Mesothelioma Help Center Mesothelioma Medical
What is mesothelioma?
How Is Malignant Mesothelioma Diagnosed?
What Causes Mesothelioma?
How Is Mesothelioma Treated?
Mesothelioma Medical Terms
What is Mesothelioma?
Malignant mesothelioma is cancer that starts in the cells that line certain parts of the body, especially the chest, belly (abdomen), and heart. The lining formed by these cells is called mesothelium. These cells protect organs by making a special fluid that allows the organs to move. For instance, this fluid makes it easier for the lungs to move during breathing.
Tumors of the mesothelium can be benign or they can be cancerous. A cancerous tumor of the mesothelium is called a malignant mesothelioma, but this is often shortened to just mesothelioma. The information that follows covers only those tumors that are cancer.
Main types of mesothelioma
There are 3 main types of mesotheliomas based on how the cells look under a microscope.
- epithelioid: This is the most common type. It tends to have a better outlook (prognosis) than the other types.
- sarcomatoid (fibrous): About 1 or 2 out of 10 mesotheliomas are of this type.
- mixed (biphasic): This type has features of the 2 types above. About 3 or 4 out of 10 mesotheliomas are the mixed type.
About 3 out of 4 mesotheliomas start in the chest cavity. These are called pleural mesotheliomas. Another 10%-20% begin in the abdomen (belly). These are called peritoneal mesotheliomas. Those starting around the heart are very rare. This cancer can also start in the tissue around the testicles, but this is also very rare.
Source: American Cancer Society, Inc www.cancer.org
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What Causes Mesothelioma?
A risk factor is anything that affects a person's chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, such as smoking, can be controlled. Others, like a person's age or family history, can't be changed. But risk factors don't tell us everything. Having a risk factor, or even several risk factors, does not mean that you will get the disease. And some people who get the disease may not have had any risk factors.
Researchers have found some factors that increase a person's risk of mesothelioma.
The main risk factor for mesothelioma is contact with asbestos. In fact, most cases of mesothelioma have been linked to asbestos in the workplace. In the past, asbestos was used in insulation, and in other things like floor tiles, door gaskets, roofing, patching compounds, and more. Since asbestos is a natural mineral, it can also be found in dust and rocks in certain parts of the United States. Most asbestos use stopped after 1989, but it is still used in some products.
When asbestos fibers are breathed in, some can travel to the ends of the small air passages and reach the lining of the lungs. There they can damage the cells lining the lungs, and with time lead to pleural mesothelioma. If swallowed, these fibers can also reach the lining of the abdominal cavity where they play a part in causing peritoneal mesothelioma.
People who may be at risk for asbestos exposure include some miners, factory workers, makers of insulation, railroad workers, ship builders, gas mask makers, and construction workers. Studies have shown that family members of people exposed to asbestos at work have an increased risk of mesothelioma, too, because asbestos fibers are carried home on the clothes of the workers.
Asbestos was used in the insulation of many older homes and public buildings around the country, including some schools. Because the asbestos is contained within the building materials, a large amount is not likely to be found in the air. The risk is thought to be much less unless the asbestos is somehow released into the air, such as when building materials begin to decompose over time, or during remodeling or removal.
The risk of getting mesothelioma depends on how much asbestos a person was exposed to and for how long. Mesotheliomas take a long time to develop. The time between the first exposure and finding the disease is often between 20 and 50 years. Another important point about asbestos once you have been exposed to asbestos, the risk of mesothelioma appears to be lifelong and it does not go down over time.
There is some evidence linking thorium dioxide (Thorotrast) to mesothelioma. Thorotrast is a material that was once used in certain x-rays. It has not been used for many years.
Some studies have suggested that infection with simian virus 40 (SV40) might increase the risk of mesothelioma. Some polio vaccines prepared between 1955 and 1963 were contaminated with SV40. Research into this question is still going on.
Source: American Cancer Society, Inc www.cancer.org
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How Is Malignant Mesothelioma Diagnosed?
Mesothelioma is most often diagnosed after a patient goes to a doctor because of symptoms. If there is a reason to suspect you may have mesothelioma, your doctor will use one or more tests to find out if the disease is present. Symptoms might suggest that a person may have mesothelioma, but tests are needed to confirm the diagnosis.
Signs and symptoms of mesothelioma
Early symptoms of mesotheliomas are not specific to the disease, and people often ignore them or mistake them for common, minor ailments. Most people with mesothelioma have symptoms for a few months before they are diagnosed, although in some people this is longer.
Symptoms of pleural mesothelioma (mesothelioma of the chest) can include:
- pain in the lower back or at the side of the chest
- shortness of breath
- weight loss
- trouble swallowing
- swelling of the face and arms
- muscle weakness
Symptoms of peritoneal mesothelioma can include:
* abdominal (belly) pain
* swelling or fluid in the abdomen
* weight loss
* nausea and vomiting
The symptoms and signs above may be caused by mesothelioma, but they may also be caused by other conditions. Still, if you have any of these problems (especially if have been exposed to asbestos), it's important to see your doctor right away so the cause can be found and treated, if needed.
Medical history and physical exam
If you have any signs or symptoms that suggest you might have mesothelioma, your doctor will want to take a complete medical history to check for symptoms and possible risk factors, especially asbestos exposure. You will also be asked about your general health.
A physical exam can provide information about possible signs of mesothelioma and other health problems. Patients with pleural mesotheliomas often have fluid in their chest cavity (pleural effusion) caused by the cancer. Fluid can build up in the abdominal cavity (ascites) in cases of peritoneal mesothelioma, or in the pericardium (pericardial effusion) in cases of pericardial mesothelioma. Rarely, mesothelioma can develop in the groin and look like a hernia. All of these might be found during a physical exam.
If symptoms and/or the results of the physical exam suggest a mesothelioma might be present, more involved tests will likely be done. These might include imaging tests, blood tests, and other procedures.
Imaging tests use x-rays, radioactive particles, or magnetic fields to create pictures of the inside of your body. Imaging tests may be done for a number of reasons, including to help find a suspicious area that might be cancerous, to learn how far cancer may have spread, and to help determine if treatment has been effective.
This is often the first test done if someone has symptoms such as a constant cough or shortness of breath. It may show an abnormal thickening of the pleura, calcium deposits on the pleura, fluid in the space between the lungs and the chest wall, or changes in the lungs themselves as a result of asbestos exposure. These findings may also suggest a mesothelioma.
Computed tomography (CT) scan
The CT scan is an x-ray procedure that produces detailed cross-sectional images of your body. Instead of taking one picture, like a regular x-ray, a CT scanner takes many pictures as it rotates around you while you are lying on a narrow platform. A computer then combines these into images of slices of the part of your body that is being studied.
CT scans are often used to help assess the likelihood that mesothelioma is present and help determine the exact location of the cancer. They can also help stage the cancer (determine the extent of its spread). For example, they can show if the cancer has spread to the liver or other organs. This can help to determine if surgery might be a treatment option. Finally, CT scans can be used to determine if treatment such as chemotherapy has been helpful in shrinking or slowing the growth of the cancer.
Prior to the scan, you may be asked to drink a contrast solution and/or get an intravenous (IV) injection of a contrast dye that helps better outline abnormal areas in the body. You may need an IV line through which the contrast dye is injected. The injection can cause some flushing (redness and warm feeling). Some people are allergic and get hives or, rarely, more serious reactions like trouble breathing and low blood pressure. Be sure to tell the doctor if you have ever had a reaction to any contrast material used for x-rays.
You need to lie still on a table while the scan is being done. During the test, the table moves in and out of the scanner, a ring-shaped machine that completely surrounds the table. You might feel a bit confined by the ring you have to lie in while the pictures are being taken.
In recent years, spiral CT (also known as helical CT) has become available in many medical centers. This type of CT scan uses a faster machine. The scanner part of the machine rotates around the body continuously, allowing doctors to collect the images much more quickly than standard CT. As a result, you do not have to hold your breath for as long while the image is taken. This lowers the chance of blurred images occurring as a result of breathing motion. It also lowers the dose of radiation received during the test. The slices it images are thinner, which yields more detailed pictures.
Positron emission tomography (PET) scan
For a PET scan, you receive an injection of glucose (a form of sugar) that contains a radioactive atom. The amount of radioactivity used is very low. Cancer cells in the body are growing quickly, so they absorb large amounts of the radioactive sugar. A special camera can then be used to create a picture of areas of radioactivity in the body. The picture is not finely detailed like a CT or MRI scan, but it can provide helpful information about your whole body.
A PET scan can help give the doctor a better idea of whether a thickening of the pleura or peritoneum seen on another imaging test is more likely cancer or merely scar tissue. If you have been diagnosed with cancer, your doctor may use this test to see if the cancer has spread to lymph nodes or other parts of the body. A PET scan can also be useful if your doctor thinks the cancer may have spread but doesn't know where.
Some newer machines are able to perform both a PET and CT scan at the same time (PET/CT scan). This allows the doctor to compare areas of higher radioactivity on the PET scan with the more detailed appearance of that area on the CT.
Magnetic resonance imaging (MRI) scan
Like CT scans, MRI scans provide detailed images of soft tissues in the body. But MRI scans use radio waves and strong magnets instead of x-rays. The energy from the radio waves is absorbed and then released in a pattern formed by the type of body tissue and by certain diseases. A computer translates the pattern into very detailed images of parts of the body. A contrast material called gadolinium is often injected into a vein before the scan to better see details.
MRI scans can sometimes help determine the exact location and extent of a tumor since they provide detailed images of soft tissues. For mesotheliomas, they may be useful in looking at the diaphragm (the thin band of muscle below the lungs that is responsible for breathing), a possible site of cancer spread.
MRI scans may be a little more uncomfortable than CT scans. They take longer -- often up to an hour. You may be placed inside a large cylindrical tube, which is confining and can upset people with a fear of enclosed spaces. Newer, more open MRI machines can help with this if needed. The MRI machine makes buzzing and clicking noises that you may find disturbing. Some places will provide earplugs to help block this out.
