Glossary



A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Adenocarcinoma:
Cancer that begins in cells that line certain internal organs and that have gland-like (secretory) properties, It can develop in any part of the body. Adenocarcinomas may develop in the lung, pancreas, breast, prostate, esophagus, stomach, vagina, urethra, and small intestines, among others

Age-Adjusted Mortality Rate:
Age is the most important characteristic governing mortality. Before the mortality experience of two or more populations can be compared, the difference in the age distributions of the population must be removed. This is accomplished through the use of an age-adjusted rate. Direct standardization weights the age-specific rates for a given sex, race/ethnicity or geographic area by the age distribution of the standard population.

The formula to calculate age-adjusted mortality rates is:

Equation for Age-Adjusted Rates


Age-Specific Mortality Rate:
The age-specific mortality rate is calculated by dividing the number of deaths for a specific age group by the population for that specific age group. For example, deaths for age group 60 to 64 divided by the population for age 60 to 64.

American College of Radiology (ACR) Accreditation:
The ACR created a nationwide accreditation program in 1987 to help ensure that women receive high quality mammography. In 1995, the College had accredited more than 10,000 mammography facilities across the country. Under the program, ACR evaluates the film, equipment and the personnel who take mammograms. Under the Mammography Quality Standards Act (MQSA) of 1992, once a facility is accredited it must then be approved for certification by the Food and Drug Administration.

American College of Surgeons (ACoS) Approved Programs:

Established in 1930, the Approvals Program of the American College of Surgeons (ACoS) Commission on Cancer surveys hospitals, treatment centers, and other facilities according to standards set by the Committee on Approvals, which recommends approval awards based on these surveys. The Approvals Program has experienced steady growth since its inception.

  ACoS Categories of Approvals:

  Programs are assigned a category of approval that describes the services available at the facility.
  Categories and descriptions (from the ACoS website) include:

  • Network Cancer Program (NCP)
    The organization owns multiple facilities providing integrated cancer care and offers comprehensive services. Generally, networks are characterized by a network-wide cancer committee leadership body or functional equivalent, standardized registry operations with a uniform data repository, and coordinated service locations and practitioners. The network participates in clinical research. Participation in the training of resident physicians is optional, and there is no minimum caseload requirement for this category.

  • NCI-designated Comprehensive Cancer Center Program (NCIP)
    The facility secures a National Cancer Institute (NCI) peer-reviewed Cancer Center Support Grant and is designated a Comprehensive Cancer Center by the NCI. A full range of diagnostic and treatment services and staff physicians with major specialty board certification, including certification in oncology, where offered, are available. This facility participates in both basic and clinical research. Participation in the training of resident physicians is optional, and there is no minimum caseload requirement for this category.

  • Teaching Hospital Cancer Program (THCP)
    The facility is associated with a medical school and participates in training residents in at least four areas, two of which are medicine and surgery. The facility offers the full range of diagnostic and treatment services, on site or by referral. The members of the medical staff are board certified in the major medical specialties, including oncology, where applicable. The facility is required to participate in clinical research. There is no minimum caseload requirement for this category.

  • Veterans Affairs Cancer Program (VACP)
    The facility provides care to military veterans and offers the full range of diagnostic and treatment services, on site or by referral. The members of the medical staff are board certified in the major medical specialties, including oncology, where applicable. Participation in clinical research is required. Participation in the training of resident physicians is optional. There is no minimum caseload required for this category.

  • Pediatric Cancer Program (PCP)
    The facility provides care only to children and may be associated with a medical school and participate in training pediatric residents. The facility offers the full range of diagnostic and treatment services for pediatric patients, on site or by referral. The members of the medical staff are board certified in the major medical specialties associated with pediatrics, including oncology, where applicable. The facility is required to participate in clinical research. There is no minimum caseload requirement for this category.

  • Pediatric Cancer Program Component (PCPC)
    The pediatric component within a larger CoC-approved facility accessions a minimum of 50 newly diagnosed pediatric cancer cases each year and offers the full range of diagnostic and treatment services for pediatric patients, on site or by referral. The members of the medical staff are board certified in the major medical specialties associated with pediatrics, including oncology, where applicable. The facility is required to participate in clinical research. The facility may be associated with a medical school and participate in the training of pediatric residents.

  • Community Hospital Comprehensive Cancer Program (COMP)
    The facility accessions 650 or more newly diagnosed cancer cases each year and provides a full range of diagnostic and treatment services that are available on site or by referral. The members of the medical staff are board certified in the major medical specialties, including oncology where available. Participation in clinical research is required. Participation in the training of resident physicians is optional.

  • Community Hospital Cancer Program (CHCP)
    The facility accessions between 100 and 649 newly diagnosed cancer cases each year and provides a full range of diagnostic and treatment services, but referral for a portion of treatment is common. The members of the medical staff are board certified in the major medical specialties. Facilities may participate in clinical research. Participation in the training of resident physicians is optional.

  • Hospital Associate Cancer Program (HACP)
    The facility accessions between 50 and 99 newly diagnosed cancer cases each year and has a limited range of diagnostic and treatment services on site. Other services are available by referral. Clinical research is not required. Participation in the training of resident physicians is optional.

