Glossary of ACC Related Terms

3-D Conformal Radiation - Three dimensional (3-D) conformal radiation therapy is a technique whereby the beams of radiation used in treatment are shaped to match the tumor. Previously, radiation treatment matched the height and width of the tumor, meaning that healthy tissue had to be exposed to the beams. Advances in imaging technology make it possible to locate the tumor precisely. Conformal radiation therapy uses the targeting information to focus precisely on the tumor while avoiding the healthy surrounding tissue. This exact targeting makes it possible to use higher levels of radiation in treatment, which are more effective in shrinking and killing tumors. 3-D conformal therapy is in some ways similar to IMRT; both are used to target cancer while sparing healthy tissue. With IMRT, radiation intensity can be turned up or down during the treatment, but sometimes due to the tumor shape and location, 3-D conformal therapy is best suited to treating a cancer. This determination is made by the radiation oncologist.


Abdomen - The part of the body that lies between the chest and the pelvis and encloses the stomach, intestines, liver, spleen, and pancreas. Also called belly, venter.


Ablation – the removal or destruction of a body part or tissue or its function. Ablation may be performed by surgery, hormones, drugs, radiofrequency, heat, or other methods.


Active Beam, Proton - High precision radiation beam using protons (or heavy ions). Protons have excellent physical properties permitting control of the shape of how the dose inside the patient's body is distributed. The dose delivered by a moving proton beam is well localized in space, not only in the lateral direction, but also very precisely in depth.


Adenocarcinoma - ACC is a sub-type of a more general category of cancers known as Adenocarcinoma which occur at various regions of the body. Head and neck cancers are divided into two subgroups: adenocarcinoma, which accounts for only 15% of the head and neck cancers, and squamous cell carcinomas, which account for the other 85%. Adenocarcinoma begins in glandular tissues in the cells that line organs with gland-like, secretory properties which are found in the surface of skin and the linings of hollow organs in the body and passage ways which are found through out the body. According to the SEER group from the NCI, ACC (Adenoid Cystic Carcinoma, Adenocystic Carcinoma) is one of the four subsets of the Adenocarcinoma type, with the other three being 1) Adenocarcinoma with mixed subtypes, 2) Mucoepidermoid carcinoma, and 3) Acinar Carcinoma. ACC accounts for approximately 1% of all head and neck cancers.


Adenoid Cystic Carcinoma (ACC) - ACC is a rare and uncommon form of malignant neoplasm that arises within secretory glands, most commonly appearing in the major and minor salivary glands in the head and neck. It also appears in many other primary sites including (but not limited to) the palate, nasopharynx, tongue base, larynx, trachea, lung, brain, bartholin gland, skin, lacrimal gland, breast, vulva, uterus and liver. ACC is known to have a tendency to grow microscopically down nerve tissue sheathing (perineural invasion) and has a high incidence of metastatic spread to other areas of the body, the most common organs being lungs, liver and bone.


Adenoma - A noncancerous tumor that starts in gland-like cells of the epithelial tissue (thin layer of tissue that covers organs, glands, and other structures within the body).


Adjutant Therapy - Treatment used in addition to the primary method. For example, radiation therapy often is used in addition (as an adjutant) to surgery. May also include chemotherapy, hormone therapy or biological therapy. The treatments work together to deliver a more effective, desired outcome.


Alopecia - Hair loss on head and/or body, a potential side effect of radiation therapy and chemotherapy


Anesthetic - A substance that causes lack of feeling or awareness. A local anesthetic causes loss of feeling in a part of the body. A general anesthetic puts the person to sleep.


Angiogram, Angiography or Arteriography - Medical imaging technique used to visualize the inside of blood vessels and organs, with particular interest in arteries, veins and the heart chambers. Traditionally done by injecting a contrast agent into the blood vessel and imaging using X-ray based techniques such as fluoroscopy. The film or image of the blood vessels is called an angiograph, or more commonly, an angiogram.


Aperture - In radiation a block containing a hole or multiple plates through which the radiation beam passes. The shape of the hole is the approximate shape of the target being treated by the beam. In general, an opening or open space, the diameter of the stop in an optical system that determines the diameter of the bundle of rays traversing the instrument.


Aphasia - Also known as rhymnasia, is a loss of the ability to produce and/or comprehend language, due to injury to brain areas specialized for these functions, eg which govern language production or the interpretation of language. It is not a result of deficits in sensory, intellectual, or psychiatric functioning, nor due to muscle weakness or a cognitive disorder, rather an acquired communication disorder that impairs a person's ability to process language, but does not affect intelligence.


Arteriovenous Malformation - A tangle of blood vessels, a defect in the circulatory system, mainly in the brain or spinal cord.


Atrophy - The decrease in size of an organ or cell by reduction in cell size and/or reduction in cell numbers, often by a mechanism involving apoptosis. There are several categories in which atrophy may occur.Decreased function, Loss of innervation, loss of blood supply, 'Pressure'atrophy, Lack of nutrition, Loss of endocrine stimulation,


Beam shaping - Radiation beams can be shaped to match their intended targets. Within virtually all treatment machines, soon after the beam is produced it is "collimated" into a useful shape by blocking unwanted parts of the beam. Depending on the desired shape, additional blocking of the beam is usually required. Multi-leaf collimators can be used to shape the beam further, under computer-controlled guidance, into complex geometric shapes for patients who require this technology. Also, newer technology allows some systems to have the ability to create static field shapes or to dynamically collimate an active beam to alter the beam intensity as well as the beam shape.


Benign, Benign Tumor - Mild and non-progressive sickness; In oncology, a benign tumor is a tumor that lacks all three of the malignant properties of a cancer. It does not grow in an unlimited, aggressive manner, does not invade surrounding tissues, and does not metastasize.


Bilateral vs Unilateral - Bilateral means two-sided, possibly symmetrical; Unilateral means one-sided.


Biological Therapy - Type of treatment that works with your immune system. It can help fight cancer or help control side effects (how your body reacts to the drugs you are taking) from other cancer treatments like chemotherapy.


Biopsy - Removing a sample of tissue for examination by a pathologist to determine the fundamental structures and pathology. This is a fundamental process in determining the evidence of cancer and the type. In some cases a less invasive needle biopsy process is used. A needle (percutaneous) biopsy removes tissue using a hollow tube called a syringe. A needle is passed through the syringe into the area being examined. The surgeon uses the needle to remove the tissue sample. Needle biopsies are often done using x-rays (usually CT scan), which guide the surgeon to the appropriate area.


Excisional biopsy - A biopsy in which an entire lesion, is removed. A excisional biopsy is in contrast to an incisional biopsy in which only a sample of tissue is cut into (incised) and removed.


Bolus - Multiple meanings: 1: a rounded mass: as a: a large pill b: a soft mass of chewed food 2 a: a dose of a substance (as a drug) given intravenously b: a large dose of a substance given by injection for the purpose of rapidly achieving the needed therapeutic concentration in the bloodstream


Brachial Plexopathy - Decreased movement or sensation in the arm and shoulder due to a nerve problem.


