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Ovarian Cancers: Evolving Paradigms in Research and Care (2016)

Chapter: Appendix B: Glossary

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Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
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Appendix B

Glossary

Adjuvant therapy—Additional cancer treatment given after the primary treatment to lower the risk that the cancer will come back. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, targeted therapy, or biological therapy (NCI, 2015a).

Adnexal mass—A lump in tissue near the uterus, usually in the ovary or fallopian tube. Adnexal masses include ovarian cysts, ectopic (tubal) pregnancies, and benign (not cancer) or malignant (cancer) tumors (NCI, 2015a).

Allele—One of two or more DNA sequences occurring at a particular gene locus. Typically one allele (“normal” DNA sequence) is common, and other alleles (mutations) are rare (NCI, 2015b).

Angiogenesis—Blood vessel formation. Tumor angiogenesis is the growth of new blood vessels that tumors need to grow. This process is caused by the release of chemicals by the tumor and by host cells near the tumor (NCI, 2015a).

Benign—Not cancerous. Benign tumors may grow larger but do not spread to other parts of the body. Also called nonmalignant (NCI, 2015a).

Bilateral salpingo-oophporectomy—Surgery to remove both ovaries and both fallopian tubes (NCI, 2015a).

Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×

Biomarker—A biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or of a condition or disease. A biomarker may be used to see how well the body responds to a treatment for a disease or condition. Also called molecular marker and signature molecule (NCI, 2015a).

BRCA1—A gene on chromosome 17 that normally helps to suppress cell growth. A person who inherits certain mutations (changes) in a BRCA1 gene has a higher risk of getting breast, ovarian, prostate, and other types of cancer (NCI, 2015a).

BRCA2—A gene on chromosome 13 that normally helps to suppress cell growth. A person who inherits certain mutations (changes) in a BRCA2 gene has a higher risk of getting breast, ovarian, prostate, and other types of cancer (NCI, 2015a).

CA-125—A substance that may be found in high amounts in the blood of patients with certain types of cancer, including ovarian cancer. CA-125 levels may also help monitor how well cancer treatments are working or if cancer has come back. Also called cancer antigen 125 (NCI, 2015a).

Cancer—A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems (NCI, 2015a).

Cancer care continuum—The trajectory from cancer prevention and risk reduction, through screening, diagnosis, treatment, survivorship, and end-of-life care (adapted from NCI, 2011).

Carcinogen—Any substance that causes cancer (NCI, 2015a).

Carcinoma—Cancer that begins in the skin or in tissues that line or cover internal organs (NCI, 2015a).

Chemosensitivity—The susceptibility of tumor cells to the cell-killing effects of anticancer drugs (NCI, 2015a).

Comparative effectiveness research (CER)—The generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. The purpose of CER is to assist consumers, clinicians, purchasers, and policy makers to make informed decisions that will improve health care at both the individual and the population levels (IOM, 2009).

Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×

Copy number variant—Refers to the genetic trait involving the number of copies of a particular gene present in the genome of an individual. Genetic variants, including insertions, deletions, and duplications of segments of DNA, are also collectively referred to as copy number variants. Copy number variants account for a significant proportion of the genetic variation between individuals (NCI, 2015b).

Debulking—Also known as cytoreduction, the surgical removal of as much of a tumor as possible. Debulking may increase the chance that chemotherapy or radiation therapy will kill all the tumor cells. It may also be done to relieve symptoms or help the patient live longer. Also called tumor debulking (NCI, 2015a).

Disease-free survival—In cancer, the length of time after primary treatment for a cancer ends that the patient survives without any signs or symptoms of that cancer. In a clinical trial, measuring the disease-free survival is one way to see how well a new treatment works (NCI, 2015a).

Epigenomics—The study of all of the epigenetic changes in a cell. Epigenetic changes are changes in the way genes are switched on and off without changing the actual DNA sequence. They may be caused by age and exposure to environmental factors, such as diet, exercise, drugs, and chemicals. Epigenetic changes can affect a person’s risk of disease and may be passed from parents to their children (NCI, 2015a).

False negative—A test result that indicates that a person does not have a specific disease or condition when the person actually does have the disease or condition (NCI, 2015a).

False positive—A test result that indicates that a person has a specific disease or condition when the person actually does not have the disease or condition (NCI, 2015a).

Genetic instability—A high frequency of mutations within the genome of a cellular lineage (Negrini et al., 2010).

