A blood test providing patient-specific probability of finding an aggressive form of prostate cancer during a biopsy. The test measures total PSA, free PSA, intact PSA and kallikrein enzymes. The company then uses this information and the patient's age and physical exam to calculate the probability percentage of having aggressive disease.
A type of minimally invasive procedure doctors use to destroy abnormal tissue that can be present in many conditions.
May be an appropriate treatment option for patients whose prostate cancer was caught early and is considered low-risk. If a man's prostate cancer is caught early, is not causing problems, and is growing very slowly, a physician may forgo treating the tumor at all. Instead, the doctor may recommend that the patient keep actively monitoring his PSA levels.
Treatment given after the primary treatment to increase the chance of a cure. Usually involves chemotherapy or radiation.
Legal documents that tell the doctor and family what a person wants for future medical care if the person later becomes unable to make decisions for him or herself. This may include whether to start or when to stop life-sustaining treatments. Another type of advance directive lets you choose a person to make decisions for you if you become unable to do it for yourself.
A general term describing stages of cancer in which the disease has spread from where it started (the primary site) to other parts of the body.
Sudden hair loss that starts with one or more circular bald patches that may overlap. The condition develops when the immune system attacks the hair follicles, resulting in hair loss.
Hormones found in men and women but with much higher levels in men; commonly called male sex hormones. The major androgen is testosterone.
A term used to describe prostate cells that are stimulated by male hormones to grow and multiply, and are suppressed by drugs that stop or disrupt the action of male hormones. Androgen-dependent cells may be normal or cancerous.
Term for prostate cancer cells that no longer respond to hormone therapy; also known as hormone-refractory.
Drugs that block the body's ability to use androgens (male hormones). They are taken as pills, up to 3 times a day. Anti-androgens are usually used along with orchiectomy (surgery) or LHRH analogs (medicines) to help treat prostate cancer.
Androgen receptor-axis-targeted (ARAT) therapy can be used for both mCRPC and nmCRPC. ARAT is similar to ADT and was developed as a treatment to further inhibit AR signaling.
An inflatable cuff implanted to squeeze the urethra or anus shut and help a person control their urine or stool.
Benign prostatic hyperplasia (BPH)
A condition in which the prostate gland is enlarged and not cancerous.
Biochemical recurrence is a rise of prostate-specific antigen (PSA) levels in the blood of a prostate cancer patient after treatment with surgery or radiation. Biochemical recurrence may occur in patients who do not have symptoms. It may mean that the cancer has come back.
A measurable indicator of the severity or presence of some disease state. More generally a biomarker is anything that can be used as an indicator of a particular disease state or some other physiological state of an organism.
For a biopsy, the doctor takes out a small piece of tissue where the cancer seems to be. This tissue is checked for cancer cells. A core needle biopsy is often used to find prostate cancer.
An imaging test that gives important information about the bones, including the location of cancer that may have spread to the bones. It uses a small amount of radioactive contrast material (radioisotope) which is given through a vein. This material settles in areas of the bone to which the cancer may have spread. The radioactive substance can be seen in pictures as it collects in the problem areas ("hot spots").
A type of radiation therapy in which radioactive material sealed in seeds is placed directly into or near a tumor. Also called uranium seed implants, radiation brachytherapy, internal radiation therapy, and implant radiation therapy.
BRCA1 & BRCA2
A gene which, when damaged (mutated), puts a person at higher risk of developing breast, ovarian, prostate, and other types of cancer, compared to people who do not have the mutation.
Pronounced kuh-KEK-see-uh; Loss of body weight and muscle mass and weakness that may occur in patients with cancer.
Castration-Resistant Prostate Cancer (CRPC)
Cancer that keeps growing even when the amount of testosterone in the body is reduced to very low levels. Many early-stage prostate cancers need normal levels of testosterone to grow, but castrate-resistant prostate cancers do not. CRPC can be referred to as nmCRPC when there is no detectable metastases upon imaging, and as mCRPC when it has advanced to metastatic stage.
