Cancer|Information,Research,Treatment,Alternative|GynCancerDoctor.com

A antibody is a tiny particle produced by specialized immune sytem cells called lymphocytes. When these lymphocytes encounters a foreign substance, they produce antibodies which help attack the intruding foreign substance. The antibody is a part of the immune system that helps rid the body of foreign substances which are usually a virus or bacteria. In this manner, antibodies can also attack cancer cells. This is an area of ongoing research.

A antigen is a chemical substance on a foreign agent such as a type of bacteria or virus or cancer cell. Specialized lymphocytes recognize this chemical as being foreign and produce antibodies that attack that antigen. Cancer cells produce a weak antigenic response and are thus open to attack by this approach. The problem is that the immune system is basically overwhelmed when the cancerous tumors grow beyond just a few dozen cells. Research is ongoing in this area.

Pronounced "a sy tees", ascites is a fluid that has accumulated in the abdomen. Normally, there is fluid produced inside the abdominal cavity, which is part of a circulation and lubrication system in the body. Several gallons a day are produded and absorbed each day. Cancer cells produce even more and interfere with absorption of this fluid. Therefore, the abdomen (belly) grows and a person starts looking like they are pregnant. Other reasons for ascites are liver, heart and kidney diseases that are not cancerous.

Simply means that it is NOT a cancer, or not malignant.

A biopsy involves a small procedure to remove or cut out a small piece of tissue in the area of concern. It is then specially prepared in the lab and looked at under the microscope to look for cancer cells.

Pronounced "brakey therapy", this refers to radiation techniques in which a radioactive substance is placed into or near the cancer and allowed to remain several hours to several days. It is often called an "implant". There are several types of techniques and instruments used in this therapy. Under some unusual circumstances the radioactive material is permanently implanted in the cancerous tissues, most often during an abdominal major operation.

Ca-125 is a cancer associated antigen that can be tested for by a blood test. If the test value is greater than 35, then the antigen is present in the blood meaning that cancer cells may be present. The test is useful in patients who we know have ovarian cancer, to monitor their response to therapy. Unfortunately, Ca125 is not specific for ovarian cancer and many many other benign conditions can also cause a positive test. It is also not usually elevated in early ovarian cancer. Therefore it is not a good screening test.
When used for monitoring known ovarian cancer patients, if it was initially elevated and does not normalize to less than 35, then the cancer is still present. The best prognosis is in those patients in whom the Ca125 becomes less than 35 within 3 treatments of chemotheapy. If it becomes normal after chemotherapy, it is a good sign but about one half of these patients still have persistent cancer. So, a normal value may give false reassurance.

Cancer is an abnormal growth of cells which are damaged and unregulated by the body's normal mechanisms. These cells divide and grow in colonies which eventually become malignant tumors. These tumors invade or grow into nearby organs and structures. Cancer cells from the tumors can break off and spread through the blood stream or the immune system (lymph nodes) to other areas; a process called metastasis.

A carcinoma is a very general term for cancer of the epithelium, such as skin or the lining of the intestinal tract. (see EPITHELIUM also). It is not a term which is specific for any one organ.

Pronounced "korio carcinoma". Other terms in this area include gestational trophoblastic disease, GTN, GTD, invasive mole, molar pregnancy. This constellation of related diseases is based on abnormal placental development. The placenta in a genetically abnormal pregnancy becomes very abnormal and no baby develops. In a small percentage, this abnormal placenta can become cancerous and invade the muscle of the uterus or spread to other organs. All of these conditions are extremely curable with a combination of surgery and chemotherapy. (see MOLE).

Cervical Intraepithelial Neoplasia (see DYSPLASIA ). A precancerous condition of the uterine cervix.

