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• Fine needle aspiration (FNA) biopsies use a needle attached to a syringe to withdraw a small amount of tissue from a tumor. When a slightly larger needle is used, it is called a needle core biopsy. Sometimes doctors use an ultrasound or a computed axial tomography, or CT, scan to view the tumor and assist them with needle placement.
  


• During an excisional biopsy, a surgeon removes an entire tumor. During an incisional biopsy, only a small amount of tumor is removed. Both of these procedures involve a surgeon cutting through the skin. Sometimes the surgery requires general anesthesia, and sometimes it can be done by simply numbing the area to be cut (local anesthesia).

Bone marrow transplant—A type of hematopoietic stem cell transplantation performed using stem cells collected from the patient or donor bone marrow.

Brachytherapy—Brachytherapy is radiation treatment inside the body. It uses radioactive materials placed close to the tumor to kill cancer cells while minimizing damage to normal tissues.

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Cancer—A group of diseases where normal cells change into abnormal cells that grow out of control, invade surrounding tissues and organs, and may spread to distant sites in the body (metastases)

Carcinogen—A carcinogen is anything that causes cancer. Carcinogens can be physical (eg, UV light), chemical (eg, cigarette smoke), or viral, but many are not known.

Carcinoma—Cancer that begins in the skin or in tissues lining or covering internal organs.

Chemotherapy—The use of drugs to destroy cancer cells. A person on chemotherapy may take one drug or a combination of drugs. Most often these drugs are given by vein using intravenous infusion. Some can be taken by mouth or given in a shot.

Clinical trials—The goal of clinical trials is to find better treatments to fight cancer. These treatments may work better or be safer than current therapies, or both.

Phases of a Clinical Trial


• Phase 1 clinical trial—The stage of drug development when the investigational product is first researched in humans and when drug safety is determined. For drugs tested in cancer therapy, patients with cancer participate in these studies instead of healthy volunteers, as is common with other types of drugs.
  


• Phase 2 clinical trial—The stage in which drug effectiveness is determined preliminarily in patients with the targeted medical condition. These studies are aimed at assessing short-term safety and therapeutic dose-range (minimum and maximum doses), and determining short-term side effects and risks associated with the investigational product. Usually a moderate number of patients participate in these studies.
  


• Phase 3 clinical trial—The stage in which large-scale safety and effectiveness are ascertained in a larger number of patients who ultimately will receive the investigational product. These studies are aimed at demonstrating short- and long-term safety and efficacy, and assessing overall therapeutic value as well as determining the benefit/risk relationship of the investigational product.
  


• Phase 4 clinical trial—These studies are performed after the investigational product is approved for a medical condition by the Food and Drug Administration (FDA) to gather additional data about the product.
  

Components of a Clinical Trial


• Protocol—A set of strict rules or guidelines to follow during a clinical trial. These rules include the clinical trial start and finish dates, blood tests and x-rays required, and interviews and questionnaires to complete.
  


• Study arm—Study arms are the options for treatment in a clinical trial. For example, one arm of a study may be those patients who take the research drug, while another arm of the study may be those who take the standard-of-care drug. A study may have multiple arms.
  


• Blind studies—In a single-blind study, patients are assigned to a study group (either research drug, "standard-of-care" drug, or standard-of-care drug plus placebo) but do not know which group they are in. In a double-blind study, neither the patient nor the physician knows which study group the patient is in. This reduces the effects of prejudgment by patients and physicians.

Cognitive deficits—Problems with thinking, learning, and memory; a side effect of some types of chemotherapy.

Combination chemotherapy—Using more than one anticancer medication together, with the goal of destroying more cancer cells.

CBC (complete blood count)—The CBC is a test that determines the number of red blood cells, white blood cells, and platelets in the blood.

CNS (central nervous system)—The brain and spinal cord.

Complete remission—Complete remission, also known as a clinical complete remission, is when physician can no longer see the tumor by simple examination, chest x-rays, and/or blood tests. A partial remission is where some tumor can still be detected.

Constipation—Constipation is difficulty passing stool. It can also refer to a decrease in the normal frequency of bowel movements. It may be accompanied by gas, pain, or pressure in the abdomen.

Cryotherapy—A method of treatment that uses cold temperature.

CT/CAT (computed axial tomography) scan—CT/CAT scans use x-rays to see the body in a three-dimensional way. Doctors use CT scanning to diagnose and stage cancer. Sometimes it is necessary to use a contrast medium for the images to show up on the computer. One type of contrast medium is injected into a vein and contains iodine. If you are allergic to iodine or shellfish (shellfish contain iodine), please let your technician know. Another type of contrast medium is used when the CT scan involves the gastrointestinal tract.

Cycle—Chemotherapy can be given in a variety of time arrangements, such as daily, weekly, or monthly. Chemotherapy is generally given in cycles. A cycle can last 1 or more days but usually lasts 2, 3, or 4 weeks.

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Dehydration—A condition caused by the loss of too much water from the body. Causes include severe diarrhea or vomiting.

Diagnosis—Identification of a condition or disease based on the signs and symptoms, laboratory tests, procedures, history, and physical examination of the patient.

Diarrhea—Bowel movements that occur more frequently and are more liquid in consistency than normal. Chemotherapy, medication, radiation, and infection may cause diarrhea. Diarrhea can also be caused by medications given to prevent nausea or by antibiotics given to treat or prevent infection.

Electrolyte imbalance—Having too many or too few electrolytes in your body. Electrolytes are electronically charged substances that help move nutrients into and waste out of your body and help keep your organs functioning properly. Examples of electrolyte imbalance are hyponatremia or hypokalemia.

Electrolytes—Substances that break down in the body into salts that help move nutrients into cells and help flush waste out of cells. Electrolytes also help keep your heart, nerves, muscles, and brain functioning properly.

Erectile dysfunction—Inability to have an erection of the penis; also called impotence.

External beam radiation—Radiation therapy in which radiation is directed from a source outside the body.

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Fatigue—Fatigue means feeling tired, weak, sleepy, forgetful, or worn out, and having no energy to go about your daily routine. Fatigue is commonly caused by cancer treatments, but can also result from the disease itself. Fatigue is also often present in patients with anemia.

Febrile neutropenia—Having a fever and a low white blood cell count (neutropenia). Having a fever during neutropenia is often a sign of infection.

Gene—Cells contain genes, which are pieces of DNA that contain information for making proteins. Genes contain information on hereditary characteristics such as hair color, eye color, and height, as well as whether one is at higher risk for developing certain diseases.

Grade—Grade is the measurement of a cancer, reflecting how abnormal the cells look under a microscope. There are several grading systems for cancer, but all divide cancers into those with:

• Least abnormality (grade 1 or well differentiated)
• Intermediate features (grade 2 or moderately differentiated)
• Greatest abnormality (grade 3 or 4 or poorly differentiated)

A specialist called a pathologist performs the grading by examining the biopsy specimen. Knowing the grade is important because higher-grade cancers tend to grow and spread more quickly and have a worse prognosis. A cancer's nuclear grade is based on features of the central part of its cells, the nucleus. The histologic grade refers to how much the tumor cells resemble normal cells of the same type of tissue.

Growth factors—A substance that is normally produced in the body that is involved in cell division, maturation, or survival. Growth factors may also be produced in a laboratory to mimic the growth factors naturally produced by the body. These synthetic growth factors may be used as biologic therapy to stimulate the immune system.

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Hb (hemoglobin)—The part of the red blood cell that carries oxygen from the lungs to other organs in the body, such as the brain and the heart. A person with a low hemoglobin level may have anemia.

Hct (hematocrit)—A blood test that measures the number of red blood cells in the bloodstream. The lower the hematocrit, the lower the number of red blood cells in the blood. A person with a low hematocrit may have anemia.

Hematopoietic stem cell transplant—Procedure that replenishes the supply of normal stem cells that are destroyed by high-dose chemotherapy and/or radiation therapy as part of a patient's cancer treatment; also called stem cell transplantation (SCT) or bone marrow transplantation (BMT).

Hematopoietic stem cell—Specialized cell in the bone marrow that produces white and red blood cells and platelets.

HER-2/neu (human epidermal growth factor receptor 2)—A protein that is involved in growth and replication of a normal cell. Some cancers have abnormal HER-2/neu proteins, which are believed to be involved in the unregulated growth of cancer cells.

Hormonal therapy—A type of cancer treatment that affects hormones in the body, such as drugs that block hormone production or change the way hormones work.

Hormone—A chemical made by glands in the body that circulate throughout the bloodstream and control the actions of certain cells and organs.

Hyperfractionated radiation—A radiation treatment method where the total dose of radiation is divided into small doses and given more than once a day.

Hypokalemia—Low potassium levels in the blood.

Hyponatremia—Low sodium levels in the body.