Castration-Sensitive Prostate Cancer (CSPC, also called Hormone-Sensitive Prostate Cancer)
A form of prostate cancer that still responds to testosterone suppression therapy. CSPC can be referred to as nmCSPC when there is no detectable metastases upon imaging, and as mCSPC when it has advanced to metastatic stage.
Drugs used to kill rapidly dividing cells in the body, which include cancer cells, but also some healthy cells. It is a systematic treatment, which means it circulates through the body and kills cancer cells throughout.
A certain percent you must pay each benefit period after you have paid your deductible. This payment is for covered services only. You may still have to pay a copay.
A copayment or copay is a fixed amount for a covered service, paid by a patient to the provider of service before receiving the service. It may be defined in an insurance policy and paid by an insured person each time a medical service is accessed.
Uses liquid nitrogen or argon gas to freeze tumors, also known as cryotherapy.
CT (Computerized Tomography) Scan
CT/CAT scans detect smaller tumors than the x-ray detects and helps the doctor determine if the tumor has spread to lymph nodes or areas surrounding the prostate.
The amount you pay for your healthcare services before your health insurer pays. Deductibles are based on your benefit period (typically a year at a time).
Digital Rectal Exam. The doctor inserts a gloved, lubricated finger into the rectum and feels the rectum, anus, and prostate (in males) to check for anything abnormal.
A simple, non-invasive urine test to assess your risk of having clinically significant high-grade prostate cancer. The ExoDx Prostate Test does not require a digital rectal exam (DRE) and provides an individualized risk score that can help determine whether to proceed or defer a prostate biopsy.
A gene is the basic physical and functional unit of heredity. The gene is the basic physical unit of inheritance. A unit of heredity which is transferred from a parent to offspring and is held to determine some characteristic of the offspring.
branch of biology concerned with the study of genes, genetic variation, and heredity in organisms; relating to genes or heredity.
The study of genes and heredity and how certain traits and qualities are passed to offspring from parents as a result of changes in DNA sequence. The results of a genetic test can confirm or rule out a suspected genetic condition, help determine a person's chance of developing or passing on a genetic disorder and provide information on how the cancer might behave. Genetic testing is useful in many areas of medicine and can change the medical care you or your family member receives.
the complete set of genes or genetic material present in a cell or organism.
the study of all of a person's genes (the genome); field of biology focusing on the structure, function, evolution, mapping, and editing of genomes.
The study of the entire genome (all of a person's genes), including interactions of those genes with each other and with the person's environment. Genomic testing may identify changes in chromosomes, genes, or proteins and can be performed on both biopsy tissue and on tissue from an entire prostate following a prostatectomy.
Is the population of cells that pass on their genetic material.
A germline mutation occurs in a sperm cell or an egg cell and is passed directly from a parent to a child at the time of conception. Because the mutation affects reproductive cells, it can pass from generation to generation. Cancer caused by germline mutations is called inherited or hereditary cancer.
the grading system used to determine the aggressiveness of prostate cancer. This grading system can be used to choose appropriate treatment options. To find a Gleason score, the tumor cells from the biopsy are looked at under a microscope. A number is assigned to them based on how abnormal they appear. The scale goes from 1 (non-aggressive) to 5 (very aggressive). The numbers of the two most common patterns are added together to create a Gleason Score. The order of the numbers do matter. While you may have an overall Gleason Score of a 7, one that is a 3+4 will progress differently from one that is a 4+3.
Differences between groups in health outcomes related to preventing, detecting, treating, and surviving prostate cancer.
Health equity means that everyone has a fair and just opportunity to prevent, find, treat, and survive prostate cancer. Achieving health equity requires removing obstacles to a usual source of healthcare and coordinated high quality specialty care; and ensuring that families have the resources to manage their health and navigate the primary and specialty care delivery system.
Too much growth of cells or tissue in a specific area, such as the lining of the prostate.
Uses the power of the body's own immune system to treat cancer. Can be used for many types of cancer, either alone or in combination with other treatments.