Genome-wide association study—A way for scientists to identify inherited genetic variants associated with risk of disease or a particular trait. This method surveys the entire genome for genetic polymorphisms, typically single-nucleotide polymorphisms, that occur more frequently in cases (people with the disease or trait being assessed) than in controls (people without the disease or trait) (NCI, 2015b).

Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×

Genomics—The study of the complete genetic material, including genes and their functions, of an organism (NCI, 2015a).

Germline DNA—The DNA in germ cells (egg and sperm cells that join to form an embryo). Germline DNA is the source of DNA for all other cells in the body. Also called constitutional DNA (NCI, 2015a).

Germline mutation—A gene change in a body’s reproductive cell (egg or sperm) that becomes incorporated into the DNA of every cell in the body of the offspring. Germline mutations are passed on from parents to offspring. Also called hereditary mutation (NCI, 2015a).

HE-4—A gene amplified in ovarian carcinomas, whereas its expression in normal tissues, including ovary, is low. It is used as a biomarker for ovarian carcinoma (Hellstrom et al., 2003).

Hereditary cancer syndrome—A type of inherited disorder in which there is a higher-than-normal risk of certain types of cancer. Hereditary cancer syndromes are caused by mutations (changes) in certain genes passed from parents to children. In a hereditary cancer syndrome, certain patterns of cancer may be seen within families. These patterns include having several close family members (such as a mother, daughter, and sister) with the same type of cancer, developing cancer at an early age, or having two or more types of cancer develop in the same person (NCI, 2015a).

Heterogeneity—Made up of elements that are not alike (NCI, 2015a).

Histology—The study of tissues and cells under a microscope (NCI, 2015a).

Histopathology—The study of diseased cells and tissues using a microscope (NCI, 2015a).

Histotype—Any of a range of tissue types that arise during the growth of a tumor (NCI, 2015a).

Incidence—The number of new cases of a disease diagnosed over a certain period of time (NCI, 2015a).

Interval debulking surgery—Surgical removal of as much of a tumor as possible during primary chemotherapy with further chemotherapy to follow (adapted from NCI, 2015a).

Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×

Intraperitoneal chemotherapy—Treatment in which anticancer drugs are put directly into the abdominal cavity through a thin tube (NCI, 2015a).

Malignancy—Also called cancer (NCI, 2015a).

Malignant—Cancerous. Malignant cells can invade and destroy nearby tissue and spread to other parts of the body (NCI, 2015a).

Metabolomics—The study of substances called metabolites in cells and tissues. Metabolites are small molecules that are made when the body breaks down food, drugs, chemicals, or its own tissue. They can be measured in blood, urine, and other body fluids. Disease and environmental factors, such as diet, drugs, and chemicals, can affect how metabolites are made and used in the body (NCI, 2015a).

Metastasis—The spread of cancer from one part of the body to another. 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. The plural form of metastasis is metastases (NCI, 2015a).

Molecular diagnosis—The process of identifying a disease by studying molecules such as proteins, DNA, and RNA in a tissue or fluid (NCI, 2015a).

Molecular marker—See definition for biomarker.

Molecular pathway—A series of actions among molecules in a cell that leads to a certain end point or cell function (NCI, 2015a).

Molecular risk assessment—A procedure in which biomarkers (for example, biological molecules or changes in tumor cell DNA) are used to estimate a person’s risk for developing cancer. Specific biomarkers may be linked to particular types of cancer (NCI, 2015a).

Molecular test—In medicine, a laboratory test that checks for certain genes, proteins, or other molecules in a sample of tissue, blood, or other body fluid. Molecular tests also check for certain changes in a gene or chromosome that may cause or affect the chance of developing a specific disease or disorder, such as cancer. A molecular test may be done with other procedures, such as biopsies, to help diagnose some types of cancer. It may also be used to help plan treatment, find out how well treatment is working, or make a prognosis (NCI, 2015a).

Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×

Molecularly targeted therapy—In cancer treatment, substances that kill cancer cells by targeting key molecules involved in cancer growth (NCI, 2015a).

Morbidity—Refers to having a disease or a symptom of disease, or to the amount of disease within a population. Morbidity also refers to medical problems caused by a treatment (NCI, 2015a).

