Glossary

Abarelix: A GnRH antagonist under investigation as a hormone therapy for prostate cancer.

Abdomen: The part of the body below the ribs and above the pelvic bone that contains organs such as the intestines, the liver, the kidneys, the stomach, the bladder, and the prostate.

Active surveillance: An alternative to immediate treatment for men with presumed low-risk prostate cancer. Involves close monitoring and withholding active treatment unless there is a significant change in the patient's symptoms or PSA.

Acute urinary retention: The inability to pass urine from the bladder.

Acquired anorgasmia: A secondary inability to have an orgasm i.e., secondary to the side effects of medical therapy.

Adenocarcinoma: A form of cancer that develops from a malignant abnormality in the cells lining a glandular organ such as the prostate; almost all prostate cancers are adenocarcinomas.

Adrenal glands: Glands located above each kidney. These glands produce several different hormones including sex hormones.

Alendronate (Zoladex): An LHRH

medication that comes in a pellet form, which is placed just under the skin. It is used to lower testosterone levels in men with advanced prostate cancer.

Alfuzosin (uroxatral): An alpha-blocker used to treat BPH.

Alkaline phosphatase: Chemical (enzyme) that is produced in the liver and bones. It is often elevated when prostate cancer has spread to the bones.

Alpha-blockers: A group of medications that may be used to treat the symptoms of benign prostate enlargement. They include doxazosin (Cardura), terazosin (Hytrin), silodosin (Rapaflo), and tamsulosin (Flowmax).

Alpha receptors: Regions/molecules on the bladder and prostate that when certain chemicals bind to mediate bladder and prostate function and tone.

Alprostadil: Prostaglandin E1. For the treatment of erectile dysfunction, alprostadil comes in several forms— specifically, a suppository that is placed into the urethra (MUSE) or a liquid form that is delivered by intracavernous injection (Caverject or Edex).

Androderm: A topical form (patch) of testosterone used for testosterone replacement therapy.

Androgel: A gel form of testosterone replacement therapy.

Androgen blockade: Therapy to prevent the effects of the male hormones (androgens).

Androgens: Hormones that are necessary for the development and function of the male sexual organs and male sexual characteristics (i.e., hair, voice change).

Anejaculation: An inability to ejaculate.

Anesthesia: The loss of feeling or sensation. With respect to surgery, means the loss of sensation of pain, as it is induced to allow surgery or other painful procedures to be performed. General: A state of unconsciousness, produced by anesthetic agents, with absence of pain sensation over the entire body and a greater or lesser degree of muscle relaxation. Local: Anesthesia confined to one part of the body. Spinal: Anesthesia produced by injection of a local anesthetic into the subarachnoid space around the spinal cord.

Aneurysm: Pertaining to a penile prosthesis, an abnormal dilation of the prosthesis related to weakening of a part of the cylinder.

Angina: Pain in the chest, with a feeling of suffocation, that occurs with decreased blood flow and oxygenation to the heart.

Anorexia: Loss of appetite.

Anorgasmia: Failure to experience an orgasm during sex. See also acquired anorgasmia and congenital anorgasmia.

Antiandrogen: Drugs that counteract the action of testosterone.

Antidepressant: Medication prescribed to relieve depression.

Antigen: A substance that stimulates the individual's body to produce cells that fight off the antigen, and in doing so, kill cancer cells.

Antioxidant: A chemical that helps prevent changes in cells and reduce damage to the cell that can cause it to become cancerous.

Anus: The outside opening of the rectum.

Apex of the prostate: The end of the

prostate gland located farthest away from the urinary bladder.

Arteriography: A test for identifying and locating arterial disease in the penis, using injected contrast to find constricted or blocked arteries.

Artery: A blood vessel that carries oxygenated blood from the heart to other parts of the body.

Artificial urinary sphincter: A prosthesis designed to restore continence in an incontinent person by constricting the urethra.

Atherosclerosis: Hardening of the arteries, often related to smoking and elevated cholesterol.

Autoinflation: Pertaining to a penile prosthesis, the spontaneous inflation of the prosthesis without manual pumping.

Axial rigidity: The rigidity as measured along the axis or length of the penis.

Benign: A growth that is not cancerous.

Benign prostatic hyperplasia: See BPH.

Bicalutamide: The generic name for Casodex, an antiandrogen.

BID: Twice a day.

Bilateral: Both sides.

Biochemical progression: Recurrence of prostate cancer as defined by an elevation in PSA.

Biopsy: The removal of small sample(s) of tissue for examination under the microscope.

Biphosphonate: A type of medication that is used to treat osteoporosis and the bone pain caused by some types of cancer.

Bladder: The hollow organ that stores and discharges urine from the body.

Bladder catheterization: Passage of a catheter into the urinary bladder to drain urine.

Bladder compliance: The ability of the bladder to hold increasing amounts of urine without increases in bladder pressure; reflects the elasticity of the bladder.

Bladder neck: The outlet area of the bladder. It is comprised of circular muscle fibers and helps in the control of urine.

Bladder neck contracture: Scar tissue at the bladder neck that causes narrowing.

Bladder outlet: The first part of the natural channel through which urine passes when it leaves the bladder.

Bladder outlet obstruction: Obstruction of the bladder outlet causing problems with urination and/or retention of urine in the bladder.

Bladder spasm: A sudden contraction of the bladder, which one is not able to control, that often produces pain and a feeling of the need to urinate.

Bladder stones: Stones present in the bladder.

Bladder ultrasound: A test done using an ultrasound to see how much urine is left in the bladder after voiding, the postvoid residual.

Bone scan: A specialized nuclear medicine study that allows one to detect changes in the bone that may be related to metastatic prostate cancer.

Bound PSA: PSA attached to the proteins in the bloodstream.

Bowel prep: Cleansing (and sterilization) of the intestines before abdominal surgery.

BPH (benign prostatic hyperplasia): Noncancerous enlargement of the prostate.

Brachytherapy: A form of radiation therapy whereby radioactive pellets are placed into the prostate.

Butterfly needle: A small needle that has tubing attached to it.

Cancer: Abnormal and uncontrolled growth of cells in the body that may spread, injure areas of the body, and lead to death.

Capsule: A fibrous outer layer that surrounds the prostate.

Carcinoma: A form of cancer that originates from epithelial tissues, such as colon, skin, lungs, prostate, bladder; see adenocarcinoma.