Brachytherapy - Also known as sealed source radiotherapy or endocurietherapy, is a form of radiotherapy where a radioactive source is placed inside or next to the area requiring treatment (seed implantation).


Brachytherapy, high-dose rate remote - A type of brachytherapy in which the radioactive source is removed between treatments.


Brachytherapy, interstitial - Brachytherapy system which involves leaving the seed in to emit radiation over an extended period of time.


Brachytherapy, intravascular - Brachytherapay one-time high dose radiation with the removal of the seed or radiation source the same day following the treatment.


Bragg Peak - The point at which protons (and other heavily charged particles) deposit most of their energy. This point occurs at the ends of the protons' paths. By varying the beam's energy, radiation oncologists can spread this peak to match the contours of tumors or other targets.


Brain Stem - The lower extension of the brain where it connects to the spinal cord. Neurological functions located in the brain stem include those necessary for survival (breathing, digestion, heart rate, blood pressure) and for arousal (being awake and alert). This region of the brain is often called “the lizard brain” because it processes the automatic foundational functioning processes for the body.


Bronchial - Having to do with the bronchi, which are the larger air passages of the lungs, including those that lead from the trachea (windpipe) to the lungs and those within the lungs.


Buccal space - The buccal space is the area between the cheek and gums, or between the teeth and the buccal mucosa or buccal membrane. Certain medications are designed to be given bucally (as opposed to orally or sub-lingually). Bacall (as opposed to oral) administration usually results in a more rapid onset of action, since the medication need not pass through the digestive system and can be absorbed directly through the skin.


CAM (Complementary and Alternative Medicine) - CAM is a group of medical and health care systems, practices and products that are not presently considered to be part of conventional medicine. Conventional medicine treatments for cancer patients are primarily surgery, radiation and chemotherapy. Complementary treatments are those treatments used in conjunction with conventional medicine, and alternative medicine is used in place of conventional treatments. Integrative medicine combines conventional medicine with those alternative medicine treatments that have evidence of safety and effectiveness. A few examples of CAM are diet, herbal supplements, massage, vitamin supplements, chiropractic, acupuncture, Chinese medicine and mind-body medicine.


Carcinogen - Any substance that causes cancer.


Carcinoma – Cancer that begins in the skin or in tissues that line or cover internal organs. All salivary gland tumors are carcinomas.


Cellulitis - Acute inflammation of the connective tissue of the skin, caused by infection with staphylococcus, streptococcus or other bacteria.


Central nervous system (CNS) - Pertaining to the brain, cranial nerves and spinal cord. The brain and spinal cord serve as the main "processing center" for the entire nervous system, and control all the workings of the body.


Cerebellopontine Angle - The angle between the cerebellum and the pons, a common site for the growth of acoustic neuromas (vestibular schwanomas).


Cerebellum - The second largest area of the brain, consisting of two hemispheres or halves and connected to the brain stem. The cerebellum is involved in the coordination of voluntary motor movement, balance and equilibrium and muscle tone. It is located just above the brain stem and toward the back of the brain.


Cerebral - Relating to the brain or the intellect, awareness and thought process.


Cerebrospinal Fluid - The clear fluid made in the ventricular cavities of the brain that bathes the brain and spinal cord.


Cerebrum - The largest area of the brain occupying the uppermost part of the skull. It consists of two halves called hemispheres. Each half of the cerebrum is further divided into four lobes: frontal, temporal, parietal, and occipital.


Chemotherapy - (commonly called chemo) is a type of cancer treatment that uses drugs to destroy cancer cells.


Choroid Plexus - An area in the brain where cerebrospinal fluid is produced.


Circumscribed or encapsulated - Localized; having a border or being wholly confined to a specific area.


Clinical Proton Therapy Center - A proton treatment facility located in, or in close association with, a hospital or cancer center. An accelerator and treatment delivery system are used to irradiate diseased tissue with proton particles. Clinical proton therapy centers enable patients and physicians to take advantage of a variety of medical specialist's health care expertise, as needed.


Clinical trial - A formal, biomedical or health-related research study carried out according to a prospectively defined protocol that is intended to discover or verify the safety and effectiveness of procedures or interventions in humans.


Collimator – A unit that shapes the beam of radiation; may be fixed or adjustable.


Collimator, multi-leaf - A unit that shapes radiation by computer digitization moving small metal plates at the aperture opening of the radiation machine, replacing custom blocking. Multi-leaf Collimators are designed to facilitate optimum dose distribution, and allow the therapist to adjust beam shape during the radiation process without reentering the treatment room.


Computer Assisted Surgery (CAS) - This represents a surgical concept and set of methods, that use computer technology for presurgical planning, and for guiding or performing surgical interventions. CAS is also known as computer aided surgery, computer assisted intervention, image guided surgery and surgical navigation. CAS has been a lead in factor for the development of robotic surgery .


Congenital - Existing before or at birth, or an essential characteristic


Craniotomy - Surgery involving the removal of skull bone, called bone flap, to gain access to the brain. The bone is put back at the end of the operation.


Critical structures - Normal tissues or organs near the tumor whose preservation limits the amount of radiation that can be administered, or, in surgery, require special attention.


Cryosurgery, cryoablation - The process off destroying tumors using liquid nitrogen(or a very cold probe) that is inserted into the tumor in order to freeze the tumor tissue, thus destroying it; a technique for freezing and killing abnormal cells. It is used to treat some kinds of cancer and some precancerous or noncancerous conditions, and can be used both inside the body and on the skin.


CT Scan (CAT scan; Computed tomography; computerized axial tomography scan) A series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an x-ray machine with the patient inside a tubular shaped device. Traditionally the images obtained look like the typical X-ray with much more detail, and are done in a series of “slices” with the width of each slice being 1 to 3cm. Newer technologies now allow the equipment to do a cylindrical scan, which produces a more extensive data base of 3D images which can be used to produce a wide range of final sets of images for the doctor requesting the scan.


CyberKnife Radiation - A radiation delivery system utilizing a frameless robotic system which is capable of delivering high doses of radiation to tumors anywhere in the body with extreme accuracy while minimizing damage to healthy surrounding tissue. The unique feature is that the LINAC photon accelerator is mounted on a large robotic arm and is movable around the patient in order to delivery multiple doses, with a typical treatment protocol of over 100 different angles. The typical treatment can maintain 2 to 5mm margin accuracy around the tumor.


Cyst - A fluid-filled mass, usually enclosed by a membrane and generally benign.


Davinci Surgery - An alternative to open surgery and conventional laparoscopy. Computer and robotic technologies are used by surgeons to perform complex and delicate operations using very small incisions with better visualization, control and accuracy.


Definitive Cancer Therapy - A treatment plan designed to potentially cure cancer using one or a combination of interventions including surgery, radiation, chemical agents, or biological therapies.