Inability to have an erection (erectile dysfunction), usually a side effect or prostate cancer treatment.
Lack of voluntary control over urination or defecation, usually a side effect of radiation.
Exercises to strengthen certain muscles in the bottom of the pelvis. These exercises may help men and women with certain forms of urinary incontinence.
LHRH (Luteinizing Hormone-Releasing Hormone) Analogs
Sometimes called gonadotropin-releasing hormone (GnRH) analogs. Man-made hormones, chemically similar to luteinizing hormone-releasing hormone (LHRH). They stop the body from making the male hormone testosterone and are sometimes used to treat prostate cancer.
LHRH (Luteinizing Hormone-Releasing Hormone) Antagonists
Also called gonadotropin-releasing hormone (GnRH) antagonists. A type of drug thought to work in a way much like the LHRH analogs, which may be able to lower testosterone levels more quickly without causing the tumor symptoms to worsen (this is called tumor flare).
A test done on a sample of blood to look for cancer cells from a tumor that are circulating in the blood or for pieces of DNA from tumor cells that are in the blood. A liquid biopsy may be used to help find cancer at an early stage. It may also be used to help plan treatment or to find out how well treatment is working or if cancer has come back. Being able to take multiple samples of blood over time may also help doctors understand what kind of molecular changes are taking place in a tumor.
The sections of the prostate. There are three sections of the prostate, one central lobe and one lobe on either side of the central lobe.
Also called local cancer. A cancer that is confined to the organ where it started; that is, it has not spread to distant parts of the body.
Locally Advanced Cancer
Cancer has spread beyond the outer layer of the prostate into nearby tissues. Locally advanced prostate cancer is considered nonmetastatic.
Small bean-shaped collection of immune system tissue, such as lymphocytes, found throughout the body along lymphatic vessels. They remove cell waste, germs, and other harmful substances from lymph. They help fight infections and also have a role in fighting cancer, although cancers can spread through them. Sometimes called lymph glands.
Lymph node biopsy
Lymph nodes are small bean-shaped parts of the immune system. A lymph node biopsy may be done if the doctor thinks the cancer might have spread from the prostate to nearby lymph nodes.
Metastatic castration-resistant prostate cancer. mCRPC is a form of advanced prostate cancer that no longer responds to hormone treatments, shows signs of growth, and has spread to other parts of the body.
A medical oncologist is a physician who specializes in the non-surgical treatment of cancer with medicines such as chemotherapy, hormonal therapy, and other drugs. While many men with prostate cancer will work most closely with a urologist, it is important to include a medical oncologist in the early phases of treatment planning.
The spread of cancer from one part of the body to another. This happens through the lymph system or through the bloodstream. A tumor formed by cells that have spread is called a "metastatic tumor" or a "metastasis." The metastatic tumor contains cells that are like those in the original (primary) tumor.
Cancer has spread to other parts of the body, such as the bones, lymph nodes, lungs or liver.
Metastatic Hormone-Sensitive Prostate Cancer is cancer that has spread outside of the prostate and can still be treated with hormone therapy. This may also be called Metastatic Castration-Sensitive Prostate Cancer (mCSPC).
MRI (Magnetic Resonance Imaging)
MRIs use magnetic fields to create clear images of body parts, including tissues, muscles, nerves and bones. MRIs make better images of organs and soft tissue than other scanning techniques, such as computer tomography (CT) or x-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints and the inside of bones.
Treatment given before the primary treatment. Usually involves chemotherapy or radiation.
Nerve Sparing Prostatectomy
Surgery to remove the prostate in which the surgeon tries to save a man's ability to have erections by leaving in the neurovascular bundles that control that function. In some cases, the urologist is able to spare the nerves on both sides of the gland; in others, the tumor is so close to one set of nerves that he has to sacrifice those nerves to be sure the entire tumor is removed. Some surgeons have been concerned that it is more likely to leave some cancer cells behind.
A nerve problem that causes pain, numbness, tingling, swelling or muscle weakness in different parts of the body. It usually begins in the hands or feet and may worsen over time. It is a common side effect from platinum-based chemotherapy drugs.