Casodex: The brand name for bicalutamide, an antiandrogen.

Castration: The surgical removal of both testicles.

Catheter: A hollow tube that allows for fluid drainage from or injection into an area.

Catheterization: The passage of a catheter into the bladder to empty the bladder of urine.

Caverject: A form of injection therapy produced by Pfizer. It contains prostaglandin E1.

Cavernosography: A technique used to visualize areas of venous leak. It involves the injection of a cavernous smooth-muscle dilator (e.g., prostaglandin E1 or trimix), followed by placement of a butterfly needle into the corpora, instillation of a contrast agent into the corpora, and x-ray photographs to visualize the sites of venous leak.

Cavernosometry: A somewhat invasive technique used to determine whether a venous leak is present.

Cell: The smallest unit of the body. Tissues in the body are made up of cells.

Central nervous system: The portion of the nervous system consisting of the brain and the spinal cord.

cGMP: A neurotransmitter that causes relaxation of the arteries and smooth muscles in the penis to permit increased blood flow into the penis.

Chemoprevention: The use of a substance to prevent the development and growth of cancer.

Chemotherapy: A treatment for cancer that uses powerful medications to weaken and destroy the cancer cells.

Cholesterol: A fat-like substance that is important to certain body functions but that, when present in excessive amounts, contributes to unhealthy fatty deposits in the arteries that may interfere with blood flow.

Chromosome: Part of the cell that carries genes and functions in the transmission of hereditary information.

Cialis: See tadalafil.

Clean intermittent catheterization (CIC): The placement of a catheter into the bladder to drain urine and the removal after the urine is drained at defined intervals throughout the day, to allow for bladder emptying. It may also be performed to maintain patency after treatment of a bladder neck contracture or urethral stricture.

Clinical trials: A carefully planned experiment to evaluate a treatment or medication (often a new drug) for an unproven use.

Colostomy: A surgical opening between the colon (large intestine) and the skin that allows stool to drain into a collecting bag.

Complication: An undesirable result of a treatment, surgery, or medication.

Conformal EBRT: EBRT that uses CT scan images to better visualize radiation targets and normal tissues.

Congenital anorgasmia: A rare form of anorgasmia that is thought to be a product of an overly strict or repressive attitude toward sex.

Congestive heart failure: An inability of the heart to pump blood adequately, leading to swelling and fluid in the lungs.

Contracture: Scarring which can occur at the bladder neck after radical prostatectomy or radiation therapy and result in decreased force of urine stream and incomplete bladder emptying.

Corona: The area of the penis just before the glans.

Corpora cavernosa: The two cylindrical structures in the penis that are composed of the penile erectile tissue. They are located on the top of the penis (singular: corpus cavernosum).

Corpus spongiosum: One of the three cylindrical structures in the penis. The urethra passes through the corpus spongiosum. It is not involved in erections.

Cryotherapy, cryosurgery: A prostate cancer therapy in which the prostate is frozen to destroy the cancer cells.

CT scan/CAT scan (computerized tomography/computerized axial tomography): A specialized x-ray study that allows one to visualize internal structures in cross-section to look for abnormalities.

Cystoscope: A telescope-like instrument that allows one to examine the urethra and inside of the bladder.

Cystoscopy: The procedure of using a cystoscope to look into the urethra and bladder.

Degarelix (Firmagon): a new LHRH analog hormonal therapy.

Debulk: To decrease the amount of cancer present by surgery, hormone therapy, or chemotherapy.

Deep venous thrombosis (DVT): The formation of a blood clot in the large deep veins, usually of the legs or in the pelvis.

Deferred therapy: Delaying treatment until the cancer appears to be a threat to the patient.

Delayed ejaculation: Taking a longer time to ejaculate. This effect is seen with some antidepressants.

Depression: A mental state of depressed mood characterized by feelings of sadness, despair, and discouragement.

Detumescence: Subsidence of swelling or turgor; with respect to erections, loss of rigidity.

Diabetes mellitus: A chronic disease associated with high levels of sugar (glucose) in the blood.

Diagnosis: The identification of the cause or presence of a medical problem or disease.

Diethylstilbestrol (DES): A form of the female hormone estrogen.

Digital rectal examination (DRE): The examination of the prostate by placing a gloved finger into the rectum.

Dihydrotestosterone (DHT):A breakdown product of testosterone, which stimulates the prostate to grow.

Disease: Any change from or interruption of the normal structure or function of any part, organ, or system of the body that presents with characteristic symptoms and signs, and whose cause and prognosis may be known or unknown.

Dissection: The surgical removal of tissue.

Docetaxel: A type of chemotherapy, a taxane, that has been shown to be effective in hormone refractory prostate cancer.

Doppler ultrasonography: Use of a Doppler probe during ultrasound to look at flow through vessels.

Double-blind: Pertaining to a study, a situation in which neither the patient nor the physician is aware of which medication the patient is receiving.

Doubling time: The amount of time that it takes for the cancer to double in size.

Down-size: To shrink or reduce the size of the cancer.

Down-stage: To reduce the initial stage of the cancer to a lower (better prognostic) stage.

Doxazosin (Cardura): An alpha-blocker used to treat BPH.

Dutasteride (Avodart): A 5-alpha-reductase inhibitor used to treat BPH. It has been shown to decrease the risk of prostate cancer.

EBRT: See external beam radiation therapy.

Edex: Alprostadil alfadex. A form of injection therapy produced by Schwarz Pharma. It contains prostaglandin Ej and works via the same mechanism as Caverject.

Efficacy: The power or ability to produce an effect.

Ejaculation: The release of semen through the penis during orgasm. After radical prostatectomy and often after a TURP, no fluid is released during orgasm.

Ejaculatory duct: The structure through which the ejaculate passes into the urethra.

Ejaculatory dysfunction: An abnormality of ejaculatory function, such as retrograde ejaculation, premature ejaculation, delayed ejaculation, or anejaculation.

Electroejaculation: Use of an electrical stimulus to induce ejaculation.

Electrovaporization: A procedure in which electric current is used to destroy prostate tissue.

Embolization: The introduction of a substance into a blood vessel in an attempt to obstruct (occlude) it.

Emission: A discharge, either voluntary or involuntary, of semen from the ejaculatory duct into the urethra.