Diagnostic radiologist A physician in the sub-specialty aiding in diagnosis using radiology.


Dietitian - A specialist enhancing health through food and nutrition.


Diffuse - Lacking a distinct border, not concentrated or localized.


Digital Rectal Examination (DRE) - A digital (finger) rectal examination is done to check for problems with organs or other structures in the pelvis and lower belly. A health professional gently puts a lubricated, gloved finger into the rectum. He or she may use the other hand to press on the lower belly or pelvic area. A digital rectal exam is done for men as part of a complete physical examination to check the prostate gland. It is done for women as part of a gynecological examination to check the uterus and ovaries. Other organs, such as the bladder, can sometimes also be felt during a digital rectal exam.


Dorsal - Relating to the back or posterior of a structure. As opposed to the ventral, or front, of the structure. Some of the dorsal surfaces of the body are the back, buttocks, calves, and the knuckle side of the hand.


Edema (Oedema, Dropsy) - Tissue swelling caused by the accumulation of fluid.


Efficacy - Able to achieve the desired results or produces beneficial results.


Electromagnetic Navigation Bronchoscopy - A minimally invasive procedure which uses a combination of a brochoscope (a very thin, lighted tube), a chest CT Scan loaded into a computer, and a low-frequency electromagnetic plate under the patient. This provides the interventional pulmonolist with a computer enhanced image of the air ways that is very similar to a GPS system (global positioning system) for placing fiducials for IMRT, performing biopsies, or examining airways in the bronchus and lungs.


Encapsulated or Circumscribed - Localized; having a border or being wholly confined to a specific area.


Epidemiology- is the study of factors affecting the health and illness of populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine.


Epigenetics - The study of mechanisms involved in the production of phenotypic complexity in morphogenesis. The word "epigenetic" literally means "in addition to changes in genetic sequence." The term has evolved to include any process that alters gene activity without changing the DNA sequence, and leads to modifications that can be transmitted to daughter cells (although experiments show that some epigenetic changes can be reversed). There likely will continue to be debate over exactly what the term means and what it covers. According to the epigenetic view of differentiation, the cell makes a series of choices (some of which may have no obvious phonotypic expression and are spoken of as determination events) that lead to the eventual differentiated state. Thus, selective gene repression or depression at an early stage in differentiation will have a wide ranging consequence in restricting the possible fate of the cell.


Erythema (acute) - Redness of the skin caused by abnormal blood accumulation in the capillaries. Common side effect after radiotherapy.


Etiology - The word is most commonly used in medical and philosophical theories, where it is used to refer to the study of why things occur, or even the reasons behind the way that things act, and is used in philosophy, physics, psychology, government, medicine, theology and biology in reference to the causes of various phenomena.


Evidence-based Medicine (EBM) - Aims to apply evidence gained from the scientific method to certain parts of medical practice.


External-Beam Radiation - Radiation delivered from a source outside the body.


Familial - tending to occur in more members of a family than expected by chance alone, but is not genetic (inherited). Might indicate a susceptibility, or a common environmental influence.


Fatigue - An unusual lack of energy and tiredness not relieved by sleep. (Also called exhaustion, lethargy, languidness, languor, lassitude, and listlessness) This is a weariness caused by any exertion. It can describe a range of afflictions, varying from a general state of lethargy to a specific work-induced burning sensation within one's muscles. It can be both physical and mental. Physical fatigue is the inability to continue functioning at the level of one's normal abilities. It can be acute (less than a month) or chronic (longer than a month). This lack of energy can prevent a person from functioning normally and impacts a person's quality of life.


Fiducials - Metallic pellets, also known as fiduciary markers, that are placed near a tumor that will be treated with IMRT and SBRT radiation machines in order to provide the radiologist with fixed points of reference. The fiducials are seen on the planning CT image so that the radiation beams can be more precisely calibrated and aimed at the tumor.


Focal - Limited to one specific area.


Fractionation; Fractionated Stereotactic Body Radiotherapy - Spreading out a determined dose of radiation into fractions over a series of days, usually administered once or twice daily. Fractionation allows normal cells time to recover, while tumor cells are less efficient in repair between fractions.


Gamma Knife radiosurgery – Used exclusively to treat a variety of lesions, tumors and structural abnormalities inside the brain by applying intersecting beams of radiation to the abnormal area. Gamma Knife radiosurgery is often a safer option than traditional neurosurgery because no incisions are involved. In Gamma Knife radiosurgery, doctors use advanced imaging technology to localize tumors and vascular abnormalities in the brain with pinpoint accuracy, so an array of radiation beams can be focused precisely on the target from many different directions. Each individual radiation beam is too weak to harm the brain tissue it passes through. The patient is fitted with a “helmet” device that has multiple entry points that allow the radiation to enter into a single isocenter that is precisely at the target tumor. The effect of gamma-knife radiosurgery occurs only at the spot in the brain where all the beams meet. With the help of a computer, this spot can be accurately plotted to within a fraction of a millimeter.


Gamma rays - A type of electromagnetic radiation used in scanning (CT, PET) and external-beam radiation and brachytherapy. These rays come from a radioactive source such as cobalt-60.


Ganglia - A mass of nerve tissue or a group of nerve cell bodies.


Gantry - A device for rotating the radiation delivery apparatus around the patient during radiation therapy. This motion is designed to treat from different angles. This structure can be smaller and contained within a room or in the case of some proton therapy centers, the gantries are three-story-high, rotating structures that guide the proton beam from the beam transport system to the beam delivery nozzle.


Glial Tissue/Cells - Cells of the nervous system. They compose a voluminous support system that is essential to the proper operation of nervous tissue and the nervous system. Unlike neurons, glial cells do not conduct nerve impulses. Glia perform a plethora of functions in the nervous system. These functions include providing support for the brain, assisting in nervous system repair and maintenance, assisting in the development of the nervous system, and providing metabolic functions for neurons.


Grading Systems - Used to classify cancer cells in terms of how abnormal they look under a microscope and how quickly the tumor is likely to grow and spread. A pathologist (a doctor who identifies diseases by studying cells under a microscope) determines whether the tumor is benign or malignant. The pathologist also determines the tumor grade. Each type of cancer is graded using a different grading system. Doctors consider tumor grade and other factors when developing an individual treatment plan for a patient.


Grading System, Classification of Malignant Tumors (TNM) - A cancer staging system that describes the extent of cancer in a patient's body. T describes the size of the tumor and whether it has invaded nearby tissue, N describes regional lymph nodes that are involved, and M describes distant metastasis (spread of cancer from one body part to another).


Gray - A measure of absorbed radiation dose. One Gray (Gy) equals 100 rads in the older terminology.


