General Prostate Cancer Diagnosis Terms
BPH (Benign Prostatic Hyperplasia)
A condition in which the prostate gland is enlarged and not cancerous.
DRE (Digital Rectal Exam)
The doctor inserts a gloved, lubricated finger into the rectum and feels the rectum, anus, and prostate (in males) to check for anything abnormal.
Prostate-Specific Antigen (PSA)
Prostate-specific Antigen (PSA) is a substance found in the blood that is made by the prostate gland. It can be used to detect unusual activity in the prostate.
PSA blood test
A PSA test is a blood test that is done to see what a patient’s PSA level is and how it changes over time. Changes in PSA can be used to detect early stages of prostate cancer.
Prostatitis
Swelling and inflammation of the prostate gland
Biopsy
For a biopsy, the doctor takes out a small piece of tissue where the cancer seems to be. This tissue is checked for cancer cells. A core needle biopsy is often used to find prostate cancer.
MRI (Magnetic Resonance Imaging)
MRIs use magnetic fields to create clear images of body parts, including tissues, muscles, nerves and bones. MRIs make better images of organs and soft tissue than other scanning techniques, such as computer tomography (CT) or x-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints and the inside of bones.
Bone Scan
An imaging test that gives important information about the bones, including the location of cancer that may have spread to the bones. It uses a small amount of radioactive contrast material (radioisotope) which is given through a vein. This material settles in areas of the bone to which the cancer may have spread. The radioactive substance can be seen in pictures as it collects in the problem areas (“hot spots”).
Transrectal ultrasound (TRUS)
For this test, a small wand is put into the patient’s rectum. It gives off sound waves and picks up the echoes as they bounce off the prostate gland. The echoes are made into a picture on a computer screen.
Gleason Score
the grading system used to determine the aggressiveness of prostate cancer. This grading system can be used to choose appropriate treatment options. To find a Gleason score, the tumor cells from the biopsy are looked at under a microscope. A number is assigned to them based on how abnormal they appear. The scale goes from 1 (non-aggressive) to 5 (very aggressive). The numbers of the two most common patterns are added together to create a Gleason Score from 2 to 10. The order of the numbers do matter. While you may have an overall Gleason Score of a 7, one that is a 3+4 will progress differently from one that is a 4+3. (The Gleason Score is slowly being replaced by a Gleason Group Score from 1 to 5 indicating very low risk to very high risk.)
General Cancer Terms
Biochemical recurrence
Biochemical recurrence is a rise of prostate-specific antigen (PSA) levels in the blood of a prostate cancer patient after treatment with surgery or radiation. Biochemical recurrence may occur in patients who do not have symptoms. It may mean that the cancer has come back.
Lymph Node
Small bean-shaped collection of immune system tissue, such as lymphocytes, found throughout the body along lymphatic vessels. They remove cell waste, germs, and other harmful substances from lymph. They help fight infections and also have a role in fighting cancer, although cancers can spread through them. Sometimes called lymph glands.
Localized Cancer
Also called local cancer. A cancer that is confined to the organ where it started; that is, it has not spread to distant parts of the body.
Metastasis
The spread of cancer from one part of the body to another. This happens through the lymph system or through the bloodstream. A tumor formed by cells that have spread is called a “metastatic tumor” or a “metastasis.” The metastatic tumor contains cells that are like those in the original (primary) tumor.
Recurrence
The return of cancer after treatment. Local recurrence means that the cancer has come back at the same place as the original cancer (primary site). Regional recurrence means that the cancer has come back after treatment in the lymph nodes near the primary site. Distant recurrence is when cancer spreads (metastasizes) after treatment to distant organs or tissues (such as the lungs, liver, bone marrow, or brain).
Prostate Cancer Treatment Terms
Active Surveillance
May be an appropriate treatment option for patients whose prostate cancer was caught early and is considered low-risk. If a man’s prostate cancer is caught early, is not causing problems, and is growing very slowly, a physician may forgo treating the tumor at all. Instead, the doctor may recommend that the patient keep actively monitoring his PSA levels. (At times, called Watchful Waiting).
Focal Therapy
Analogous to lumpectomy for breast cancer. May be an appropriate treatment option for patients whose prostate cancer is localized to one or two spots in the prostate as usually detected by an MRI. There are various forms of focal therapy. Side effects are minimal and further treatment options are mostly left open.
Open Radical Prostatectomy
An operation to remove the prostate gland and some of the tissue around it. Surgery that removes the entire prostate gland plus some tissue around it. This is used most often if the cancer is thought not to have spread outside of the gland. It involves an abdominal incision that extends from the belly button to the pubic bone.
