National Academies Press: OpenBook

Ensuring Quality Cancer Care (1999)

Chapter: Glossary

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Suggested Citation:"Glossary." Institute of Medicine. 1999. Ensuring Quality Cancer Care. Washington, DC: The National Academies Press. doi: 10.17226/6467.
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Glossary

A

activities of daily living:

self-care abilities related to personal care, such as bathing, dressing, eating, and continence.

adenocarcinoma:

cancer that starts in glandular tissue (e.g., breast, lung, thyroid, colon, pancreas).

alkylating agents:

a family of anticancer drugs that combine with a cancer cell's DNA to prevent normal cell division.

allogeneic transplantation:

bone marrow transplant in which the donor marrow is obtained from a person who is not an identical twin and then given to the patient.

ambulatory care:

the use of outpatient facilities doctors' offices, home care, outpatient hospital clinics and day-care facilities—to provide medical care without the need for hospitalization. Often refers to any care outside a hospital.

androgen ablation:

elimination of adrenal and testicular sources of male hormones, such as testosterone, from the prostate; used to treat end-stage prostate cancer.

aneurysm:

circumscribed dilation (ballooning out) of an artery or a heart chamber, often due to an acquired or congenital weakness of the wall of the artery or chamber.

anthracycline:

antitumor antibiotic that has shown activity in a wide range of hematological malignancies and solid tumors; believed to exert antitumor effects through direct binding to DNA.

antiandrogen therapy:

treatment that entails blocking the production of or binding to male hormone receptors on cell surfaces, for example, to reduce stimulation of testosterone-induced growth of prostate cancer.

arthroplasty:

creation of an artificial joint to correct the stiffening or fixation of a joint; an operation to restore as far as possible the integrity and functional power of a joint.

autologous bone marrow transplant:

bone marrow transplant in which the donor marrow is obtained from the patient, stored, and then given back to the patient following the anti-cancer treatments.

Suggested Citation:"Glossary." Institute of Medicine. 1999. Ensuring Quality Cancer Care. Washington, DC: The National Academies Press. doi: 10.17226/6467.
×

axillary node-negative:

lymph nodes in the armpit (axillary nodes) that do not show evidence of cancer.

B

benign prostatic hyperplasia (BPH):

a noncancerous enlargement of the prostate gland that produces bothersome lower urinary tract symptoms in aging men.

biologic response modifiers:

naturally occurring substance produced by cells that stimulate or modulate the growth and function of multiple cells, including immune cells, bone marrow cells, and tumor cells; examples include interferon, interleukin, colony-stimulating factors, and monoclonal antibodies.

bone marrow:

the inner, spongy core of bone that produces blood cells.

bone scan:

picture of the bones using a radioactive dye that shows injury, disease, or healing; may be used to determine if cancer has spread to the bone, if anticancer therapy is successful, and if affected areas are healing.

brachytherapy:

radiotherapy in which the source of irraditaion is placed close to the surface of the body or within a body cavity; e.g., application of radium to the cervix.

BRCA 1:

gene located on the short arm of chromosome 17; when damaged (mutated), a woman is at greater risk of developing breast and/or ovarian cancer compared to women who do not have the mutation.

BRCA 2:

mutation of this gene, located on chromosome 13, is associated with increased risk of breast cancer.

breast-conserving surgery:

surgery to remove a breast cancer and a small amount of tissue around the cancer, but without removing the entire breast or surrounding tissues.

C

case mix:

the characteristics of a health care facility's patient population for a given period of time, classified by such factors as individual sociodemographic characteristics, disease, diagnostic or therapeutic procedures performed, method of payment, duration of hospitalization, and intensity and type of services provided.

census tract level:

geographic unit used by the census bureau to designate areas within a county.

cisplatin:

a chemotherapy agent containing platinum with antitumor activity; binds DNA and interferes with DNA synthesis.

colposcopy:

examination of the vagina and cervix by means of an endoscope; generally takes place after an abnormal Pap smear.

conformal radiation therapy:

this technique uses conventional linear accelerators equipped with computer-controlled collimators to produce a high-dose radiation volume that conforms to the tumor with great precision.

craniotomy:

an operation on the cranium; incision into the cranium.

cryosurgery:

the use of a special cold probe as a surgical instrument; it is used to destroy cancer tissues by freezing it.

cystitis:

inflammation of the urinary bladder.