Blood levels of certain substances are often elevated in people with mesothelioma:
- soluble mesothelin-related peptides (SMRPs), detected with the MesoMark® test
Blood tests for these substances are not used to diagnose the disease, but elevated levels may make the diagnosis more likely. Thus far, these blood tests have proven more useful in people who have already been diagnosed to follow their progress during and after treatment.
If mesothelioma is diagnosed, other blood tests will be done to check the blood cell counts and levels of certain chemicals in the blood. These tests can give the doctor an idea of how extensive the disease may be, as well as how well organs such as the liver and kidneys are functioning.
Tests of fluid and tissue samples
A person's symptoms and the results of exams, imaging tests, and/or blood tests may strongly suggest that mesothelioma is present, but the actual diagnosis is made by removing cells from an abnormal area and looking at them under a microscope. This is known as a biopsy. It may be done in different ways, depending on the situation.
Thoracentesis, paracentesis, and pericardiocentesis
If you have a buildup of fluid in the body that may be related to mesothelioma, a sample of this fluid can be removed by inserting a long, hollow needle through the skin and into the fluid and removing it. Numbing medicine is used on the skin before the needle is inserted. This may be done in a doctor's office or in the hospital.
This procedure has different names depending on where the fluid is:
- Thoracentesis removes fluid from the chest cavity.
- Paracentesis removes fluid from the abdomen.
- Pericardiocentesis removes fluid from the sac around the heart.
The fluid is then tested to see its chemical makeup and is looked at under a microscope to see if there are cancer cells in the fluid. If cancer cells are present, special tests can determine if the cancer is a mesothelioma, a lung cancer, or another type of cancer.
Not finding any cancer cells in the fluid does not necessarily mean there is no cancer, as not all fluid may contain cancer cells. In many cases, doctors need to get an actual sample of the pleural or peritoneal tissue to determine if mesothelioma is present.
Suspected tumors in the chest are sometimes sampled by needle biopsy. A long, hollow needle is passed through the skin in the chest between the ribs and into the pleura. Imaging tests such as CT scans are used to guide the needle into the tumor so that a small sample can be removed to be looked at under the microscope. This procedure is also done without a surgical incision or overnight hospital stay. In some cases, the sample removed may not be big enough to make an accurate diagnosis, and a more invasive biopsy method may be needed.
A possible complication of this approach is the buildup of air between the lung and the chest wall, which is known as a pneumothorax. In some cases this can lead to the collapse of part of a lung, causing shortness of breath. If this happens, it can be treated by temporarily placing a suction tube through the skin and into the chest, which will re-expand the lung.
Thoracoscopy, laparoscopy, and mediastinoscopy
In most cases, a tissue sample of a pleural or pericardial tumor can be obtained using a technique called thoracoscopy. Most often this is done in the operating room while you are under general anesthesia (in a deep sleep). The doctor inserts a thin, lighted tube with a small video camera on the end (a thoracoscope) through a small cut made in the chest wall to view the space between the lungs and the chest wall. (Sometimes more than one cut is made.) Using this, the doctor can see potential areas of cancer and remove small pieces of tissue to look at under the microscope. Thoracoscopy can also be used to sample lymph nodes and fluid and assess whether a tumor is growing into nearby tissues or organs.
Similarly, laparoscopy can be used to see and obtain a biopsy of a peritoneal tumor. In this procedure, a flexible tube containing a small video camera is inserted into the abdominal cavity through small cuts on the front of the abdomen.
If imaging tests such as a CT scan suggest that the cancer may have spread to the lymph nodes between the lungs, the doctor may do a procedure called a mediastinoscopy. This is also done in an operating room while you are under general anesthesia (in a deep sleep). A small cut is made in the front of the neck above the breastbone (sternum) and a thin, hollow, lighted tube is inserted behind the sternum. Special instruments can be passed through this tube to take tissue samples from the lymph nodes along the windpipe and the major bronchial tube areas. Cancers in the lung often spread to lymph nodes, but mesotheliomas do this less often. Tests on lymph nodes can give the doctor information on whether a cancer is still localized or if it has started to spread, and can help distinguish lung cancer from mesothelioma.
In some cases, more invasive procedures may be needed to get a large enough tissue sample to make a diagnosis. Surgery, either a thoracotomy (which opens the chest cavity) or a laparotomy (which opens the abdominal cavity), allows the surgeon to remove a larger sample of tumor or, sometimes, to remove the entire tumor.
If you might have pleural mesothelioma, the doctor may also do a bronchoscopy. The doctor passes a long, thin, flexible, fiber-optic tube called a bronchoscope down the throat to look at the lining of the lung's main airways. You will be sedated for this. If a tumor is found, the doctor can take a small sample of the tumor through the tube.
Testing the samples in the lab
No matter which approach used to obtain them, biopsy and fluid specimens are sent to the pathology lab. There, a doctor will look at them under a microscope and do other tests to determine if cancer is present (and if so, what type of cancer it is).
It is often hard to diagnose mesothelioma by looking at the cells from the fluid around the lungs, abdomen, or heart. It is even hard to diagnose mesothelioma with tissue from small needle biopsies. Under the microscope, mesothelioma can look like several other types of cancer. For example, pleural mesothelioma may resemble some types of lung cancer, and peritoneal mesothelioma may look like some cancers of the ovaries.
For this reason, special lab tests are often done to help distinguish mesothelioma from some other cancers. These tests often use special techniques to recognize certain markers (types of chemicals) contained in mesothelioma cells.
- Immunohistochemistry tests look for different proteins on the surface of the cells. It can be used to tell if the cancer is a mesothelioma or a lung cancer, which can appear to start in the lining of the chest cavity.
- DNA microarray analysis is a newer test that actually looks at patterns of genes in the cancers. Mesotheliomas have different gene patterns than other cancers.
- Electron microscopy can sometimes help diagnose mesothelioma. The electron microscope can magnify samples more than 100 times greater than the light microscope that is generally used in cancer diagnosis. This more powerful microscope makes it possible to see the small parts of the cancer cells that distinguish mesothelioma from other types of cancer.
If mesothelioma is diagnosed, the doctor will also determine what type of mesothelioma it is, based on the patterns of cells seen in the microscope. Mesotheliomas are classified as either epithelioid, sarcomatoid, or mixed/biphasic.
Pulmonary function tests
Pulmonary function tests (PFTs) may be done after a mesothelioma diagnosis to see how well your lungs are working. This is especially important if surgery is an option in treating the cancer. Because surgical removal of part or all of lung results in lower lung capacity, it's important to know how well the lungs are working beforehand. These tests can give the surgeon an idea of whether surgery may be an option, and if so, how much lung can safely be removed.
There are a few different types of PFTs, but they all basically involve having you breathe in and out through a tube that is connected to different machines.
Source: American Cancer Society, Inc www.cancer.org
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How Is Mesothelioma Treated?
Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don't hesitate to ask him or her questions about your treatment options.
If you have mesothelioma, you doctor will suggest one or more ways to treat the cancer. This is an important decision and you should take time to think about all of your choices.
You may want to get a second opinion. A second opinion can give you more information and help you feel better about the treatment choice you make. Also, some insurance companies require a second opinion before they will agree to pay for certain treatments.
Because this is such a rare cancer, it has been hard for doctors to compare the value of different treatments. Since many doctors have little or no experience treating this disease, you may be referred to a specialist at a large medical center. Treatment options include surgery, chemotherapy, and radiation therapy. One problem with treating mesothelioma is that it does not grow as a single tumor. Instead, it tends to spread along surfaces, nerves, and blood vessels. This makes it hard for treatment to get rid of all of the disease.
Surgery for some types of mesothelioma might be done to try to bring about a cure or to relieve symptoms. Surgery to relieve symptoms (called palliative surgery) is often done in cases where the tumor has already spread or when the patient is too sick to go through more involved surgery.
Surgery to try and cure the cancer
To attempt a cure, major surgery might be needed. This might be done if the patient is in good health (other than the cancer) and if it seems as if the tumor is only in one place. While surgery is not likely to cure the cancer, it might extend the patient's life.
But in most cases, the cancer has often spread to other places before it is found. So the role of surgery in treating this cancer is not clear. If your doctor recommends surgery, ask for more details about the operation and what the goal is.
Palliative surgery may be an option if the tumor has already spread beyond the mesothelium and is hard to remove completely, or if you are too ill for a bigger operation. The goal of this surgery is to relieve or prevent symptoms, rather than trying to cure the cancer.
Other measures to relieve symptoms
In many cases, treatments other than surgery are used to relieve symptoms. Fluid in the chest can be removed by placing a needle into the chest cavity and drawing the fluid out. Sometimes talc or drugs are injected into the chest. This causes the linings of the lung and chest wall to stick together, sealing the space and preventing further fluid build-up
Fluid in the abdomen (belly) or around heart can be removed by placing a long, hollow needle through the skin, into the fluid, and removing it. Numbing medicine is used on the skin before the needle is put in. This may be done in a doctor's office or in the hospital. While these methods can relieve symptoms, they are not meant to cure the cancer.
If the above methods don't work, a shunt might be placed in the chest. A shunt is a device that allows fluid to move from one part of the body to another. The shunt is a long, thin, tube with a small pump in the middle. In the operating room, the doctor puts one end of the shunt into the chest cavity and the other end into the abdomen (belly). Once the shunt is in place, the patient uses the pump several times a day to move the fluid from the chest to the abdomen, where it is more likely to be absorbed by the body.
Another approach sometimes used to control the build-up of fluid is a catheter -- a thin flexible tube. One end of the catheter is placed in the chest or abdomen and the other end is left outside the body. This is done in a doctor's office or hospital. Once in place, the catheter can be attached to a special bottle or other device to drain out the fluid.
Radiation therapy is treatment with high energy rays (such as x-rays) to kill or shrink cancer cells. The radiation may come from outside the body (external radiation) or from radioactive materials placed directly in the tumor (internal or implant radiation). External radiation is the preferred type for mesothelioma. It is given in the same way as the type of x-ray used to find a broken bone, although it takes longer. Treatments are usually given daily (5 days a week) for 3 to 5 weeks.