Robot Assisted Laparoscopic Prostatectomy
Using the advanced surgical system, miniaturized robotic instruments are passed through several small keyhole incisions in the patient’s abdomen to allow the surgeon to remove the prostate and nearby tissues with great precision. This is less invasive than a conventional radical prostatectomy,
Nerve Sparing Prostatectomy
Surgery to remove the prostate in which the surgeon tries to save a man’s ability to have erections by leaving in the neurovascular bundles that control that function. In some cases, the urologist is able to spare the nerves on both sides of the gland; in others, the tumor is so close to one set of nerves that he has to sacrifice those nerves to be sure the entire tumor is removed. Some surgeons have been concerned that it is more likely to leave some cancer cells behind. (Can be done either open or robot assisted.)
HIFU
High-intensity focused ultrasound (HIFU) is a prostate cancer treatment that uses the energy of highly focused ultrasound to pinpoint, heat and kill prostate cancer cells. HIFU is generally a non-invasive (no incisions) outpatient procedure.
ADT (Hormone Therapy)
Prostate cancer needs testosterone to grow. Reducing how much testosterone your body makes may slow the cancer’s growth or shrink the cancer temporarily. Testosterone is an androgen (male sex hormone), so this treatment is called androgen deprivation therapy (ADT). It is also known as hormone therapy.
Radiation (External Beam)
Use of carefully aimed doses of radiation from a source outside the body that is focused on the cancer.
Brachytherapy
A type of radiation therapy in which radioactive material sealed in seeds is placed directly into the prostate. Also called radioactive seed implants, radiation brachytherapy, internal radiation therapy, and implant radiation therapy.The seeds are left in the prostate to decay naturally. (Also sometimes referred to as Low-Dose brachytherapy.)
High-Dose brachytherapy
A type of radiation therapy in which radioactive material sealed in seeds is placed directly into the prostate for a certain period of time and removed. The placement of the seeds is sometimes targeted. It is usually followed by a short course of external beam radiation.
Stereotactic Radiosurgery (SRS), Stereotactic Radiotherapy (STR), Stereotactic Body Radio-therapy (SBRT)
A precise delivery of a single, high dose of radiation in a one-day session done to the body (CyberKnife).
Transurethral Resection of the Prostate (TURP)
An operation that removes a part of the prostate gland that surrounds the urethra (the tube through which urine exits the bladder). The procedure is used for some men with prostate cancer who cannot have the prostate removed (radical prostatectomy) because of advanced age or other serious illnesses. This operation can be used to relieve symptoms caused by a tumor, but it is not expected to cure this disease or remove all of the cancer. TURP is used more often to relieve symptoms of benign prostatic hyperplasia (BPH).
Ablation
Prostate ablation is any procedure used to kill prostate cancer cells. During a prostate ablation procedure, energy (such as heat, cold, lasers, or chemicals) is used to kill the cancer cells. The energy may also destroy some of the surrounding normal prostate tissue.
Treatment side-effect Terms
Erectile Dysfunction (Impotence)
Inability to have an erection (erectile dysfunction), usually a side effect or prostate cancer treatment.
Incontinence
Lack of voluntary control over urination or defecation, usually a side effect of radiation.
Kegel Exercises
Exercises to strengthen certain muscles in the bottom of the pelvis. These exercises may help men and women with certain forms of urinary incontinence.
Glossary of medical specialists
Urologic Oncologist
A Urologist who specializes in cancers of the Genito-Urinary (GU) system and if necessary, perform surgeries to remove cancers of the GU system.
Radiation Oncologist
Specializes in using Radiation to treat cancer.
Radiologist – Specializes in viewing and interpreting images from Ultrasound, CT, MRI and PET-CT scans. The results are then sent to the oncologist who ordered the imaging test. As a result, patients don’t usually meet the Radiologist.
Pathologist
Specializes in viewing and analyzing tissue samples taken from prostate biopsies or from radical prostatectomy surgeries and then forwarding the results to the oncologist who requested them. As a result, patients don’t usually meet the Pathologist.
Pelvic Floor Physiotherapist
They specialize in helping patients deal with incontinence after prostate cancer treatment.
Support Resources
Online site of Prostate Cancer Support Toronto:
Videos of experts’ presentations:
https://pcstoronto.ca/pccn-toronto-videos/
Telephone Support Line:
416-932-8820
Email Support address: