cancer. Genital warts: these are raised growths in the genital areas caused by human papilloma virus HPV) infection. Germ cells: these are reproductive cells of the body and include egg cells in women and sperm cells in men. Tumors that arise from germ cells are called germ cell tumors. Gleason score: this is a system of grading prostate cancer tissue based on how it looks under a microscope. Gleason scores range from 2 to 10 and indicate how likely it is that a tumor will spread. A low Gleason score means the cancer tissue is less likely to spread whereas a high Gleason score means the cancer tissue is more likely to spread. Hematuria: blood in the urine. Hemoptysis: coughing out blood from the respiratory tract. Hemorrhoid: swollen blood vessel, usually seen in the anus or the rectum Hepatic: of liver, hepatic cancer Hepatoblastoma: it is a type of liver cancer more common in infants and children. Hepatocellular carcinoma: this is the most common type of liver cancer. Hereditary nonpolyposis colon cancer (HNPCC): this is an inherited disorder in which the affected individuals have a higher-than-normal chance of developing colorectal cancer. High intensity focused ultrasound: (HIFU): this is a procedure in which high-energy sound waves


are aimed directly at the cancer or abnormal cells. These waves create heat and kill the abnormal or cancer cells. Some types of prostate cancers are treated with HIFU. Histology: the study of cells and tissues under a microscope. History: the signs and symptoms the patient may have for a particular disease Hysterectomy: an operation where uterus and/or cervix are removed. When both uterus and the cervix are removed, it is called a total hysterectomy. When only the uterus is removed, it is called a partial hysterectomy. Immunotherapy: a treatment that boosts body's immune system to fight cancer, for example, immunotherapy of bladder cancer with BCG vaccine. Implant: a substance or object that is put in the body as prosthesis, for example, breast implant after removal of breast for cancer. Intensity modulated radiation therapy (IMRT): this is a type of radiation therapy that uses computer-generated images to show the size and shape of the tumor and direct thin beams of radiation at the tumor from different angles. This type of radiation therapy reduces the damage to healthy tissue near the tumor. In situ: means 'in its original place'. Carcinoma in situ means the abnormal cells are found only in the place they were first formed and have not spread nearby. Incidence of cancer: the number of new cases of a cancer diagnosed each year. Incision: a cut made in the body by a surgeon to perform surgery. Induction therapy: this is the initial treatment given to reduce a cancer, for example, induction therapy for acute myeloid leukemia. Intrathecal chemotherapy: treatment in which anticancer drugs are injected into the fluid-filled space between the tissue that cover the brain and spinal cord. Intravenous (IV) chemotherapy: treatment in which anticancer drugs are injected into a vein through a canula. Labial: of lip Laryngeal: of larynx, laryngeal cancer Laser surgery: a surgical procedure that uses intense, narrow beams of light to cut and destroy cancer tissue. Leukemia: a cancer that starts in blood forming tissues such as bone marrow. Lymphedema: a condition where extra lymph fluid builds up in tissues and causes swelling. This


can be seen in the arm after breast operations. Malignant: means cancerous. Malignancy is the term used to describe malignant cells that invade and destroy tissues. Mass: a lump. It can be benign mass or malignant mass. Mastectomy: removal of breast. Medical oncologist: a doctor who specializes in diagnosing and treating cancer using chemotherapy, hormonal therapy, biological therapy, and targeted therapy. Mesothelioma: cancer arising from the mesothelial lining of the pleura (covering of lung) Melanoma: the cancer that begins in melanocytes. Common site is the skin but can also occur in the eyes. Metastasis: the spread of cancer from one part of the body to another. The cancer that is formed by cells that have spread from original site is called metastatic cancer or metastatic tumor. Mucosal: of mucosa, mucosal lining of vagina Mutate: means 'to change'. Mutation means change in DNA of a cell. Nasal: of nose, nasal polyp Neoplasia: it is an abnormal and uncontrolled cell growth. Neoplasm: it is an abnormal mass of tissue. Neoplasms can be benign or malignant (cancer). Nodule: it is a growth or lump or mass that can be benign or malignant. Oncogene: this is a changed or mutated gene and may cause growth of cancer cells. Oncology: the study of cancer Oncologist: a doctor who specializes in treating cancer. Oral: of mouth, oral cancer Ovarian: of ovary, ovarian cancer Palliative therapy or treatment: this is the treatment given to relieve the symptoms and reduce the suffering of cancer patient. Palliative care aims to improve the quality of life of patients. Pancreatic: of pancreas, pancreatic cancer Pharyngeal: of pharynx, pharyngeal cancer