HBO (Hyperbaric Oxygen Treatment) - HBO is a specialized treatment where a patient in placed inside a chamber and breathes 100% oxygen intermittently for approximately one hour while the pressure of the treatment chamber is increased to greater than one atmosphere absolute pressure (atm abs). This treatment increases the vascular supply to tissue for a condition known as osteoradionecrosis, which increases the healing capabilities of tissue damage caused by radiotherapy for cancer of the head and neck. The treatment is typically done for a total of 30 days: 20 days prior to having a surgical procedure and then 10 days after it is done. This process uses either a single person chamber where the patient lies down in a tube shaped structure, or in a multi-place chamber which holds from 2 to 6 patients who sit in a circle.


Head and Neck Cancers - Cancer that arises in the head or neck region (in the nasal cavity, sinuses, lips, mouth, salivary glands, throat, or larynx [voice box]). Most head and neck cancers begin in the squamous cells that line the mucosal surfaces in the head and neck. Head and neck cancers are identified by the area in which they begin. Tobacco and alcohol use are the most important risk factors for head and neck cancers. Typical symptoms of head and neck cancer include a lump or sore (for example, in the mouth) that does not heal, a sore throat that does not go away, difficulty swallowing, and a change or hoarseness in the voice. The treatment plan for an individual patient depends on a number of factors, including the exact location of the tumor, the stage of the cancer, and the person's age and general health. Rehabilitation and regular follow-up care are important parts of treatment for patients with head and neck cancer.


Hemiplegia - Complete paralysis of one side of the body.


Hereditary - Inherited or genetic; passed on from parent to child.


Histology - The study of cells using a microscope, also called microscopic anatomy. Pathologists are the primary doctors who analyze a tumor sample from a biopsy. In completing a biopsy, a physician removes all or a section of a tumor through surgical means or by using a large bore needle to obtain a sample. The pathologist then analyzes the sample under a microscope and makes the diagnosis for a particular type of cancer such as ACC. The diagnosis is based upon the shape, structure, framework (stroma), color and growth pattern of the cells. ACC tumors are characterized by a distinctive pattern in which abnormal "nests" or cords of certain cells (epithelial cells) surround and/or infiltrate ducts or glandular structures within the affected organ. These structures are typically filled with a mucus-like material or contain abnormal fibrous membranes (hyaline membranes).


Hyperfractionation - A method of dosing radiation therapy in which small amounts of radiation are administered more frequently, typically more than once per day.


Hyper-pigmentation - Darkening of the skin


Hypopituitarism - Damage to the pituitary gland (which is located at the base of the skull and regulates growth and metabolism) causing it to produce lower than normal levels of its hormones.


Hypothalamus - part of the brain that contains a number of small nuclei with a variety of functions. One of the most important functions is to link the nervous system to the endocrine system via the pituitary gland (hypophysis).


Hypoxia - Insufficient levels of oxygen in blood or tissue.


IGRT (Image guided Radiation Therapy) - Image-guided radiation therapy (IGRT) is the process of frequent two and three-dimensional imaging, during a course of radiation treatment, used to direct radiation therapy utilizing the imaging coordinates of the actual radiation treatment plan. The patient is localized in the treatment room in the same position as planned from the reference imaging dataset. An example of Three-dimensional (3D) IGRT would include localization of a cone-beam computed tomography (CBCT) dataset with the planning computed tomography (CT) dataset from planning. Similarly Two-dimensional (2D) IGRT would include matching planar kilo-voltage (kV) radiographs fluoroscopy or mega-voltage (MV) images with digital reconstructed radiographs (DRRs) from the planning CT. This process is distinct from the use of imaging to delineate targets and organs in the planning process of radiation therapy. However, there is clearly a connection between the imaging processes as IGRT relies directly on the imaging modalities from planning as the reference coordinates for localizing the patient. The variety of image gathering hardware used in planning includes Computed Tomography(CT), Magnetic Resonance Imaging (MRI), and Positron Emission Tomography (PET) among others. Through advancements in imaging technology, combined with a further understanding of human biology at the molecular level, the impact of IGRT on radiotherapy treatment continues to evolve.


Immunohistochemical testing (tumor marker testing) - A laboratory method used to identify and analyze cell types by microscopic localization of specific antigens in tissues(using antibodies with fluorescent or pigmented material). The results from this type of test can identify the presences or absence of a particular types of cell receptors or tumor markers that can show the potential relative sensitivity for particular therapeutic treatment agents or drugs.


Immunotherapy - Use of the body's immune system to fight tumors.


IMRT (Intensity Modulated Radio Therapy) - A type of 3-dimensional radiation therapy that uses computer-generated images to show the size and shape of the tumor. Thin beams of radiation of different intensities are aimed at the tumor from many angles. This type of radiation therapy reduces the damage to healthy tissue near the tumor. Also called IMRT.


Induration - Hardening of tissue


Infiltrating - Referring to a tumor that penetrates the normal, surrounding tissue


Inflammation - a protective tissue response to injury or destruction of tissues, which serves to destroy, dilute, or wall off both the injurious agent and the injured tissues. The classical signs of acute inflammation are pain (dolor), heat (calor), redness (rubor), swelling (tumor), and loss of function (function laesa).


Inflammatory necrotic tissue - Tissue death with associated inflammation.


Infratentorial - Below the tentorium, a flap of the membrane protecting the brain that separates the cerebral hemispheres from the brain structures in the posterior fossa.


Interdisciplinary - Involving two or more disciplines.


Interstitial radiation - Treatment given by placing radioactive material directly into the target, often a tumor. Also called brachytherapy or seed implant radiation.


Interventional Radiology - (abbreviated IR or sometimes VIR for vascular and interventional radiology) is a sub-specialty of radiology in which minimally invasive procedures are performed using image guidance. Some of these procedures are done for purely diagnostic purposes (e.g., angiogram), while others are done for treatment purposes (e.g., angioplasty). Pictures (images) are used to direct these procedures, which are usually done with needles or other tiny instruments like small tubes called catheters. The images provide road maps that allow the Interventional Radiologist to guide these instruments through the body to the areas of interest.


Intra-cerebral - Occurring or situated within the cerebrum


Intra-cranial - Occurring or situated within the skull (cranium).


Intraoperative Radiation - A type of external radiation used to deliver a single, large dose of ionizing energy to a tumor area during the time of surgery. The radiation is aimed directly at the tumor bed and surrounding tissue while the tissue is exposed.


Intraventricular - Pertaining to the space within a ventricle or to the conduction system within the walls of a ventricle.


Invasive tumor - Another synonym of cancer. The name refers to invasion of surrounding tissues.


Ionizing Radiation - radiation with enough energy so that during an interaction with an atom, it can remove tightly bound electrons from the orbit of an atom, causing the atom to become charged or ionized. - Radiation therapy is the use of ionizing radiation to kill cancer cells and shrink tumors. Radiation therapy injures or destroys cells in the area being treated (the "target tissue") by damaging their genetic material, making it impossible for these cells to continue to grow and divide. Although radiation damages both cancer cells and normal cells, most normal cells can recover from the effects of radiation and function properly. The goal of radiation therapy is to damage as many cancer cells as possible, while limiting harm to nearby healthy tissue.


