Glossary

Medical speak, explained.

Some definitions for terms you‘ll see throughout this site.

10-year Individual Cure Rate – A cure rate calculated from a doctor’s computerized database of all men he has previously treated showing the chance of a man having an undetectable PSA (PSA 0.2 ng/ml or lower) ten years after whatever treatment he receives. Calculated cure rate for a man’s own particular case of prostate cancer.

alpha blockers – Pills taken by men to relax muscles inside the prostate that constrict the urethra, impeding urinary flow. Medications in this category are Flomax^®, Cardura^®, Hytrin^® and Uroxatral^®.

ASTRO definition of treatment failure – Three consecutive PSA rises above the lowest PSA. Does not use PSA 0.2 ng/ml and does not define cure. Produces inaccurate, inflated results.

conformal beam radiation – Technique of delivering linear accelerator radiation using handmade blocks.

cure of prostate cancer – Two steps: (1) achievement of PSA 0.2 ng/ml or lower and (2) PSA remains at this level forever.

cure rate – Percent of all men treated for prostate cancer who have PSA 0.2 ng/ml 10 years later. Ten-year outcome is the standard time for measuring cure from prostate cancer.

dose intensification (seed activation) – Iodine seeds with a 60-day half-life and linear accelerator radiation beginning 21 days after the implant produce dose synergy, since both forms of irradiation are given simultaneously. Used to destroy prostate cancer cells inside the prostate, where most are located, and also all normal prostate cells to prevent a second cancer. Dose intensification is an integral part of prostRcision.

DRE (Digital Rectal Examination) – Finger examination of the prostate through the rectum to stage patients.

erectile dysfunction (ED) – Partial or complete loss of erection of the penis expressed as mild ED through complete ED (impotent).

Gleason score – A determination by the pathologist of how fast prostate cancer is growing. Gleason score ranges from 2 (slow growth) through 10 (fast growth).

I-125 seeds – Tiny metal capsules holding radioactive iodine (I-125) which emits a high dose of irradiation to a very small area for about one year.

IMRT (Intensity Modulated Radiation Therapy) – A computer-driven technique for administering linear accelerator irradiation.

Individual Cure Rate (ICR) – Cure rates calculated for an individual man using all the men previously treated who have similar PSA, Gleason score as well as other pathology report factors and stage in the RCOG Computerized prostRcision Database.

microscopic capsule penetration – Cancer cells that erode through the capsule, which covers the prostate and spread to the adjacent rectum, bladder, sex nerves and muscles that control urination. Spread can also occur by the "tunnel" of perineural invasion or at the bottom (apex) of the prostate where there is no capsule. Microscopic capsule penetration can only be detected under the microscope after a radical prostatectomy.

Overall cure rate – Cure rate of all men treated at an institution regardless of their PSA or prostate biopsy pathology report findings.

peer-review process – A process whereby cancer research papers, either for publication in medical journals or presentation at major medical meetings, are reviewed anonymously by other doctors.

perineural invasion – A way in which prostate cancer cells can leak outside the prostate (microscopic capsule penetration) by a "tunnel" through the prostate capsule. This can be seen on prostate biopsy – a report by a pathologist detailing what he sees under the microscope including Gleason score, percent of cancer in each needle, number of needles with cancer, percent Gleason grade 4 or 5 and perineural invasion.

ProstRcision^® – Treatment technique pioneered at RCOG consisting of a radioactive I-125 seed implant followed by IMRT accelerator radiation. Seeds are used as targets for precision radiation and microscopic capsule penetration cancer is treated.

PSA (Prostate Specific Antigen) – A protein produced only by prostate cells, cancer and normal, and secreted into the blood stream.

PSA 0.2 ng/ml – The standard definition for cure. Cure of prostate cancer is defined by men whose PSA falls to 0.2 ng/ml or lower and remains at this level forever.

radical prostatectomy – Surgical removal of the prostate gland. There are three techniques – open, laparoscopic and robotic.

second opinion prostate biopsy pathology report – A review by expert pathologists in which the original prostate biopsy pathology findings are reviewed and double checked. A separate report is provided.

seed “activation” – Dose intensification of logical integration.

seeds as target – Use of the silver and gold seeds to outline the prostate on x-rays and make a target for subsequent external beam irradiation.

sexual impotence – Complete loss of penile erection.

stage – Determination of location of prostate cancer by examining the prostate by DRE.

treatment outcome – Cure rates and/or complication rates.

undetectable PSA – PSA 0.2 ng/ml or lower.

urinary incontinence – Involuntary leakage of urine such that a man may have to wear pad or adult diapers.

Viagra^®/Levitra^®/Cialis^® – Pills to treat erectile dysfunction (ED). Improves penile erection for most, but not all men.