New anti-cancer treatments are first evaluated in the laboratory. When a new treatment is initially tested in humans, it is referred to as a Phase I Trial. The purpose is to determine what an appropriate dose is and generally whether or not it has any specific anti-cancer activity. When an appropriate dose is determined, then the treatment is evaluated by a Phase II Trial, in which the object is to determine if the treatment has any effect against a variety of different types of cancer. If it does, then a Phase III Trial is done in which this new treatment is tested against what is currently thought to be the best standard treatment. Usually, Phase III trials are randomized, which means that the treatment you receive, new/experimental vs. standard, is determined by chance;an example would be a flip of the coin, although the techniques uses are more sophisticated and often use computers to determine who gets which treatment. This prevents any bias from influencing the outcome when the results are evaluated. All of the current major chemotherapy drugs have gone through this type of testing. Not all experimental trials involve chemotherapy; some may involved surgical procedures or radiation therapy or other diagnostic or treatment options.

A cone shaped piece of cervical tissue is removed, usually requiring a general anesthetic in the operating room. This is a usually used as a bigger biopsy as well as a treatment for precancerous conditions of the cervix.

A cancer is considered to have been cured if, after treatment, remains undetectable for a long period of time. In many cases 5 year survival rate is used as an equivalent to cure. This means that for most cancers, if one lives past 5 years, it is highly unlikely that the cancer will come back. This is not true for all cancers, but is a pretty good rule for gynecologic cancers.

A cyst is simply a fluid filled structure. A "complex" cyst has internal structures or septations. A cyst with no internal structures (simple cyst) is extremely unlikely to be cancerous at any age. A complex cyst, especially if it contains many solid areas and is larger has a higher chance of being malignant. The chances of malignancy in a complex cyst are also related to age. If the age is greater than 50 and there are more than a few septations, the chances of malignancy approaches 50%. However, it is extremely important that the particulars of your situation and the actual ultrasound films are reviewed by an expert before treatment decision-making.

Deoxyribonucleic acid. This is the genetic material in the nucleus of a cell. It is composed of long chains of molecules called nucleotides. The specific sequence of a segment of these nucleotides codes for a specific cell function. This segment is a gene. (see GENE)

Pronounced "ep ee thee lium. This is a general term describing a lining, which is either external or internal to the body. Skin is an external lining. The lining of the intestinal tract is a glandular lining. Epithelial linings are often exposed to the environment; the air we breathe, the food we eat, the sun exposure etc. Cancers of epithelium are called carcinomas. Cancers of glandular linings are called adenocarcinomas. (see SQUAMOUS EPITHELIUM).

A gene is a specific segment of DNA that determines a specific cell function. Genes control things like eye color, hair color, height and size. An example group of genes that are important to cancer development is the tumor suppressor genes. Such genes control the growth of a cell and its ability to repair itself if it is changed by a mutation (perhaps from an environmental insult). If a tumor suppressor gene mutates and is no longer able to stop the cell from uncontrolled growth then that cell give rise to the development of cancer.
There are hundreds of thousands of genes controlling all processes in the body. Genes are passed down through the generations. Some cancers are partly inherited (BRCA1 and BRCA2 breast and ovarian cancer), but most involve spontaneous or "sporadic" mutation in an individual due to faulty suppressor gene function, environmental insult and other factors.

The lining covering, or epithelium, of many internal organs like the lining of the stomach, intestine, colon, endocervix(inside the cervical canal), uterus and fallopian tube, as well as other internal organs. Cancers that originate from cells of a glandular lining are called adenocarcinomas.

Many cancers are "graded" according to what they look like under the microscope. If the cancer retains the appearance of the normal structure from which it arose, then it is called well differentiated, or Grade I. If it is difficult to determine the structure of origin, then it is called poorly differentiated or Grade III. Moderately differentiated or Grade II cancers are in between. Clinically, Grade I cancers tend to behave better and are less aggressive than Grade III, which tends to behave the worst. Grade II is in between.

Pronounced "hy da ti di form" mole (see MOLE).

Excessive growth, usually of glandular epithelium in various organs. In many cases it can be pre-cancerous.