As a rule, it is hard to treat mesothelioma with radiation -- the need to treat a large part of the lung leads to problems with lung damage. But newer types of radiation therapy may be used in different ways to treat mesothelioma:
- It can be used as the main treatment of mesothelioma in some patients, especially those whose health is too poor to have surgery.
- It can be used after surgery to try to kill any small deposits of cancer that could not be seen and removed during surgery.
- Radiation therapy can be used to ease symptoms of mesothelioma such as shortness of breath, pain, bleeding, and trouble swallowing.
There can be side effects from radiation. Most of these will go away after a short while. The skin in the area treated may look sunburned and then become darker. You may also feel tired. Be sure to talk with your doctor about any side effects. Often there are medicines or other things that can be done to help control them.
Chemotherapy ("chemo") is the use of drugs to kill cancer cells. The drugs can be swallowed in pill form or they can be injected by needle into a vein or muscle. Once the drugs enter the bloodstream, they spread throughout the body. In treating mesothelioma, these drugs may also be given directly into the chest (or abdominal) cavity at the site of the tumor. More than one drug may be used to make the treatment work better.
Depending on the type and stage of the cancer, chemo may be given as the main treatment or along with surgery. Chemo for mesothelioma is given to relieve symptoms, not to cure the cancer.
Doctors give chemo in cycles, with a rest period in between cycles to allow the body time to recover. Chemo cycles often last about 3 to 4 weeks. Chemo is often not recommended for patients in poor health, but being older should not keep a person from getting chemo.
Chemo can cause side effects. These side effects will depend on the type of drugs given, the amount taken, and how long treatment lasts. Side effects could include the following:
- nausea and vomiting
- loss of appetite
- hair loss
- mouth sores
- an increased risk of infection
- bleeding or bruising after minor cuts
- shortness of breath
Most side effects go away once treatment is over. Anyone who has problems with side effects should talk with their doctor or nurse, as there are often ways to help.
Source : American Cancer Society, Inc www.cancer.org
We have helped people with mesothelioma cancer for more than seven years on the Internet. The Mesothelioma Help Center is designed to give you quick & simple answers about mesothelioma treatments, asbestos exposure, mesothelioma diagnosis, mesothelioma symptoms, mesothelioma doctors, and we can refer you to an experienced mesothelioma lawyer in who has successfully settled mesothelioma cases.
Source: American Cancer Society, Inc www.cancer.org
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New mesothelioma and anti-cancer drugs are constantly being researched and developed. Such drugs are required by the Food and Drug Administration (FDA) to go through extensive clinical trial testing during which their safety and efficacy is monitored.
The patients who choose to participate in these clinical trials typically suffer from a highly advanced type of cancer. Rather than electing to submit to traditional mesothelioma treatments that have proven ineffective in combating the rare asbestos cancer, patients can instead choose from a variety of experimental treatments. While such experimental treatments are more risk-oriented than traditional treatment modalities, they present cancer patients with a more proactive medium through which to fight to live.
Vegin is a new experimental drug manufactured by VasGene Therapeutics, Inc., Veglin is an anti-angiogenesis drug undergoing clinical trials at the University of Southern California's Keck School of Medicine. Veglin inhibits VEGF proteins, halting the formation of blood vessels and limiting the ability of tumors to grow and spread. Veglin is an antisense oligonucleotide, meaning that it can bond to messenger RNA (nucleic acid that directs protein production) and block the production of VEGF proteins.
If Veglin is successful in blocking tumor secretion of VEGF proteins, it is believed that it will be capable of preventing metastasis while simultaneously killing existing cancer cells.
ALIMTA [ (pemetrexed) is now available on expanded access basis.
ALIMTA is now available for people with malignant pleural mesothelioma, a cancer usually associated with exposure to asbestos. As of July 9, 2002 the Food and Drug Administration agreed to place ALIMTA in an expanded access program, which gives patients access to an agent that isn't yet commercially available, although the sponsor is actively pursuing marketing approval. Eli Lilly is pursuing approval of ALIMTA in combination with cisplatin for the treatment of malignant pleural mesothelioma, a disease that causes tumors to grow in the linings of the lung, or pleura. Patients live an average of six to nine months following diagnosis. The company said results of a Phase III trial showed that patients treated with ALIMTA and cisplatin combined lived longer and had less pain and shortness of breath, than patients treated with cisplatin alone. In the trial, the most common side effect from cisplatin and ALIMTA was a decrease in infection- fighting white blood cells. Under the expanded access program, ALIMTA will be given free of charge to patients who meet medical eligibility requirements.
L-NDDP (aroplatin) Intrapleural administration is intended to exceed the usefulness of other platinum drugs like Cisplatin that are limited by toxicity and drug resistance.
Endostatin has been shown to inhibit a tumor's ability to grow blood vessels without destroying normal healthy cells. Works with angiostatin. Lovastatin. A cholesterol drug shown to potentially inhibit the growth of cancer cells.
Intrapleural interferon gamma.
The anti-cancer drug, Interferon Gamma is directly administered into the affected area.
A Word about Clinical Trials
Clinical trials are separated into four distinct phases:
- Phase I & II: the first two phases of any clinical trial revolve around drug safety. Candidates for phases I & II include patients with an advanced form of a given disease (in this case, cancer), who are given the opportunity to try experimental treatments.
- Phase III: the third phase of any clinical trial revolves around comparing the drug with standard forms of treatment proven to work. Participants of phase III have a more optimistic prognosis while also meeting clinical trial criteria.
- Phase IV: the fourth and final phase of any clinical trial coincides with the preliminary marketing of the drug. Studies gather information on the drug's effect in various populations while monitoring any long-term side effects
Mesothelioma Treatment Options - Drug Therapy
This traditional approach uses special anti-cancer (cytotoxic) medicines and chemicals to try to kill the malignant cells. Often, it is offered as an additional therapy alongside radical surgery and/or in combination with radiation therapy or immunotherapy, particularly when the cancer has spread beyond an operable area. Many drugs have been tried; however all have met with only limited success against malignant mesothelioma.
The chemotherapeutic agents can be administered either systemically (in the blood stream) or intrapleurally (in the pleural cavity itself.) These cytotoxic drugs are very potent and can have many severe side effects which you should discuss with your doctor.
Understanding Chemotherapy - detailed information on chemotherapy, its side effects and current research:
University of Pennsylvania Cancer Center's information page on chemotherapy: http://www.oncolink.org/types/article.cfm?c=3&s=5&ss=603&id=6998
Search the National Cancer Institute web site for current chemotherapy trials.
Malignant mesothelioma of the peritoneum is both rare and difficult to treat. Peritoneal perfusion chemotherapy has recently been used in patients with secondary peritoneal carcinomatosis with promising results. See E. De Bree, et al. - Malignant peritoneal mesothelioma treated by continuous hyperthermic peritoneal perfusion chemotherapy", in Annals of Oncology, 11:753-756.
A study comparing standard combination chemotherapy with infusional carboplatin. See White, S.C., et al. - "Randomized phase II study of cisplatin-etoposide versus infusional carboplatin in advanced non-small-cell lung cancer and mesothelioma" in Annals of Oncology, February 2000; 11(2):201-206
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For most mesothelioma patients, diet is often an overlooked subject, but eating the right nutritional foods for strength and energy is just as important as taking the proper medication.
Mesothelioma patients undergoing treatment should follow a special cancer diet devised by their nutritionists. Cancer diets involve eating the correct amounts of protein and calories as well as drinking the right amount of water to keep the ailing body replenished and energized. The body needs plenty of nourishment when it is going through chemotherapy or even when the patient is taking certain medications.
As with most cancers, along side traditional treatment changing your diet can help. Increase soy beans products in your diet, the alpha carotene and lycopene in soy help to revert and reduce tumor growth and metastasis. Other anti-cancer foods that should be plentiful in your diet are cabbage, kale, Brussels sprouts, shiitake mushrooms, broccoli, pears, citrus fruits, turmeric, tomatoes, blackberries, raspberries, blueberries, green tea, walnuts, spinach, wheat bran, rice bran, rosemary, garlic, thyme, oregano and onions. These foods should be organic. Cut down on meat (especially grilled or barbecued) and dairy food consumption, pickled food, smoked food, alcohol, saturated fats, salt, sun exposure and smoking.
The following supplements may help if you are suffering from Mesothelioma.
Multivitamins and Multiminerals
- B group vitamins
- Vitamin E
- Vitamin A
- Vitamin C
- Vitamin D
- Vitamin K
- Co-enzyme Q10
- Shark cartilage
- Fish Oil
- Evening primrose oil
Source: Stewart Hare C.H.Ed Dip NutTh
Below are some of the important nutrients patients are encouraged to include in their mesothelioma diet:
- Protein is important for any cancer patient because it helps repair tissue damaged by surgery, chemotherapy, or radiation. Protein also helps maintain a strong and healthy immune system, lowering a mesothelioma patient’s risk of infection after aggressive cancer treatments. The National Cancer Institute recommends increasing protein in a cancer diet with cheese, milk, ice cream, yoghurt, eggs, nuts, peanut butter, meats and fish.
- Fats are an essential part of the cancer diet because they supply the body with the necessary energy it needs while undergoing treatment. The amount of fats (meaning the number of calories) a cancer diet should consist of is dependent on a mesothelioma patient’s age and body size. The National Cancer Institute recommends increasing caloric intake with such foods as butter, milk, cheese, honey, sugar, granola and dried fruits.
- Water is another essential element of the cancer diet. Without a substantial amount of water, the body will dehydrate. It is important that anyone undergoing cancer treatment receive enough water to keep their bodies hydrated and replenished.
The details of every patient’s mesothelioma diet will vary. Some patients will need to incorporate more fat into their diets, while others may need more protein. It is important that patients devise a cancer diet under the guidance of their doctor and nutritionist to ensure that they receive the proper amount of nutrients to improve their quality of life.
Source: MesotheliomaAttorneyAdviceCenter (www.maacenter.org).
Diet and Nutrition for Mesothelioma Patients
Eating a healthy diet that contains all the essential nutrients can be a challenge for anyone. But for people with mesothelioma and other cancers, this challenge is even more difficult. Although loss of appetite and nausea are common in people with mesothelioma, eating a healthy, balanced diet becomes more important than ever. Proper nutrition helps to boost the immune system, maintain energy levels and fight the free radicals that can cause cancer. In addition, diet and nutrition can play an important role in reducing the toxic side effects of some mesothelioma treatments.