Iridium - A radioactive isotope used in interstitial brachytherapy.


Karnofsky score - A rating from 0 to 100 attempting to quantify cancer patients' general wellbeing.


Larynx - The organ of voice that is part of the upper air passage connecting the pharynx with the trachea that contains the vocal cords.


Late effects - Side effects of cancer treatment that appear months or years after treatment has ended. Late effects include physical and mental problems and second cancers.


Lateral - Relating to or situated at or on the side; relating to the left or right lateral region of the abdomen.


Lesion - Abnormal tissue found on or in an organism, usually damaged by disease or trauma.


Lesions of cranial nerve - ACC commonly invades and wraps around nerves, and when doing so the tumor can destroy the nerve. If this nerve is located in the head the tumor can e.g. result in deafness, tinnitus, dizziness, vertigo and vomiting.


LINAC Radiosurgery - Linac is short for the term linear accelerator. Linear accelerator machines produce radiation that is referred to as high energy X-ray. A linear accelerator machine is designed to be a general purpose radiation delivery machine and in general requires modifications to enable it to be used for radiosurgery or IMRT (intensity modulated radiation therapy). Often, the modification is the addition of another piece of machinery.


Linear accelerator (LINAC) - A machine prevalent throughout the world that creates high-energy radiation to treat cancers using electricity in a linear accelerator to form a stream of fast-moving subatomic particles such as X rays or electrons. Also called a mega-voltage (MeV) or "linac" (pronounced LYNN-ack) it delivers high-energy x-ray photons or electrons in curving paths around the patient. The linear accelerator can perform radiosurgery on larger tumors in a single session or during multiple sessions, which is called fractionated stereotactic radiotherapy. Multiple manufacturers make this type of machine, which have brand names such as Peacock(r), X-Knife(r), CyberKnife(r), Clinac(r).


Lingula - A small, tongue like structure that slightly extends out in the left, upper lobe near the heart.


Lobe - A portion of an organ, such as the liver, lung, breast, thyroid, or brain.


Lobectomy - The removal an entire, complete lobe of the lung. The lungs are subdivided into sections referred to as "lobes". The right lung has three lobes, while the left lung has two lobes. A lobectomy is an operation in which the surgeon removes one of "lobes" of the lung. The term "ectomy", when attached to the name of a body part, generally means that body part or a part of the body part is being removed. After lobectomy, some compensatory non-pathologic emphysema occurs as the remaining lung tissue over expands to fill in that portion of the thoracic space previously occupied by the resected tissue. A lobectomy should be one of the last surgical options due to the loss of valuable lung tissue.


Local - In the area of the tumor; confined to one specific area.


Lung Lobe Anatomy - (anatomy sections of lung) The lungs are divided into lobes. The right lung has 3 lobes(upper,middle,lower); the left lung has only 2 lobes(upper and lower).


Lung Perfusion and Lung Ventilation - scans are usually performed in the same session they test lung performance and functioning.The tests uses nuclear medicine to produce a picture of blood flow to the lungs and measures the ability of the lungs to take in air and which areas of the lung are capable of ventilation. These tests are called by different names, including perfusion lung scan, aerosol lung scan, radionucleotide ventilation lung scan, ventilation lung scan, xenon lung scan, ventilation/perfusion scanning (VPS), pulmonary scintiphotography, or, most commonly, V/Q scan.


Lymphedema - also spelled lymphoedema, also known as lymphatic obstruction A condition in which excess fluid collects in tissue and causes swelling. It may occur in the arm or leg after lymph vessels or lymph nodes in the underarm or groin are removed or treated with radiation.


Malignant - Cells and tumors that are cancerous or life-threatening, capable of invading, spreading, and tending to become progressively worse. The opposite of benign (noncancerous).


Mandibular Gland - A salivary gland situated behind the angle of the jaw, sometimes partly covered by the parotid salivary gland and the mandible.


Margins - Margins Usually 2-4 mm is the amount of normal-appearing skin surrounding the tumor and removed surgically with the tumor( but the size will depend on the type and stage of the cancer)


Margins, negative – This means the pathologist found that the margin area is free of cancer cells.


Margins, positive – This means there is still cancer tumor in the body after surgery, and it usually the result of inadequate resection of the cancer. Positive surgical margins increase the risk of biochemical recurrence independently from pathological stage or grade.


Marker - see Tumor Marker


Mass Effect - The effect of a growing mass like a tumor, e.g. damage to the brain due to the bulk of a tumor, the blockage of fluid, and/or excess accumulation of fluid within the skull.


Mastication Space/Masticator Space - space containing the masticatory muscles (medial and lateral pterygoid muscle, masseter muscle, temporal muscle); these muscles attach to the ascending ramus and angle of the mandible. The nerve of the masticator space is the mandibular nerve (third branch of the trigeminal nerve); it supplies the motor innervation of the masticatory muscles and provides via the inferior alveolar nerve sensation to the mandibular teeth, gums and lower lip/chin region. The part of the masticator space below the level of the zygomatic arch is sometimes called the infra-temporal fossa, and the part above it the temporal fossa.


Mastication - the act of chewing accomplished by the coordinated activity of the tongue, mandible, mandibular musculature, and structural components of the temporomandibular joints, and controlled by the neuromuscular mechanism. Abnormalities of this function commonly occur and often have diagnostic significance. Painful teeth may cause slow, intermittent or one-sided eating. Dropping of the food from the mouth during eating may have a similar cause.


Masticatory -Muscles including the masseter, temporal, pterygoids and digastric muscles.


Medial - Describes a structure toward the midline of the body and lateral away from that median plane. Intermediate describes a structure between a medial and a lateral structure. The nose is medial to the ears while the ears are lateral to the nose. The cheeks are intermediate between the nose and the ears.


Medial Pterygoid - also known as pterygoideus medialis and external pterygoid muscle one of the four muscles of mastication. It acts to close the jaws.


Median Survival Time - The time from either diagnosis or treatment at which half of the patients with a given disease are found to be, or expected to be, still alive. In a clinical trial, median survival time is one way to measure how effective a treatment is. Median means the middle value. An equal number of people live longer as die earlier than the median.


Membrane - Thin layer of tissue covering a surface, lining a body cavity, or dividing a space or organ.


Meninges - They are three, thin membranes that completely cover the brain and the spinal cord. Spinal fluid flows in the space between two of the membranes.


Metastasis, "Mets", Metastatic - The spreading of malignant, cancer cells from one part of the body to another, unconnected site. Cells in the second tumor are like those in the original tumor but may not have the exact same exact cellular structures. In ACC, even though the primary location tends to be in the head and neck, the lungs are a common area for metastatic spread of the disease which can occur years after the primary site has been effectively treated. Metastases may already occur in an early stage of the primary tumor.


