THE CANCER DICTIONARY
`
`\
`
`Roberta Altman
`
`Michael J. Sarg, MD.
`
`Associate Chief of Medical Oncology,
`St. Vincent’s Hospital, New York City
`
`Associate Professor of Clinical Medicine,
`New York Medical College
`
`I?
`FactsOnFlle
`
`AN INFOBASE HOLDlNGS COMPANY
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`The Cancer Dictionary
`
`Copyright © 1992 by Roberta Altman and Michael]. Sarg, M.D.
`
`All rights reserved. No part of this book may be reproduced or utilized in any form
`or by any means, electronic or mechanical, including photocopying, recording, or
`by any information storage or retrieval systems, without permission in writing
`from the publisher. For information contact:
`
`Facts On File, Inc.
`460 Park Avenue South
`
`New York, NY 10016
`
`Library of Congress Cataloging-in—Publication Data
`
`Altman, Roberta
`
`The cancer dictionary / Roberta Altman, Michael Sarg.
`p.
`cm.
`
`Includes Bibliographical references and index.
`ISBN 0—8160-2608-4 (hc/alk. paper)
`ISBN 0-8160-3027-8 (pb)
`11. Title.
`l. Cancer—Dictionaries.
`I. Sarg, Michael.
`[DNLMz 1. Neoplasms—dictionaries. Q2 13 A468c]
`RC262.A39
`1992.
`616.99'4’003—dc20
`DNLM/DLC
`
`for Library of Congress
`
`91-46941
`
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`Jacket design by Mary McKenna-Ridge
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`Manufactured by Hamilton Printing Company
`Printed in the United States of America
`
`109876543
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`This book is printed on acid-free paper.
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`51
`cancer
`’______________________.__—__.
`
`removed but do not require a STOMA. A section of
`the ileum (lower part of the small intestine) is re-
`moved during surgery; one end is attached to the
`URETERS and the other is connected to the remainder
`of the urethra, forming a canal for the urine. To avoid
`1eakage, the person must urinate frequently.
`
`cAMP a combination of the anticancer drugs CY-
`TOXAN, ADRIAMYCIN, METHOTREXATE, and PROCARBA-
`ZINE sometimes used in the treatment of NONSMALL
`CELL LUNG CANCER. See individual drug listings for
`side effects. See also COMBINATION CHEMOTHERAPY.
`
`cancer a general term for more than 100 diseases
`characterized by the uncontrolled, abnormal growth
`of cells in different parts of the body that can spread
`to other parts of the body. Different cancers have
`“unique" characteristics
`requiring different
`treat-
`ments. Cancer is frequently a chronic—that is, re-
`curring——disease.
`Cancer has been around for centuries. Evidence of
`cancer has been found in skeletons of prehistoric
`animals and in Etruscan, Peruvian, and Egyptian
`mummies. A link between the environment and a
`
`tumor was first observed in England in 1775 by
`Percival Pott, who found that cancer of the scrotum
`appeared frequently in chimney sweeps in London.
`Today, cancer is classified into five major groups:
`
`- CARCINOMA—a cancerous tumor or lump, originat-
`ing in the surface tissue of body organs. It is the
`most common form of cancer, accounting for 80 to
`90% of cases
`
`' SARCOMA—a cancerous tumor originating in the
`bone, cartilage, muscle, fibrous connective tissue,
`or fatty tissue
`° MYELOMA—a cancerous tumor originating in the
`plasma cells of the BONE MARROW
`' LYMPHOMA—a cancerous tumor originating in the
`lymph system
`' LEUKEMIA—cancer originating in the blood-forming
`tissue.
`
`Cancer cells cause harm in a number of different
`
`ways. They deprive normal cells of nourishment or
`Space. They can form a mass, or tumor, which may
`eventually invade and destroy normal tissues. They
`can also spread (metastasize) by traveling through
`the bloodstream or lymphatic system to other parts
`of the body.
`
`Most cancers take years to develop. For example,
`lung cancer used to be fairly rare among women.
`After World War 11, millions of women started smok—
`
`ing when it became “socially acceptable.” About 40
`years later, lung cancer replaced breast cancer as the
`leading cause of death from cancer among women.
`Cancer that
`is detected and treated before it has
`
`invaded adjacent organs or metastasized has the greatest
`possibility of being cured.
`The risk of cancer increases as one ages. However,
`it can affect males and females of any age, any social
`class, and any nationality.
`There were more than 1,040,000 new cases of
`
`cancer diagnosed in the United States in 1990 (not
`including carcinoma IN SITU and nonmelanoma skin
`cancer) and about 500,000 deaths. In the early 19005
`most people who got cancer died within a few years.
`By the 19305 one person in five lived five or more
`years after being treated. That changed to one in four
`in the 19405, and one in three in the 19505. In 1990
`it was four in ten, or 40%. However, when normal
`
`life expectancy is taken into account, the relative five—
`year survival rate is 50%.