If you or someone you know has mesothelioma, here are some diet and nutrition tips for fighting the disease and living well while undergoing treatment.
- A consultation with a dietician can help you create a nutritious meal plan that is tailored to your needs.
- Most sources recommend a lower-carbohydrate diet for people with cancer. At the same time, higher amounts of protein can help repair tissue damaged by surgery or treatments. It can also help to maintain a healthy immune system.
- Include fats in your diet to help supply your body with the energy it needs.
- Drink plenty of water to keep your body hydrated and flush out the toxins produced by mesothelioma treatments.
- If loss of appetite prevents you from eating more than a few bites at each meal, you can boost your caloric intake and avoid excessive weight loss by consuming high-calorie foods. These include butter, milk, cheese, honey and sugars.
- Focus on liquids and soft foods if you are nauseated or have difficulty swallowing. Blended drinks such as fruit smoothies may be more tolerable than solid foods. Commercially prepared liquid diet supplements are also useful.
- To be sure you are getting enough of the nutrients you need, you may want to ask your doctor if nutritional supplements are right for you.
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Mesothelioma Medical Terms
Additur - When a judge thinks that the jury has not recommended enough money for the plaintiff and orders that an additional amount be added to the total.
Amendment - A change to the plaintiff's pleading or the defendant's response. All amendments are filed with the court and given to the opposing side.
Appeal - After a trial judge enters a judgment, one of the parties may ask a higher-level court to review the judgment to make sure that it was justified.
Appellate - A word used to describe things having to do with the process of appeal. For example: the "appellate" court is a court with higher authority that the one where the trial was.
Award - A decision made by a court, usually involving money. A plaintiff may get an "award" of money from the defendant.
adjuvant therapy (add- joo-vunt ): treatment used in addition to the main treatment. It usually refers to hormonal therapy, chemotherapy, or radiation added after surgery to increase the chances of curing the disease or keeping it in check.
Adrenal gland: one adrenal gland is located near each kidney. Their main function is to produce hormones which control metabolism, fluid balance, and blood pressure. In addition, they produce small amounts of "male" hormones (androgens) and "female" hormones (estrogens and progesterone).
Advance directives: legal documents that tell the doctor and family what a person wants for future medical care, including whether to start or when to stop life-sustaining treatment.
Alopecia (al-o-pee- shuh ): hair loss. This often occurs as a result of chemotherapy or, less often, from radiation therapy to the head. In most cases, the hair grows back after treatment ends.
Alveoli (al- vee -o-lie): air cells of the lungs.
Alternative and complementary therapies: therapy refers to any of the measures taken to treat a disease. Unproven therapy is any therapy that has not been scientifically tested and approved. Use of an unproven therapy instead of standard therapy is called alternative therapy. Some alternative therapies have dangerous or even life-threatening side effects. For others, the main danger is that a patient may lose the opportunity to benefit from standard therapy. Complementary therapy, on the other hand, refers to therapies used in addition to standard therapy. Some complementary therapies may help relieve certain symptoms of cancer, relieve side effects of standard cancer therapy, or improve a patient's sense of well-being. The ACS recommends that patients considering use of any alternative or complementary therapy discuss this with their health care team.
anemia (uh- neem-ee-uh ): low red blood cell count.
Anesthesia (an- es-the-zuh ): the loss of feeling or sensation as a result of drugs or gases. General anesthesia causes loss of consciousness ("puts you to sleep"). Local or regional anesthesia numbs only a certain area.
Angiogenesis (an-gee-o-JEN-uh-sis): the formation of new blood vessels. Some cancer treatments work by blocking angiogenesis, thus preventing blood from reaching the tumor.
Antibiotic: drugs used to kill organisms that cause disease. Antibiotics may be made by living organisms or they may be created in the lab. Since some cancer treatments can reduce the body's ability to fight off infection, antibiotics may be used to treat or prevent these infections.
Antibody: a protein in the blood that defends against foreign agents, such as bacteria. These agents contain certain substances called antigens. Each antibody works against a specific antigen. (See also antigen.)
Antiemetic (an- ti-eh-MEH-tik ): a drug that prevents or relieves nausea and vomiting, common side effects of chemotherapy.
Anti-estrogen: a substance (for example, the drug tamoxifen ) that blocks the effects of estrogen on tumors. Anti-estrogens are used to treat breast cancers that depend on estrogen for growth.
Antigen (an- tuh-jen ): a substance that causes the body's immune system to react. This reaction often involves production of antibodies. For example, the immune system's response to antigens that are part of bacteria and viruses helps People resist infections. Cancer cells have certain antigens that can be found by laboratory tests. They are important in cancer diagnosis and in watching response to treatment. Other cancer cell antigens play a role in immune reactions that may help the body's resistance against cancer.
Antimetabolites (an-tie- meh-TAB-o-lites ): substances that interfere with the body's chemical processes, such as those creating proteins, DNA, and other chemicals needed for cell growth and reproduction. In treating cancer, antimetabolite drugs disrupt DNA production, which in turn prevents cell division and growth of tumors. (See also DNA.)
Aspirate (as- pir -ate): to draw in or out by suction. See needle aspiration.
Asymptomatic (a- simp-to-MAT-ik ): not having any symptoms of a disease. Many cancers can develop and grow without producing symptoms, especially in the early stages. Screening tests such as mammograms help to find these early cancers, when the chances for cure are usually highest. (See also screening.)
Atypical (a-tip-uh- kul ): not usual; abnormal. Often refers to the appearance of cancerous or precancerous cells. (See also hyperplasia.)
autologous bone marrow transplantation (aw- tahl-uh-gus ): See bone marrow transplantation.
Axilla (ax- il -la): the armpit.
Axillary dissection (ax- il-lair-ee ): removal of the lymph nodes in the armpit ( axillary nodes). They are examined for the presence of cancer.
Barium enema: (also called a double contrast barium enema) A method used to help diagnose colorectal cancer. Barium sulfate, a chalky substance, is used to partially fill and open up the colon. When the colon is about half-full of barium, air is inserted to cause the colon to expand. This allows good x-ray films to be taken.
Basal cell carcinoma: the most common non-melanoma skin cancer. It begins in the lowest layer of the epidermis, called the basal cell layer. It usually develops on sun-exposed areas, especially the head and neck. Basal cell cancer is slow-growing and is not likely to spread to distant parts of the body.
Benign (be-nine): not cancer; not malignant.
Benign tumor: an abnormal growth that is not cancer and does not spread to other areas of the body.
benign prostatic hyperplasia or BPH (be-nine pros- tah -tick hy-per-PLAY-zuh ): non-cancerous enlargement of the prostate that may cause problems with urination such as trouble starting and stopping the flow. \
Bilateral (bi-lat- er-ul ): on both sides of the body; for example, bilateral breast cancer is cancer in both breasts.
Biologic response modifiers: substances that boost the body's immune system to fight against cancer; interferon is one example. Also called biologic therapy.
Biopsy (buy-op-see): the removal of a sample of tissue to see whether cancer cells are present. There are several kinds of biopsies. In some, a very thin needle is used to draw fluid and cells from a lump. In a core biopsy, a larger needle is used to remove more tissue.
Blood count: a count of the number of red blood cells and white blood cells in a given sample of blood.
Bone marrow: the soft tissue in the hollow of flat bones of the body that produces new blood cells.
bone marrow aspiration and biopsy: a procedure in which a needle is placed into the cavity of a bone, usually the hip or breast bone, to remove a small amount of bone marrow for examination under a microscope.
Bone marrow transplant: a complex treatment that may be used when cancer is advanced or has recurred, or as the main treatment in some types of leukemia. The bone marrow transplant makes it possible to use very high doses of chemotherapy that would otherwise be impossible. Autologous bone marrow transplant means that the patient's own bone marrow is used. An allogeneic bone marrow transplant uses marrow from a donor whose tissue type closely matches the patient's. For leukemia, the patient usually as an allogenic transplant.
When used for advanced or recurrent cancer, a portion of the patient's or donor's bone marrow is withdrawn, cleansed, treated, and stored. Then the patient is given high doses of chemotherapy to kill the cancer cells. But the drugs also destroy the remaining bone marrow, thus robbing the body of its natural ability to fight infection. The cleansed and stored marrow is given by transfusion (transplanted) to rescue the patient's immune defenses. It is a risky procedure that involves a lengthy and expensive hospital stay that may not be covered by the patient's health insurance. The best place to have a bone marrow transplant is at a comprehensive cancer center or other facility that has the technical skill and experience to perform it safely.
Bone scan: an imaging method that gives important information about the bones, including the location of cancer that may have spread to the bones. It can be done on an outpatient basis and is painless, except for the needle stick when a low-dose radioactive substance is injected into a vein. Pictures are taken to see where the radioactivity collects, pointing to an abnormality.
Brain scan: an imaging method used to find anything not normal in the brain, including brain cancer and cancer that has spread to the brain from other places in the body. This scan can be done in an outpatient clinic. It is painless, except for the needle stick when a radioactive substance is injected into a vein. The pictures taken will show where radioactivity collects, indicating an abnormality.
bone survey (skeletal): an x-ray of all the bones of the body; often done when looking for metastasis to the bones.
Brachytherapy (break- ee-ther-uh-pee ): internal radiation treatment given by placing radioactive material directly into the tumor or close to it. Having this treatment does not make a person radioactive, except while the material remains in the body. It is usually removed in a few hours.
Breach of warranty - A legal theory that says that a party should pay for promising that something was safe but wasn't.
Bronchi ( bron-ki ): in the lungs, the two main air passages leading from the windpipe (trachea). The bronchi provide a passage for air to move in and out of the lungs.
Bronchiole ( brong-key-ol ): one of the smaller sub-divisions of the bronchi.
Bronchoscopy ( bron-kos-ko-pee ): examination of the bronchi using a flexible, lighted tube called a bronchoscope.