Endorectal MRI: MRI study of the prostate that involves placing a probe into the rectum to better assess the prostate gland.

Enzyme: A chemical that is produced by living cells that causes chemical reactions to occur while not being changed itself.

Epidural anesthesia: A special type of anesthesia whereby pain medications are placed through a catheter in the back, into the fluid that surrounds the spinal cord.

Erectile dysfunction: The inability to achieve and/or maintain an erection satisfactory for the completion of sexual performance.

Erection: The process whereby the penis becomes rigid.

Erosion: Destruction of a tissue surface—for example, a penile prosthesis eroding through the skin.

Estramustine: An anticancer drug that stops growth of cells and eventually destroys them.

Estrogen: A female hormone.

Eulexin: The brand name for flutamide, an antiandrogen.

Experimental: An untested or unproven treatment or approach to treatment.

External-beam radiation therapy (EBRT): Use of radiation that passes through the skin and is focused for maximal effect on a target organ, such as the prostate, to kill cancer cells.

Extravasation: A discharge or escape of fluid, normally found in a vessel or tube, into the surrounding tissue.

FDA: Food and Drug Administration. Agency responsible for the approval of prescription medications in the United States.

Firmagon: See Degarelix.

Fistula: An abnormal passage or communication, usually between two internal organs, or leading from an internal organ to the surface of the body.

Flare reaction: A temporary increase in tumor growth and symptoms that is caused by the initial use of LHRH agonists. It is prevented by the use of an antiandrogen 1 week before LHRH agonist therapy begins.

Fluoroscopy: Use of a fluoroscope, a radiologic device that is used for examining deep structures by means of x-rays.

Flutamide (Eulexin): An antiandrogen that is taken three times a day to provide total androgen blockade, blocking the effects of androgens made by the adrenals.

Foley catheter: A latex or silicone catheter that drains urine from the bladder.

Free PSA: The PSA present that is not bound to proteins. It is often expressed as a ratio of free PSA to total PSA in terms of percent, which is the free PSA divided by the total PSA x 100.

Frequency: A term used to describe the need to urinate eight or more times per day.

Frozen section: A preliminary quick evaluation of tissue, removed at the time of biopsy or during surgery, by the pathologist who freezes the sample of tissue and shaves off a thin slice to examine under the microscope.

GAQ: See global assessment questionnaire.

Gastrointestinal (GI): Related to the digestive system and/or the intestines.

Gender: The category to which an individual is assigned on the basis of sex, either male or female.

Gene therapy: The deliberate alteration of genes in an attempt to affect their function.

General anesthesia: Anesthesia which involves total loss of consciousness.

Genetics: A field of medicine that studies heredity.

Genitalia, male: The external sexual organs—in the male, the penis, testes, epididymis, and vas deferens.

Genitourinary tract: The urinary system (kidney, ureters and bladder, and urethra) and the genitalia (in the male the prostate, seminal vesicles, vas deferens, and testicles).

Gland: A structure or organ that produces substances that affect other areas of the body.

Glans: The tip of the penis.

Gleason grade: A commonly used method to classify how cells appear in cancerous prostate tissues; the less the cancerous cells look like normal cells, the more malignant the cancer; two numbers, each from 1 to 5, are assigned to the two most predominant types of cells present. These two numbers are added together to produce the Gleason score. Higher numbers indicate more aggressive cancers.

Global assessment questionnaire (GAQ): A self-administered questionnaire that allows patients to rate improvement in erectile function.

Glycosylated end-products :A chemical associated with diabetes that may contribute to erectile dysfunction by decreasing nitric oxide activity.

Glycosylated hemoglobin: A chemical in the blood that allows monitoring of blood sugar control in individuals with diabetes mellitus. An elevated HgbAlc is indicative of poor blood sugar control.

GnRH (LHRH) antagonist: A form of hormone therapy which works at the level of the brain to directly suppress the production of testosterone without initially raising the testosterone level.

Goserelin acetate (Zoladex):An LHRH analogue used in the treatment of advanced prostate cancer.

Groin: The area between the lower abdomen and the thigh.

Gynecomastia: Enlargement or tenderness of the male breast(s).

Hardening of the arteries: Descriptive expression that commonly refers to a group of diseases (forms of arteriosclerosis) characterized by abnormal thickening and hardening (sclerosis) of arterial walls, in which the arteries lose their elasticity. If the thickening/hardening is significant, it may interfere with blood flow.

Hematoma: A blister-like collection of blood under the skin.

Hematospermia: The presence of blood in the ejaculate (semen).

Hematuria: The presence of blood in the urine. It may be gross (visible) or microscopic (only detected under the microscope).

Hemibody: Half of the body.

Hereditary: Inherited from one's parents or earlier generations.

Heredity: The passage of characteristics from parents to their children by genes (genetic material).

Hernia: A weakening in the muscle that leads to a bulge, often in the groin.

Hesitancy: A delay in the start of the urine stream during voiding.

High-density lipoprotein (HDL): "Good" cholesterol.

High-flow priapism: Priapism that occurs secondary to increased arterial flow.

High grade: Very advanced cancer cells.

High intensity focused ultrasonography: A form of prostate cancer therapy that involves focusing high intensity ultrasound into the prostate to heat the prostate and destroy prostate cancer cells. It is being used in Europe but has not been approved in the United States.

High risk: More likely to have a complication or side effect.

History: An oral or written interview that consists of questions about your medical, social, and sexual background.

Histrelin acetate (Vantas): A type of LHRH analogue used for treatment of advanced prostate cancer.

Hormone refractory: Prostate cancer that is resistant to hormone therapy.

Hormone resistant: Prostate cancer that is resistant to hormone therapy.

Hormone therapy: The manipulation of the disease's natural history and symptoms by altering hormone levels.

Hormones: Substances (estrogens and androgens) responsible for secondary sex characteristics (hair growth and voice change in men).

Hot flashes: The sudden feeling of being warm, may be associated with sweating and flushing of the skin, which occurs with hormone therapy.

Hydronephrosis: Dilation of the kidneys, usually due to obstruction.

Hypercholesterolemia: An excess of cholesterol in the blood.

Hyperplasia: Enlargement of an organ or tissue because of an increase in the number of cells in that organ or tissue; an example is benign pro-static hyperplasia.

