Glossary
Abiraterone (Zytiga)
An anti-androgen agent used for prostate cancer. It is used in patients whose cancer is castration resistant (has not responded to treatments that lower testosterone levels) or whose cancer is high risk and castration sensitive (has responded to treatments that lower testosterone levels).
Active Surveillance
Monitoring the course of the disease through regular PSA tests, DRE’s, biopsies and imaging with the expectation of offering curative treatment when, or if, the disease progresses. These genomic (molecular) tests are available for patients to confirm that they may be candidates for active surveillance: Decipher, Oncotype DX Prostate, Prolaris and ProMark.
Advanced Prostate Cancer
Prostate cancer is called “advanced” if it has spread outside of the prostate gland. It may have moved to the tissues nearby, which doctors call “locally advanced.” It also could have spread to the lymph nodes, bones, or other parts of the body. Then it’s called metastatic prostate cancer.
Androgen-Deprivation Therapy (ADT)
Treatment to suppress or block the production or action of male hormones. This is done by having the testicles removed, by taking female sex hormones, or by taking drugs called antiandrogens. Also called androgen ablation and androgen suppression.
Apalutamide (Erleada)
A non-steroid antiandrogen medication approved by the FDA for the treatment of non-metastatic, castration-resistant prostate cancer and for metastatic hormone-sensitive prostate cancer in combination with testosterone suppression therapy.
Biochemical Recurrence of prostate cancer
Among men treated with prostatectomy or radiation therapy for localized prostate cancer, the state of an increasing prostate-specific antigen (PSA) level is known as biochemical recurrence (BCR).
Biopsy Cores
A needle is passed through the skin to take a sample of tissue from the prostate. These samples are biopsy cores. The tissue is then examined under a microscope for cancer.
Bone scan
The imaging of the bone using nuclear medicine. It is used to detect bone disease and metastases from other cancers.
Brachytherapy
A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into the prostate, or near a tumor. Also called implant radiation therapy, internal radiation therapy, and radiation brachytherapy.
Cabazitaxel (Jevtana)
A chemotherapy agent similar to docetaxel (taxotere) commonly used to treat prostate cancer. It is approved to treat metastatic castration-resistant prostate cancer that has been previously treated with docetaxel. It is a microtubule inhibitor.
Carboplatin/Etoposide
Chemotherapy combination found to be successful in metastatic castration resistant prostate cancer.
Castration-naïve
Castration-naïve is used to define patients who have not been treated with ADT and those who are not on ADT at the time of cancer progression.
Castration-Resistant Prostate Cancer (CRPC)
Cancer that has disease progression after androgen-deprivation therapy when patients have either increase of PSA, progression or growth of cancer, or new metastases.
Cisplatin (Platinol)
A chemotherapy agent commonly used for castration resistant prostate cancer that is no longer responsive to antiandrogen agents.
Clinical Trials
Studies that are assessing new ways to treat diseases, including prostate cancer. Patients who enroll in these trials can receive new prostate cancer treatments before they are approved by the FDA as mainstay treatments.
Cryotherapy
It is the freezing of cancer cells with a metal probe inserted through a small incision in the area between the rectum and the scrotum, the skin sac that contains the testicles. It is not an established therapy or standard of care for men newly diagnosed with prostate cancer. Cryosurgery has not been compared with radical prostatectomy or radiation therapy, so doctors do not know if it is a comparable treatment option. Its effects on urinary and sexual function are also not well known.
Darolutamide (Nubeqa)
An antiandrogen medication which is used in the treatment of non-metastatic castration-resistant prostate cancer in men. It is specifically approved to treat non-metastatic castration-resistant prostate cancer in conjunction with surgical or medical castration
Denosumab (Xgeva)
An injection that is of a class of medications called RANK ligand inhibitors. These medications prevent bone loss by blocking receptors in the body that cause bone breakdown. It works to prevent osteoporosis and osteopenia caused by androgen deprivation therapy for prostate cancer.
Docetaxel (Taxotere)
A chemotherapy drug which is a microtubule inhibitor commonly used to treat prostate cancer with testosterone suppression therapy.
Enzalutamide (Xtandi)
A nonsteroidal antiandrogen (anti-testosterone) agent used to treat:
• Metastatic castration-sensitive prostate cancer (mCSPC),
• Non-metastatic castration-resistant prostate cancer (nMCRPC), and
• Metastatic castration-resistant prostate cancer (mCRPC)
External Beam Radiation Therapy (EBRT)
External-beam radiation therapy is the most common type of radiation treatment. The radiation oncologist uses a machine located outside the body to focus a beam on the area with the cancer. Types of EBRT include: Three dimensional conformal radiation therapy (3DCRT), Intensity-modulated radiation therapy (IMRT), Stereotactic body radiation therapy (SBRT), and Proton therapy.
Fine-particle Abiraterone
Fine-particle Abiraterone is a new formulation that increases the availability of the drug within the body but decreases the effects of food on the effectiveness of the treatment.