  • Affiliate Hospital Cancer Program (AFCP)
    The facility accessions fewer than 50 newly diagnosed cancer cases each year, has limited access to services on site, and forms a partnership with a sponsoring CoC-approved hospital to provide access to the full range of diagnostic and treatment services. Clinical research is not required. Participation in the training of resident physicians is optional.

  • Integrated Cancer Program (ICP)
    The facility offers one treatment modality and forms a partnership with a CoC-approved hospital facility to provide access to the full range of diagnostic and treatment services. Participation by the integrated facility in clinical research is optional. Participation in the training of resident physicians is optional, and there is no minimum caseload requirement for this category.

  • Freestanding Cancer Center Program (FCCP)
    The facility offers a minimum of two treatment modalities, and the full range of diagnostic and treatment services are available by referral. Referral to a CoC-approved program is preferred. Participation in clinical research is optional. Participation in the training of resident physicians is optional, and there is no minimum caseload requirement for this category.

Angiography:
Radiography (X-rays) of vessels after the injection of radiopaque material.


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Basal Cell Carcinoma:
The most common form of skin cancer which, when detected and treated early, will usually result in a complete cure.

Benign: (beh-NINE)
Not cancer. Benign tumors may grow larger but do not spread to other parts of the body.

Best Practice:
In medicine, treatment that experts agree is appropriate, accepted, and widely used. Health care providers are obligated to provide patients with the best practice. Also called standard of care and standard therapy.

Biopsy:
The removal and examination, usually microscopic, of tissue from the living body, in order to establish a precise diagnosis.

Board Certification:
The intent of the certification of physicians is to provide assurance to the public that a physician specialist certified by a Medical Specialty Board has successfully completed an approved educational program and evaluation process which includes an examination designed to assess the knowledge, skills, and experience required to provide quality patient care in that specialty.

Body Mass Index:
A tool for indicating weight status; allows people to compare their own weight status to the general population. For adults over 20 years old, BMI falls into one of these categories:

BMI Weight Status
Below 18.5 = Underweight
18.5 - 24.9 = Normal
25.0 - 29.9 = Overweight
30.0 and Above = Obese


Formula for calculating body mass index (BMI):

English Formula

Equation for Engilsh BMI


Metric Formula

Equation for Metric BMI


Bone Marrow Transplant:
Marrow is a substance found in the cavities of the body's bones. It resembles blood and contains stem cells, which produce red cells, white cells and other blood components. Marrow transplants are a treatment for patients with anemias, lymphomas and a number of other life-threatening blood diseases.

Brachytherapy: (BRAY-kee-THAYR-uh-pee)
A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called implant radiation therapy, internal radiation therapy, and radiation brachytherapy.

BRCA1:
A gene on chromosome 17 that normally helps to suppress cell growth. A person who inherits certain mutations (changes) in a BRCA1 gene has a higher risk of getting breast, ovarian, prostate, and other types of cancer.

BRCA2 :
A gene on chromosome 13 that normally helps to suppress cell growth. A person who inherits certain mutations (changes) in a BRCA2 gene has a higher risk of getting breast, ovarian, prostate, and other types of cancer.

BRFSS :
The Behavioral Risk Factor Surveillance System (BRFSS) is a United States cross- sectional health survey that looks at behavioral risk factors. It is run by Centers for Disease Control and Prevention and conducted by the individual state health departments. The survey is administered by telephone and is the world's largest such survey. In addition to all 50 states, the BRFSS is also conducted by health departments in The District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands.


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Cancer:
A class of more than 100 diseases, all of which are characterized by malignant uncontrolled cell growth that, left untreated, will prove fatal. All cancers have the capacity to metastasize, or form secondary tumors at other sites. See Carcinoma.

Cancer Cluster:
The occurrence of a greater than expected number of cancer cases within a geographic area, a group of people or a specific time period.

Cancer Committee:
The multi-disciplinary cancer committee must be designated as a standing committee in the bylaws of the participating institution.

Cancer Conference:
Physicians, nurses, cancer registrars and others involved in the diagnosis and treatment of patients with cancer participate in case-oriented meetings. These interdisciplinary conferences are held weekly, twice monthly or monthly, depending on the category of approval and the number of new cases at each institution. All major cancer sites that are seen at the institution are discussed during the year.

Cancer Health Disparities:
Adverse differences in cancer incidence (new cases), cancer prevalence (all existing cases), cancer death (mortality), cancer survivorship, and burden of cancer or related health conditions that exist among specific population groups in the United States. These population groups may be characterized by age, disability, education, ethnicity, gender, geographic location, income, or race. People who are poor, lack health insurance, and are medically underserved (have limited or no access to effective health care) - regardless of ethnic and racial background - often bear a greater burden of disease than the general population.

Cancer Liaison Physician:
Represents a single facility involved in cancer control and the management of patients with cancer; their role as the point person at each institution includes information gathering and exchange and acting as a link to the institution's administration, medical and allied health staff, cancer program leadership, as well as patients and their families

Cancer Patient Evaluation:
Cancer programs are required to conduct two patient care evaluation studies each year. The evaluation of care must include oversight and action by the cancer committee into the study design, quality of data collection, review of the analysis, summary of the findings, identification of problems and solutions, initiation of corrective action, and follow-through to determine that corrective actions resulted in the desired change.

