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National Collaborating Centre for Cancer (UK). Prostate Cancer: Diagnosis and Treatment. Cardiff (UK): National Collaborating Centre for Cancer (UK); 2008 Feb. (NICE Clinical Guidelines, No. 58.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of Prostate Cancer

Prostate Cancer: Diagnosis and Treatment.

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Appendix 5Glossary

Active surveillance

A method of managing men with low or intermediate-risk localised prostate cancer that aims to target radical treatment only to those who would benefit most.

Adjuvant treatment

A treatment given in addition to the main treatment.


A family of hormones that promote the development and maintenance of male sex characteristics.

Androgen withdrawal

A treatment that lowers testosterone levels, that is, bilateral orchidectomy or treatment with LHRH agonists (e.g. goserelin).

Androgen blockade

The use of drugs that bind to and block the hormone receptors of cancer cells, preventing androgens from stimulating cancer growth.

Anti-androgen drugs

Drugs that act by binding to and blocking the hormone receptors of cancer cells, thereby preventing androgens from stimulating the cancer (e.g. bicalutamide).


Without obvious signs or symptoms of disease. Cancer may cause symptoms and warning signs, but, especially in its early stages, cancer may develop and grow without producing any symptoms.


Something that does not metastasise and treatment or removal is curative.

Benign Prostatic Hyperplasia

A non-cancerous condition in which an overgrowth of prostate tissue pushes against the urethra in some men, restricting the flow of urine. Also known as benign prostatic hypertrophy.


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


A type of cytotoxic drug used to treat bone metastases.

Bone scan

A scan intended to show any abnormal areas of bone.

Bowel toxicity

Symptoms caused by treatment-related damage to the bowel.


A form of radiotherapy in which the radiation is given using radioactive sources as either permanently implanted seeds (low dose rate) or temporarily implanted wires (high dose rate) directly into the prostate.

Cancer networks

A cancer network brings together all organisations involved in planning, commissioning and delivery of cancer services in order to provide high quality care across their locality. Typically a cancer network services a population of around one or two million people.

Clinically detected disease

Cancer that came to light as a result of a symptom or abnormal clinical finding.

Cohort studies

Research studies in which groups of patients with a particular condition or specific characteristic are compared with matched groups who do not have it.

Combined androgen blockade

A type of prostate cancer hormone therapy which combines an anti-androgen with either chemical castration or surgical castration.


The effect of all other diseases an individual patient might have other than the primary disease of interest.

Computed tomography

An x-ray imaging technique. In spiral CT the x-ray machine scans the body in a spiral path. Also known as helical CT.


Counselling takes place when a counsellor sees a client in a confidential setting to explore a difficulty the client is having, distress they may be experiencing or their dissatisfaction with life.


A treatment which aims to eradicate prostate cancer by freezing the prostate gland.

Decision aids

Booklets or videos/DVDs that provide information about the disease, treatment options and outcomes, and help patients to explore how their individual values impact on their treatment decision.

Digital rectal examination

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

Disease free survival

Length of time after treatment during which no disease is found.

Distant spread

Spread of cancer from the primary site to nearby lymph glands or more distant parts of the body (also known as ‘metastatic’ or ‘secondary’ spread).

Endorectal coil imaging

A type of medical imaging in which MRI is used in conjunction with a coil placed into the rectum in order to obtain high quality images of the area surrounding the rectum.


Disease of the intestines.

Erectile dysfunction

A consistent inability to sustain an erection sufficient for sexual intercourse.

External beam radiotherapy

This is radiotherapy given by using ionising radiation (e.g. high energy X-rays) produced in a machine and directed at the tumour from outside the patient.

Flexible sigmoidoscopy

The inspection of the rectum and sigmoid colon by the aid of a flexible sigmoidoscope.


Formation of a fistula in a part of the body. A fistula is an abnormal passage between two internal organs or from an internal organ to the body surface.

Free PSA

The level of free PSA (i.e. PSA that is not bound to other proteins) in the blood.

Gleason score

An internationally recognised grading system, based on examination of tissue obtained by prostate biopsy, where a pathologist allocates an overall cell abnormality score that can help predict prostate tumour behaviour. A low Gleason score (≤6) indicates a relatively favourable cancer, a high Gleason score (≥8) indicates a relatively aggressive cancer.


The degree of malignancy of a tumour, judged by its appearance under the microscope.


Enlargement of the breasts in men.