D

debulking:

procedure to remove as much of the cancer as possible; reducing the "bulk" of the cancer.

ductal carcinoma:

a very early form of breast cancer confined to cells lining the breast ducts, as opposed to the glandular tissue of the breast.

Suggested Citation:"Glossary." Institute of Medicine. 1999. Ensuring Quality Cancer Care. Washington, DC: The National Academies Press. doi: 10.17226/6467.
×

E

echography:

the location, measurement, or delineation of deep structures by measuring the reflection or transmission of high frequency or ultrasonic waves.

endarterectomy:

excision of diseased tissues surrounding the lumen of an artery.

endoscopy:

a procedure in which the doctor looks inside the body through a lighted tube called an endoscope.

etiology:

the science and study of the causes of disease and their mode of operation.

exenteration:

removal of internal organs and tissues, usually radical removal of the contents of a body cavity, such as all the pelvic organs.

extracapsular extension:

invasion of a tumor beyond the capsule surrounding its organ of origin, for example if prostate cancer invades beyond the capsule surrounding the prostate or tumor near a joint extends beyond the joint capsule.

F

febrile neutropenia:

fever associated with a low neutrophil count.

G

germ cell:

reproductive cells produced by the ovaries (eggs) or the testis (sperm).

Gleason score:

grade of tumor of the prostate; based on glandular differentiation.

H

hematopoietic stem cells:

cells in the bone marrow from which all cells in the circulating blood are derived.

hospice:

a discrete site of care in the form of an inpatient hospital or nursing home unit or a freestanding facility; an organization or program that provides, arranges, and advises on a wide range of medical and supportive services for dying patients and their families and friends; an approach to care for dying patients based on clinical, social, and metaphysical or spiritual principles.

K

kappa coefficient:

used to measure the strength of agreement between two data gatherers for interval, ordinal, or nominal-level variables.

Karnofsky performance status:

a scale of objective criteria for the quality of life, which is used for patients with incapacitating diseases; the scale was developed for patients with cancer and of use in AIDS.

L

laparascopic colectomy:

excision of part or all of the colon using a laparoscope passed through the abdominal wall.

lesion:

abnormal area, may be benign or malignant.

leukemia:

any cancer of the blood-forming tissues characterized by production of leukocytes: white blood cells.

lobular carcinoma in situ:

a very early type of breast cancer that develops within the milk-producing glands (lobules) of the breast and does not penetrate through the wall of the lobules.

local recurrence:

recurrence of a tumor at its original location.

lumpectomy:

complete surgical removal of a cancerous breast lump with little adjacent breast tissue.

luteinizing hormone-releasing hormone (LHRH):

a hormone released from the hypothalamus that triggers the secretion of luteinizing hormone from the anterior pituitary.

lymphadenectomy:

excision of the lymph nodes.

Suggested Citation:"Glossary." Institute of Medicine. 1999. Ensuring Quality Cancer Care. Washington, DC: The National Academies Press. doi: 10.17226/6467.
×

lymphoma:

cancer that begins in the lymphatic system, such as in the lymph nodes, spleen, and thymus.

M

magnetic resonance imaging (MRI):

a technique that employs a magnetic field to provide images of the internal structure of the body; computer-generated images from the magnetic frequencies correspond to particular structures in the body.

managed care:

an entity that assumes both the clinical and financial responsibility for the provision of health care for a defined population.

margin:

border between a tumor and normal tissue.

mastectomy:

excision of all or part of the breast.

medical oncologist:

physician who specializes in the diagnosis and treatment of cancer, especially in the use of chemotherapy to treat cancer.

metastasis:

the spread of cancer from its original site to one or more additional body sites.

modified radical mastectomy:

removal of the breast, skin, nipple, areola, and most of the axillary lymph nodes on the same side, leaving the chest muscles intact.

N

neoadjuvant therapy:

use of anticancer drugs before initial surgery or radiation treatment.

neutropenia:

low neturophil (a type of white blood cell) count; this is associated with high risk of infection. nonseminomatous: subtype of testicular cancer.

O

open colectomy:

removal of part or all of the colon through abdominal surgery.

orchiectomy:

removal of one or both testes.