`Different cancers have different symptoms. The
`American Cancer Society has a general list of seven
`basic symptoms that could be warning signs of can-
`cer:
`
`1. unusual bleeding or discharge
`2. a lump that does not go away
`3. a sore that does not heal within two weeks
`
`4.; change in bowel or bladder habits
`5. persistent hoarseness or cough
`6.
`indigestion or difficulty in swallowing
`7. change in a wart or mole.
`
`These symptoms can also occur in many other
`conditions. If they persist, medical attention should
`be sought.
`There are four types of treatment for cancer. In the
`early 19005, SURGERY was the only known treatment
`for cancer. In the 19305, radium (RADIATION THERAPY)
`
`was recognized as an effective treatment for cancer.
`CHEMOTHERAPY (anticancer drugs) was first used in
`the 19505, when it successfully treated choriocarci—
`noma, a gynecological cancer. Treatment became in-
`creasingly more effective as combinations of surgery,
`radiation, and chemotherapy became more common
`in the treatment of different cancers. The 19703 and
`
`19805 saw the increasing development of immuno-
`therapy or BIOLOGICAL THERAPY. Although this type of
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`52 cancer genes
`
`treatment is still in its earliest stage, many researchers
`are optimistic that
`the continuing investigation of
`biological therapy will find ways for the body’s own
`IMMUNE SYSTEM to fight successfully the cancer battle
`within it.
`
`Another focus of continuing research is the devel-
`opment of new diagnostic tests, and the refinement
`of tests already in use, that detect cancer in its earliest
`stage and accurately show where in the body it has
`spread and that can assess the possibility that the
`cancer will recur, or return, after it has been treated.
`
`Some of the newer techniques and tests being studied
`include using high-frequency sound waves to pro-
`duce detailed pictures of structures in the body;
`measuring minute differences of heat in the body to
`locate cancer; and using TUMOR MARKERS, biological
`substances in the body that can indicate the presence
`of cancer.
`
`Finally, scientists continue to search for the causes
`of cancer and ways to prevent it. Some researchers
`theorize that cancer cells are always present in the
`body and that the immune system is always fighting
`them off until something goes wrong, and one area
`being heavily researched is the role that genes play
`in the development of cancer (and in its treatment).
`Scientists are also trying to identify additional CAR-
`CINOGENS, agents that cause cancer. One carcinogen
`that has been known about
`for years is cigarette
`smoke. It is well documented that smoking puts a
`person at a much greater risk of getting lung cancer
`as well as other cancers. Some foods and vitamins,
`
`such as beta carotene and fiber, are being investigated
`for their role in preventing cancer.
`See subject index for types of cancers, symptoms,
`side effects, drug treatments, and other major topics
`included in this volume.
`
`cancer genes see ONCOGENE.
`
`cancer registry see TUMOR REGISTRY.
`
`CAP a combination of the anticancer drugs CISPLA-
`TIN, ADRIAMYCIN, and CYTOXAN sometimes used in the
`treatment of NONSMALL CELL LUNG CANCER and cancer
`
`of the kidney, bladder, and prostate. See individual
`listings for side effects. See also COMBINATION CHE-
`MOTHERAPY.
`
`carbohydrate antigen see CA 19-9.
`
`carbon dioxide laser a laser that uses carbon diox-
`
`ide to produce a powerful light beam. In LASER THER-
`APY for cancer, the carbon dioxide laser is primarily
`used as a surgical tool. The carbon dioxide laser is
`used to shrink or destroy tumors. The light energy
`changes to heat and cuts or vaporizes cancerous tissue
`with relatively little bleeding. When it is used with
`an ENDOSCOPE, the laser‘s light is transmitted through
`the flexible endoscope, enabling the surgeon to see
`and work, with great precision, in parts of the body
`that otherwise could only be reached with traditional
`surgery.
`
`carboplatin (kaf’bo-pla’tin) [CBDCA, JM-8, Para-
`platin, cyclobutan dicarboxyiate platinum] an-AL-
`KYLATING anticancer drug, which in the late 19805
`and early 19905 was considered the drug of choice
`in the treatment of OVARIAN CANCER. It is also used
`
`in a variety of other cancers, including cancer of the
`lung, head, and neck.
`It was designed to be as
`effective as CISPLATIN, the parent compound, with less
`toxicity.
`It
`is given by IV (injection into a vein).
`Possible side effects are severe nausea and vomiting,
`BONE MARROW DEPRESSION, ANEMIA, kidney problems,
`and neurological damage. Carboplatin is one of the
`more important anticancer drugs in use.
`
`carboxamide see DTIC.
`
`carcinoembryonic antigen see CEA.