Cancer Program Components:
An approved cancer program has four components: the cancer committee, cancer conferences, patient care evaluation, and the cancer registry.

Cancer Registrar or Tumor Registrar:
Person who abstracts and records the data on cancer cases; oftentimes, that person is also responsible for assisting in planning the cancer conferences and the cancer committee meetings, and providing reports.

Cancer Registry:
Information about all malignancies that are diagnosed or treated in the institution is entered into the cancer registry database. This data allows the cancer committee to monitor patient follow-up and treatment results. The registry data is also valuable for planning resource allocations.

Carcinogenesis:
The process by which normal cells are transformed into cancer cells.

Carcinoma:

A malignant tumor of epithelial origin; refer to cancer.

Carcinoma In-Situ:
An early stage in development, when the cancer is still confined to one layer of tissue. Cancers diagnosed at this stage are highly curable.

Case-Control Study:
A study that compares two groups of people: those with the disease or condition under study (cases) and a very similar group of people who do not have the disease or condition (controls). Researchers study the medical and lifestyle histories of the people in each group to learn what factors may be associated with the disease or condition. For example, one group may have been exposed to a particular substance that the other was not. Also called retrospective study.

Chemotherapy:
The treatment of diseases such as cancer by drug therapy.

Childhood Cancer Protocols:

  • Childhood Cancer Group (CCG):
    The Children's Cancer Group (CCG) is a national cooperative research organization which was founded in 1955. It is devoted to the development of new treatments and cures for the cancers of children and young adults. It conducts research on the biology of these cancers, their causes, and the long term follow-up of cured patients into adult life. The Group's highest scientific priority is to transition new biological findings, learned from laboratory research, into clinical trials which can benefit children with cancer.

  • Pediatric Oncology Group (POG):
    The Pediatric Oncology Group is a National Cancer Institute-sponsored clinical trials cooperative group of individuals and institutions dedicated to controlling cancer among children and adolescents. Since their inception in 1980, POG has enrolled nearly 50,000 children and adolescents in state-of-the-art pediatric cancer research studies.

Cobalt Machines:
Radiation treatments can be administered externally or internally, depending on the type and extent of the tumor. External radiation treatment are administered by machines that deliver high-energy radiation. The Cobalt-60 machine was the first megavoltage machine, and is still used in institutions throughout the world.

Colonoscopy:
A procedure which uses a lighted, tubular instrument with a viewing device called a colonoscope to examine the colon.

Colposcopy:
Visual examination of the tissues of the cervix and vagina by inserting a magnifying instrument called a colposcope.

Computed Tomography (CT) or Computerized Axial Tomography (CAT):
The gathering of anatomical information from a cross-sectional plane of the body, presented as an image generated by a computer synthesis of x-ray transmission data obtained from many different directions on the given plane.

Confidence Interval:
A confidence interval is a range around a measurement (in this case, rate) that shows its precision. Ninety five percent confidence intervals are usually given for the age-adjusted mortality rates displayed or linked to on the Texas Cancer Information website. A statistical definition of the 95 percent confidence interval is that if the measurement were conducted 100 times, 95 times the true value would be within the calculated confidence interval and five times the true value would be either higher or lower than the range of the confidence interval. Wider confidence intervals in relation to the rate itself indicate instability. For more information on confidence intervals, visit the source listed below.
Source: New York State Cancer Registry, About Age Adjusted Rates, 95% Confidence Intervals and Unstable Rates


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Demography:
The study of populations, especially with reference to population size, density, fertility, mortality, growth, age distribution, migration, and vital statistics, and the interaction of all these with social and economic conditions.

Detection:
The discovery of a physical abnormality in a person who might or might not show symptoms of disease. Detection can result from self-examination or special screening and/or diagnostic tests administered by health care professionals.

Dialysis: (dye-AL-ih-sis)
The process of filtering the blood when the kidneys are not able to cleanse it.

Digital mammography:
A technique that uses a computer, rather than x-ray film, to record x-ray images of the breast.

Digital rectal examination (DRE):
An examination in which a doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities. Also called DRE.

Distant Cancer:
Refers to cancer that has spread from the original (primary) tumor to distant organs or distant lymph nodes. Also known as distant metastasis.

Double Contrast Barium Enema:
An examination of the colon by X-ray after administration of barium, a contrast medium. Additional X-rays are taken after the patient has expelled the barium.

Dysplasia:
The abnormal pathological development of cells, indicating possible malignancy.


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Early Detection Programs:
Programs used with diseases that have characteristics appropriate for screening and a valid screening test; those who test positive are referred for further evaluation by a subsequent diagnostic test or procedure to determine whether they do have the disease.

Eligibility Criteria:
In clinical trials, requirements that must be met for an individual to be included in a study. These requirements help make sure that patients in a trial are similar to each other in terms of specific factors such as age, type and stage of cancer, general health, and previous treatment. When all participants meet the same eligibility criteria, it gives researchers greater confidence that results of the study are caused by the intervention being tested and not by other factors.