Hyperprolactinemia: A condition characterized by excess prolactin production. It may be related to a tumor of the pituitary gland but also may be caused by certain medications.

Hypertension: High blood pressure.

Hyperthermia: Heating of the prostate to destroy tissue.

Hypoechoic: In ultrasonography, giving off few echoes; said of tissues or structures that reflect relatively few ultrasound waves directed at them.

Hypogonadism: A condition in which the testes are not producing adequate testosterone. It may occur because of a testicular problem or because of a lack of stimulation of the testes by the brain.

Hyponatremic: A low sodium level in the blood.

Hypotension: Low blood pressure: May be associated with dizziness, fast heart rate and feeling weak and faint.

Iatrogenic: Resulting from treatment by a physician, such as from medications, procedures, or surgery.

ICU (intensive care unit): A specialized area of the hospital where critically ill patients are taken care of.

IM: Intramuscular.

Immune system: A complex group of organs, tissues, blood cells and substances that work to fight off infections, cancers or foreign substances.

Impotence: See erectile dysfunction.

Incidence: The rate at which a certain event occurs—for example, the number of new cases of a specific disease that occur during a certain period.

Incidental: Insignificant or irrelevant.

Incision: Cutting of the skin at the beginning of surgery.

Incontinence: Leakage of a substance without control. If the substance is urine, it is called urinary incontinence; if stool, it's called fecal incontinence. There are various kinds and degrees of urinary incontinence:

• Overflow incontinence is a condition in which the bladder retains urine after voiding, and as a result, urine leaks out, similar to a full cup under the faucet.

• Stress incontinence is the involuntary leakage of urine during periods of increased bladder pressure, such as coughing, laughing, and sneezing.

Indications: The reasons for undertaking a specific treatment.

Infarct: An area of dead tissue resulting from a sudden loss of its blood supply.

Inflammation: Swelling, redness, pain, and irritation as the result of injury, infection, or surgery.

Informed consent: Permission given by a patient for a particular treatment after the patient has been notified of the indications for the procedure, the possible benefits and risks of the procedure, and alternative procedures that could be performed for the patient's condition.

Inpatient: A patient who is admitted to the hospital for treatment.

Insulin-dependent diabetes mellitus: Diabetes in which the body does not produce sufficient insulin.

Integrative treatment: Treatments that are designed to work together.

Intermittency: An inability to complete voiding and emptying the bladder with one single contraction of the bladder. A stopping and starting of the urine stream during urination.

Internist: A medical doctor who specializes in the nonsurgical treatment of disease and disease prevention.

Interposition: The act of placing between.

Interstitial: Within an organ, such as interstitial brachytherapy, whereby radioactive seeds are placed into the prostate.

Intracavernous: Into the corpora cavernosa.

Intracavernous pressure: The pressure within the corpora cavernosa, as measured during cavernosography.

Intramuscular (IM): Pertaining to the muscles; injection into the muscle.

Intraurethral: Placed into the urethra.

Intraurethral alprostadil: See MUSE.

Intravenous: Into the veins.

Invasive: In cancer, means the spread of the cancer beyond the site where it initially developed into surrounding tissues.

Investigational: See experimental.

Investigator: A doctor or other individual who is involved with an experimental study or clinical trial.

Ischemia: A deficiency of blood flow to an area that compromises the health of the tissue.

IV: Intravenous.

IVP (intravenous pyelogram): A radiologic study, in which a contrast material (dye) is injected into the veins and is picked up by the kidneys and passed out into the urine, which allows one to visualize the urinary tract.

Kegel exercises (pelvic floor muscle exercises): Exercises that help one strengthen muscles that aid in the control of urinary incontinence.

Kidney: One of a pair of organs responsible for eliminating chemicals and fluid from the body.

Laparoscopic radical prostatectomy: Removal of the entire prostate, seminal vesicles, and part of the vas deferens via the laparoscope.

Laparoscopic: Performed with a laparoscope.

Laparoscopy: Surgery performed through small incisions with visualization provided by a small fiberoptic instrument and fine instruments that fit through the small incisions.

Laser: A concentrated beam of high-energy light that is used in surgery.

Leukemia: A cancer of the blood-forming organs that affects the blood cells.

Leuprolide: An LHRH analogue that is administered once every 28, 84, 112 days, or yearly to lower testosterone levels for the treatment of advanced prostate cancer.

Levitra: See vardenafil.

LH: See luteinizing hormone.

LHRH analogue: A medication that tells the brain to tell the testicles to stop producing testosterone. It may initially raise serum testosterone, thus it is combined initially with an antiandrogen in men with metastatic prostate cancer.

LHRH antagonist: See GnRH antagonist.

Libido: Sex drive, interest in sex.

Lifestyle: The way a person chooses to live.

Lobe: A part of an organ. There are five distinct lobes in the prostate: two lateral lobes, one middle, an anterior, and a posterior.

Local anesthesia: Control of pain in a localized area of the body.

Local recurrence: The return of cancer to the area where it was first identified.

Localized: Confined, limited, contained to a specific area.

Lower urinary tract symptoms (LUTS): Symptoms that may be storage (urgency, frequency, urgency incontinence, nocturia) or voiding (hesitancy, intermittency, weak stream, postvoid dribbling, straining to void) symptoms.

Low-flow priapism: Priapism that occurs secondary to venous outflow obstruction.

Low-grade: Cancer that does not appear aggressive, advanced.

Luteinizing hormone (LH): A chemical produced by the brain that stimulates the testes to produce testosterone.

Lycopene: A substance found in tomatoes that has anticancer effects on the prostate.

Lymph: A clear fluid that is found throughout the body. Lymph fluid helps fight infections.

Lymph node(s): Small bean-shaped glands that are found throughout the body. Lymph fluid passes through the lymph nodes, which filter out bacteria, cancer cells, and toxic chemicals.

Lymph node dissection: In the case of prostate cancer, pelvic lymph node dissection, which is the surgical removal of the lymph nodes in the pelvis to determine if prostate cancer has spread to the these nodes.

Lymphadenectomy: The technical term for lymph node dissection.

Lymphangiography: An x-ray test in which contrast is injected into the lymph vessels to determine if there is any blockage/tumor spread to the lymph nodes.

Lymphocele: A collection of lymph fluid in an area of the body.