The last part of carcinoma-in-situ is pronounced "sy two". This is premalignant condition. This is not a cancer, but represents abnormal cell changes that precedes a cancer. Since it is not a cancer, treatment is usually simple, curative and the condition is not life-threatening.

Simply means within the peritoneum, which is the lining of the entire abdominal-pelvic cavity. The abdomen is like a big bag which contains all the intestines, liver, spleen, gall bladder and in the female pelvis, the reproductive organs.

Surgery performed using small stab wounds (half inch), through which telescopes and operating instruments are placed. Many operations in gynecologic oncology can be performed this way. Otherwise known as "minimally invasive surgery".

Surgery performed through various incisions into the abdominal wall. This is the standard approach to most surgeries. The alternatives may include vaginal or laparoscopic surgery.

Loop Electrosurgical Excision Procedure. This is a technique for removing portions of the cervix with an electro-cautery wire loop. Usually this is performed for both diagnosis and treatment of premalignant and benign cervical problems, usually in an office setting. This procedure has all but replaced the cervical cone biopsy, although there are specific cases where the so called "cold knife cone biopsy" is still the procedure of choice.

A very nonspecific term for a visually(can see with the naked eye) or radiographically(can see with an x-ray film) identifiable abnormal area.

The lymphatic system, which is the core of the immune system, partly serves to help drain tissue fluid from all areas of the body. Microscopic lymphatic vessels drain into regional centers where there are clusters of lymph nodes that strain the lymphatic fluid streaming through them. The fluid is then eventually returned to the blood circulation system. Cancer can spread by way of the lymphatic system, and is central to staging of most gynecologic cancers. Success or failure of treatment often depends on whether the regional lymph nodes are involved (advanced stage) with cancer.

Surgical removal of lymph nodes in areas near the organ involved with cancer. This is part of staging of cancer; determining if the cancer has spread beyond the organ of origin.

A major category of white blood cells that is part of the immune response. Collections of lymphocytes are organized into lymph nodes. When stimulated by an antigen the lymphocyte produces a variety of chemicals called lymphokines and antibodies, both of which perform immune response functions.

Marrow is a substance inside certain larger bones that contains the stem cells from which various blood cells are made. These include red blood cells(oxygen carrying), white blood cells(infection fighting), and platelets(help with coagulation of blood in case of bleeding). The bone marrow itself can become cancerous (leukemias), but its importance in gynecologic cancers is mainly that chemotherapy affects the stem cells. Usually, after each course of chemotherapy, the bone marrow produces new white/red blood cells and platelets to replace the ones that were damaged by chemo. After many chemotherapy treatments, this response gets weakers and weaker. Drugs exist which help the bone marrow produce new cells (Procrit, Neupogen and others), but these can only help while there are an adequate number of stem cells left. Radiation therapy can also irreversibly damage the bone marrow if the radiation beams are near those areas.

Pronounced "meta play sha" or "meta play see ah". This term describes a normal process by which cervical glandular epithelium transforms into cervical squamous epithelium.

Pronounced "ma tas ta sis", this is a term which means that a cancer has spread beyond the organ it started in. The cancer has then metastasized. For example, a cancer that originated in the uterus which is found in the liver is not a liver cancer, but is metastatic uterine cancer. Some types of cancer rarely metastasize while others are known to do this very early.

Pronounced "ma tas ta tic", this is a term which means that a cancer has spread beyond the organ it started in. The cancer has then metastasized. For example, a cancer that originated in the uterus which is found in the liver is not a liver cancer, but is metastatic uterine cancer. Some types of cancer rarely metastasize while others are known to do this very early.

Pronounced "my toe sis", Mitosis is a very intricate process by which a dividing cell evenly distributes the genetic material to each daughter cell. This process occurs in most cells in the human body in order to grow and to replace old cells. Cancers undergo rapid mitosis,or rapid cell division, which is why they tend to grow rapidly.