Endpoint:
In clinical trials, an event or outcome that can be measured objectively to determine whether the intervention being studied is beneficial. The endpoints of a clinical trial are usually included in the study objectives. Some examples of endpoints are survival, improvements in quality of life, relief of symptoms, and disappearance of the tumor.

Energy Balance:
In biology, the state at which the number of calories eaten equals the number of calories used. Energy balance is affected by physical activity, body size, amount of body fat and muscle, and genetics.

Enteral Feeding:
The term used to describe nourishment put directly into the stomach or intestines by a method other than chewing or swallowing. Generally used with patients that have trouble taking any nourishment by mouth or to supplement those patients unable to take enough nourishment by mouth.

Enterostomal Therapy:
A specialized field of nursing involving the care of patients with abdominal stomas, dermal wounds, pressure ulcers, incontinence and related skin conditions.

Environmental Tobacco Smoke:
Smoke that comes from the burning of a tobacco product and smoke that is exhaled by smokers. Inhaling environmental tobacco smoke is called involuntary or passive smoking. Also called ETS and secondhand smoke.

Epidemiology:
The study of the distribution and causes of disease occurrence in a population.

Estrogen Receptor:
A protein found inside the cells of the female reproductive tissue, some other types of tissue, and some cancer cells. The hormone estrogen will bind to the receptors inside the cells and may cause the cells to grow. Also called ER.


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Familial Cancer:
Cancer that occurs in families more often than would be expected by chance. These cancers often occur at an early age, and may indicate the presence of a gene mutation that increases the risk of cancer. They may also be a sign of shared environmental or lifestyle factors.

Fecal Immunochemical Test: (fee-kuhl im-you-no-KIM-uh-kuhl test): (also called FIT):
A newer test to look for "hidden" blood in the stool, which could be a sign of cancer. The test is not affected by vitamins or foods, though it still requires 2 or 3 specimens. See also fecal occult blood test, false positive, and colorectal cancer screening.

Fecal-Occult Blood Test:
Examination of stool for traces of blood not visible to the naked eye.

Five-Year Survival:
A term commonly used as the statistical basis for successful treatment. A patient with cancer is generally considered cured after five or more years without recurrence of the disease.

Flexible Sigmoidoscopy:
A procedure which uses a thin, lighted tuble about ten inches long called a sigmoidoscope to examine the first ten to twelve inches of the rectum.


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Gamma Knife Therapy:
A treatment using gamma rays, a type of high-energy radiation that can be tightly focused on small tumors or other lesions in the head or neck, so very little normal tissue receives radiation. The gamma rays are aimed at the tumor from many different angles at once, and deliver a large dose of radiation exactly to the tumor in one treatment session. This procedure is a type of stereotactic radiosurgery. Gamma Knife therapy is not a knife and is not surgery. Gamma Knife is a registered trademark of Elekta Instruments, Inc.

Gastroenterologist: (GAS-troh-EN-teh-RAH-loh-jist)
A doctor who specializes in diagnosing and treating disorders of the digestive system.

GeneticTesting:
Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder.

Global Budgets:
Proposed limits to all health care spending.

Gynecologic Oncologist:
A doctor who specializes in treating cancers of the female reproductive organs.


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Health Care Professionals:
Practitioners of disease prevention, detection, treatment and rehabilitation. These include physicians, nurses, dentists, dietitians, health educators, social workers and therapists, among others.

HDR:
An amount of radiation that is greater than that given in typical radiation therapy. HDR is precisely directed at the tumor to avoid damaging healthy tissue, and may kill more cancer cells in fewer treatments. Also called high-dose radiation.

Helical Computed Tomography Scanning: (HEH-lih-kul kum-PYOO-ted toh-MAH-gruh-fee)
SA detailed picture of areas inside the body. The pictures are created by a computer linked to an x-ray machine that scans the body in a spiral path. Also called spiral CT scan.

Hematologist: (HEE-muh-TAH-loh-jist)
A doctor who specializes in treating blood disorders.

Hepatocellular carcinoma (HCC): (HEP-ah-to-SEL-yoo-lar KAR-sih-NOH-mah)
Hepatocellular carcinoma (HCC) is the most common primary liver cancer. HCC incidence has been steadily rising in the US, and has got the fastest growing cause of cancer-related mortality in men. Major risk factors for HCC include hepatitis C virus and hepatitis B virus infections, alcoholic cirrhosis and cirrhosis related to nonalcoholic steatohepatitis (NASH). Treatment options include surgical resection, liver transplantation, local therapies such as local ablation or trans-arterial chemo-embolization (TACE) for early stage disease. Regular surveillance of at-risk patients may result in earlier HCC stage at diagnosis, better treatment options and eventually decreased mortality.

Hereditary: (huh-REH-dih-tayr-ee)
Transmitted from parent to child by information contained in the genes.

High-Risk Group:
When the chance for developing cancer is greater for an individual or a group of people than it is for the general population, that individual or group is thought to be high-risk. People may be considered to be high-risk for many factors or combinations of factors, including a family history of a disease, personal habits, or exposure to products which can cause cancer in the environment or workplace.

Home Health Care:
Basic to skilled care provided in the patient's home.

Hospice:
Comprehensive program designed to address the physical, emotional and spiritual needs of individuals and their families who face a life-threatening illness.