Non-metastatic castration-resistant prostate cancer. nmCRPC is prostate cancer that does not respond to hormone treatment but is still contained within the prostate and has not spread to other parts of the body.
Excessive urination during the night.
A registered nurse with a master's or doctoral degree and special certification. Nurse practitioners diagnose and manage illness and disease, usually working closely with doctors.
A nutritionist provides information and guidance about good nutrition. This can help a patient combat cancer- or treatment-related weight loss or gain by recommending foods that provide adequate calories, vitamins, and protein. In addition, a nutritionist provides helpful tips and recipes customized to fit your specific dietary needs.
A registered nurse with a master's degree in oncology nursing who specializes in the care of cancer patients. Oncology nurse specialists may prepare and give treatments, monitor patients, prescribe and provide supportive care, and teach and counsel patients and their families.
Oncology Social Worker
Oncology social workers are trained to work with prostate cancer patients and their families, most frequently men with advanced prostate cancer. It is important to understand your emotional well being and get the support you need mentally as well as physically. An oncology social worker provides individual counseling, access to support groups, and referrals to related services for men with prostate cancer.
surgery to remove the testicles; also called castration.
Urine leak that happens when the bladder cannot be emptied. A person with overflow incontinence may need to get up often during the night to urinate, take a long time to urinate, and have a dribbling stream with little force. Overflow incontinence is usually caused by blockage or narrowing of the bladder outlet, either from cancer or scar tissue.
A doctor, nurse, or pharmacist who is an expert in pain control.
Palliative Treatment/ Care
Treatment that relieves symptoms, such as pain, but is not expected to cure disease. Curative treatment can be used at the same time as palliative treatment, but the main purpose of palliative care is to improve the patient's quality of life.
A doctor who specializes in diagnosing and classifying diseases in the lab by testing and looking at cells under a microscope. The pathologist determines whether a tumor is benign (not cancer) or cancer, and if cancer, the exact cell type and grade.
A urine test that may suggest the possibility of prostate cancer by examining the expression of PCA3, which is a gene specific to prostate cancer. The PCA3 score is used to determine the need for repeated biopsies.
Artificial device placed in the penis during surgery to help a man have erections.
Percent-Free PSA (fPSA)
a test that shows how much prostate-specific antigen (PSA) circulates unattached to blood proteins (alone) in the blood. The percent-free PSA (fPSA) is the ratio of how much PSA circulates free compared to the total PSA level. The percentage of free PSA is lower in men who have prostate cancer than in men who do not. A low fPSA may suggest the need for a biopsy.
an operation in which the prostate is removed through an incision (cut) in the skin between the scrotum and anus.
The prostate health index combines three blood tests that give a "Phi core", which may help physicians more accurately determine the probability of grinding cancer during a biopsy.
A physical therapist can help deal with the physical changes caused by cancer treatment. Before or after surgery or radiation therapy, working with a physical therapist to strengthen the pelvic floor can help to manage or prevent side effects such as urinary incontinence.
Medical care designed to optimize efficiency or therapeutic benefit for particular groups of patients, especially by using genetic or molecular profiling.
Someone who has an elevated predisposition to being diagnosed with cancer due to a risk running through their family
Primary Care Physician (PCP)
This is a one's personal physician, most likely an internist or family medicine physician who treats common illnesses and oversees general care.
Prostate-Specific Antigen (PSA)
Prostate-specific Antigen (PSA) is a substance found in the blood that is made by the prostate gland. It can be used to detect unusual activity in the prostate.
Swelling and inflammation of the prostate gland
An artificial replacement of a part of the body through a surgical procedure. Penile prosthesis may be considered if the patient has had erectile dysfunction for some time following cancer treatment and nonsurgical therapy has failed or is unacceptable.
PSA blood test
A PSA test is a blood test that is done to see what a patient's PSA level is and how it changes over time. Changes in PSA can be used to detect early stages of prostate cancer.
