Prostate cancer clinical quality performance indicators: engagement document

Document explaining the process of, and inviting engagement on, revision of the prostate cancer QPIs.


Appendix 7: Glossary of Terms

Adenocarcinoma

Cancer that begins in cells that line certain internal organs and that have gland-like (secretory) properties.

Adjuvant

Additional cancer treatment given after the primary treatment to lower the risk that the cancer will come back. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, targeted therapy, or biological therapy.

Androgen

A type of hormone that promotes the development and maintenance of male sex characteristics.

Anterior

In human anatomy, has to do with the front of a structure, or a structure found toward the front of the body.

Anti-Androgen

A compound (usually a synthetic pharmaceutical) that blocks or otherwise interferes with the normal action of androgens at cellular receptor sites.

Asymptomatic

Having no symptoms. You are considered asymptomatic if you:

  • Have recovered from an illness or condition and no longer have symptoms
  • Have an illness or condition (such as early stage high blood pressure or glaucoma) but do not have symptoms

Bilateral

Affecting both the right and left sides of the body.

Biochemical recurrence

Rise in the blood level of PSA (prostate-specific antigen) in prostate cancer patients 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. Also called biochemical relapse and PSA relapse.

Biopsy

Removal of a sample of tissue from the body to assist in diagnosis of a disease.

Bladder

The organ which stores urine.

Bone scan

A technique to create images of bones on a computer screen or on film.

Bowel

The long, tube-shaped organ in the abdomen that completes the process of digestion. The bowel has two parts, the small bowel and the large bowel.

Brachytherapy

A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumour. Also called implant radiation therapy, internal radiation therapy, and radiation brachytherapy.

Capsular

In medicine, a sac of tissue and blood vessels that surrounds an organ, joint, or tumour. A capsule is also a form for medicine that is taken by mouth. It usually has a shell made of gelatine with the medicine inside.

Carcinoma

Cancer that begins in the skin or in tissues that line or cover internal organs.

Cause-specific survival

A method of estimating net survival. Only deaths attributable to the cancer of diagnosis are counted as deaths, giving the probability of survival in the absence of other causes of death.

Chemotherapy

The use of drugs that kill cancer cells, or prevent or slow their growth.

Claustrophobia

Fear of enclosed spaces.

Clinical trials

Type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease.

Computed Tomography ( CT)

An x-ray imaging technique, which allows detailed investigation of the internal organ of the body.

Contraindication

A symptom or medical condition that makes a particular treatment or procedure inadvisable because a person is likely to have a bad reaction.

Core

A piece of prostate tissue.

Curative intent

Treatment which is given with the aim of curing the cancer.

Cystoscopy

Examination of the bladder and urethra using a cystoscope, inserted into the urethra. A cystoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.

Diagnosis

The process of identifying a disease, such as cancer, from its signs and symptoms.

Digital Rectal Examination ( DRE)

An examination in which a doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities.

EMEA

European Medicines Agency

Enemas

The injection of a liquid through the anus into the large bowel.

External Beam Radiotherapy ( EBRT)

A type of radiotherapy that uses a machine to aim high-energy rays at the cancer from outside of the body.

Gleason Score

A system of grading prostate cancer tissue based on how it looks under a microscope. Gleason scores range from 2 to 10 and indicate how likely it is that a tumour will spread. A low Gleason score means the cancer tissue is similar to normal prostate tissue and the tumour is less likely to spread; a high Gleason score means the cancer tissue is very different from normal and the tumour is more likely to spread.

Histological / Histopathogical

The study of the structure, composition and function of tissues under the microscope, and their abnormalities.

Hormone therapy

Treating a disease with hormones, or by blocking the action of hormones.

Incontinence

Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (faecal incontinence).

Information Services Division ( ISD)

A division of National Services Scotland, part of NHS Scotland. ISD provides health information, health intelligence, statistical services and advice that support the NHS in progressing quality improvement in health and care and facilitates robust planning and decision making.

Intervention

A treatment or action taken to prevent or treat disease, or improve health in other ways.

Laser coagulation

The coagulation (clotting) of tissue using a laser.

Local anaesthetic

Drug which reduces or abolishes sensation from a specific area, to numb it.

Locally advanced

Cancer that has spread from where it started to nearby tissue or lymph nodes.

Luteinizing-hormone-
releasing hormone ( LHRH) agonist

A hormonal therapy for prostate cancer.

Magnetic Resonance Imaging ( MRI)

A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue.

Margin

See Resection Margins

Metastases/ Metastatic disease

Spread of cancer away from the primary site to somewhere else via the bloodstream or the lymphatic system.

MHRA

Medicines and Healthcare products Regulatory Committee.

Monotherapy

Treatment of a condition by means of
a single drug.

Mortality

Either (1) the condition of being subject to death; or (2) the death rate, which reflects the number of deaths per unit of population in any specific region, age group, disease or other classification, usually expressed as deaths per 1000, 10,000 or 100,000.