HPV:
A member of a family of viruses that can cause abnormal tissue growth (for example, genital warts) and other changes to cells. Infection with certain types of HPV increases the risk of developing cervical cancer. Also called human papillomavirus.

HPV Vaccine:
A vaccine being studied in the prevention of human papillomavirus infection and cervical cancer. Infection with certain types of HPV increases the risk of developing cervical cancer. Also called human papillomavirus vaccine.

Hyperalimentation: (HY-per-AL-ih-men-TAY-shun)
A form of nutrition that is delivered into a vein. Hyperalimentation does not use the digestive system. It may be given to people who are unable to absorb nutrients through the intestinal tract because of vomiting that won't stop, severe diarrhea, or intestinal disease. It may also be given to those undergoing high-dose chemotherapy or radiation and bone marrow transplantation. It is possible to give all of the protein, calories, vitamins and minerals a person needs using hyperalimentation. Also called parenteral nutrition, total parenteral nutrition, and TPN.


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Immunotherapy:
Biological therapy/treatment to stimulate or restore the ability of the immune system to fight infection and disease.

In-Situ Cancer:
In place; localized and confined to one area. Carcinoma in situ is an early stage of the development of a cancer, when it is still confined to one layer of tissue.

Incidence:
The number of occurrences of a given disease within a population. Cancer incidence is the number of new cases of cancer diagnosed in one year. Data on the incidence of cancer in Texas are maintained by the Texas Cancer Registry at the Texas Department of Health.

Incidence Rate:
Calculated by dividing the number of new cases of a particular cancer during a given period of time by the number of people known to be at risk.

Infusion Therapy:
A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion.

Intensity-Modulated Radiation Therapy (IMRT):
A type of 3-dimensional radiation therapy that uses computer-generated images to show the size and shape of the tumor. Thin beams of radiation of different intensities are aimed at the tumor from many angles. This type of radiation therapy reduces the damage to healthy tissue near the tumor.

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

Interstitial Irradiation Therapy:
A type of internal radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into a tumor or body tissue.

Intracavitary Radiation Therapy:
A type of internal radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into a body cavity such as the chest cavity or the vagina.

Intra-Operative Radiation Therapy:
Radiation treatment aimed directly at a tumor during surgery. Also called IORT.


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JCAHO:
Joint Commission on Accreditation of Healthcare Organizations is the nation's oldest (founded in 1919) independent, not-for-profit and largest standards-setting and accrediting body in healthcare. The mission of the JCAHO is to improve the quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care. The Joint Commission is recognized nationwide as a symbol of quality which indicates that an organization meets certain performance
standards.


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Linear Accelerators:
Linear accelerators, using high-energy x-ray beams, are now the most commonly used machines. Technological advances have permitted the development of machines with increased energy, allowing for precise treatments of deep seated tumors with less damage (i.e. skin sparing) to superficial tissues.

Local:
An invasive neoplasm confined entirely to the organ of origin.

Low-Income:
Means having an income that is equal to or less than the levels established by the Office of Management and Budget as poverty level.


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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. Magnetic resonance imaging makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. Magnetic resonance imaging is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones. Also called MRI, NMRI, and nuclear magnetic resonance imaging.

Malignancy:
A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body.

Mammography:
A screening and diagnostic technique that uses low-dose x-rays to find tumors in the breast.

Managed Competition:

Centralized management of the distribution of goods and services from various providers. It is often considered to be synonymous with a market-based approach because it allows consumers to choose from among competing health plans. In the context of national health care reform, it would include a defined package of basic benefits with supplemental options.

Medical Oncologist: (MEH-dih-kul on-KAH-loh-jist)
A doctor who specializes in diagnosing and treating cancer using chemotherapy, hormonal therapy, and biological therapy. A medical oncologist often is the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists.

Medicaid:
Medicaid is a program administered at the state level, which provides medical assistance to the needy. Families with dependent children, the aged, blind, and disabled who are in financial need are eligible for Medicaid. It may be known by different names in different states.

Medicare:
Medicare is the Federal program which helps pay health care costs for people 65 and older and for certain people under 65 with long-term disabilities.

Medicare Certification:
Process which focuses on provider and supplier specific process quality indicators and outcome measures in order to improve care provided to beneficiaries.

Metastasis:
The spread of cancer cells to new areas of the body.

Military health care:
Military health care includes TRICARE/CHAMPUS (Civilian Health and Medical Program of the Uniformed Services) and CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), as well as care provided by the Department of Veterans Affairs (VA).

Morbidity:
Any departure, subjective or objective, from a state of physiological or
psychological well-being. In this sense, sickness, illness, and a morbid condition are synonymous.

Mortality Rate:
Calculated by dividing the number of people who have died of a particular cancer during a given period of time by the total population at risk.


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Neoplasm:
An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Neoplasms may be benign (not cancer), or malignant (cancer). Also called tumor.

Neurosurgeon: (NOO-ro-SER-jun)
A doctor who specializes in surgery on the brain, spine, and other parts of the nervous system.

Nonblinded:
Describes a clinical trial or other experiment in which the researchers know what treatments are being given to each study subject or experimental group. If human subjects are involved, they know what treatments they are receiving.