Microsurgery - Delicate surgery involving the use of a special microscope and small instruments.


Microwave ablation - Microwave ablation is the most recent development in the field of tumor ablation. The technique allows for flexible approaches to treatment, including percutaneous, laparoscopic, and open surgical access. With imaging guidance, the tumor is localized, and a thin (14.5-gauge) microwave antenna is placed directly into the tumor. A microwave generator emits an electromagnetic wave through the exposed, non-insulated portion of the antenna. Electromagnetic microwaves agitate water molecules in the surrounding tissue, producing friction and heat, thus inducing cellular death via coagulation necrosis. The main advantages of microwave technology, when compared with existing thermoablative technologies, include consistently higher intratumoral temperatures, larger tumor ablation volumes, faster ablation times, and an improved convection profile.


Modulator Wheel, Proton - A spinning, polycarbide wheel with vanes of variable depth. In proton radiation therapy, protons passing through the thinner vanes travel farther into the body than those passing through the thicker sections. Different wheels, with different vanes, can be used to shift the peak energy (the Bragg peak) to different depths of the tumor.


Morbidity - A disease or incidence of disease within a population. Morbidity also refers to adverse effects caused by treatment.


Morphology - is a branch of life science dealing with the study of gross structure of an organism or taxon and its component parts. It can be subdivided into two distinct branches: anatomy is the study of the structure and internal organs of an organism.


MRI Scan (Magnetic Resonance Imaging) - A diagnostic scanning device that uses a magnetic field, radio waves, and a computer to produce highly detailed images of the body. Signals emitted by normal and diseased tissue during the scans are assembled into multiple images from multiple scans that are each a thin "slice". MRI makes better images of organs and soft tissue than other scanning techniques, such as computed 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. Both MRI and CT scans may be used in planning radiation therapy.


Mucositis - A complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth.


Multidisciplinary - Involving two or more medical disciplines. It is always a good advice to contact an oncologist, surgeon and radiologist to plan a therapy treatment together.


Multiple cross-fired beams


Nanoparticles - Nanoparticles are generally considered to be a number of atoms or molecules bonded together with a radius of <100nm.These nanoparticles give us the ability to see cells and molecules that we otherwise cannot detect through conventional imaging. (They are used for molecular imaging of malignant lesions and targeted drug delivery in cancer treatment).


Nausea - An unpleasant sensation in the abdomen with stomach distress, a distaste for food and a very strong urge to vomit.


Necrosis - Refers to the death of living tissues; Necrosis is commonly caused by radiation treatments.


Neoplasm - A tumor, either benign or malignant.


Nerve Palsy - Damage to the nerve and loss of motor function, impairment of sensory function or paralysis due to nerve damage. It may express in weakness of the muscles of facial expression and eye closure.


Nervous System - The entire integrated system of nerve tissue in the body: the brain, brain stem, spinal cord, nerves and ganglia.


Neuritis - The inflammation of a nerve or group of nerves that is characterized by pain, loss of reflexes, and atrophy (see definition) of the affected muscles. It also causes paraesthesias (an abnormal sensation such as prickling or burning) and paralysis.


Neurology (Neurological) - A branch of medicine addressing nerves and concerned especially with the structure, functions, diseases and treatment of the whole nervous system


Neutron - A neutral, uncharged subatomic particle used in a very unique type of cancer radiation treatment.


Neutron Radiation - Neutron radiation is a kind of non-ionizing radiation which consists of free neutrons. Neutrons can also be used for imaging of industrial parts termed neutron radiography when using film, neutron radioscopy when taking a digital image, such as through image plates, and neutron tomography for three dimensional images.


Neutron Ray particulate -  ionizing radiation consisting of neutrons. Often used for the primary site of slower growing tumors like ACC.


Novalis Radiation - Radiosurgery offers new hope to cancer patients. The Novalis Tx(tm) radiosurgery platform captures the rapid growth of this non-invasive treatment option by maximizing throughput, offering flexibility in treatment protocols, and providing fast planning, setup and treatment.


Nozzle, Proton - The device through which protons are delivered to the patient. At Loma Linda University Medical Center, proton beam delivery begins in the accelerator, where an ion source generates protons. The accelerator (synchrotron) energizes the protons to a prescribed energy and sends them to the beam transport system, which sends the beam to the treatment rooms. Each treatment room has a nozzle, which looks much like the nozzle of a water hose and is the final element in the beam delivery system. The nozzle not only delivers the beam to the patient, but also monitors beam uniformity, alignment, and dose delivered.


Obturator - A prosthetic device that closes or blocks up an opening (as a fissure in the palate) an artificial device to replace or augment a missing or impaired part of the body. A dental prosthesis is often used for areas of the mouth that have been removed due to surgery.


Oncologist - A physician who specializes in treating cancer (radio oncologist for radiation, medical oncologist for chemotherapies). Medical oncologists, like radiation oncologists and surgical oncologists, receive intensive training and serve long residency periods to become experts in their specialty.


Osteoradionecrosis - Death of the bone and soft tissue caused by radiation injury with the highest incidence being in the mandible. The fundamental cause is loss of vascular (blood vessel) supply with the subsequent incidence of wounds not healing, infection and progressive tissue hypoxia


Otolaryngologist (Ear Nose Throat / ENT doctor) - A medical specialty concerned especially with the ear, nose, and throat


Palliative care - Treatment of symptoms associated with the effects of cancer and its treatment. Palliative care can also be considered to be treatment to relieve, rather than cure, symptoms caused by cancer and help people to live more comfortably with a higher quality of life.


Paresis - Partial paralysis of voluntary and involuntary muscles. A condition typified by partial loss of movement, impaired movement or weakness.


Parotid Glands - The two parotid glands are the largest of all the salivary glands which produce saliva to help lubricate the oral cavity for food consumption. They are each located in front of the ear on either side of the face, with extensions behind the ear and also extending down into the upper neck region.


Parotidectomy - The surgical removal of parotid gland. The two parotid glands are the two largest salivary glands in the head and neck areas which lie on either side of the head in the rear cheek area.


Pathology - 1) The study of the essential nature of diseases, especially of the structural and functional changes produced by them 2) the anatomic and physiological deviations from the normal that constitute disease or characterize a particular disease. A pathologist is the medical doctor trained in this area of study and is the physician who typically diagnosis a tissue sample as being cancer and of what type.


Pelvis - The lower part of the trunk of the body, composed of four bones.


Perineural invasion - ACC has a unique tendency to microscopically infiltrate the nerve tissues around the tumor site, which is called perineural invasion. Nerve tissues microscopically appear like pipes with strands of wire running through them. ACC finds a "path of least resistance" by growing along the tissue that surrounds those strands of wires inside the pipe. This creates a real challenge for both diagnosis and treatment. Physicians of patients with primary tumor sites in the head and neck area may order regular imaging studies of the major nerves that lead back to the brain. Some medical professionals have reported that in reviewing imaging scans, ACC appears to "skip" areas and can infiltrate areas more removed from the primary tumor site.