Multi-disciplinary team meeting ( MDT)

A meeting which is held on a regular basis, which is made up of participants from various disciplines appropriate to the disease area, where diagnosis, management, and appropriate treatment of patients is discussed and decided.

Nadir level

Lowest point.

Nodal

Affecting the cells that form small lumps near the joints in your body.

NoSCAN

North of Scotland Cancer Network

Orchidectomy

Surgery to remove one or both testicles.

Organ confined disease

Cancer which is confined to the prostate and has not spread to any other organ.

Pacemaker

Artificial device implanted into the body to monitor heart rate.

Palliative/Palliation

Anything which serves to alleviate symptoms due to the underlying cancer but is not expected to cure it.

Palpable disease

Cancer which can be felt by touch.

Pathology

The study of disease processes with the aim of understanding their nature and causes. This is achieved by observing samples of fluid and tissues obtained from the living patient by various methods, or at post mortem.

Pelvic

Having to do with the pelvis (the lower part of the abdomen located between the hip bones).

Performance status

A measure of how well a patient is able to perform ordinary tasks and carry out daily activities. ( PS WHO score of 0=asymptomatic, 4=bedridden).

Prognosis/Prognostic

An assessment of the expected future course and outcome of a person's disease.

Progression

In medicine, the course of a disease, such as cancer, as it becomes worse or spreads in the body.

Prostate

A gland in the male reproductive system. The prostate surrounds the part of the urethra (the tube that empties the bladder) just below the bladder, and produces a fluid that forms part of the semen.

Prostate Specific Antigen ( PSA)

A protein made by the prostate gland and found in the blood. Prostate-specific antigen blood levels may be higher than normal in men who have prostate cancer, benign prostatic hyperplasia ( BPH), or infection or inflammation of the prostate gland.

PSA bounce

A brief rise and then fall in the blood level of PSA (prostate-specific antigen) that occurs in some patients 1-3 years after receiving radiation treatment for prostate cancer. PSA bounce does not mean that the cancer has come back. It may be caused by the release of PSA from destroyed cancer cells or from normal prostate tissue exposed to the radiation treatment.

Quality Performance Indicator ( QPI)

A proxy measure of quality patient care.

Radiation Therapy Oncology Group ( RTOG)

A clinical cooperative group founded to increase the survival and quality of life of patients diagnosed with cancer.

Radical Prostatectomy

Surgery to remove the entire prostate. The two types of radical prostatectomy are retropubic prostatectomy (surgery through an incision in the wall of the abdomen) and perineal prostatectomy (surgery through an incision between the scrotum and the anus).

Radical Treatment

Treatment that aims to get to completely get rid of a cancer.

Radiotherapy

The use of radiation, usually X-rays or gamma rays, to kill tumour cells.

Rectal

By or having to do with the rectum. The rectum is the last several inches of the large bowel closest to the anus.

Recurrence

When new cancer cells are detected at the site of the original tumour, following treatment.

Relapse

The return of a disease or the signs and symptoms of a disease after a period of improvement.

Resection margins

The edge or border of the tissue removed in surgery.

Salvage

Treatment that is given after the cancer has not responded to other treatments.

Sarcoma

A cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

SCAN

South and East Scotland Cancer Network

Scottish Medicines Consortium ( SMC)

The purpose of the SMC is to accept for use those newly licensed drugs that clearly represent good value for money to NHSScotland. SMC analyses information supplied by the drug manufacturer on the health benefits of the drug and justification of its price.

Seminal Vesicle

A gland that helps produce semen.

Sigmoidoscopy

Examination of the lower bowel using a sigmoidoscope, inserted into the rectum. A sigmoidoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.

Staging

Process of describing to what degree cancer has spread from its original site to another part of the body. Staging involves clinical, surgical and pathology assessments.

Surgical margins

See Resection Margins

Surgical resection

Surgical removal of the tumour/lesion.

Survival

The percentage of people in a study or treatment group who are alive for a certain period of time after they were diagnosed with or treated for a disease, such as cancer.

Symptomatic

Having to do with symptoms, which are signs of a condition or disease.

TNM staging system

TNM classification provides a system for staging the extent of cancer. T refers to the size of the primary tumour. N refers to the involvement of the lymph nodes. M refers to the presence of metastases or distant spread of the disease.

Toxicity

The extent to which something is poisonous or harmful.

Trans Rectal Ultrasound ( TRUS) Guided Biopsy

Is a procedure that takes small samples of tissue from the prostate gland.

Tumour

A lump or mass of cells which can be either benign (not cancerous) or malignant.

Tumour volume

The size of a cancer measured by the amount of space taken up by the tumour.

ug/l

Micrograms per litre.

Urinary

Having to do with urine or the organs of the body that produce and get rid of urine.

WoSCAN

West of Scotland Cancer Network.

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