A localised collection of blood, usually clotted, in an organ, space or tissue, due to a break in the wall of a blood vessel.


The presence of blood in the urine. Macroscopic haematuria is visible to the naked eye, and microscopic haematuria is only seen by microscopic examination of a sample from a urine test.

Haemorrhagic changes

Changes to blood vessels in the lining of the bladder or bowel which makes them more fragile and likely to bleed.

High intensity focused ultrasound

A technique where high-frequency ultrasound waves are aimed at the cancer, heating up the cells with the aim of causing cell death and eradicating the cancer.

Holmium laser resection of the prostate (HoLeP)

Surgery to remove tissue from the prostate using an instrument inserted via the urethra using a high powered laser. Can be used to improve symptoms in men with restriction to their urinary stream from BPH or a prostate tumour.

Hormonal therapy

Treatment of cancer by removing and/or, blocking the effects of hormones which stimulate the growth of prostate cancer cells.

Hormone refractory (also known as hormone resistant)

A condition where the tumour no longer responds to hormonal therapy.


A medical condition in which abnormally high concentrations of calcium compounds are found in the bloodstream.


The number of new cases of a disease in a given time period.

Isotope bone scan

An imaging technique which uses an injection of a short-lived radio-active isotope to show up abnormal areas of the bone.

Karnofsky status

Classifies patients according to their functional impairment.

Lead time bias

A bias seen in epidemiology studies of survival resulting from differences in the time point at which the disease is first diagnosed.

Locally advanced prostate cancer

Cancer which has been staged as T3 or T4 (spread outside the prostate gland).

Local treatment

Treatment that is directed at tumour cells in one localised area.

Localised prostate cancer

Cancer which has been staged as T1 or T2 (confined to the prostate gland).

Luteinising hormone-releasing hormone agonists

Hormonal drugs that inhibit the production of androgens from the testes.


A surgical procedure in which lymph nodes are removed for analysis.


Disease or swelling of the lymph nodes.

Lymph nodes

Small organs which act as filters in the lymphatic system. Lymph nodes close to the primary tumour are often the first sites to which cancer spreads.


Cancerous. Malignant tumours can invade and destroy nearby tissue and spread to other parts of the body.

Magnetic resonance imaging

A non-invasive method of imaging which allows the form and metabolism of tissues and organs to be visualised (also known as nuclear magnetic resonance).

Magnetic resonance spectroscopy imaging

A noninvasive imaging method that provides information about cellular activity (metabolic information). It is used in oncology along with magnetic resonance imaging (MRI) which provides information about the shape and size of the tumor (spacial information).

Maximum androgen blockade

The combined use of LHRHa’s and anti-androgen treatment.

Medical castration

Hormonal therapy with an LHRHa given to lower the levels of the testosterone hormone made by the testicles.


A form of statistical analysis used to synthesise results from a collection of individual studies.

Metastases/metastatic disease

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

Metastatic prostate cancer

Cancer which has spread from the primary site in the prostate to the lymph nodes, bones or other parts of the body.


The state of being diseased.


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 1,000, 10,000 or 100,000.

Multi Disciplinary Team

A team with members from different health care professions (e.g. urology, oncology, pathology, radiology, nursing).

Myelosuppressive chemotherapy

Chemical agents, used to treat malignant tumors that also can inhibit bone marrow activity, resulting in decreased production of white blood cells.


Treatment given before the main treatment.


The lowest measured amount.


A calculating device based on statistical probabilities, which is used to provide individualised estimates of the likelihood of clinical outcomes.

Obstructive uropathy

Impairment of kidney function as a result of back pressure caused by obstruction of the urethra or lymph nodes. This may be a result of prostatic or lymph nodal disease.


The study of cancers.


(also known as bilateral subcapsular orchidectomy or surgical castration)

Surgery to remove the active component of both testicles in order to reduce the level of testosterone.


Loss of bony tissue resulting in bones that are brittle and liable to fracture.

PDE5 inhibitor

A drug used in the treatment of erectile dysfunction.


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

Percutaneous nephrostomy

A procedure involving the insertion of a catheter, through the skin, into the kidney to drain urine when there is a blockage in the ureter or bladder.

Perineal prostatectomy

A technique where the prostate is removed through an incision made between the scrotum and the anus.

Plain radiographs

Single X-ray images.