PET Scan (Positron Emission Tomography) - A PET scan allows physicians to measure the body's abnormal molecular cell activity to detect Cancer (such as breast cancer, lung cancer, colorectal cancer, lymphoma, melanoma and other skin cancers), Brain Disorders (such as Alzheimer's Disease, Parkinson's Disease, and epilepsy), and Heart Disease (such as coronary artery disease). PET scans are simple, painless, and fast, offering patients and their families life-saving information that helps physicians detect and diagnose diseases early and quickly begin treatment. Also, they can be used in radiation treatment planning to help identify tumor tissue by the behavior of its cells, sometimes in cases where the tumor tissue is not visible on CT scans or MRI. But ACC tumors may not always show up in PET scans.


PET/CT - Positron Emission Tomography and Computed Tomography in one session. Commonly used for full body scans.


Photodynamic Therapy (PDT) - PDT is a treatment that uses a drug, called a photosensitizer or photo-sensitizing agent, and a particular type of light. A light sensitive drug is given through a vein and concentrates in the tumor. During a surgical procedure, a special light activates the drug which kills the tumor cells.


Photon - A quantum (energy packet) of electromagnetic radiation; the elementary particle of photon radiation therapy. X rays and gamma rays are photon radiation.


Photon-beam Radiation - A type of radiation therapy that reaches deep tumors with high-energy x-rays made by a machine called a linear accelerator.


Pineal Gland - Lies below the corpus callosum (cerebrum) that produces the hormone melatonin. Melatonin is believed to control the biological rhythms of the body.


Pituitary Gland - The main endocrine gland. It produces hormones (including prolactin, corticotropin, and growth hormone) that control other glands and many body functions. Attached to and receives messages from the hypothalamus.


Pleomorphic Adenoma - A benign (non-cancerous) type of tumor that is similar in cellular appearance to ACC which can result in an initial mis-diagnosis for ACC.


Pleural Cavity - The space enclosed by the pleura, which is a thin layer of tissue that covers the lungs and lines the interior wall of the chest cavity. The lungs; the lungs are surrounded by two serous membranes, the pleurae. The outer pleura (parietal pleura) covers and is attached to the chest wall. The inner pleura (visceral pleura) covers and is attached to the lung and other structures, such as blood vessels, bronchi and nerves. Between the two is a thin space known as the pleural space, which normally contains a small amount of pleural fluid. The parietal pleura is highly sensitive to pain; the visceral pleura is not, because it receives no nerves of general sensation.


Pneumonectomy (Total or Partial) - The removal of the entire left or right lung or part of the lung. Once the lung is removed, the involved side of the thoracic cavity is an empty space. In order to reduce the size of this cavity, the phrenic nerve is severed on the affected side to paralyze the diaphragm in an elevated position. A thoracoplasty may also be performed, which is the removal of several ribs or portions of ribs to further reduce the thoracic space.


Pneumothorax (collapsed lung) - A potential medical emergency caused by accumulation of air or gas in the pleural cavity, occurring as a result of disease, or injury, medical procedure, or spontaneously occurring with no expected potential.


PNI (psychoneuroimmunology) - The study of the interaction between psychological processes and the nervous and immune systems of the human body. PNI takes an interdisciplinary approach, incorporating psychology, neuroscience, immunology, physiology, pharmacology, molecular biology, psychiatry, behavioral medicine, infectious diseases, endocrinology, and rheumatology.


Pons - Part of the brain stem, containing the origins of the 5th, 6th, 7th and 8th cranial nerves.


Posterior - the back of a structure, or a structure found toward the back of the body.


Primary Care Provider - A person who provides support management of another person's health care over time. A primary care provider is able to give a wide range of care, including prevention and treatment, can discuss cancer treatment choices, and can refer a patient to a specialist.


Progression Tumor growth - A carcinogenic process whereby cells genetically altered by initiators undergo a second (non-genetic) cell expansion that allows uncontrollable growth.


Protocol - An outline of care; a treatment plan.


Proton - A positively charged particle of an atom. The charge and relatively large mass (1800 times that of an electron) of protons account for the Bragg peak effect used for radiation treatment.


Proton Beam Therapy - A type of high-energy, external radiation therapy that uses streams of protons (small, positively charged particles) that come from a special machine. Proton beam radiation is different from x-ray radiation.


Psychosocial Services -Support services relating to the psychological, social, behavioral, and spiritual aspects of cancer, including education, prevention, and treatment of problems in those areas.


Pulmonary Function Test - Spirometry (meaning the measuring of breath) is the most common of the Pulmonary Function Tests (PFTs), measuring lung function, specifically the measurement of the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled. Spirometry is an important tool used for generating pneumotachographs which are helpful in assessing conditions such as asthma, pulmonary fibrosis, cystic fibrosis, and COPD. In patients with lung tumors it can be used as a measurement of the progression and effects of the tumors.


Pulmonary - Referring to the lungs, or to the pulmonary artery


Pulmonary Metastases - Metastases in the lung.


Quality of life - Subjective sense of well-being. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual's sense of well-being, and ability to carry out various activities. An aspect of a medically possible treatment is the quality of life with or without this treatment.


Rad - "Radiation absorbed dose" or a measure of the amount of radiation absorbed by tissues (100 rad = 1 Gray). *see Gray


Radiation - Energy carried by waves or a stream of particles. Visible light, x-rays, photon, neutron and proton beam are all examples of radiation.


Radiation Oncologist A radiologist specialized in using radioactive substances and x-rays to treat cancer.


Radiation Physicist - The person responsible for the administration of radiation therapy including estimating the dose required for a treatment, arranging for the dose to be delivered and making arrangements for safety of the patient and staff, and disposing of any residual radioactive material. Technical aspects of the work include computer estimations, preparation of isodose curves, preparation of wedge and compensating filters, and calibration of teletherapy equipment.


Radiation Therapist - The modern term for the physician is "radiation oncologist," even though the physician may use radiation to treat conditions other than cancer. The older term for a radiation therapist is "radiation therapy technologist," and therapists are still called "techs" from time to time.


Radiation Therapy (irradiation) - The use of high-energy, ionizing, penetrating rays or subatomic particles to treat disease. Types of radiation include x-rays, electrons, protons, neutrons, photons, alpha and beta particles, and gamma rays. Radioactive substances include cobalt, radium, iridium, and cesium. This treatment has been utilized for many decades as a standard. Radiation therapy may or may not utilize an enhanced targeting device. If a surgery of a primary site or a recurrence ends up with unclean margins (cancerous) a radiation therapy is commonly recommended.


Radiologist - A physician specially trained to interpret diagnostic images (e.g. x-ray, MRI, CT, PET) and perform specialized x-ray procedures.