Nuclear Imaging:
Nuclear medicine studies document organ function, in contrast to conventional radiology, which creates images based upon anatomy. Many of the nuclear studies can measure the degree of function present in an organ. Images may be obtained immediately, as the isotope is injected, or up to several days later to allow sufficient radionuclide to collect in the selected organ or system.. For example, when tumors metastasize to bone they may stimulate abnormal bone production. This abnormality causes more of the radionuclide to be in
this region.


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Obesity:
A condition in which a person has abnormally high amounts of unhealthy body fat; medically defined as a body mass index of 30 or greater.

Occupational Therapy:
The use of avocational or vocational tasks as a form of therapy.

Oncology:
A science dealing with the physical, chemical, and biologic properties and features of cancer, including causes and the disease process.

Oncology Nurse:
A nurse who specializes in treating and caring for people who have cancer.

Oncologist:
A physician who, after extensive training, specializes in cancer treatment.

Orthovoltage:
Orthovoltage is a type of radiation therapy that has been available for over 60 years. The x-rays are strong enough to kill cancer cells but do not penetrate more than a few millimeters beyond the surface of the skin. Orthovoltage treatments are given for very superficial, small tumors such as skin cancers. Orthovoltage is an excellent alternative to surgery for skin cancer in sensitive locations such as the folds of the nose or the eyelids.


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Pack Year:
A way to measure the amount a person has smoked over a long period of time. It is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked. For example, 1 pack year is equal to smoking 1 pack per day for 1 year, or 2 packs per day for half a year, and so on.

Palliative Care:
Treatment to relieve, rather than cure, symptoms caused by cancer. Palliative care can help people live more comfortably.

Pap Test:
A simple microscopic examination of cells. The Pap test can detect cancer of the cervix at an early, highly curable stage.

Pediatric Hematologist: (PEE-dee-A-trik HEE-muh-TAH-loh-jist)
A doctor who specializes in treating blood disorders in children.

Phase I Trial:
The first step in testing a new treatment in humans. These studies test the best way to give a new treatment (for example, by mouth, intravenous infusion, or injection) and the best dose. The dose is usually increased a little at a time in order to find the highest dose that does not cause harmful side effects. Because little is known about the possible risks and benefits of the treatments being tested, phase I trials usually include only a small number of patients who have not been helped by other treatments.

Phase II Trial:
A study to test whether a new treatment has an anticancer effect (for example, whether it shrinks a tumor or improves blood test results) and whether it works against a certain type of cancer.

Phase III Trial:
A study to compare the results of people taking a new treatment with the results of people taking the standard treatment (for example, which group has better survival rates or fewer side effects). In most cases, studies move into phase III only after a treatment seems to work in phases I and II. Phase III trials may include hundreds of people.

Phase IV Trial:
After a treatment has been approved and is being marketed, it is studied in a phase IV trial to evaluate side effects that were not apparent in the phase III trial. Thousands of people are involved in a phase IV trial.

Physical Therapy:
The treatment of pain, disease, or injury by physical and mechanical means. For example, massage, regulated exercise, water, heat, or light may be used as a part of physical therapy.

Plasmapheresis:
The process of using a machine to separate plasma from certain cells in the blood; only the cells are returned to the person. Plasmapheresis can be used to remove excess antibodies or plasma from the blood.

Population Estimates:

Estimates generally use existing data collected from various sources.

While projections and estimates may appear similar, there are some distinct differences between the two measures. Estimates are for the past, while projections are based on assumptions about future demographic trends at the time the projections are produced.

An estimate and a projection available for the same date (e.g., July 1997), may not agree because they were produced at different times based on different assumptions.

Population Projections:

Projections are estimates of the population for future dates. They illustrate plausible courses of future population change based on assumptions about future births, deaths, international migration, and domestic migration. Projected numbers are based on an estimated population consistent with the most recent decennial census as enumerated, projected forward using a variant of the cohort-component method.

Positron Emission Tomography (PET):

Tomographic imaging of local metabolic and physiological functions in tissues, indicating the presence or absence of disease; the image is formed by a computer synthesis of data transmitted by positron-emitting radionuclides that have been incorporated into natural biochemical substances administered to the patient.

Prevalence:
The number of persons in a population with a given disease at a given time.

Prevention:
Primary prevention is the reduction or control of causative factors of potential health problems. This includes reducing or eliminating various risk factors such as quitting smoking to reduce the risk of lung cancer and wearing sunscreen to reduce the chances of developing skin cancer and environmental measures such as reducing exposure to toxic or carcinogenic substances. This category also includes health-service interventions, such as vaccinations or such preventive "therapy" tools as fluoridated water supplies or dental sealants.

Secondary prevention is the early detection and treatment of health problems, such as using mammography to detect breast cancer and Pap tests to detect cervical cancer, along with the resulting diagnosis and initial treatment.

Tertiary prevention involves providing appropriate supportive and rehabilitative services to minimize morbidity and maximize the quality of life, such as the rehabilitation of injuries and the prevention of secondary complications.

Primary Care:
Health services that meet most basic health care needs over time. Primary care includes physical exams, treatment of common medical conditions, and preventive care such as immunizations and screenings. Primary care doctors are usually the first health professionals patients see for basic medical care. They may refer a patient to a specialist if needed.