CEA: carcinoembryonic antigen (car-sin-o- em-bre-ON-ic an- tuh-jin ): antigens found in fetal tissue. If found in an adult, they may be specific to cancerous tumors. Tests for these antigens may help in diagnosing cancer and in finding out if the cancer has spread
CT scan: computed tomography (tom- og-ruh-fee ): an imaging test in which many x-rays are taken of a part of the body to produce cross-sectional pictures of internal organs. Except for the injection of a dye (needed in some but not all cases), this is a painless procedure that can be done in an outpatient clinic. It is often referred to as a "CT" or "CAT" scan.
Cancer: Cancer is not just one disease but rather a group of diseases. All forms of cancer cause cells in the body to change and grow out of control. Most types of cancer cells form a lump or mass called a tumor. The tumor can invade and destroy healthy tissue. Cells from the tumor can break away and travel to other parts of the body. There they can continue to grow. This spreading process is called metastasis. When cancer spreads, it is still named after the part of the body where it started. For example, if breast cancer spreads to the lungs, it is still breast cancer, not lung cancer.
Some cancers, such as blood cancers, do not form a tumor. Not all tumors are cancer. A tumor that is not cancer is called benign. Benign tumors do not grow and spread the way cancer does. They are usually not a threat to life. Another word for cancerous is malignant
cancer care team: the group of health care professionals who work together to find, treat, and care for People with cancer. The cancer care team may include any or all of the following and others: primary care physician, pathologist, oncology specialists (medical oncologist, radiation oncologist), surgeon, nurse, oncology nurse specialist, oncology social worker. Whether the team is linked formally or informally, there is usually one person who takes the job of coordinating the team.
Cancer-related checkup: a routine health examination for cancer in persons without obvious signs or symptoms of cancer. The goal of the cancer-related checkup is to find the disease, if it exists, at an early stage, when chances for cure are greatest. Clinical breast examinations, Pap smears, and skin examinations are examples of methods used in cancer-related checkups. (See also detection.)
Carcinogen (car-sin-o-gin): any substance that causes cancer or helps cancer grow. For example, tobacco smoke contains many carcinogens that greatly increase the risk of lung cancer.
Carcinoma (car-sin-o-ma): a malignant tumor that begins in the lining layer (epithelial cells) of organs. At least 80% of all cancers are carcinomas.
Carcinoma in situ (car-sin-o-ma in sigh-too): an early stage of cancer in which the tumor is confined to the organ where it first developed. The disease has not invaded other parts of the organ or spread to distant parts of the body. Most in situ carcinomas are highly curable.
Case manager: the member of a cancer care team, usually a nurse or oncology nurse specialist, who coordinates the patient's care throughout diagnosis, treatment, and recovery. The case manager is a new concept that provides a guide through the complex system of health care by helping cut through red tape, getting responses to questions, managing crises, and connecting the patient and family to needed resources.
Catheter ( cath-eh-tur ): a thin, flexible tube through which fluids enter or leave the body.
Cell: he basic unit of which all living things are made. Cells replace themselves by splitting and forming new cells (mitosis): The processes that control the formation of new cells and the death of old cells are disrupted in cancer.
Chemoprevention (key-mo-pre-VEN-shun): prevention or reversal of disease using drugs, chemicals, vitamins, or minerals. While this idea is not ready for widespread use, it is a very promising area of study. The Breast Cancer Prevention Trial has shown that the drug tamoxifen can prevent some cases of breast cancer among women with high risk of the disease. But the drug may have some serious side effects.
Chemotherapy (key-mo-THER-uh-pee): treatment with drugs to destroy cancer cells. Chemotherapy is often used with surgery or radiation to treat cancer when the cancer has spread, when it has come back (recurred), or when there is a strong chance that it could recur.
Client: The person who hires a lawyer for legal services.
Contingency fees: What a personal-injury attorney gets paid if he or she wins a case for the client. If the attorney loses the case, he or she does not get paid.
Colon: he large intestine, part of the digestive tract. The colon is a muscular tube about 5 feet long.
Colonoscopy (co- lun-AH-skuh-pee ): examination of the colon with a long, flexible, lighted tube called a colonoscope: The doctor can look for polyps during the exam and even remove them using a wire loop passed through the colonoscope .
Colony stimulating factors (CSF): types of growth factors that promote growth and division of blood-producing cells in the bone marrow. CSFs are naturally produced in the body. But extra amounts may be given as a treatment to reduce or prevent certain side effects of chemotherapy due to not having enough blood cells.
colostomy (co-loss- tuh -me): an opening in the abdomen for getting rid of body waste (stool). A colostomy is sometimes needed after surgery for cancer of the rectum.
Combined modality therapy: two or more types of treatment used alternately or together to get the best results. For example, surgery for cancer is often followed by chemotherapy to destroy any cancer cells that may have spread from the original site.
Complementary treatment: see alternative and complementary therapy
Corticosteroid ( cor-ti-co-STER-oid ): any of a number of steroid substances obtained from the cortex of the adrenal glands. They are sometimes used as an anti-cancer treatment.
Cryosurgery (cry-o-surgery): use of probes to flash-freeze and kill diseased tissue. Sometimes used to treat prostate or other cancers.
Cyst ( sist ): a fluid-filled mass that is usually benign. The fluid can be removed for analysis. (See needle aspiration.)
Cystoscopy (sis- tahs -co-pee): examination of the bladder with an instrument called a cystoscope .
cytokine (sight-o- kine ): a product of cells of the immune system that may stimulate immunity and cause the regression of some cancers.
cytology (cy- tahl -uh-gee): the branch of science that deals with the structure and function of cells.
cytotoxic (sight-o- tox-ic ): toxic to cells; cell-killing.
dmages: The cost of the injury suffered by the plaintiff.
dfendant: The person who must answer the law suit filed by the plaintiff.
dliberate: What a jury does at the end of a trial when it considers the evidence presented in court.
dposition: The sworn testimony a person gives in a scheduled meeting with the opposing side's lawyers about a particular case.
dsbursement check: The form in which money from a settlement or a judgment reaches the plaintiff.
discovery: The process after a law suit is filed, but before trial begins, in which both sides gather and disclose as much information about a case as possible. Interrogatories, depositions and requests for production are all part of the discovery process.
DES (die-eth-l- steh-BES-ter-ol ): abbreviation for diethylstilbestrola synthetic form of estrogen.
DNA ( dee-ok-see-ri-bo-new-CLAY-ic ): abbreviation for deoxyribonucleic acid. DNA holds genetic information on cell growth, division, and function.
DRE: stands for digital rectal exam. The doctor inserts a gloved finger into the rectum to feel for anything not normal.
detection finding disease: Early detection means that the disease is found at an early stage, before it has grown large or spread to other sites. Note: many forms of cancer can reach an advanced stage without causing symptoms. Mammography can help to find breast cancer early, and the PSA blood test is useful in finding prostate cancer.
diagnosis: identifying a disease by its signs or symptoms, and by using imaging procedures and laboratory findings. The earlier a diagnosis of cancer is made, the better the chance for long-term survival.
differentiation (dif- er -en-she-A-shun): the normal process through which cells mature so they can carry out the jobs they were meant to do. Cancer cells are poorly differentiated.
dissection: surgery to divide, separate, or remove tissues. (See also axillary dissection.)
doubling time: the time it takes for a cell to divide and double itself. Cancers vary in doubling time from 8 to 600 days, averaging 100 to 120 days. Thus, a cancer may be present for many years before it can be felt.
drug resistance: refers to the ability of cancer cells to become resistant to the effects of the chemotherapy drugs used to treat cancer.
dysphagia ( dis-fay-je-uh ): having trouble swallowing or eating.
dysplasia ( dis-play-zuh ): abnormal development of tissue.
edema (eh-deem-uh): build-up of fluid in the tissues, causing swelling. Edema of the arm can occur after radical mastectomy, axillary dissection of lymph nodes, or radiation therapy. (See also lymphedema .)
electrofulgeration (e- lek-tro-ful-ger-A-shun ): a type of treatment that destroys cancer cells by burning with an electrical current.
emesis ( em -eh-sis): vomiting
endocrine glands (en-do- krin glands): glands that release hormones into the bloodstream. The ovaries are one type of endocrine gland.
endocrine therapy: manipulation of hormones in order to treat a disease or condition. (See also hormone therapy.)
endoscopy (en-dos- ko -pee): inspection of body organs or cavities using a flexible, lighted tube called an endoscope.
enterostomal therapist (en- ter-es-STO-mal ther-uh-pist ): a nurse with special training in caring for and teaching People with ostomies (such as colostomies) or wounds. A nurse with this training may be referred to as an "ET nurse."
epidemiology ( ep-uh-deem-ee-AHL-uh-gee ): the study of diseases in populations by collecting and analyzing statistical data. In the field of cancer, epidemiologists look at how many People have cancer; who gets specific types of cancer; and what factors (such as environment, job hazards, family patterns, and personal habits, such as smoking and diet) play a part in the development of cancer.
esophageal speech (eh- sof-eh-JEE-uhl ): a special type of speech used by some People after surgery for cancer of the voice box (larynx). Air is swallowed and a "belching" type of speech can be produced. New devices, improved surgery, and the use of chemotherapy and radiation therapy instead of surgery, have reduced the need for learning esophageal speech.
etiology ( ee-tee-ahl-eh-jee ): the cause of a disease. In cancer, there are probably many causes, although research is showing that both genetics and lifestyle are major factors in many cancers.
familial adenomatous polyposis ( fa-mil-e-uhl ad- ehn-NO-mah-tus poly- po -sis): an hereditary condition that is a risk factor for colorectal cancer. People with this syndrome develop polyps in the colon and rectum. Often these polyps become cancerous. Abbreviated FAP.
fascia ( fash -uh): a sheet or thin band of fibrous tissue that covers muscles and some organs of the body.
fecal occult blood test: a test for "hidden" blood in the stool. The presence of such blood could be a sign of cancer.
fibrosis: formation of scar-like (fibrous) tissue. This can occur anywhere in the body.