Mortality—Refers to the state of being mortal (destined to die). In medicine, a term also used for death rate, or the number of deaths in a certain group of people in a certain period of time. Mortality may be reported for people who have a certain disease, live in one area of the country, or who are of a certain gender, age, or ethnic group (NCI, 2015a).

Neoadjuvant chemotherapy (NACT)—Neoadjuvant therapy is a treatment given as a first step to shrink a tumor before the main treatment, which is usually surgery, is given. Examples of neoadjuvant therapy include chemotherapy, radiation therapy, and hormone therapy. It is a type of induction therapy (NCI, 2015a).

Next-generation sequencing (NGS)—A high-throughput method used to determine a portion of the nucleotide sequence of an individual’s genome. This technique utilizes DNA-sequencing technologies that are capable of processing multiple DNA sequences in parallel. Also called massively parallel sequencing and NGS (NCI, 2015b).

Omics—Scientific disciplines comprising study of related sets of biological molecules. Examples of omics disciplines include genomics, transcriptomics, proteomics, metabolomics, and epigenomics (IOM, 2012).

Oophorectomy—Surgery to remove one or both ovaries (NCI, 2015a).

Overall survival—The length of time from either the date of diagnosis or the start of treatment for a disease, such as cancer, that patients diagnosed with the disease are still alive. In a clinical trial, measuring the overall survival is one way to see how well a new treatment works (NCI, 2015a).

PARP inhibitor—A substance that blocks an enzyme in cells called PARP. PARP helps repair DNA when it becomes damaged. DNA damage may be caused by many things, including exposure to ultraviolet light, radiation, certain anticancer drugs, or other substances in the environment. In cancer treatment, blocking PARP may help keep cancer cells from repairing their

Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×

damaged DNA, causing them to die. PARP inhibitors are a type of targeted therapy. Also called poly (ADP-ribose) polymerase inhibitor (NCI, 2015a).

Patient-reported outcome (PRO)—A measurement based on a report that comes directly from the patient (i.e., study subject) about the status of a patient’s health condition without amendment or interpretation of the patient’s response by a clinician or anyone else. A PRO can be measured by self-report or by interview provided that the interviewer records only the patient’s response. (FDA, 2009).

Peritoneum—The tissue that lines the abdominal wall and covers most of the organs in the abdomen (NCI, 2015a).

Polymorphism—A common change in the genetic code in DNA. Polymorphisms can have a harmful effect, a good effect, or no effect. Some polymorphisms have been shown to increase the risk of certain types of cancer (NCI, 2015a).

Prevalence—The number of existing cases of a disease at one point in time (NCI, 2008).

Progression-free survival—The length of time during and after the treatment of a disease, such as cancer, that a patient lives with the disease but it does not get worse. In a clinical trial, measuring the progression-free survival is one way to see how well a new treatment works (NCI, 2015a).

Proteomics—The study of the structure and function of proteins, including the way they work and interact with each other inside cells (NCI, 2015a).

Psychosocial—In medicine, describes the psychological (emotional) and social parts of a disease and its treatment. Some of the psychosocial parts of cancer are its effects on patients’ feelings, moods, beliefs, the way they cope, and relationships with family, friends, and co-workers (NCI, 2015a).

Recurrence—Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrent or relapsed cancer (NCI, 2015a).

Relapse—The return of a disease or the signs and symptoms of a disease after a period of improvement (NCI, 2015a).

Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×

Residual disease—Cancer cells that remain after attempts to remove the cancer have been made (NCI, 2015a).

Salpingectomy—Surgical removal of the fallopian tubes (NCI, 2015a).

Salpingo-oophorectomy—Surgical removal of the fallopian tubes and ovaries (NCI, 2015a).

Sensitivity—When referring to a medical test, sensitivity refers to how well a test can detect a specific disease or condition in people who actually have the disease or condition. No test has 100 percent sensitivity because some people who have the disease or condition will not be identified by the test (see false negative) (NCI, 2015a).

Single-nucleotide polymorphism (SNP)—The most common type of change in DNA (molecules inside cells that carry genetic information). SNPs occur when a single nucleotide (building block of DNA) is replaced with another. These changes may cause disease, and may affect how a person reacts to bacteria, viruses, drugs, and other substances (NCI, 2015a).

Specificity—When referring to a medical test, specificity refers to the percentage of people who test negative for a specific disease among a group of people who do not have the disease. No test is 100 percent specific because some people who do not have the disease will test positive for it (see false positive) (NCI, 2015a).