Malignancy: Cancer. Uncontrolled growth of cells that can spread to other areas of the body and cause death.

Malignant: Cancerous, with the potential for uncontrolled growth and spread.

Medical oncologist: See oncologist.

Megace (megestrol): A medication that is used to treat hot flashes associated with hormone therapy.

Metastatic cancer: Cancer that has spread outside of the organ or structure in which it arose to another area of the body.

Metastatic recurrence: The return of cancer in an area of the body that is not the site where it originally developed.

Metastases: See metastatic cancer.

Microscopic: Small enough that a microscope is needed to see it.

Migration: Spontaneous change of place.

Mitoxantrone: An anticancer drug that belongs to a family of drugs called antitumor antibiotics. It interferes with the growth of cancer cells.

Moderately differentiated: An intermediate grade of cancer as based on pathological evaluation of the tissue.

Molecular biology: The part of biology that deals with the formation, structure, and activity of macromolecules that are essential for life, such as nucleic acids.

Morbidity: Unhealthy results and complications resulting from treatment.

Mortality: Death related to disease or treatment.

MRI (magnetic resonance imaging): A study that is similar to a CT scan in that it allows one to see internal structures in detail, but it does not involve radiation.

Multifocal: Found in more than one area.

MUSE: Intraurethral alprostadil; a small suppository that comes preloaded in a small applicator that is placed into the tip of the penis. The small button at the other end of the suppository is squeezed to release the suppository into the urethra. Gentle rubbing of the penis causes the suppository to dissolve. The prostaglandin is then absorbed through the urethral mucosa and passes into the corpora cavernosa, where it stimulates blood flow into the penis through the cAMP pathway.

Myth: A popular belief or tradition that is unfounded and unproven.

NAION: See nonarteritic ischemic optic neuropathy.

Negative: A test result that does not show what one is looking for.

Neoadjuvant therapy: The use of a treatment, such as chemotherapy, hormone therapy, and radiation therapy, before surgery.

Neoplastic: Malignant, cancerous.

Nephrostomy tube: A tube that is placed through the back into the kidney and allows for drainage of urine from that kidney.

Neridronate (Nerixia): A type of biphosphonate. See biphosphonate.

Nerve: A cordlike structure composed of a collection of nerve fibers that conveys impulses between a part of the central nervous system and some other region of the body.

Nerve-sparing: With regard to prostate cancer, it is the attempt to not damage or remove the nerves that lie on either side of the prostate gland that are in part responsible for normal erections. Injury to the nerves can cause erectile dysfunction.

Nerve-sparing prostatectomy: Form of radical prostatectomy whereby an attempt is made to spare the nerves involved in erectile function.

Neurogenic bladder: A bladder that has an abnormality in its nerve supply.

Neurologic: Pertaining to the brain or nerves.

Neurotransmitter: A chemical released from a nerve cell that transmits an impulse to another nerve, cell, or organ.

Nilandron: The brand name for nilutamide, an antiandrogen.

Nitrate: A form of nitric acid that causes dilation (opening up) of the blood vessels to the heart. Nitroglycerin is a form of nitrate.

Nitric oxide: A chemical in the body that stimulates production of cGMP, which is necessary for erectile function.

Nitroglycerin: A medication that is usually taken sublingually (under the tongue) for the relief of angina. It may also be applied to the chest in a paste form for the prevention of angina.

Nocturia: Awakening one or more times at night with the desire to void.

Nocturnal: Occurring or active at night.

Nocturnal penile tumescence (NPT) study: A specialized study that evaluates the frequency and the quality of nocturnal erections.

Nonarteritic ischemic optic neuropathy (NAION): A sudden, painless loss of vision in one or both eyes. The cause is reduced blood flow to the optic nerve.

Noninsulin-dependent diabetes mellitus: Diabetes in which the body does not respond adequately to insulin.

Noninvasive: Not requiring any incision or the insertion of an instrument or substance into the body.

Norepinephrine: A neurotransmitter that regulates the sympathetic nervous system.

Nucleic acids: Any of a group of complex compounds found in all living cells. Nucleic acids in the form of DNA and RNA control the functions of cells and heredity.

Nutrition: The science or study that deals with food and nourishment, especially in humans.

Objective: Perceptible to the external senses; something the physician uses to quantify, measure, or identify.

Obturator nerve: A nerve located in the pelvis near the pelvic lymph nodes that controls movement of the leg.

Occlusion: Blockage of flow.

Occult: Not detectable on gross examination.

Occult cancer: Cancer that is not detectable through standard physical exams; symptom-free disease.

Oral: Taken by mouth.

Oncologist: A medical specialist who is trained to evaluate and treat cancer.

Orchiectomy: Removal of the testicle(s).

Organ: Tissues in the body that work together to perform a specific function, e.g., the kidneys, bladder, heart.

Organ-confined disease: Prostate cancer that is apparently confined to the prostate clinically or pathologically; not going beyond the edges of the prostate capsule.

Orgasm: Sexual climax; the culmination of sexual excitement.

Orgasmic dysfunction: Alterations in orgasmic function or the inability to achieve an orgasm.

Orthostatic hypotension: The acute lowering of blood pressure when a person changes from a sitting or lying position to an upright position (standing). Also called postural hypotension.

Osteoblastic lesion: Pertaining to plain x-ray of a bone, increased density of bone seen on x-ray when there is extensive new bone formation due to cancerous destruction of the bone.

Osteolytic lesion: Pertaining to plain x-ray of a bone, refers to decreased density of bone seen on x-ray when there is destruction and loss of bone by cancer.

Osteoporosis: The reduction in the amount of bone mass, leading to fractures after minimal trauma.

Overactive bladder: A syndrome consisting of urgency with or without urgency incontinence; often with frequency and nocturia "without an identifiable cause.

Overflow incontinence: A condition in which the bladder retains urine after voiding, and as a result, urine leaks out, similar to a full cup under the faucet.

Palliative: Treatment designed to relieve a particular problem without necessarily solving it, e.g., palliative therapy is given. in order to relieve symptoms and improve quality of life, but it does not cure the patient.

Palpable: Capable of being felt during a physical examination by an experienced doctor. In the case of prostate cancer, this refers to an abnormality of the prostate that can be felt during a rectal examination.

Palpation: Feeling with the hand or fingers, by applying light pressure.