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Immune system—The body's defense system against bacterial, viral, and fungal infections. The immune system includes white blood cells and protective barriers such as the skin and mucous membranes. The principal organs of the immune system are the bone marrow, spleen, and lymph system.

Immunotherapy—A type of therapy that stimulates the immune system to help fight cancer. Immunotherapy may also be used to lessen side effects of treatment. Immunotherapy is sometimes referred to as biological therapy

Infection—An invasion of microorganisms that have the ability to multiply and produce disease.

Inflammation—Redness, swelling, pain, and/or a feeling of heat in an area of the body, often due to infection, irritation, or injury.

Infusion—A process of delivering medications, fluids, or blood products into the body through the bloodstream. A needle is used to gain access through a vein, and a catheter with tubing is used to deliver the fluid.

Intensity-modulated radiation treatment—A radiation therapy technique that delivers full doses of radiation to cancer cells but reduces damage to normal tissue near the tumor.

Internal radiation—Radiation therapy in which a radioactive source is placed inside the body near the cancer site

Intravenous (IV)—Into a vein. An intravenous medication is delivered into the body through a vein.

Jaundice—A yellowing of the skin caused by abnormal liver function.

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Leukemia—Cancer that begins in the cells of blood-forming tissue (eg, bone marrow).

Local therapy—Cancer treatment that only affects a tumor and the area close to it.

Lymph nodes—Lymph nodes are small, oval glands found throughout the body. They act as filters and fight infection. Cancer cells often spread to other parts of the body through the lymphatic system.

Lymphoma—Cancer that begins in cells of the immune system.

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Malignant—Malignant means that a tissue has cancer cells in it that come from a different site in the body; it also refers to a cancerous disease.

Malnutrition—A condition caused by not getting enough calories or nutrients such as vitamins and minerals. Causes of malnutrition include not getting enough nutrients in your diet or not being able to absorb nutrients, all of which can result from cancer or some cancer treatments.

Menopause—The time of life when a woman's ovaries stop producing hormones and menstrual periods stop; usually occurs naturally around age 50.

Metastasis—The spread of cancer from one part of the body to another.

Micrometastases—Small amounts of cancer cells that have spread throughout the body but are too few to be detected on tests.

Modality—A method of treatment. A multi-modality treatment regimen involves several types of treatment, such as chemotherapy, radiation, and surgery.

Monoclonal antibody—Targeted cancer treatment that involves a type of protein that can bind to substances in the body, including tumor cells. Each monoclonal antibody is made to target a specific substance.

Mucositis—Inflammation of the lining of the gastrointestinal tract. Oral mucositis refers to inflammation of the lining of the mouth. Mucositis may involve sores, swelling, pain, and redness.

Myelosuppression—Myelosuppression occurs when the bone marrow slows production of blood cells. This results in fewer red blood cells, white blood cells, or platelets available to perform their normal functions in the body. Chemotherapy can cause decreased bone marrow function. Most often, myelosuppression refers to the loss of white blood cells.

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Nausea—Feeling queasy or sick to your stomach.

Neoadjuvant chemotherapy—Chemotherapy given before surgery in order to shrink the tumor.

Neutropenia—Neutropenia occurs if there is a lower-than-normal number of neutrophils (infection-fighting white blood cells) in the blood. It is a common side effect of chemotherapy treatment. Neutrophils fight infection, so a person with a low neutrophil count will be more at risk for developing infection. Doctors check the number of neutrophils when they measure the white blood cell count; the result is often referred to as the ANC, or absolute neutrophil count.

Neutrophil—The most common type of white blood cell. Neutrophils help the body fight infection. Since the most common type of white blood cell is the neutrophil, a low white blood cell count usually indicates that the neutrophil count is low. It is easier to get an infection and harder to recover from an infection when the number of neutrophils in the bloodstream is low.

NSAID (nonsteroidal anti-inflammatory drug)—Medications, usually available without a prescription, that decrease inflammation (swelling, fever) and reduce pain.

Oncologist—A physician who specializes in the treatment of cancer.

Opioid—A substance used to treat moderate to severe pain that binds to opioid receptors in the central nervous system.

Oral—When medication is given by mouth.

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Palliative care—Palliative care focuses on controlling symptoms and improving quality of life for patients who have incurable diseases.

Partial remission—Partial remission is a significant decrease in the number of cancer cells, but not their complete disappearance, in response to the cancer therapy. This is in contrast to a clinical complete remission where the tumor cells are no longer observable by, for example simple examination, x-ray and/or blood tests.

Pathology—The study of the causes and characteristics of disease.