Primary Care Doctor:
A doctor who manages a person's health care over time. A primary care doctor is able to give a wide range of care, including prevention and treatment, can discuss cancer treatment choices, and can refer a patient to a specialist.

Private Health Insurance:
Private health insurance is coverage by a health plan provided through an employer or union or purchased by an individual from a private health insurance company.


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Radiation Oncologist:
A doctor who specializes in using radiation to treat cancer.

Radiation Therapy:
The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

Randomized Clinical Trial:
A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial.

Regional:
In oncology, describes the body area right around a tumor.

Rehabilitation:
Programs which help patients adjust to health problems or disablement and return to a full productive life. Rehabilitation may involve physical restoration, such as the use of prostheses, or emotional help such as counseling or providing emotional support.

Remission:
A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body.

Remote Afterloading:
A radiotherapy technique in which an applicator, such as an acrylic mold of an area to be irradiated, is placed in or on the patient and then loaded from a safe source with a high-activity radioisotope. The applicator contains grooves for the insertion of nylon tubes into which the radioactive material can be introduced. Remote afterloading is used in the treatment of head, neck, vaginal, and cervical tumors.

Respite Care:
Care provided to the patient while the family or other care givers are given time to recuperate from the daily stress of providing long-term. This may require temporary help from other family members, or from community respite programs like those offered by the Visiting Nurses Association.

Retrospective Study:
A study that compares two groups of people: those with the disease or condition under study (cases) and a very similar group of people who do not have the disease or condition (controls). Researchers study the medical and lifestyle histories of the people in each group to learn what factors may be associated with the disease or condition. For example, one group may have been exposed to a particular substance that the other was not. Also called case-control study.

Risk Assessment:
The evaluation of an individual's personal and family history, often by using questionnaires to estimate the degree to which that person is at risk for developing certain types of cancer. For example, assessing an individuals risk of developing cancer can provide information on ways to lower personal risk and can make the person aware of early warning signs and the type and frequency of screening programs to follow.

Risk Factor:
Something that increases a person's chance of developing a disease; an aspect of personal behavior or lifestyle, an environmental exposure, or an inborn or inherited characteristic, which on the basis of epidemiologic evidence is known to be associated with health-related conditions.


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SCHIP:
SCHIP, the State Children’s Health Insurance Program, is a program administered at the state level, providing health care to low-income children whose parents do not qualify for Medicaid. SCHIP may be known by different names in different states.

Screening:
Checking for disease when there are no symptoms. Since screening may find diseases at an early stage, there may be a better chance of curing the disease. Examples of cancer screening tests are the mammogram (breast), colonoscopy (colon), Pap smear (cervix), and PSA blood level and digital rectal exam (prostate). Screening can also include checking for a person’s risk of developing an inherited disease by doing a genetic test.

Screening Mammogram:
X-rays of the breasts taken to check for breast cancer in the absence of signs or symptoms.

Secondhand Smoke:
Smoke that comes from the burning of a tobacco product and smoke that is exhaled by smokers. Inhaling secondhand smoke is called involuntary or passive smoking. Also called environmental tobacco smoke and ETS.

Self-Referred Patients:
Patients which refer themselves for a procedure such as mammography or refer themselves to a hospital without a physician's referral.

Simulators - Simulation and Treatment Planning:

The purpose of treatment planning is to determine the best way to deliver the radiation treatment and to limit the radiation dose to normal tissues. An x-ray machines called a simulator is used to visualize and define the exact treatment area. Temporary dye or permanent tattoos about the size of a small freckle may be used to mark reference points on the skin to allow exactly the same are to be treated each day.

Sliding Scale Fee:
A fee based on the individual's ability to pay for services; may vary from 100% of the fee to 0%.

Small Volume Portable Pumps:
Pumps used for infusion that can be used at home or in nursing homes.

Social Service:
A community resource that helps people in need. Services may include help getting to and from medical appointments, home delivery of medication and meals, in-home nursing care, help paying medical costs not covered by insurance, loaning medical equipment, and housekeeping help.

Social Support:
A network of family, friends, neighbors, and community members that is available in times of need to give psychological, physical, and financial help.

Social Worker:
A professional trained to talk with people and their families about emotional or physical needs, and to find them support services.

Specialist:
In medicine, a doctor or other health care professional who is trained and licensed in a special area of practice. Examples of medical specialists include oncologists (cancer specialists) and hematologists (blood specialists).

SPF:
A scale for rating the level of sunburn protection in sunscreen products. The higher the SPF, the more sunburn protection it gives. Sunscreens with a value of 2 through 11 give minimal protection against sunburns. Sunscreens with a value of 12 through 29 give moderate protection. SPFs of 30 or higher give high protection against sunburn. Also called sun protection factor.

Squamous Cell Carcinoma:
A common form of skin cancer which, when detected and treated early, will result in complete cure.

Stage:
A distinct phase in the course of a disease. Stages of cancer are typically defined by the degree of containment or spread of the tumor: in situ, localized, regional or distant spread.

Standard Therapy:
In medicine, treatment that experts agree is appropriate, accepted, and widely used. Health care providers are obligated to provide patients with standard therapy. Also called best practice and standard of care.