`
`carcinogens (kar—sin’-0-jenz) substances known to
`cause and/or promote cancer. Carcinogens can be
`created by humans, such as cigarette smoke, or sim-
`ply be present naturally in the environment, as is
`ULTRAVIOLET RADIATION from the sun, both of which
`
`are known to play a major role in the development
`of cancer. x RAYS and VIRUSES are also known carcin-
`ogens.
`
`Carcinogens can work to cause cancer in different
`ways. Some cause changes that turn a normal cell in
`the body into a cancer cell. Others can set up con-
`ditions that help the action of other factors that cause
`the cancer.
`
`Many cancers develop slowly. It can take from 5
`to 40 years for cancer to develop after exposure to a
`cancer-causing agent, making it difficult to identify
`carcinogens. The number of exposures and the length
`of time exposed to a carcinogen are two of the factors
`that play a role in when and if cancer will develop.
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`Treatment IN D
`2 78
`——_—_———_—____“~\
`
`Treatment IND (investigational new drug) a pro-
`gram of the Food and Drug Administration that
`makes certain experimental drugs available to seri-
`ously ill people, generally people for whom there is
`no other available treatment. Drug companies may
`charge for the drug. See COMPASSIONATE DRUG.
`
`treatment port see EXTERNAL RADIATION THERAPY.
`
`triamcinolone see ADRENOCORTICOIDS.
`
`triazinate [TZT, Baker’s antifol, ethansulfonic acid
`compound] an anticancer drug being investigated
`for its use in the treatment of cancers of the brain,
`kidney, stomach, breast, colon, and lung. It is ad-
`ministered by lV (injection into a vein). Common
`side effects may include nausea, vomiting, BONE MAR—
`ROW DEPRESSION, skin darkening, skin rashes, mouth
`sores, and diarrhea. Occasional and rare side effects
`
`may include visual disturbances and headaches.
`
`triethylene thiophosphora see THIOTEPA.
`
`true cords see VOCAL CORDs.
`
`TSE see TESTICULAR SELF-EXAMINATION.
`
`TSEB see TOTAL SKIN ELECTRON BEAM RADIATION
`THERAPY.
`
`TSH see THYROID STIMULATING HORMONE.
`
`TSPA see THIOTEPA.
`
`tubular ductal breast cancer a relatively rare form
`of BREAST CANCER occurring about 1% of the time.
`The tumor has tube-shaped structures ringed with a
`single layer of cells. It is a well-differentiated carci-
`noma. It generally has a favorable PROGNOSIs.
`
`tubulovillous polyps see INTERMEDIATE POLYPS.
`
`tumor an abnormal tissue growth or mass on or in
`the body that serves no useful purpose. A tumor can
`be benign (noncancerous) or malignant (cancerous).
`It can be a MIXED TUMOR, meaning it has two or more
`cell types. Most tumors do not become cancerous.
`Following are the characteristics that distinguish a
`benign tumor from a malignant tumor:
`
`- a benign tumor grows slowly, has limited growrh
`and does not destroy normal cells; a malignant
`tumor grows rapidly, destroys normal cells, and has
`unlimited growth potential
`- a benign tumor continues to grow in the place Where
`it originated; a malignant tumor can spread to Other
`parts of the body
`° a benign tumor usually does not have serious side
`effects (the major exception being brain tumors
`which grow in a confined space); malignant tumors
`are life threatening
`- benign tumors grow in an orderly way; malignant
`tumors grow in a disorderly way, unpredictably.
`
`Some tumors are characterized as precancerous,
`Precancerous tumors do not always become cancer-
`ous, but they Should be removed, if possible, to avert
`the possibility of cancer developing.
`
`tumor barrier barriers developed by tumors that
`prevent chemotherapy (anticancer drugs) from reach-
`ing many of the cancer cells in the tumor. An example
`of a barrier would be an area of collapsed blood
`vessels. The anticancer drugs that travel through the
`bloodstream would not be able to reach an area with
`few or no normal blood vessels. Therefore, the che-
`motherapy may be able to destroy the outer parts of
`the tumor but would not be able to eradicate the
`entire tumor.
`
`tumor debulking surgical removal of as much of a
`tumor as possible.
`
`tumor embolization (em”bo-li-za’shun) obstruc-
`tion of blood vessels by a tumor. This condition can
`prevent chemotherapy (anticancer drugs) from reach-
`ing parts of the tumor.
`
`tumor growth factors (TGF) hormone-like proteins
`secreted by a cancerous tumor that stimulate the
`growth of identical cancer cells. MONOCLONAL ANTI-
`BODIES can bind to the substances and inactivate
`them. Researchers have identified TGF associated
`
`with different cancers. For example, TFG-alpha, epi-
`dermal growth factor, and fibroblast growth factors
`are produced by human breast cancer cells that have
`been stimulated by estrogen.
`
`lymphocytes,
`tumor infiltrating lymphocytes (TIL)
`a type of WHITE BLOOD CELL,
`that can invade or
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