PAP (prostatic acid phosphatase): A chemical that was once used to try to determine if the prostate cancer had spread outside of the prostate.

Parenteral: Administered not by mouth but rather by injection by some other route (e.g., intramuscular, subcutaneous).

Partin tables: Tables that are developed based on results of the PSA, clinical stage, and Gleason score involving thousands of men with prostate cancer. These tables are used to predict the likelihood that prostate cancer has spread to the lymph nodes or seminal vesicles, penetrated the capsule, or remains confined to the prostate. The tables were developed by Dr. Partin at Johns Hopkins University.

Pathologist: A doctor trained in the evaluation of tissues under the microscope to determine the presence/ absence of disease.

PC SPES: An herbal therapy for prostate cancer that is comprised of eight different herbs.

PDE-5 inhibitor: See Phosphodiesterase type 5 inhibitor.

Pelvic floor muscle exercise: See Kegel exercises.

Pelvic lymph node dissection: A procedure to remove lymph nodes that prostate cancer typically spreads to.

Pelvis: The part of the body that is framed by the hip bones.

Penile arterial bypass surgery: A surgical procedure that provides an alternative pathway to bring blood flow into the penis and avoids the obstructed artery.

Penile prosthesis: A device that is surgically placed into the penis that allows a man with erectile dysfunction to have an erection.

Penis: The male organ that is used for urination and intercourse.

Percutaneous: Through the skin.

Perineal: Refers to an incision made behind the scrotum and in front of the anus: The prostate can be removed through a perineal incision.

Perineal prostatectomy: Removal of the entire prostate, seminal vesicles, and part of the vas deferens through an incision made in the perineum.

Perineum: The area of the body that is behind the scrotum and in front of the anus.

Periprostatic: That tissue that lies immediately adjacent to the prostate.

Permanent section: The formal preparation of tissue removed at the time of surgery for microscopic evaluation.

Peyronie's disease: A benign (non-cancerous) condition of the penis that tends to affect middle-aged men. It is characterized by the formation of plaques in the tunica albuginea of the penis and may cause erectile dysfunction.

Pharmacology: The science of drugs, including their composition, uses, and effects.

Phosphodiesterase type 5 (PDE-5):

An enzyme that is responsible for the breakdown of cGMP. Inhibition of PDE-5 leads to a buildup of cGMP.

Phosphodiesterase type 5 (PDE-5) inhibitor: A chemical that prevents the function of PDE-5. The use of such an inhibitor leads to an increase in cGMP.

Physiologic: Functioning in a normal range for human physiology.

PIN (prostatic intraepithelial neoplasia): An abnormal area in a prostate biopsy specimen that is not cancerous, but may become cancerous or be associated with cancer else where in the prostate.

Pituitary adenoma: A benign tumor of the pituitary gland. An adenoma of the anterior pituitary may produce excessive amounts of prolactin.

Pituitary gland: A gland in the brain that is composed of two parts (lobes), the anterior gland and the posterior gland. The anterior pituitary gland produces a variety of hormones, including luteinizing hormone and prolactin.

Placebo: A fake medication ("candy pill") or treatment that has no effect on the body that is often used in experimental studies to determine if the experimental medication/treatment has an effect.

Ploidy status: The genetic status of cells, similar to the grade.

Pneumatic sequential stockings: Inflatable stockings that squeeze the legs intermittently to decrease the risk of a blood clot in the legs.

Polycythemia: An increase in the total red blood cell mass in the blood.

Poorly differentiated: High-grade, aggressive cancer as determined by microscopic evaluation of the tissue.

Positive biopsy: For cancer, it is the detection of cancer in the tissue.

Positive margin: The presence of cancer cells at the cut edge of tissue removed during surgery. A positive margin indicates that there may be cancer cells remaining in the body.

Posterior: The rear or back side.

Postural hypotension: See orthostatic hypotension.

Premature ejaculation: Quick ejaculation. The fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual outlines three criteria for premature ejaculation: (1) persistent or repeated ejaculation occurs with slight stimulation before, on, or shortly after penetration and before the person wishes it; (2) the disturbance causes considerable anguish or interpersonal difficulty; and (3) the premature ejaculation is not due exclusively to the direct effects of a chemical.

Pressure/flow study: A component of a urodynamic study, whereby the bladder pressure is plotted against the urine flow rate. It is useful in determining if obstruction to the outflow of urine is present.

Prevalence: The number of cases of a disease that are present in a population at one given point in time. Priapism: An erection that lasts longer than 4 to 6 hours.

Proctitis: Inflammation of the rectum.

Prognosis: The long-term outlook or prospect for survival and recovery from a disease.

Progression: The continued growth of cancer or disease.

Prolactin: One of the hormones produced by the pituitary gland. In males, elevated prolactin levels can lower testosterone levels, decrease libido, and affect erectile function.

Prolonged erection: An erection that lasts longer than 4 hours but less than 6 hours. It may be associated with the use of pharmacologic therapy for erectile dysfunction.

Proscar (finasteride): A drug that decreases prostate size. It is FDA approved for BPH; it has been shown to decrease the incidence of prostate cancer.

Prostaglandin E1: A type of prostaglandin that increases the cAMP level, which causes smooth-muscle relaxation.

Prostate: A gland that surrounds the urethra and is located just under the bladder. It produces fluid that is part of the ejaculate (semen). This fluid provides some nutrient to the sperm.

Prostate specific antigen (PSA): A chemical produced by benign and cancerous prostate tissue. The level tends to be higher with prostate cancer.

Prostate surgery: Surgery for benign and malignant diseases of the prostate.

Prostatectomy: Any of several surgical procedures in which part or all of the prostate gland is removed. These procedures include laparoscopic radical prostatectomy, radical perineal prostatectomy, radical retropubic prostatectomy, and transurethral prostatectomy (TURP), and open prostatectomy for BPH either retropubic prostatectomy or suprapubic prostatectomy.

ProstaScint: A specialized study that detects an antigen called the prostate-specific antigen. It may be picking up recurrent prostate cancer.

Prostatic stents: Cylindrical devices that can be placed in the urethra to relieve prostatic obstruction.

Prostatitis: Inflammation or infection of the prostate gland.

Prosthesis: An artificial device used to replace the lost normal function of a structure or organ in the body.

Protocol: Research study used to evaluate a specific medication or treatment.