Peripheral neuropathy—A possible side effect of some chemotherapy, characterized by numbness, tingling, or burning in the hands and feet.

Peripheral stem cell transplant—During a peripheral stem cell transplant, peripheral stem cells are removed from a patient or donor and are processed and stored. The patient then receives high-dose chemotherapy to kill cancer cells. Afterward, the stem cells are given back to the patient through an intravenous line to "rescue" the patient from the harmful effects of the chemotherapy. The stem cells find their way back to the patient's bone marrow and begin making healthy blood cells. This procedure makes it possible to treat cancer with higher doses of chemotherapy because it replaces the cells damaged during chemotherapy.

Peristalsis—The contraction and relaxation movements in the intestines that move its contents forward.

Platelets—One of the three types of cells made in the bone marrow. The main function of platelets is to aid in clotting the blood following an injury.

Prognosis—A prediction of the likely outcome of a disease based on the current health of the patient and the usual course of the disease.

Proliferate—To reproduce through cell division.

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Radiation therapy—A cancer treatment that involves the use of x-rays, gamma rays, and other types of radiation to kill cancer cells, either by directly damaging their DNA or inhibiting their ability to proliferate.

Rectal—A route of administration of therapy where the medication is given through the rectum.

Red blood cell—Red blood cells are made in the bone marrow and released into the blood. They circulate in the blood and carry oxygen and carbon dioxide to and from every cell in the body.

Regimen—A plan of treatment, including doses, scheduling, and duration of treatment.

Remission—The disappearance of a cancer, as determined by clinical evaluation, resolution of symptoms, or both. Complete remission is the disappearance of all signs of cancer after treatment. Partial remission is a notable decrease in cancer cells, but not their complete disappearance, in response to therapy.

Risk factor—Anything that increases the chance of getting a certain disease, such as cancer. Some risk factors can be controlled, such as smoking. Other risk factors, such as age and race, cannot be controlled.

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Sarcoma—Cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

Side effect—A change in a person's condition caused by taking a drug, medical device, or other treatment. For example, common side effects of chemotherapy include fatigue, nausea, vomiting, and loss of appetite. Acute side effects are short-term side effects that often go away soon after treatment stops. Chronic side effects are long term.

Single agent—Single-agent therapy refers to the use of one chemotherapeutic medication for the treatment of cancer.

Stage—Staging is a method of determining the extent of the cancer, or how far the disease has spread. The stage is determined after performing a series of diagnostic tests, which may include x-rays, CT/CAT scans, and sometimes surgery. Knowing the stage of the cancer will help your doctor decide the best treatment course.

Symptom—A sign or indicator of a disease or illness.

Systemic therapy—Cancer treatment that affects cells throughout the body. Chemotherapy is a systemic treatment.

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Thrombocytes—A piece of cell formed from the bone marrow that aids in wound healing and blood clotting. Also called platelets.

Thrombocytopenia—A condition resulting from an abnormally low number of platelets (thrombocytes) circulating in the blood. Bleeding and/or bruising may occur if the platelet count is especially low (less than 20,000/mL).

Topical—A route of administration of therapy where medication is absorbed through the skin.

Transfusion—An intravenous infusion of blood or blood components.

Tumor—A collection of cells that appears as a lump, mass, or swelling.

Tumor markers—Substances in the blood or urine that are associated with particular kinds of cancer. These chemicals can be measured to help doctors diagnose cancer and evaluate the effectiveness of a cancer treatment. A rise in the level of a marker could mean the cancer is growing; a drop in the level could indicate the treatment regimen is effective.

Ulceration—A break on the skin or on the surface of an organ. Ulcers are sometimes associated with cancer.

VAD (vascular access device)—VADs are catheters, or "ports", that are surgically placed in a large vein near the heart and stay in place for long periods of time. When a VAD is used, smaller, more easily irritated veins in the arms do not have to be accessed for chemotherapy.

White blood cell—A white blood cell is one of the three main types of blood cells. White blood cells are responsible for fighting infection. There are several kinds of white blood cells, including monocytes, lymphocytes, neutrophils, eosinophils, and basophils.

X-ray—A test used for diagnosis and assessment. During an x-ray, a small amount of radiation passes through the body and leaves an image of the shape of the internal organs on film.

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Understanding Cancer – Chemotherapy Side Effects – Treating Cancer in Other Ways
Tracking Your Test Results – Understanding Insurance and Tax Issues
Chemotherapy Resources and Organizations – Register for Programs