No, this is not an animal... This is either a benign pigmented skin area or something  known as a Molar pregnancy, or an early pregnancy gone bad in which case the placenta grows abnormally and the fetus(baby) does NOT develop. In some cases, these abnormal placental elements can invade or grow into the muscular wall of the uterus and to metastasize or spread to distant parts of the body by the bloodstream. Please also see GESTATIONAL CHORIOCARCINOMA

This means dead tissue which has lost its blood supply. Cancers often outgrow their blood supply and become necrotic in areas as new cancer cells grow nearby. Radiation can also cause a loss of blood supply to parts of the body as well as the cancer which is being treated. These areas become necrotic, often have a bad odor as they can get infected easily. In some cases necrotic areas need to be surgically removed, in other cases the body reabsorbs these areas.

This means the probability or chance that a disease is not present when the test is negative or normal.

The omentum is a large fatty structure which drapes over the intestines inside the abdomen. It evolved in the human body mainly to act as a "band-aid" in case of bad infection or intestinal rupture( e.g. appendicitis). In those cases it simply drapes over the affected area acting like a band-aid to limit spread of infection. Unfortunately, since is has a lot of tiny blood vessels, it is fertile ground for cancers to implant and grow. This is most often a problem in ovarian cancer, and when extensively involved is described as an "omental cake".

A gene that, when altered by an injury or mutation, can result in the cell becoming a cancer cell. An inherited oncogene abnormality may cause cancers to run in families, such as BRCA1 and BRCA2.

When the treatment goal is mainly to relieve symptoms caused by a cancer it is known as palliative. This is in contradistinction to curative therapy, where the goal is mainly to try to cure a cancer. Somtimes, the goals are mixed, but in general, palliative care is instituted when cure is not possible.

When the treatment goal is mainly to relieve symptoms caused by a cancer it is known as palliative. This is in contradistinction to curative therapy, where the goal is mainly to try to cure a cancer. Somtimes, the goals are mixed, but in general, palliative care is instituted when cure is not possible.

The peritoneum is the internal lining of the abdominal cavity, sort of like the skin covers the external surface of the body.

Platelets are blood element which are important in helping blood clot and limiting bleeding from injury. When a blood vessel is cut or ruptured, platelets "plug" the leak and release substances which accelerate other clotting mechanisms. Platelets can be significantly lowered during chemotherapy.

The probability or chance that a disease is really present when a test for that disease is positive. (see SENSITIVITY, SPECIFICITY and NEGATIVE PREDICTIVE VALUE).

The probability or chance that a disease is really present when a test for that disease is positive. (see SENSITIVITY, SPECIFICITY and NEGATIVE PREDICTIVE VALUE).

This is not a very good medical term which describes pre-malignant changes (visible under a microscope after a biopsy of the area in question) which can turn into a cancer. Dysplasia and terms like that are better used in these circumstances. Some cancers have well defined precancer precursors, others do not.

Prevalence describes the number of cancers that exist in a given population at any moment in time. Prevalence is usually unknown because not all of the cancers at that moment have been diagnosed in a given population. (see INCIDENCE).

Red cells circulate in the blood stream and carry oxygen. If the red blood cell count is low, the condition is called anemia. Weakness and fatigue are common symptoms of anemia. Chemotherapy and radiation therapy can result in lowered red blood cell counts.

A determination of the effectiveness of treatment. This usually requires a measurable amount of cancer( by exam or test) to see if it has become stable, reduced or eliminated. A complete clinical response means that a previously measurable cancer has gone away with treatment. It cannot be detected by examination, blood tests, x-ray or scan. A partial response means that the measurable amount of cancer has decreased by 50%. If there has been minimal reduction in size or if the disease has not changed in size, it is known as stable disease.