Radiation (External Beam)
Use of carefully aimed doses of radiation from a source outside the body that is focused on the cancer.
A radiation oncologist is a highly trained physician specializing in the treatment of prostate cancer using the various types of radiation approved to treat the disease.
An operation to remove the prostate gland and some of the tissue around it. Surgery that removes the entire prostate gland plus some tissue around it. This is used most often if the cancer is thought not to have spread outside of the gland.
Radioligand therapy, or RLT, is an innovative approach to treating certain types of cancer, including prostate cancer. It works by delivering a precise dose of radiation directly to a specific target, with the hope of avoiding as many normal cells as possible.
a doctor with special training in diagnosis of diseases by interpreting or reading x-rays and other types of diagnostic imaging studies; for example, CT and MRI scans.
A group of drugs that include radioactive elements or radioisotopes, such as strontium-89 or samarium-153, which are given into a vein (intravenously or IV) to treat bone pain related to cancer that has spread to the bones.
The return of cancer after treatment. Local recurrence means that the cancer has come back at the same place as the original cancer (primary site). Regional recurrence means that the cancer has come back after treatment in the lymph nodes near the primary site. Distant recurrence is when cancer spreads (metastasizes) after treatment to distant organs or tissues (such as the lungs, liver, bone marrow, or brain).
Complete or partial disappearance of the signs and symptoms of cancer in response to treatment; the period during which a disease is under control. A remission may not be a cure.
A condition, often happening after prostate surgery or radiation in which orgasm causes semen to enter the bladder, rather than leaving the body through the penis. Also known as a dry orgasm.
Social Determinants of Health
The Social Determinants of Health, or SDOH, are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems that impact a range of health/well-being, functioning, and quality of life outcomes. The SDOH are shaped by the distribution of money, power, and resources at global, national, and local levels.
Referring to the cells of the body in contrast to the germ line cells.
These mutations occur from damage to genes in an individual cell during a person's life. Cancers that occur because of somatic mutations are referred to as sporadic cancers. Somatic mutations are not found in every cell in the body and they are not passed from parent to child.
process used to find out if the cancer has spread within the prostate or to other parts of the body, using biopsy and imaging.
Stereotactic Radiosurgery (SRS), Stereotactic Radiotherapy (STR), Stereotactic Body Radio-therapy (SBRT)
A precise delivery of a single, high dose of radiation in a one-day session done to the body (CyberKnife).
Edge of the tissue removed during surgery. A negative surgical margin means that no cancer cells were found on the outer edge of the removed tissue, and is considered a sign that none of the cancerous mass was left behind. A positive surgical margin means that cancer cells are found at the outer edge of the tissue removed and is usually a sign that some cancer remains in the body.
A doctor who specializes in using surgery to treat cancer.
Transrectal ultrasound (TRUS)
For this test, a small wand is put into the patient's rectum. It gives off sound waves and picks up the echoes as they bounce off the prostate gland. The echoes are made into a picture on a computer screen.
Transurethral Resection of the Prostate (TURP)
An operation that removes a part of the prostate gland that surrounds the urethra (the tube through which urine exits the bladder). The procedure is used for some men with prostate cancer who cannot have the prostate removed (radical prostatectomy) because of advanced age or other serious illnesses. This operation can be used to relieve symptoms caused by a tumor, but it is not expected to cure this disease or remove all of the cancer. TURP is used more often to relieve symptoms of benign prostatic hyperplasia (BPH).
A urologist is a physician specializing in diseases of the male reproductive organs and male and female urinary tract. Some urologists have oncology training. All urologists are surgeons as well, and many perform prostate cancer surgery.
A device that creates an erection by drawing blood into the penis; a ring placed at the base of the penis then traps the blood and keeps the erection. Can be a helpful tool when dealing with side effects from prostate cancer treatment.
May be an appropriate treatment option for patients whose prostate cancer was caught early and is considered low-risk. Patients who choose this treatment pathway will likely choose not to have the prostate cancer actively monitored like those who choose active surveillance.