Gleason Score
A grading system that is used to help evaluate the prognosis of men with prostate cancer and is done using samples from prostate biopsies. The architecture of the cancer cells is used to determine Gleason Score which will determine prognosis and treatment plan.
Grade Group
A way of describing prostate cancer based on how abnormal the cancer cells are in a biopsy. It is based on Gleason Score and ranges from 1-5; the lower the group score, the more normal the cells look.
High- Intensity Focused Ultrasound (HIFU)
HIFU is a heat-based type of focal therapy where an ultrasound probe is inserted into the rectum and then sound waves are directed at cancerous parts of the prostate gland. This treatment is designed to destroy cancer cells while limiting damage to the rest of the prostate gland.
Hormone Sensitive Treatment
A treatment for prostate cancer that grows directly in response to testosterone. Treatments include hormone therapy and androgen-deprivation therapy.
(HRRm) or homologous recombination repair deficiency (HRD)
Also known as a BRCA mutation this causes the BRCA protein not to function as it should. The BRCA protein looks for breaks in both strands of DNA and repairs them. When these breaks are left unrepaired, it predisposes people to cancer, increasing their risk for prostate cancer.
Life Expectancy Table
Life expectancy can be adjusted based upon the clinician’s assessment of overall health as follows: Best quartile of health – add 50%, Worst quartile of health – subtract 50%, Middle two quartiles of health – no adjustment.
Lutetium-177
Lutetium-177 (177Lu)–PSMA-617 is a radioligand therapy that delivers beta-particle radiation to PSMA-expressing cells.
Lymph Nodes
These are small structures that filter harmful substances in the body. They contain immune cells and fight infections and malignancy.
Metastasis
Spreading of cancer to a distant site.
Methylprednisolone
A corticosteroid medication that is used to treat and reduce inflammation in the body.
Mitoxantrone (Novantrone)
A drug used with other drugs to treat advanced prostate cancer that did not improve with hormone therapy. Mitoxantrone hydrochloride damages the cell’s DNA and may kill cancer cells. Mitoxantrone hydrochloride is a type of antitumor antibiotic.
Multi-parametric magnetic resonance imaging (mpMRI)
A special type of scan that creates more detailed pictures of your prostate than a standard MRI scan that enables clinicians to better detect suspected prostate cancer.
National Comprehensive Cancer Network (NCCN)
The National Comprehensive Cancer Network (NCCN) is a 501(c)3 not-for-profit alliance of 30 of leading cancer centers. All NCCN Member Institutions are not-for-profit organizations. NCCN and its Member Institutions are dedicated to improving the quality and effectiveness of care provided to patients with cancer. NCCN develops scientific, evaluative information to inform and improve decisions that can lead to better care. The development of NCCN information is based upon the independent evaluation of available scientific evidence integrated with the expert judgment of leading clinicians. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
Observation (watchful waiting)
Monitoring the course of the disease through PSA and DRE tests with the expectation to deliver palliative therapy for the treatment of symptoms, but not curative treatment.
Olaparib
Olaparib, (Lynparza) is in a class of medications called poly (ADP-ribose) polymerase (PARP) inhibitors. It travels through your body and targets cancer cells, preventing them from using PARP to repair DNA. This causes cancer cells to die. (Link)
Palliative Care
Palliative care is specialized medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family.
PARP inhibitors
PARP inhibitors (i.e., Rubraca and Lynparza) are FDA approved therapies for men with metastatic castration-resistant prostate cancer, who have certain genetic mutations.
Pembrolizumab (Keytruda)
A humanized antibody, also known as a checkpoint inhibitor, used in cancer immunotherapy. It has shown success in combating bone-predominant metastatic-castration resistant prostate cancer.
Pelvic Lymph Node Dissection (PLND)
Lymph nodes house white blood cells which are the workers of the immune system. When there is a cancer nearby, the white blood cells in that area populate in the nearby lymph nodes. Lymph node dissection includes the removal of lymph nodes near a cancer and improve chances of remission from cancer.
PET Scan
A PET can is an imaging test that helps doctors look for disease in the body. A PET scan uses an imaging agent—like PYLARIFY®—that contains a small amount of radioactive tracer, which targets cancer cells. Once there, the imaging agent lights up, helping the reader of the PET scan find the disease location, usually before tumors appear on other types of imaging scans.
Prostate Cancer (Adenocarcinoma)
The uncontrolled-malignant growth of cells originating from the prostate; one of the most common cancers in men.
Prostate Surface Membrane Antigen (PSMA)
Prostate Surface Membrane Antigen (PSMA) is cell surface protein is significantly overexpressed in metastatic-castration-resistant prostate cancer compared to other PSMA-expressing tissues such as kidney, small intestine, or salivary glands. It therefore making it a promising target for prostate cancer-specific imaging and therapy.
PSA
Prostate specific antigen is an enzyme secreted by the skin cells of the prostate gland. It is used to screen for cancer and monitor treatment of prostate related diseases.