A cancer of supporting structures such as bone, muscle, cartilage and fat. Gynecologic sarcomas are unusual, but can affect any gyn organ. Most often it affects the uterus, although this is still relatively unusual. In some cases mixed elements of a malignancy are present in a uterus or ovary, involving both sarcoma and carcinoma. This is known as a Mixed Mullerian Tumor. Many of these sarcomas or mixed tumors can be very aggressive, even if caught early.

A screening test is one which is done on "normal" people without symptoms or physical findings in order to find hidden disease, in this case early or hidden cancer. For gynecologic cancers the only good screning tools available are for cervical cancer, those being the Pap smear and newer technologies like visual tests(PapSure) and viral tests(DiGene). These tests DO NOT test for ovarian or endometrial (uterine) cancer. There are no good screening tests available yet for uterine or ovarian cancer.

Refers to the probability or chance that a test will be positive when the disease that is being tested for is present. (see SPECIFICITY, POSITIVE PREDICTIVE VALUE and NEGATIVE PREDICTIVE VALUE).

Refers to the probability or chance that a test will be negative when the disease that is being tested for is not present. (see SENSITIVITY, NEGATIVE PREDICTIVE VALUE and POSITIVE PREDICTIVE VALUE.

Superficial cells covering surfaces, like skin or vagina.   Usually used as a general term which describes cancer of squamous epithelium. Most commonly, squamous cancers in gynecology are cervical, vaginal and vulvar. (see EPITHELIUM and SQUAMOUS EPITHELIUM)

A determination of the extent of a newly diagnosed cancer. Mainly, is the cancer still localized to the organ of origin or has it spread, and how far? Each type of cancer has its own staging criteria. A commonly used staging system in gynecology (FIGO) assigns the cancer to one of four stages. Stage I refers to a cancer localized to the site of origin. Stage II is a cancer that has spread into adjacent tissue. Stage III cancers have spread within the region. Stage IV indicates distant spread or involvement of another organ system. There are usually substages for each of the four common stages.
The official staging system used by cancer registries is the TNM system. T indicates the status of the primary tumor and is subdivided into T1, T2, T3 and T4, depending on the size and extent of the primary tumor. N indicates the status of the regional lymph nodes and is subdivided into Nx, No, N1, and N2. M indicates distant metastases, Mo-none, M1, - present. Some cancers are assigned a stage by examination and x-ray tests. Others require a surgical exploration. Staging is important because it indicates the appropriate treatment, allows evaluation of treatment results, and can compare results from different types of treatment.

FIGO and TNM staging systmes are cross-referenced by most pathologists and cancer registries.

The stem cell in the bone marrow is one that gives rise to the blood cells. The stem cells produce both red and white blood cells. If the stem cells are destroyed during chemotherapy then there will be no white blood cells to combat infection, which may be fatal. If some stem cells can be removed prior to chemotherapy, then huge doses of chemotherapy, that would otherwise be fatal, can be given and the stem cells replaced after the chemotherapy. It is called a stem cell because it has the ability to become any of the blood elements. The other cells in the bone marrow have lost this ability and can make only a specific type of blood cell element. Stem cell transplant for solid tumors, especialy for gynecologic tumors, has been all but abandoned. There is no apparent increase in cure rates and the treatment is extremely toxic.

After food is swallowed it travels down the esophagus to the stomach, which is the initial storage and digestive bag for food. From there the food is transferred to the small intestine, then the large instestine or colon, and out through the rectum and anus.

Pronounced "strow ma", this is the supporting tissue around or beneath an epithelium. The skin is an epithelium supported by the fibrous fatty stroma beneath it. (see EPITHELIUM)

This is a broad and sometimes misused medical term meaning "heading on an unalterable path to death". From that point of view, we are all terminal. It is sometimes used in an acute seting when an irreversible failure of a critical organ system develops. People who are living with their cancer, even though the cancer may not be curable, are not necessarily terminal.

Otherwise known as a lump, implies a growth, which can be either benign or malignant.

Vulvar Intraepithelial Neoplasia. (see DYSPLASIA).