Proton-beam therapy: In conjunction with external-beam therapy, use of powerful beams of photons that are focused onto the prostate.

PSA density: The amount of PSA per gram of prostate tissue (PSA/g of prostate tissue).

PSA nadir: The lowest value that the PSA reaches during a particular treatment.

PSA progression: Increase in PSA after treatment of prostate cancer.

PSA velocity: The rate of change of the PSA over a period of time (change in PSA/change in time).

Psychogenic: Stemming from the mind or psyche.

QD: Daily

QID: Four times a day

QOD: Every other day

Quality of life: An evaluation of healthy status relative to the patient's age, expectations, and physical and mental capabilities.

Radial rigidity: Rigidity across the width or radius of the penis.

Radiation oncologist: A physician who treats cancer through the use of radiation therapy.

Radiation proctitis: Inflammation of the rectal lining as a result of radiation therapy.

Radiation therapy: Use of radioactive beams or implants to kill cancer cells.

Radical perineal prostatectomy:

Removal of the entire prostate and seminal vesicles for prostate cancer through a perineal incision.

Radical prostatectomy: A surgical procedure to remove the entire prostate and the seminal vesicles and part of the vas deferens to treat prostate cancer. May be performed via retropubic, laparoscopic, perineal, and robotic approaches.

Radical retropubic prostatectomy:

The surgical removal of the entire prostate plus the seminal vesicles and part of the vas deferens through an incision that extends down from the umbilicus (belly button).

Randomized: The process of assigning patients to different forms of treatment in a research study in a random manner.

Rapid eye movement (REM): A phase in the sleep cycle. Nocturnal erections occur during this phase of sleep.

Recurrence: The reappearance of disease. The recurrence may be clinical (a physical finding) or laboratory (e.g., a rise in the PSA).

Red blood cells: The cells in the blood that carry oxygen to the tissues.

Refractory: Resistant to therapy.

Regression: Reduction in the size of a single tumor or reduction in the number and/or size of several tumors.

Resectionist: The physician (urologist) who use the resectoscope during a turp.

Resectoscope: An instrument used to remove (resect) prostate, bladder, or urethral tissue through the urethra.

Resistance: Opposition to blood flow out of the penis.

Retention: Difficulty in emptying the bladder of urine; may be complete, in which one is unable to void, or partial, in which urine is left in the bladder after voiding.

Retrograde ejaculation: A condition whereby the ejaculate passes backward into the bladder instead of forward out the tip of the penis. This problem frequently occurs after transurethral prostatectomy.

Retropubic prostatectomy: An open surgical procedure to remove benign prostatic tissue, useful with very large prostates, does not remove the entire prostate; only a radical prostatectomy removes the entire prostate.

Risk: The chance or probability that a particular event will or will not happen.

Rhinitis: An inflammation of the nasal passages.

Robotic-assisted radical prostatectomy: A radical prostatectomy performed with the assistance of a robot.

Salvage: A procedure intended to "rescue" a patient after a failed prior therapy, e.g., a salvage radical prostatectomy after failed external-beam therapy.

Screening: Examination or testing of a group of individuals to separate those who are well from those who have an undiagnosed disease or defect or who are at high risk.

Scrotum: The pouch of skin that contains the testicles.

Selective serotonin reuptake inhibitor (SSRI): A type of medication that is used for depression and for premature ejaculation. Commonly used SSRIs include sertraline, paroxetine, and fluoxetine.

Semen: The thick whitish fluid, produced by glands of the male reproductive system, that carries the sperm (reproductive cells) through the penis during ejaculation.

Seminal vesicles: Glandular structures that are located above and behind the prostate: They produce fluid that is part of the ejaculate.

Sensitivity: The probability that a diagnostic test can correctly identify the presence of a particular disease.

Sex hormones: Substances (estrogens and androgens) responsible for secondary sex characteristics (e.g., hair growth and voice change in males).

Sexual dysfunction: An abnormality in the function of any component of the sexual response cycle.

Sexual response cycle: In male the cycle of interest, arousal, climax, ejaculation, and detumescence.

Sickle cell disease/sickle cell trait: A genetically inherited condition in which red blood cells take on an abnormal shape (sickle) in response to decreased oxygenation, dehydration, and acidosis. This abnormal shape makes it difficult for the red blood cells to pass through the blood vessels and leads to blockages of the vessels, causing pain and ischemia to tissues. In the penis, it may lead to priapism. African Americans are at increased risk for sickle cell disease/trait.

Side effect: A reaction to a medication or treatment.

Sign: Objective evidence of a disease, i.e., something that the doctor identifies.

Sildenafil (Viagra): The first oral therapy, phosphodiesterase type V inhibitor, for the treatment of erectile dysfunction.

Silodosin (Rapaflo): An alpha-blocker used to treat BPH.

Sinusoid: A blood-filled cavernous space. In the penis, these spaces are separated by a network of connective tissues containing muscle cells, small arteries, veins, and nerves.

Sleep apnea: A condition in which a person stops breathing for a short period of time during sleep (anywhere from a few seconds to a minute or two), causing him to wake repeatedly and get insufficient sleep.

Somnolence: Sleepiness, unnatural drowsiness.

Soy: Soy products are made from soy beans, a legume. Soy products are high in isoflavones, which may be helpful in preventing cancer cell growth.

Specificity: The probability that a diagnostic test can correctly identify the absence of disease.

Sperm: The cells in the male ejaculate that are produced by the testes that fertilize eggs.

Sphincter: A muscle that surrounds and by its tightening causes closure of an opening, e.g., the sphincter at the bladder outlet and in the urethra.

SSRI: See selective serotonin reuptake inhibitor.

Stage: A term used to describe the size and the extent of a cancer.

Staging: The process of determining the extent of disease, which is helpful in determining the most appropriate treatment. Often involves physical examination, blood testing, and x-ray studies.

Stress incontinence: The involuntary loss of urine during sudden rises in intra-abdominal pressure, e.g., with coughing, laughing, sneezing, or picking up heavy objects.

Striant: A transbuccal form of testosterone replacement therapy.

Stricture: Scarring as a result of a procedure or an injury that causes narrowing and in the case of the urethra may constrict the flow of urine.

Subjective: Pertaining to or perceived by the affected individual, but not perceptible to the other senses of another person.