Stereotactic Radiation Therapy:
A type of external radiation therapy that uses special equipment to position the patient and precisely deliver radiation to a tumor. The total dose of radiation is divided into several smaller doses given over several days. Stereotactic radiation therapy is used to treat brain tumors and other brain disorders. It is also being studied in the treatment of other types of cancer, such as lung cancer. Also called stereotactic external-beam radiation therapy and stereotaxic radiation therapy.

Subclavian/Long-line Catheter:
A tubular instrument for the passage of fluid from or into the subclavian vein.

Surgical Oncologist:
A doctor who performs biopsies and other surgical procedures in cancer patients.

Survival Rate:
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. The survival rate is often stated as a five-year survival rate, which is the percentage of people in a study or treatment group who are alive five years after diagnosis or treatment. Also called overall survival rate.

Survivor:
One who remains alive and continues to function during and after overcoming a serious hardship or life-threatening disease. In cancer, a person is considered to be a survivor from the time of diagnosis until the end of life.

Survivorship:
In cancer, survivorship covers the physical, psychosocial, and economic issues of cancer, from diagnosis until the end of life. It focuses on the health and life of a person with cancer beyond the diagnosis and treatment phases. Survivorship includes issues related to the ability to get health care and follow-up treatment, late effects of treatment, second cancers, and quality of life. Family members, friends, and caregivers are also part of the survivorship experience.

Symptom:
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

Symptom Management:
Care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of symptom management is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called comfort care, palliative care, and supportive care.

Syndrome:
A set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.


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Targeted Therapy:
A type of treatment that uses drugs or other substances, such as monoclonal antibodies, to identify and attack specific cancer cells. Targeted therapy may have fewer side effects than other types of cancer treatments.

Thoracic Surgical Oncologist:
A surgeon who specializes in operating on tumors found inside the chest.

Tumor:
An abnormal mass of tissue that is not inflammatory, arises from cells of pre-existent tissues, and serves no useful purpose. See Neoplasm.


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Ultrasonography:
An exam in which sound waves are bounced off tissues and the echoes are converted into a picture. Ultrasound can reveal information about the shape, texture, and composition of tumors and cysts that cannot be seen on conventional x-ray studies. For example, suspicious lumps found during a mammographic study can be examined with ultrasound to determine whether they are benign cysts or solid masses.

Ultraviolet Radiation:
Invisible rays that are part of the energy that comes from the sun. Ultraviolet radiation also comes from sun lamps and tanning beds. It can damage the skin and cause melanoma and other types of skin cancer. Ultraviolet radiation that reaches the Earth's surface is made up of two types of rays, called UVA and UVB rays. UVB rays are more likely than UVA rays to cause sunburn, but UVA rays pass deeper into the skin. Scientists have long thought that UVB radiation can cause melanoma and other types of skin cancer. They now think that UVA radiation also may add to skin damage that can lead to skin cancer and cause premature aging. For this reason, skin specialists recommend that people use sunscreens that reflect, absorb, or scatter both kinds of ultraviolet radiation. Also called UV radiation.


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Ventilator Care:
The care of patients who need an apparatus for producing mechanical ventilation (breathing), especially in cases of paralysis or inadequate spontaneous ventilation.

Virtual Colonoscopy:
Virtual colonoscopy, also known as CT colonography, uses an x-ray machine linked to a computer to generate unique 2- and 3-D images of the colon and rectum that can be manipulated for better viewing angles and stored for later study. The procedure does call for the insertion of a rectal tube to push air into the colon for a better view. No sedation is required, but as with traditional colonoscopy, patients must take laxatives and fast 24 hours prior to screening. (Source: National Cancer Institute at http://cancer.gov/.)


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Watchful Waiting:
Closely monitoring a patient's condition but withholding treatment until symptoms appear or change. Also called active surveillance, expectant management, and observation.


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Sources

Definitions which appear in this glossary are from the following sources:

American Cancer Society, 1983. Cancer Word Book. Reprint, 1990.

Greenspan EZ, 1990. The Breast Cancer Epidemic in the United States: How 15,000 More Lives Can be Saved Each Year: A Medical Oncologists Perspective. The Chemotherapy Foundation.

Karp S. et. al. Cancer in Colorado Women 1979 to 1985: Prevention, Incidence, Survival and Mortality. A Cooperative Publication of the American Cancer Society, Colorado Division and the Colorado Department of Health, Colorado Central Cancer Registry.

Last JM., 1983. A Dictionary of Epidemiology. Oxford University Press.

Merriam Webster Inc., 1986. Webster's Medical Desk Dictionary.

National Cancer Institute
www.cancer.gov

National Cancer Institute Dictionary of Cancer Terms
http://www.cancer.gov/dictionary/

United States Department of Health and Human Services, 1991. Healthy People 2000: National Health Promotion and Disease Prevention Objectives for the Nation. Washington: Public Health Service.

U.S. Census Bureau
www.census.gov

WB Saunders Company, 1988. Dorlands Illustrated Medical Dictionary.

Williams & Wilkins, 1994. Stedman's Concise Medical Dictionary, Illustrated, Second Edition.

Altman, Roberta and Sarg, Michael J., editors. The Cancer Dictionary (revised edition, 2000).




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