PAP test: this is a procedure in which cells are scraped from the cervix and examined under a microscope. This test is done to detect cancer or to detect changes in the cervix that may lead to cancer. Partial: not whole, partly, for example, partial gastrectomy which means part of stomach is removed. Penectomy: surgery to remove part or the entire penis Penile: of penis, penile cancer Plastic surgery: a surgical procedure that improves the appearance of body structures. The person who does plastic surgery is called plastic surgeon. Plastic surgeons are involved in many reconstruction surgeries of breast, vagina or face after cancer treatment. Polyps: these are small growths that arise from mucous membrane of colon and rectum. Precancerous (premalignant) is a condition that may become cancer later. Proctoscopy: examination of the rectum using a proctoscope, inserted into the rectum. Prognosis: the likely outcome of cancer. The prognosis of most cancers in advanced stage is poor. Prophylactic surgery: this is a surgery to remove part of a body or organ with no signs of cancer but in an attempt to prevent development of cancer in that organ in future. For example, prophylactic mastectomy or prophylactic removal of ovaries are sometimes done. Prostatic: of prostate, prostatic cancer Prostate-specific antigen (PSA): this is a protein produced by prostate gland. The level of PSA in blood may be increased in men who have prostate cancer or enlarged prostate. Pulmonary: of lung Radiation oncologist: a doctor who specializes in using radiation to treat cancer. Radiation physicist: a person who makes sure that the radiation machine delivers the right amount of radiation to the correct site in the body. Radiation therapist: a health professional who gives radiation treatment. Radiofrequency ablation: a procedure that uses radio waves to heat and destroy abnormal and cancer cells. Recurrent cancer: cancer that has come back after treatment or after being undetectable for a period of time. The cancer is said to have recurred. Refractory cancer or resistant cancer: cancer that does not respond to treatment.


Regimen: it is a treatment plan where the dosage, the schedule and the duration of treatment is specified. Relative survival rate: it is an estimated number that compares the chances that a person with cancer will survive after the diagnosis or treatment of a cancer with those who do not have the cancer. It is usually calculated in terms of 2, 5 or 10 years. For example, the 5-year relative survival rate for colorectal cancer in America, if detected and treated early, is 90%. Remission: this means disappearance of or decrease in signs and symptoms of cancer. A cancer is said to be in complete remission when there are no signs and symptoms of cancer; it is in partial remission if some signs and symptoms of cancer have disappeared. Renal: of kidney, renal cancer Resection: removal of part or all of an organ. Risk factor: a risk factor is something that increases the chance of developing a cancer. For example, smoking is a risk factor for many cancers. Screening: checking for diseases when there are no symptoms of cancer. Examples of cancer screening tests include PAP tests, mammogram, and colonoscopy. Sentinel lymph node: it is the first lymph node to which cancer is likely to spread from the primary tumor. Staging of cancer: this is doing examinations and tests to find out the extent of cancer in the body and also whether the cancer has spread to other parts of the body. Staging cancer helps to give best treatment to the patient. Stem cell: a cell from which other types of cells develop. For example, red blood cells develop from blood-forming stem cells. Stent: it is a device that is placed in a body structure to keep it open. For example, a stent may be inserted in the bile duct if it is blocked by cancer of gallbladder. Stoma: this is an opening made surgically from an area inside the body to the outside. For example, colostomy has a stoma in the abdominal wall. Surgical menopause: a woman stops to have menstrual period following removal of her ovaries. This is seen in operations on cancers of ovaries or uterus. Surgical oncologist: a doctor who performs surgical procedures in cancer patients. Systemic chemotherapy: treatment of cancer with chemotherapy drugs that travel through bloodstream and reach cells all over the body. Targeted therapy: a type of cancer treatment that uses drugs or other substances to identify and


attack specific cancer cells. Testicular: of testis, testicular cancer Thermotherapy: treatment of disease using heat. Topical treatment: medicines that are applied on the surface of the body, for example, Aldara cream is applied topically on the skin to treat basal cell cancer. Ulcer: this is a break on the skin or in the lining of an organ. For example, an ulcer on the face may be a sign of basal cell carcinoma. Urethral: of urethra, urethral discharge Uterine: of uterus, uterine cancer Urologic oncologist: a doctor who specializes in treating cancers of the urinary system. Vaginal of vagina, vaginal cancer Visceral: of the viscera, viscera mean internal organs. Visceral pain is pain coming Vulval or vulvar: of vulva, vulval pr vulvar cancer Wart: a raised growth on the surface of the skin or other organs. Watchful waiting: This involves closely watching a patient's condition but not giving any active treatment. This is used in certain cancers like prostate or myeloma where the cancer progresses very slowly. Wedge resection: this is a surgical procedure where a triangular piece of tissue is removed in order to treat a cancer.

If you would like to know more about cancer including signs, symptoms, diagnosis, treatment, follow-up and other cancer-related issues like family tumors, sexuality, cancer in pregnancy, children and HIV patients, palliative care, psychological problems, and prevention and screening of tumors, please visit 'Do I Have Cancer? '. This 270 pages eBook provides a complete package of information on cancer that is guaranteed to give enough information on any issue related to malignant tumors. The next article in this series is 'Symptoms of Cancer' Dr Naresh Parajuli MBBS MIPH MM FRACGP


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