File a law suit - To prepare a set of papers describing the facts and legal questions and deposit them with the court.
fine needle aspiration: see needle aspiration.
five-year survival rate: the percentage of People with a given cancer who are expected to survive five years or longer with the disease. Five year survival rates have some drawbacks. Although the rates are based on the most recent information available, they may include data from patients treated several years earlier. Advances in cancer treatment often occur quickly. Five-year survival rates, while statistically valid, may not reflect these advances. They should not be seen as a predictor in an individual case.
flow cytometry (flow cy-tom-uh-tree): a test of tumor tissue to see how fast the tumor cells are reproducing and whether the tumor cells contain a normal or abnormal amount of DNA. This test is used to help predict how aggressive a cancer is likely to be. (See also ploidy , DNA, S-phase fraction.)
frozen section: a piece of tissue that has been quick-frozen and then examined under a microscope. This method gives a quick diagnosis, sometimes while the surgeon is waiting to complete a procedure. The diagnosis is confirmed in a few days by a more detailed study called a permanent section. (See also permanent section.)
GI tractgastrointestinal tract: gastrointestinal tract. The digestive tract. It consists of those organs and structures that process and prepare food to be used for energy; for example, the stomach, small intestine and large intestine.
gene: a segment of DNA that contains information on hereditary characteristics such as hair color, eye color, and height, as well as susceptibility to certain diseases. Women who have BRCA1 or BRCA2 gene mutations (defects) have an inherited tendency to develop breast cancer.
genetic testing: tests performed to see if a person has certain gene changes known to increase cancer risk. Such testing is not recommended for everyone, rather for those with specific types of family history. Genetic counseling should be part of the process as well.
gene therapy: a new type of treatment in which defective genes are replaced with normal ones. The new genes are delivered into the cells by viruses or proteins.
glands: a cell or group of cells that produce and release substances used nearby or in another part of the body.
Gleason score: a method of grading prostate cancer cells on a scale of 2 to 10. The higher the number, the faster the cancer is likely to grow.
grade: The grade of a cancer reflects how abnormal it looks under the microscope. There are several grading systems for cancer, such as the Gleason score for prostate cancer. Each grading system divides cancer into those with the greatest abnormality (poorly differentiated), the least abnormality (well-differentiated), and those in between (moderately differentiated). Grading is done by the pathologist who examines the tissue from the biopsy. It is important because higher grade cancers tend to grow and spread more quickly and have a worse prognosis.
growth factors: a naturally occurring protein that causes cells to grow and divide. Too much growth factor production by some cancer cells helps them grow quickly, and new treatments to block these growth factors are being tested in clinical trials. Other growth factors help normal cells recover from side effects of chemotherapy.
hematologist (hem-uh- tahl-eh-jist ): a doctor who specializes in finding and treating conditions that arise in the blood and blood-forming tissues, including bone marrow.
hematoma (hem-uh-toe-ma): a collection of blood outside a blood vessel caused by a leak or an injury.
hereditary cancer syndrome: conditions associated with cancers that occur in several family members because of an inherited, mutated gene.
high risk: when the chance of developing cancer is greater than that normally seen in the general population. People may be at high risk from many factors, including heredity (such as a family history of breast cancer), personal habits (such as smoking), or the environment (such as overexposure to sunlight).
Hodgkin's disease: a often curable type of cancer that affects the lymphatic system. Named for the doctor who first identified it.
hormone: a chemical substance released into the body by the endocrine glands such as the thyroid, adrenal, or ovaries. The substance travels through the bloodstream and sets in motion various body functions. For example, prolactin , which is produced in the pituitary gland, begins and sustains the production of milk in the breasts after childbirth.
hormone therapy: treatment with hormones, drugs that interfere with hormone production or hormone action, or surgical removal of hormone-producing glands to kill cancer cells or slow their growth. The term also applies to the replacement of other hormones (androgens, thyroid, etc.) that are deficient because of organ failure.
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.
hyperalimentation ( hy -per-al-eh-men-TAY-shun): giving nutrition other than as food, often intravenously.
hyperplasia ( hy-per-PLAY-zuh ): too much growth of cells or tissue in a specific area, such as the lining of the breast ducts or the prostate. By itself, hyperplasia is not cancerous, but when there is a lot of growth or the cells are not like normal cells, the risk of cancer developing is greater.
hyperthermia therapy ( hy-per-therm-ee-uh ): treatment of disease by raising body temperature.
ileostomy (ill- ee-oss-tuh-me ): an operation in which the end of the small intestine, the ileum, is brought out through an opening in the abdomen. The contents of the intestine, unformed stool, are expelled through this opening into a bag called an appliance.
imaging: any method used to produce a picture of internal body structures. Some imaging methods used to detect cancer are x-rays (including mammograms and CT scans), magnetic resonance imaging (MRI), scintigraphy , and ultrasound.
immune system: the complex system by which the body resists infection by microbes such as bacteria or viruses and rejects transplanted tissues or organs. The immune system may also help the body fight some cancers.
immunology ( im-mune-ahl-o-jee ): study of how the body resists infection and certain other diseases. Knowledge gained in this field is important to those cancer treatments based on the principles of immunology.
immunosuppression ( im-mune-no-suh-PREH-shun ): a state in which the body's immune system does not respond as it should. This condition may be present at birth, or it may be caused by certain infections (such as human immunodeficiency virus or HIV), or by certain cancer therapies, such as cancer-cell killing ( cytotoxic ) drugs, radiation, and bone marrow transplantation.
immunotherapy ( im-mune-no-THER-uh-pee ): treatments that promote or support the body's immune system response to a disease such as cancer.
infraclavicular nodes (in- frah-cluh-VIC-u-lar ): lymph nodes located beneath the collar bone (clavicle).
implant: a small amount of radioactive material placed in or near a cancer. Also, an artificial form used to restore the shape of an organ after surgery, for example, a breast implant.
impotence ( im-po-tense ): not being able to have or keep an erection of the penis.
incontinence (in-con- tuh-nence ): loss of urinary control.
informed consent: a legal document that explains a course of treatment, the risks, benefits, and possible alternatives; the process by which patients agree to treatment.
in situ: in place; localized and confined to one area. A very early stage of cancer.
interferon (in- ter -fear-on): a protein produced by cells. Interferon helps regulate the body's immune system, boosting activity when a threat, such as a virus, is found. Scientists have learned that interferon helps fight against cancer, so it is used to treat some types of cancer.
interstitial radiation therapy (in- ter-stih-shul radiation therapy): a type of treatment in which a radioactive implant is placed directly into the tissue (not in a body cavity).
interrogatory: A set of questionnaires exchanged by the parties during the discovery process.
invasive cancer: cancer that has spread beyond the area where it first developed to involve adjacent tissues. For example, invasive breast cancers develop in milk glands (lobules) or milk passages (ducts) and spread to the nearby fatty breast tissue. Some invasive cancers spread to distant areas of the body (metastasize), but others do not. Also called infiltrating cancer.
liable: To be legally responsible for causing an injury.
LHRH analogs: Stands for leuteinizing hormone-releasing hormone. Man-made hormones
that block the production of the male hormone testosterone; sometimes used as a treatment for prostate cancer.
judgment: A decision given by a judge. Usually, a judgment is based on the jury's verdict.
judgment notwithstanding the verdict ( j.n.o.v .): A judge's decision to throw out the jury's verdict altogether and enter the opposite result.
laryngectomy (lair-en- jek-tuh-me ): surgery to remove the voice box (larynx), usually because of cancer.
lesion (lee- zhun ): a change in body tissue; sometimes used as another word for tumor.
leukemia ( loo -key-me-uh): cancer of the blood or blood-forming organs. People with leukemia often have a noticeable increase in white blood cells (leukocytes).
leukopenia ( loo-ko-PEEN-ee-uh ): decrease in the while blood cell count, often a side effect of chemotherapy.
leukoplakia ( loo-ko-play-key-uh ): formation of white patches on the tongue or cheek. These are often pre-malignant.
linear accelerator: a machine used in radiation therapy to treat cancer. It gives off gamma rays and electron beams.
lobectomy (lob- bek -to-me): surgery to remove a lobe of an organ--usually the lung.
localized cancer: a cancer that is confined to the place where it started; that is, it has not spread to distant parts of the body.
lump: any kind of mass in the breast or elsewhere in the body.
lymphatic system: the tissues and organs (including bone marrow, spleen, thymus, and lymph nodes) that produce and store lymphocytes (cells that fight infection) and the channels that carry the lymph fluid. The entire lymphatic system is an important part of the body's immune system. Invasive cancers sometimes penetrate the lymphatic vessels (channels) and spread (metastasize) to lymph nodes. lymph ( limf ): clear fluid that flows through the lymphatic vessels and contains cells known as lymphocytes. These cells are important in fighting infections and may also have a role in fighting cancer.
lymph nodes: small bean-shaped collections of immune system tissue such as lymphocytes, found along lymphatic vessels. They remove cell waste and fluids from lymph and help fight infections. Also called lymph glands.
lymphocytes: a type of white blood cell that helps the body fight infection.
lymphoma ( lim -foam-uh): a cancer of the lymphatic system, a network of thin vessels and nodes throughout the body. Its function is to fight infection. Lymphoma involves a type of white blood cells called lymphocytes. The two main types of lymphoma are Hodgkin's disease and non-Hodgkin's lymphoma. The treatment methods for these two types of lymphomas are very different.