Supplement: Something that completes or is an addition. A medication/ therapy that is used in addition to another medication/therapy.

Supraphysiologic: Higher than the normal functional state or level in the body.

Suprapubic prostatectomy: An open surgical procedure for removing benign prostatic tissue, useful with very large prostates. Unlike a radical prostatectomy the entire prostate is not removed.

Suprapubic tube: A type of catheter placed percutaneously (through the skin) into the bladder through the lower abdominal wall in order to drain urine.

Suramin: An anticancer drug that may be helpful in metastatic cancer.

Symptom: Subjective evidence of a disease, i.e., something a patient describes, e.g., pain in abdomen.

Syncope: A temporary loss of consciousness.

Tadalafil (Cialis): An oral therapy, phosphodiesterase type V inhibitor, used for the treatment of erectile dysfunction. It has a longer half-life than the other oral therapies.

Tamsulosin (Flomax): An alpha-blocker used to treat BPH.

Taxane: A drug that inhibits cell growth by stopping cell division.

Terazosin (Hytrin): An alpha-blocker used to treat BPH.

Testim: A gel form of testosterone replacement therapy.

Testis: One of two male reproductive organs that are located within the scrotum and produce testosterone and sperm.

Testoderm: A topical form (patch) of testosterone used for testosterone replacement therapy.

Testosterone: The male hormone or androgen that is produced primarily by the testes and is needed for sexual function and fertility.

Three-dimensional (3-D) conformal radiation therapy: A variation of external-beam radiation therapy in which a computer, CT scan images, and a brace are used to focus the radiation more directly on the target organ/location.

TID: Three times a day.

Tissue: Specific type of material in the body, e.g., muscle, hair.

Total androgen blockade: The total blockage of all male hormones (those produced by the testicles and the adrenals) using surgery and/or medications.

Total PSA: The combination of bound and free PSA.

TNM system: Tumor, nodes, and metastases. The most common stagin system for prostate cancer.

Transdermal: Entering through the skin, as in administration of a drug applied to the skin in an ointment, gel, or patch form.

Transferrin: A chemical in the body that has been shown to stimulate the growth of prostate cancer.

Transperineal: Through the perineum.

Transrectal: Through the rectum.

Transrectal ultrasound: Visualization of the prostate by the use of an ultrasound probe placed into the rectum.

Transurethral: Through the urethra.

Transurethral incision of the prostate: A method of treating prostatic obstruction using an incision instead of resection; also known as TUIP.

Transurethral prostatectomy: See TURP.

Trazodone: A psychiatric medication that has been reported to cause priapism.

Triptorelin pamoate (Trelstar):An LHRH analogue used in the management of advanced prostate cancer. Tumescence: Condition of being tumid or swollen; with respect to erections, penile rigidity.

Tumor: Abnormal tissue growth that may be cancerous or noncancerous (benign).

Tumor markers: Chemicals that can be used to detect and follow the treatment of certain cancers. Tumor volume: The amount of cancer present in an organ.

Tunica albugínea: The dense, fibrous, elastic sheath enclosing the corpora cavernosa in the penis. Compression of small veins against the tunica albuginea during erection prevents the outflow of blood from the corpora, causing the penis to be rigid.

TURP (transurethral prostatectomy): A surgical technique performed under anesthesia using a specialized instrument similar to the cystoscope that allows the surgeon to remove the pro-static tissue that is bulging into the urethra and blocking the flow of urine through the urethra. After a TURP, the outer rim of the prostate remains.

Ultrasound: A technique used to look at internal organs by measuring reflected sound waves.

Undergrading: A term that indicates that the grade of cancer is worse than that found in the biopsy tissue.

Understaging: The assignment of an overly low clinical stage at initial diagnosis because of the difficulty of assessing the available information with accuracy.

Unit: Term referring to a pint of blood.

Ureters: Tubes that connect the kidneys to the bladder, through which urine passes into the bladder.

Urethra: The tube that runs from the bladder neck to the tip of the penis through which urine passes.

Urgency: A sudden compelling desire to urinate that is difficult to defer.

Urge Incontinence: associated with urgency.

Urinary incontinence: The loss of control of urine.

Urinary retention (acute): The inability to urinate leading to a filled bladder.

Urodynamics test: A test that assesses how well the bladder functions.

Uroflow: A measurement of the flow rate and volume of urine voided.

Urologist: A doctor that specializes in the evaluation and treatment of diseases of the genitourinary tract in men and women.

Vacuum device: A device that is used to provide an erection. It consists of three parts: a cylinder, a pump, and a constricting band.

Vardenafil (Levitra): An oral therapy, phosphodiesterase type V inhibitor, used in the management of erectile dysfunction.

Vascular: Pertaining to blood vessels.

Vas deferens: A pair of tiny tubes that connects each testicle to the urethra through which sperm passes.

Vasectomy: A procedure in which the vas deferens are cut and tied off, clipped, or cauterized to prevent the exit of sperm from the testicles. It makes a man sterile.

Vasoactive: Affecting the size (diameter) of blood vessels.

Vasospasm: Constriction of the arteries.

Vasovagal attack: A transient vascular and neurogenic reaction marked by pallor (white, ghost-like look), sweating, slow heart rate, and lowering of the blood pressure.

Vein: A blood vessel in the body that carries deoxygenated blood from the tissues back to the heart.

Venlafaxine: An antidepressant that is helpful in managing hot flashes associated with hormone therapy.

Venous leak: The situation in which veins do not compress to prevent blood from draining out of the corpora during erection. Venous leak may also refer to the rare occasions in which abnormally located veins allow for persistent drainage of blood during an erection.

Venous ligation surgery: A surgical procedure in which leaky veins in the penis are ligated to prevent blood from continually flowing out of the penis during erection.

Viadur: An LHRH analogue that is administered by implant yearly to lower testosterone levels for the treatment of advanced prostate cancer.

Viagra: See sildenafil.

Wasting: An indentation in the penis.

Watchful waiting: Active observation and regular monitoring of a patient without actual treatment.

Well-differentiated: A low-grade.

X-ray: A type of high-energy radiation that can be used at low levels to make images of the internal structure of the body and at high levels for radiation therapy.

Zoladex: See goserelin acetate.

Zoledronate (zometa): A biphosphonate that increases bone density in men on hormonal therapy.