Pylarify
Pylarify (piflufolastat F 18) is a radioactive diagnostic agent, which allows visualization of cancer that has traveled to lymph nodes, bone and soft tissue and determine the presence or absence of recurrent and/or metastatic prostate cancer.
Radical prostatectomy
A radical prostatectomy is the surgical removal of the entire prostate and the seminal vesicles. Lymph nodes in the pelvic area may also be removed.
Radiopharmaceuticals
Radiopharmaceuticals (radioligand) typically consist of a radioactive atom (i.e., radionuclide) combined with a cancer cell-targeting molecule. This therapeutic combination specifically delivers the radioactive payload to the prostate cancer cell and destroys it.
Radium-223
Radium-223 is a type of internal radiotherapy treatment for cancer that began in the prostate and has spread to the bones.
Rucaparib
Rucaparib, (Rubraca) is in a class of medications called poly (ADP-ribose) polymerase (PARP) inhibitors. It travels through your body and targets cancer cells, preventing them from using PARP to repair DNA. This causes cancer cells to die.
Rucaparib for BRCAm
Rucaparib is a newly approved medication that inhibits PARP 1-3 and plays a role in DNA repair. On May 15, 2020 the U.S. Food and Drug Administration (FDA) granted accelerated approval to rucaparib (Rubraca) for patients with deleterious BRCA mutation (germline and/or somatic)-associated metastatic castration-resistant prostate cancer who have been treated with androgen receptor–directed therapy and a taxane-based chemotherapy.
Sipuleucel-T (Provenge)
An immunotherapy adapted to each individual prostate cancer patient. Before treatment, blood is removed from the patient in a process called leukapheresis. Special immune cells are separated from the patient’s blood, modified in the laboratory, and then put back into the patient to recognize and destroy prostate cancer cells. Sipuleucel-T does not lead to lower PSA levels.
Small Cell/ Neuroendocrine Prostate Cancer
Neuroendocrine prostate cancer (NEPC) is an aggressive variant of prostate cancer that may arise in new patients or those previously treated with hormonal therapies for prostate adenocarcinoma as a mechanism of resistance.
Supportive Care
The goal of supportive care is to prevent or to treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and the psychological, social, and spiritual problems related to a disease or its treatment.
Targeted radionuclide therapy
Targeted radionuclide therapy involves a radioactive drug called a radiopharmaceutical that targets cancer cells.
Theranostics
Theranostics is a combination of the terms, therapeutics and diagnostics. It is used to describe the combination of using one radioactive drug to identify (diagnose) and a second radioactive drug to deliver therapy to treat the localize or metastatic cancer.
TNM Staging
The globally recognized standard to classify the extent of the spread of a cancer based on the tumor size and data on lymph node extension and metastases.
TRUS biopsy
TRUS biopsy (transrectal ultrasound biopsy) is used to produce detailed images of the prostate gland and surrounding tissues. This test is often used to help diagnose prostate cancer, as well as other conditions, such as an enlarged prostate gland or male infertility.
References
1. Conteduca V, Oromendia C, Eng KW, et al. Clinical features of neuroendocrine prostate cancer. Eur J Cancer. 2019;121:7-18. doi:10.1016/j.ejca.2019.08.011
2. “FDA Approves Rucaparib in BRCA-Mutated Metastatic Castration-Resistant Prostate Cancer.” FDA Approves Rucaparib in BRCA-Mutated Metastatic Castration-Resistant Prostate Cancer – The ASCO Post, www.ascopost.com/news/may-2020/fda-approves-rucaparib-in-brca-mutated-metastatic-castration-resistant-prostate-cancer/.
3. Hause RJ, Pritchard CC, Shendure J, Salipante SJ. Classification and characterization of microsatellite instability across 18 cancer types [published correction appears in Nat Med. 2017 Oct 6;23 (10 ):1241] [published correction appears in Nat Med. 2018 Apr 10;24(4):525]. Nat Med. 2016;22(11):1342-1350. doi:10.1038/nm.4191
4. “NCI Dictionary of Cancer Terms.” National Cancer Institute, www.cancer.gov/publications/dictionaries/cancer-terms/def/grade-group.
5. “Prostate Cancer – Types of Treatment.” Cancer.Net, 21 May 2020, www.cancer.net/cancer-types/prostate-cancer/types-treatment.
6. The American Cancer Society medical and editorial content team. “Chemotherapy for Prostate Cancer.” American Cancer Society, American Cancer Society, www.cancer.org/cancer/prostate-cancer/treating/chemotherapy.html.
IMPORTANT:
This information is provided for educational purposes only to support patients in understanding and discussing appropriate treatment options with their doctors. Included is information from treatment guidelines for doctors and other sources. However, this information should not be considered as patient treatment guidelines or recommendations, but as educational materials only. Patients should discuss treatments identified herein with their doctors to understand the risks and benefits of each based on their personal diagnosis. Treatment decisions should only be made between the patient and his doctor.