MRI: Stands for magnetic resonance imaging. A method of taking pictures of the inside of the body. Instead of using x-rays, MRI uses a powerful magnet and transmits radio waves through the body; the images appear on a computer screen as well as on film. Like x-rays, the procedure is physically painless, but some People find it psychologically uncomfortable to be in the small core of the MRI machine.
malignant tumor ( muh-lig-nant ): a mass of cancer cells that may invade surrounding tissues or spread (metastasize) to distant areas of the body.
margin: edge of the tissue removed during surgery. A negative margin is a sign that no cancer was left behind. A positive margin indicates that cancer cells are found at the outer edge of tissue removed during surgery. It is usually a sign that some cancer remains in the body.
mediastinoscopy (me- dee-as-tin-OS-ko-pee ): examination of the chest cavity using a lighted tube inserted under the chest bone (sternum). This allows the doctor to see the lymph nodes in this area and remove samples to check for cancer.
medical oncologist: a doctor who is specially trained to diagnose and treat cancer and who specializes in the use of chemotherapy and other drugs to treat cancer.
melanoma ( mel-uh-no-muh ): a cancerous (malignant) tumor that begins in the cells that produce the skin coloring ( melanocytes ). Melanoma is almost always curable in its early stages. However, it is likely to spread, and once it has spread to other parts of the body the chances for a cure are much less.
metastasis ( meh-tas-teh-sis ): the spread of cancer cells to distant areas of the body by way of the lymph system or bloodstream.
micrometastases: the spread of cancer cells in groups so small that they can only be seen under a microscope.
monoclonal antibodies: antibodies made in the laboratory and designed to target specific substances called antigens. Monoclonal antibodies which have been attached to chemotherapy drugs or radioactive substances are being studied to see if they can seek out antigens unique to cancer cells and deliver these treatments directly to the cancer, thus killing the cancer cells without harming healthy tissue. Monoclonal antibodies are also used in other ways, for example, to help find and classify cancer cells.
morbidity: a measure of the new cases of a disease in a population; the number of People who have a disease.
motion: An application made to a judge to make an order or ruling on a particular problem.
mortality: a measure of the rate of death from a disease within a given population.
mucinous carcinoma ( mu -sin-us car-sin-o-ma): a type of carcinoma that is formed by mucus-producing cancer cells.
mucositis ( mu -co-site-us): inflammation of a mucous membrane such as the lining of the mouth.
mutation: a change; a change in a gene.
needle aspiration: a type of needle biopsy. Removal of fluid from a cyst or cells from a tumor. In this procedure, a needle is used to reach the cyst or tumor, and with suction, draw up (aspirate) samples for examination under a microscope. If the needle is thin, the procedure is called a fine needle aspiration or FNA. (See also biopsy.)
needle biopsy: removal of fluid, cells, or tissue with a needle for examination under a microscope. There are two types: fine needle aspiration (FNA) and core biopsy. FNA uses a thin needle to draw up (aspirate) fluid or small tissue fragments from a cyst or tumor. A core needle biopsy uses a thicker needle to remove a cylindrical sample of tissue from a tumor.
needle localization: a procedure used to guide a surgical breast biopsy when the lump is hard to locate or when there are areas that look suspicious on the x-ray but there is not a distinct lump. A thin needle is placed into the breast. X-rays are taken and used to guide the needle to the suspicious area. The surgeon then uses the path of the needle as a guide to locate the abnormal area to be removed.
Negligence/negligent - Irresponsible actions that led to someone's injury. To be "negligent" is to be legally at fault for causing a person's injuries.
neoplasm (nee-o- plas -um): an abnormal growth (tumor) that starts from a single altered cell; a neoplasm may be benign or malignant. Cancer is a malignant neoplasm.
nodal status: a small, solid lump that can be located by touch.
non-Hodgkin's lymphoma: a cancer of the lymphatic system. The lymphatic system is a network of thin vessels and nodes throughout the body. Its function is to fight infection. What distinguishes non-Hodgkin's lymphoma from Hodgkin's lymphoma is the absence of a type of cell called the Reed-Sternberg cell. This cell is present only in Hodgkin's lymphoma. The treatment methods for Hodgkin's and non-Hodgkin's lymphomas are very different.
nuclear medicine scan: a method for localizing diseases of internal organs such as the brain, liver, or bone. Small amounts of a radioactive substance (isotope) are injected into the bloodstream. The isotope collects in certain organs. A scintillation camera is used to produce an image of the organ and detect areas of disease.
nucleus (new- clee -us): the center of a cell where the DNA is housed and replicated. Studying the size and shape of a cell's nucleus under the microscope can help pathologists distinguish cancer cells from benign cells.
nurse practitioner: a registered nurse (RN) who has completed additional courses and specialized training. Nurse practitioners can work with or without the supervision of a physician. They take on additional duties in diagnosis and treatment of patients, and in many states they may write prescriptions. (See also oncology nurse specialist.)
oncogene (on- ko -gene): a type of gene. Normally inactive, when these genes are "turned on" (activated), they cause normal cells to change into cancer cells.
oncology (on-call-o- jee ): the branch of medicine concerned with the diagnosis and treatment of cancer.
oncologist (on-call-o- jist ): a doctor who is specially trained in the diagnosis and treatment of cancer. Medical oncologists specialize in the use of chemotherapy and other drugs to treat cancer. Radiation oncologists specialize in the use of x-rays (radiation) to kill tumors. Surgical oncologists specialize in using surgery to treat cancer.
oncology nurse specialist: a registered nurse with a master's degree in oncology and who specializes in the care of cancer patients. Oncology nurse specialists may prepare and administer treatments, monitor patients, prescribe and provide supportive care, and teach and counsel patients and their families. Some oncology nurse specialists are also certified nurse practitioners.
oncology social worker: a person with a master's degree in social work who works with cancer patients. The oncology social worker provides counseling and assistance to People with cancer and their families, especially in dealing with the non-medical crises that can result from cancer, such as financial problems, housing (when treatments must be taken at a facility far away from home), and child care.
ostomy ( os -to-me): a general term meaning an opening, especially one made by surgery. See also colostomy, ileostomy , urostomy , and tracheostomy .
paralegal: A lawyer's assistant.
party: One of the People or companies that is participating in a law suit.
personal injury: Harm suffered by someone, possibly through the fault of another person or company.
plaintiff: The person or company that files a law suit.
pleading: The official set of papers that explain the facts of a particular case and lists the legal theories that justify a demand of compensation.
Product liability: A legal theory that says a product was marketed or sold as being safe but was instead harmful or defective.
PSA: (prostate specific antigen) a protein made by the prostate. Levels of PSA often go up in men with prostate cancer. The PSA test measures levels in the blood and is used to help find prostate cancer as well as to monitor the results of treatment.
palliative care (pal-e-uh- tive care): treatment that relieves symptoms, such as pain, but is not expected to cure the disease. The main purpose is to improve the patient's quality of life.
palpation (pal-pay-shun): using the hands to examine. A palpable mass is one that can be felt.
pathologist (path-all-eh- jist ): a doctor who specializes in diagnosis and classification of diseases by laboratory tests (such as examination of tissue and cells under a microscope). The pathologist determines whether a lump is benign or cancerous.
permanent section: Preparation of tissue for microscopic examination. The tissue is soaked in formaldehyde, processed in various chemicals, surrounded by a block of wax, sliced very thin, attached to a microscope slide and stained. This usually takes 1-2 days. It provides a clear view of the sample so that the presence or absence of cancer can be determined.
placebo ( pluh -see-bow): an inert, inactive substance that may be used in studies (clinical trials) to compare the effects of a given treatment with no treatment. In common speech, a "sugar pill."
platelet: a part of the blood that helps it "stick together" (clot) to promote healing after an injury. Chemotherapy can cause a drop in the platelet count--a condition called thrombocytopenia.
pleura ( pler -uh): the membrane around the lungs and lining of the chest cavity.
pnuemonectomy (new-mo-NEK-to-me): surgery to remove a lung.
ploidy (ploy- dee ): a measure of the amount of DNA contained in a cell. Ploidy is a marker that helps predict how quickly a cancer is likely to spread. Cancers with the same amount of DNA as normal cells are called diploid and those with either more or less than that amount are aneuploid . About two-thirds of breast cancers are aneuploid .
polypectomy (poly-peck-tow-me): surgery to remove a polyp.
polyp: a growth from a mucous membrane commonly found in organs such as the rectum, the uterus, and the nose.
pre-cancerous: see pre malignant.
predisposition: susceptibility to a disease that can be triggered under certain conditions. For example, some women have a family history of breast cancer and are therefore more likely (but not necessarily destined) to develop breast cancer.
pre-malignant: changes in cells that may, but do not always, become cancer. Also called precancerous.
prevalence: a measure of the proportion of persons in the population with a certain disease at a given time.
primary site: the place where cancer begins. Primary cancer is usually named after the organ in which it starts. For example, cancer that starts in the breast is always breast cancer even if it spreads (metastasizes) to other organs such as bones or lungs.
prognosis ( prog -no-sis): a prediction of the course of disease; the outlook for the cure of the patient. For example, women with breast cancer that was detected early and who received prompt treatment have a good prognosis.
prostate (pros- tate ): (Note that there is no "r" in the second syllable) a gland found only in men. It is just below the bladder and in front of the rectum. The prostate makes a fluid that is part of semen. The tube that carries urine, the urethra, runs through the prostate.
prostate specific antigen: see PSA prostatitis (pros- tuh-TIE-tus ): inflammation of the prostate. Prostatitis is not cancer.
prosthesis (pros-thee-sis): an artificial form to replace a part of the body, such as a breast prosthesis.
protocol (pro- teh -call): a formal outline or plan, such as a description of what treatments a patient will receive and exactly when each should be given.
radiation oncologist: a doctor who specializes in using radiation to treat cancer.
radiation therapist: a person with special training who runs the equipment that delivers the radiation.
radiation therapy: treatment with radiation to destroy cancer cells. This type of treatment may be used to reduce the size of a cancer before surgery, to destroy any remaining cancer cells after surgery, or, in some cases, as the main treatment.
radical prostatectomy: surgery to remove the entire prostate gland, the seminal vesicles and nearby tissue.
radioisotope: a type of atom that is unstable and prone to break up (decay). This break-up gives off small fragments of atoms and energy. Exposure to certain radioisotopes can cause cancer. Radioisotopes can also be used to treat cancer. During some tests, radioisotopes are injected into the blood. They travel through the body and collect in areas where the disease is active, showing up as highlighted areas on the pictures.
radiologic technologist: a health professional (not a doctor) trained to position patients for x-rays, take the images, and then develop and check the images for quality. The films taken by the technologist are sent to a radiologist to be read.
radiologist: a doctor who has special training in reading x-rays and other types of diagnostic imaging studies, for example, ultrasound and magnetic resonance imaging.
radionuclide bone scan: a study using a small amount of radioisotope to produce images of the bones.
recover/recovery: To get a judgment of money. The money "recovered" is called the "recovery."
remittitur: When a judge thinks that the jury has recommended that the plaintiff should get too much money and orders that an amount be subtracted from the total.
reply: The defendant's response to the charges made by the plaintiff in the plaintiff's pleading.