Positron emission tomography

A specialised imaging technique using a radioactive tracer to produce a computerised image of body tissues and find abnormalities. PET scans may be used to help diagnose cancer, to see how far it has spread and to investigate response to treatment.


A female sex hormone which can either be naturally occurring or synthetic.

Progressive disease

Prostate cancer that shows either clinical, radiological or biochemical evidence of growth.


A gland of the male reproductive system which produces fluid for semen.

Prostate biopsies

Removal of samples of tissue from the prostate gland for microscopic examination and other tests.


Surgery to remove part, or all of the prostate gland. Radical prostatectomy aims at the removal of the entire prostate gland and lymph nodes. This can be performed by an open approach or by keyhole technique (laparoscopic or robotically assisted laparoscopic prostatectomy).

Prostate intraepithelial neoplasia

An abnormality of prostate tissue identified by microscopic examination. It represents a potentially pre-malignant lesion but may also co-exist with cancer in a small proportion of men.

Prostate Specific Antigen

A protein produced by the prostate gland and identified in the blood. Men with prostate cancer tend to have higher levels of PSA in their blood (although most men with prostate cancer have normal PSA levels). PSA levels may also be increased by conditions other than cancer and levels tend to increase naturally with age.

PSA density

The PSA level in the blood relative to the volume of the prostate.

PSA test

A test which measures PSA levels in the blood.

PSA velocity

The rate of change of PSA level over time.

Radical treatment

Treatment given with the aim of cure, rather than just improving symptoms.


The use of radiation, usually x-rays or gamma rays, to kill tumour cells. Conventional external beam radiotherapy also affects some normal tissue outside the target area. Conformal radiotherapy aims to reduce the amount of normal tissue that is irradiated by shaping the x-ray beam more precisely. The beam can be altered by placing metal blocks in its path or by using a device called a multi-leaf collimator. This consists of a number of layers of metal sheets which are attached to the radiotherapy machine; each layer can be adjusted to alter the shape and intensity of the beam.

Randomised controlled trials

A type of experiment which is used to compare the effectiveness of different treatments. The crucial feature of this form of trial is that patients are assigned at random to groups which receive the interventions being assessed or control treatments. RCTs offer the most reliable (i.e. least biased) form of evidence on effectiveness.

Retropubic prostatectomy

A technique where the prostate is removed through an incision in the abdomen.

Salvage local therapy

Local treatment (e.g. radiotherapy, surgery or chryotherapy) given with curative intent for local recurrence following primary radical surgery.

Salvage therapy

Treatment that is given after prostate cancer has progressed, following other treatments.

Salvage radiotherapy

Radiotherapy given with curative intent when disease has re-occurred after surgery.

Sclerotic bone metastases

Secondary cancer deposits in the bone which show on X-rays as areas of increased bone density.

Screen-detected cancer

Cancer identified by screening a defined population (e.g. using PSA measurement).

Staging/TNM staging

Clinical description of the size and extent of a patient’s tumour, by allocation into internationally agreed categories.

Surgical castration

Treatment which removes the testicles (orchidectomy) and reduces the level of testosterone.


Survival is the probability of surviving with a diagnosis of a disease.

Systematic review

A review of the literature carried out in order to address a defined question and using quantitative methods to summarise the results.

Systemic treatment

Treatment, usually given by mouth or by injection, that reaches and affects tumour cells throughout the body rather than targeting one specific area.


Permanent dilation of groups of superficial capillaries and venules.

Total PSA

The level of PSA in the blood.

Transrectal ultrasound

An ultrasound examination of the prostate using a probe inserted into the rectum.

Trans-urethral resection of the prostate

Surgery to remove tissue from the prostate using an instrument inserted via the urethra. Can be used to improve symptoms in men with restriction to their urinary stream from BPH or a prostate tumour.

Ultrasound-guided prostate biopsy

A technique to allow targeted sampling of prostate tissue using a needle guided by images obtained from an ultrasound.


An excess in the blood of urea, creatinine and other nitrogenous end products of protein and amino acids metabolism.


The tubes carrying urine from the kidneys to the bladder.


The tube leading from the bladder through which urine leaves the body.


A branch of medicine concerned with the diagnosis and treatment of diseases of the urinary organs in females and the urogenital system in males.

Watchful waiting

A method of managing men with prostate cancer who are not suitable for radical treatment, involving treatment only if and when they develop symptoms.

Copyright © 2008, National Collaborating Centre for Cancer.

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Bookshelf ID: NBK49522


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