Staging—Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment (NCI, 2015a).

Survivor—One who remains alive and continues to function during and after overcoming a serious hardship or life-threatening disease. In cancer, a person is considered to be a survivor from the time of diagnosis until the end of life (NCI, 2015a).

Survivorship—In cancer, survivorship focuses on the health and life of a person with cancer post-treatment until the end of life. It covers the physical, psychosocial, and economic issues of cancer, beyond the diagnosis and treatment phases. Survivorship includes issues related to the ability to get health care and follow-up treatment, late effects of treatment, second cancers, and quality of life. Family members, friends, and caregivers are also considered part of the survivorship experience (NCI, 2015a).

Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×

Telomere—The ends of a chromosome. Each time a cell divides, the telomeres lose a small amount of DNA and become shorter. Over time, the chromosomes become damaged and the cells die. In cancer cells the telomeres do not get shorter, and may become longer, as the cells divide (NCI, 2015a).

TP53—A tumor suppressor gene that normally inhibits the growth of tumors. This gene is altered in many types of cancer (NCI, 2015a).

Tumor—An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign or malignant (NCI, 2015a).

Tumor burden—Refers to the number of cancer cells, the size of a tumor, or the amount of cancer in the body. Also called tumor load (NCI, 2015a).

REFERENCES

FDA (U.S. Food and Drug Administration). 2009. Guidance for industry patient-reported outcome measures: Use in medical product development to support labeling claims. http://www.fda.gov/downloads/drugs/guidances/ucm193282 (accessed October 21, 2015).

Hellstrom, I., J. Raycraft, M. Hayden-Ledbetter, J. A. Ledbetter, M. Schummer, M. McIntosh, C. Drescher, N. Urban, and K. E. Hellstrom. 2003. The HE4 (wfdc2) protein is a biomarker for ovarian carcinoma. Cancer Research 63(13):3695-3700.

IOM (Institute of Medicine). 2009. Initial national priorities for comparative effectiveness research. Washington, DC: The National Academies Press.

IOM. 2012. Evolution of translational omics: Lessons learned and the path forward. Washington, DC: The National Academies Press.

NCI (National Cancer Institute). 2008. Cancer health disparities. http://www.cancer.gov/about-nci/organization/crchd/cancer-health-disparities-fact-sheet (accessed October 9, 2015).

NCI. 2011. Cancer control continuum. http://cancercontrol.cancer.gov/od/continuum.html (accessed October 9, 2015).

NCI. 2015a. NCI dictionary of cancer terms. http://www.cancer.gov/publications/dictionaries/cancer-terms (accessed September 16, 2015).

NCI. 2015b. NCI dictionary of genetics terms. http://www.cancer.gov/publications/dictionaries/genetics-dictionary (accessed September 16, 2015).

Negrini, S., V. G. Gorgoulis, and T. D. Halazonetis. 2010. Genomic instability—An evolving hallmark of cancer. Nature Reviews: Molecular Cell Biology 11(3):220-228.

Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×

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Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×
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Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×
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Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×
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Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×
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Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×
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Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×
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Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×
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Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×
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Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×
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Suggested Citation:"Appendix B: Glossary." National Academies of Sciences, Engineering, and Medicine. 2016. Ovarian Cancers: Evolving Paradigms in Research and Care. Washington, DC: The National Academies Press. doi: 10.17226/21841.
×
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In an era of promising advances in cancer research, there are considerable and even alarming gaps in the fundamental knowledge and understanding of ovarian cancer. Researchers now know that ovarian cancer is not a single disease--several distinct subtypes exist with different origins, risk factors, genetic mutations, biological behaviors, and prognoses. However, persistent questions have impeded progress toward improving the prevention, early detection, treatment, and management of ovarian cancers. Failure to significantly improve morbidity and mortality during the past several decades is likely due to several factors, including the lack of research being performed by specific disease subtype, lack of definitive knowledge of the cell of origin and disease progression, and incomplete understanding of genetic and non-genetic risk factors.

Ovarian Cancers examines the state of the science in ovarian cancer research, identifies key gaps in the evidence base and the challenges to addressing those gaps, considers opportunities for advancing ovarian cancer research, and examines avenues for translation and dissemination of new findings and communication of new information to patients and others. This study makes recommendations for public- and private-sector efforts that could facilitate progress in reducing the incidence of morbidity and mortality from ovarian cancers.

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