Request for production - A demand by one party that the other party disclose certain documents connected to a law suit.
retain: To hire a lawyer.
recurrence: cancer that has come back after treatment. Local recurrence is when the cancer comes back at the same place as the original cancer. Regional recurrence is when the cancer appears in the lymph nodes near the first site. Distant recurrence is when it appears in organs or tissues (such as the lungs, liver, bone marrow, or brain) farther from the original site than the regional lymph nodes. Metastasis means that the disease has recurred at a distant site.
red blood cells: blood cells that contain hemoglobin, the substance that carries oxygen to other tissues of the body.
regimen ( rej -uh-men): a strict, regulated plan (such as diet, exercise, or other activity) designed to reach certain goals. In cancer treatment, a plan to treat cancer.
regional involvement: the spread of cancer from its original site to nearby areas, but not to distant sites such as other organs.
rehabilitation: activities to help a person adjust, heal, and return to a full, productive life after injury or illness. This may involve physical restoration (such as the use of prostheses, exercises, and physical therapy), counseling, and emotional support.
relapse: reappearance of cancer after a disease-free period. See recurrence.
remission: complete or partial disappearance of the signs and symptoms of cancer in response to treatment; the period during which a disease is under control. A remission may not be a cure.
rescue treatment: procedures or treatments such as bone marrow transplantation that "rescue" a patient's immune system and blood-forming organs from the effects of high dose chemotherapy.
resection: surgery to remove part or all of an organ or other structure.
risk factor: anything that increases a person's chance of getting a disease such as cancer. Different cancers have different risk factors. For example, exposure to sunlight is a risk factor for skin cancer, smoking is a risk factor for lung and other cancers, and a high-fat, low-fiber diet is a risk factor for colorectal cancer. Some risk factors, such as smoking, can be controlled. Others, like a person's age, can't be changed
sarcoma ( sar-co-muh ): a malignant tumor growing from connective tissues, such as cartilage, fat, muscle, or bone.
scan: a study using either x-rays or radioactive isotopes to produce images of internal body organs.
scintillation camera (sin-till-AY-shun): device used in nuclear medicine scans to detect radioactivity and produce images that help diagnose cancer and other diseases.
screening: the search for disease, such as cancer, in People without symptoms. For example, the principal screening measure for breast cancer is mammography. Screening may refer to coordinated programs in large populations.
secondary tumor: a tumor that forms as a result of spread (metastasis) of cancer from the place where it started.
sentinel lymph node biopsy: a new procedure that might replace standard axillary lymph node dissection. Blue dye or a radioisotope tracer is injected into the tumor site at the time of surgery and the first (sentinel) node that picks up the dye is removed and biopsied . If the node is cancer- free, no more nodes are removed.
side effects: effects of treatment (other than the effects on the cancer) such as hair loss caused by chemotherapy, and fatigue caused by radiation therapy.
sigmoidoscopy ( sig-moid-AH-sko-pee ): a test to help find cancer or polyps on the inside of the rectum and part of the colon. A slender, hollow, lighted tube is placed into the rectum. The doctor is able to look for polyps or other abnormalities.
S-phase fraction: (SPF) the percentage of cells that are replicating their DNA. DNA replication usually means that a cell is getting ready to split into two new cells. A low SPF is a sign that a tumor is slow-growing; a high SPF shows that the cells are dividing rapidly and the tumor is growing quickly.
spinal tap: a procedure in which a thin needle is placed in the spinal canal to withdraw a small amount of spinal fluid or to give medicine into the central nervous system through the spinal fluid.
sputum cytology ( spu-tum sigh- tahl -uh-gee): a study of phlegm cells under a microscope to see whether they are normal or not.
squamous cell carcinoma ( skwa-mus cell car-sin-o- mah ): cancer that begins in the non-glandular cells, for example, the skin. staging: the process of finding out whether cancer has spread and if so, how far. There is more than one system for staging. The TNM system, described below, is one used often.
The TNM system for staging gives three key pieces of information:
T refers to the size of the Tumor N describes how far the cancer has spread to nearby Nodes M shows whether the cancer has spread (Metastasized) to other organs of the body
Letters or numbers after the T, N, and M give more details about each of these factors. To make this information somewhat clearer, the TNM descriptions can be grouped together into a simpler set of stages, labeled with Roman numerals. In general, the lower the number, the less the cancer has spread. A higher number means a more serious cancer.
stem cell and stem cell transplant: a variation of bone marrow transplantation in which immature blood cells called stem cells are taken from the patient's blood and later, in the lab, stimulated with growth factors to produce more stem cells which are returned to the patient by transfusion.
stenosis ( steh -no-sis): a narrowing (stricture) of a duct or canal.
stereotactic needle biopsy ( ster-e-o-TACK-tik buy-op-see): a method of needle biopsy that is useful in some cases in which calcifications or a mass can be seen on mammogram but cannot be found by touch. A computer maps the location of the mass to guide the placement of the needle. (See also needle aspiration, needle biopsy.)
stoma: an opening, especially an opening made by surgery to allow elimination of body waste. (See also colostomy, ileostomy , urostomy .)
stomatitis ( sto-ma-ti-tis ): inflammation or ulcers of mouth area. Stomatitis can be a side effect of some kinds of chemotherapy.
settlement/settle: The agreement reached between parties to a law suit to resolve the suit without going to trial. The parties agree to "settle" the suit, usually for a particular sum of money.
sue: To bring a legal action against a person or company.
supraclavicular lymph nodes ( su-prah-clah-VIK-u-lar ): lymph nodes that are found just above the collarbone (clavicle).
surgical biopsy: see biopsy
survival rate: the percentage of survivors with no trace of disease within a certain period of time after diagnosis or treatment. For cancer, a 5-year survival rate is often given. This does not mean that People can't live more than five years, or that those who live for 5 years are necessarily permanently cured.
systemic disease (sis-tem- ick ): in cancer, this term means that the tumor that originated in one place has spread to distant organs or structures.
systemic therapy: treatment that reaches and affects cells throughout the body; for example, chemotherapy.
TNM staging system: see staging
testosterone ( tes-toss-ter-own ): the male hormone, made primarily in the testes. It stimulates blood flow, growth in certain tissues, and the secondary sexual characteristics. In men with prostate cancer, it can also encourage growth of the tumor.
therapy: any of the measures taken to treat a disease. Unproven therapy is any therapy that has not been scientifically tested and approved. Use of an unproven therapy instead of standard (proven) therapy is called alternative therapy. Some alternative therapies have dangerous or even life-threatening side effects. For others, the main danger is that a patient may lose the opportunity to benefit from standard therapy. Complementary therapy, on the other hand, refers to therapies used in addition to standard therapy. Some complementary therapies may help relieve certain symptoms of cancer, relieve side effects of standard cancer therapy, or improve a patient's sense of well-being. The ACS recommends that patients considering use of any alternative or complementary therapy discuss this with their health care team.
thrombocytopenia ( throm-bo-sigh-toe-PEEN-e-uh ): a decrease in the number of platelets in the blood; can be a side effect of chemotherapy.
tissue: a collection of cells, united to perform a particular function.
trachea (tray-key-uh): the "windpipe." The trachea connects the larynx (voice box) with the bronchi and serves as the main passage for air into the lungs.
tracheostomy (tray-key-ah- sto -me): surgery to create an opening of the trachea through the neck.
transrectal ultrasound (trans- rec-tal ultra sound): TRUS: the use of sound waves to create a picture of the prostate on a screen to help detect tumors.
tumor: an abnormal lump or mass of tissue. Tumors can be benign (not cancerous) or malignant (cancerous).
tumor marker: abnormal proteins on the surface of some cancerous cells that sometimes are used to monitor response to treatment or detect recurrence.
tumor suppressor genes: genes that, when present, prevent cell growth but when not present or when not active allow cells to grow out of control.
ultrasound: an imaging method in which high-frequency sound waves are used to outline a part of the body. The sound wave echoes are picked up and displayed on a television screen. Also called ultrasonography .
unilateral: affecting one side of the body. For example, unilateral breast cancer occurs in one breast only. (See also bilateral).
urethra ( yoo-ree-thruh ): the tube that carries urine from the bladder to the outside. In women, this tube is fairly short; in men it is longer, passing through the penis, and it also carries the semen.
urine cytology (urine cy- tahl-uh-ge ): urine is examined under a microscope to look for cancerous and precancerous cells. Cytology can also be done on bladder washings. Bladder washing samples are taken by placing a salt solution into the bladder through a tube (catheter) and then removing the solution for testing.
urologist ( yur-ol-o-jist ): a doctor who specializes in treating problems of the urinary tract in men and women, and of the genital tract in men.
urostomy ( yur-os-tuh-me ): surgery to divert urine through a new passage and then through an opening in the abdomen. In a continent urostomy , the urine is stored inside the body and drained a few times a day through a tube placed into an opening called a stoma.
uterus: the womb. The pear-shaped organ in women that holds and nourishes the growing embryo and fetus. The uterus has three areas: the body or upper part; the isthmus or the narrowed central area; and the cervix, the lower portion.
vaccine: the modified virus of a disease used to bring about resistance to that disease for a period of time, or even permanently. Development of a cancer vaccine is a subject of intense research.
Verdict - The response given by the jury to legal questions raised by the evidence in trial.
virus: very small organisms that cause infections. Viruses are too small to be seen with a regular microscope. They reproduce only in living cells.
watchful waiting: instead of active treatment for prostate cancer, the doctor may suggest close monitoring. This may be a reasonable choice for older men with small tumors that might grow very slowly. If the situation changes, active treatment can be started.
white blood cells: there are several types of blood cells that help defend the body against infections. Certain cancer treatments such as chemotherapy can reduce the number of these cells and make a person more likely to get infections.
wrongful death: A legal theory that says a person or company is lawfully responsible for another person's death because of something irresponsible the person or company did.
x-rays: 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.
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