P

palliation:

the act of relieving or soothing a symptom, such as pain, without actually curing the cause.

palliative care:

treatment of symptoms associated with the effects of cancer and its treatment.

pancreatico-duodenectomy:

excision of all or part of the pancreas together with the duodenum.

perioperative:

around the time of operation.

peripheral stem cell:

a cell collected from blood that is capable of producing diverse cell types.

pneumonectomy:

surgery to remove part or all of the lung.

proctitis:

inflammation of the mucous membrane of the rectum.

prostate specific antigen:

a protein found in the blood that may be elevated in patients with prostate cancer.

Q

Q-twist (Quality-Adjusted Time Without Symptoms or Toxicity):

a statistical technique that brings quality of life factors into the analysis of treatment regimens.

quadrantectomy:

a partial mastectomy in which the quarter of the breast that contains tumor is removed.

R

radiation oncologist:

physician who specializes in the diagnosis and treatment of cancer, especially in the use of x-rays (radiation) to treat cancer.

radical prostatectomy:

the removal of the prostate and the surrounding tissue as a treatment for prostate cancer.

Suggested Citation:"Glossary." Institute of Medicine. 1999. Ensuring Quality Cancer Care. Washington, DC: The National Academies Press. doi: 10.17226/6467.
×

randomized (clinical) trial:

an experiment designed to test the safety and efficacy of a medical technology in which people are randomly allocated to experimental or control groups, and outcomes are compared.

S

seed implants:

technique in which the radioactive source is placed in close proximity to the malignancy and provides a predictable dose of radiation to a confined area.

segmental resection:

removal of the lump and a small amount of surrounding breast tissue.

spiculated mass:

tumor with highly irregular, spiked appearance—usually associated with invasive ductal and lobular carcinoma.

staging:

the determination of the anatomic extent of a cancer.

stress incontinence:

involuntary discharge of urine due to anatomic displacement which exerts an opening pull on the bladder orifice, as in straining or coughing.

T

thoracotomy:

incision into the chest wall.

tumor necrosis factor:

a substance produced by certain white blood cells that kills cancer cells.

tumor-node-metastasis (TNM):

standard nomenclature for the staging of tumors according to three basic components: the size of the primary tumor (T), involvement of regional lymph nodes (N), and metastastis (M). Numbers are used to denote size and degree of involvement; for example, 0 indicates undetectable and 1, 2, 3, and 4, a progressive increase in size or involvement.

Suggested Citation:"Glossary." Institute of Medicine. 1999. Ensuring Quality Cancer Care. Washington, DC: The National Academies Press. doi: 10.17226/6467.
×
Page 226
Suggested Citation:"Glossary." Institute of Medicine. 1999. Ensuring Quality Cancer Care. Washington, DC: The National Academies Press. doi: 10.17226/6467.
×
Page 227
Suggested Citation:"Glossary." Institute of Medicine. 1999. Ensuring Quality Cancer Care. Washington, DC: The National Academies Press. doi: 10.17226/6467.
×
Page 228
Suggested Citation:"Glossary." Institute of Medicine. 1999. Ensuring Quality Cancer Care. Washington, DC: The National Academies Press. doi: 10.17226/6467.
×
Page 229
Suggested Citation:"Glossary." Institute of Medicine. 1999. Ensuring Quality Cancer Care. Washington, DC: The National Academies Press. doi: 10.17226/6467.
×
Page 230
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Ensuring Quality Cancer Care Get This Book
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We all want to believe that when people get cancer, they will receive medical care of the highest quality. Even as new scientific breakthroughs are announced, though, many cancer patients may be getting the wrong care, too little care, or too much care, in the form of unnecessary procedures.

How close is American medicine to the ideal of quality cancer care for every person with cancer? Ensuring Quality Cancer Care provides a comprehensive picture of how cancer care is delivered in our nation, from early detection to end-of-life issues. The National Cancer Policy Board defines quality care and recommends how to monitor, measure, and extend quality care to all people with cancer. Approaches to accountability in health care are reviewed.

What keeps people from getting care? The book explains how lack of medical coverage, social and economic status, patient beliefs, physician decision-making, and other factors can stand between the patient and the best possible care. The board explores how cancer care is shaped by the current focus on evidence-based medicine, the widespread adoption of managed care, where services are provided, and who provides care. Specific shortfalls in the care of breast and prostate cancer are identified. A status report on health services research is included.

Ensuring Quality Cancer Care offers wide-ranging data and information in clear context. As the baby boomers approach the years when most cancer occurs, this timely volume will be of special interest to health policy makers, public and private healthcare purchasers, medical professionals, patient advocates, researchers, and people with cancer.

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