Radioprotector - A substance, usually a chemical, used to protect cells from radiation. During a radiation treatment chemicals, herbs or vitamins should not be taken to fully gain from the wanted radiation effect.


Radioresistant - Resistant to radiation therapy.


Radiosensitive - Responsive to radiation therapy.


Radiosensitizer - A substance, usually a chemical, used to sensitize cells to the radiation effects.


Radiosurgery (stereotactic) - Use of a number of precisely aimed, highly focused beams of ionizing radiation to target a specific area.


Randomization - A method based on chance in which participants of a clinical study are assigned to comparison and/or control and treatment groups. Randomization minimizes the differences among groups by equally distributing people with particular characteristics among all the trial groups. Randomization can also be done in laboratory and observational studies.


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 cancer.


Recurrence - Cancer tumor or symptoms of a tumor that has returned 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. When it occurs at a different location it is normally referred to as metastatic tumor.


Resection - Surgical removal of a tumor.


Residual Tumor - Tumor remaining after surgery.


RFA (Radio Frequency Ablation) - A procedure that uses radio waves to heat and destroy abnormal cells. The radio waves travel through electrodes (small devices that carry electricity). Radiofrequency ablation may be used to treat cancer and other conditions.


Salivary Gland Cancer - Salivary gland cancer is a cancer that starts in one of the salivary glands. It is not a single disease. There are actually several different salivary glands found inside and near your mouth. Several types of cancer and benign (non-cancerous) tumors can develop in these glands.


Scintigram - A nuclear angiogram; a scintigram involves injection of a radioactive substance into the patient's circulatory system. As the substance travels through the body, a special scanning camera takes pictures. Commonly used for a bone scan too see if there are metastases.


SEER - The Surveillance, Epidemiology, and End Results (SEER) Program of the NCI is a collection of central cancer registries in the United States that collect and submit cancer incidence, prevalence, mortality, survival, stage at diagnosis data and other statistics to the National Cancer Institute. The National Cancer Act of 1971 mandated the collection, analysis, and dissemination of data useful in the prevention, diagnosis, and treatment of cancer leading to the establishment of the SEER Program.


Segment Bronchopulmonary - One of the smaller subdivisions of the lobes of the lungs, separated by connective tissue septa and supplied by branches of the respective lobar bronchi.


Segmental Resection, Segmentectomy - A surgical procedure to remove part of an organ or gland. It may also be used to remove a tumor and normal tissue around it. In lung cancer surgery, segmental resection refers to removing a section of a lobe of the lung.


Sella - The saddle-shaped, hollowed extension of the sphenoid bone at the base of the skull that contains the pituitary gland.


Sensorineural Hearing Loss - A form of deafness caused by damage to the nerves or parts of the inner ear governing the sense of hearing that occurs due to dysfunction of the auditory nerve (VIII cranial nerve)


Septum - (plural: septa) A dividing wall or partition.


Sequela - A morbid condition following or occurring as a consequence of another condition or event.


Side Effects – The issues often described with a cancer treatment by radiation or chemo. Side effects are commonly classified and sorted by common vs. rare, acute vs. late (chronic), mild vs. severe and temporary vs. permanent. An acute side effect that has an abrupt onset of symptoms, a short course, and it occurs during or within 90 days of treatment. An acute side effect is always temporary. Late/chronic side effects is a condition that persists or occurs more than 90 days after treatment. A late effect can be temporary or permanent. A permanent side effect remains for the remainder of a patient's life.


Simulation - The process of locating and precisely marking the treatment field to be targeted in radiation therapy. This process typically uses CT or X-Ray scans depending upon the type of radiation used and is a common part of radiation treatment planning for many radiation systems.


Simulator - Diagnostic radiography unit mounted on gantries that mimic a treatment machine's range of motion and positions.


SRS (Stereotactic Radiosurgery) - A type of external radiation therapy that uses special equipment to position the patient and precisely give a single large dose of radiation to a tumor. It is used to treat brain tumors and other brain disorders that cannot be treated by regular surgery. It is also being studied in the treatment of other types of cancer. Treatment of the head usually require a head frame (a mask) to fix the head in one position for each session. Also called radiation surgery, radiosurgery, and stereotaxic radiosurgery.


Stage - The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.


Stenosis of the ear canal - A narrowing or stricture of a duct, canal or tube due to scar tissue or tumor.


Stereotactic - Precise positioning in three dimensional space. Refers to surgery or radiation therapy directed by various scanning devices.


Steroids - A type of drug used to relieve swelling and inflammation and to decrease swelling around tumors. Some steroid drugs may also have anti-tumor effects.


Stomatitis - Sores (inflammation or irritation) inside the mouth.


Surgery, reconstructive - A type of plastic surgery that restores the shape of a body area to normal for functional or aesthetic reasons.


Survivor - A cancer survivor is an individual with cancer of any type, current or past, who is still living.


Survivorship care - Survivorship care is a distinct phase of care for cancer survivors that includes four components: (1) prevention and detection of new cancers and recurrent cancer; (2) surveillance for cancer spread, recurrence, or second cancers; (3) intervention for consequences of cancer and its treatment; and (4) coordination between specialists and primary care providers to ensure that all of the survivor's health needs are met.


Target volume - The area meant to receive the radiation; usually areas containing verified or suspected tumors.


Tentorial - Pertaining to the tentorium of the cerebellum (the part of the brain involved in coordination of movement, walking, and balance.).


Thoracoscopy (VATS: video-assisted thoracic surgery) - Thoracoscopy is the insertion of an endoscope, a narrow-diameter tube with a viewing mirror or camera attachment, through a very small incision (cut) in the chest wall. The procedure used to directly visualize the pleura, lungs, and mediastinum and to obtain tissue for testing. It is also helpful in staging and dissection of lung cancers or resection of lung mets.


Tinnitus - A noise in the ears, such as a high pitched ringing, buzzing, roaring, "white noise", or clicking when no external sound is present. The sensation can be experienced as being more inside the head than actually in the ears. It occurs often after surgery or radiation of the ear area.


Tomotherapy Radiation - The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.


Trachea - The airway that extends from the larynx into the thorax where it divides into the right and left bronchi. Also called the windpipe.


Treatment code - The federal Health Insurance Portability and Accountability Act (HIPAA) required the Secretary of Health and Human Services (HHS) to adopt standards for the electronic exchange of administrative and financial health care transactions to improve the efficiency and effectiveness of the health care system in the United States. Federal regulations adopted national standards for electronic health care transactions, code sets, and national identifiers for providers, health plans, and employers. Compliance was required by October 16, 2003. The federal standards supersede any state law that is contrary to them.


Treatment Field/Port - The area exposed to radiation beam.


Treatment Table - The table that the patient lies on during treatment. In proton radiation treatment, final patient alignment is performed by adjusting the motorized table with respect to the proton nozzle. This ensures that the treatment position matches the position the patient was in when the planning CT scans were taken.


Treatment Volume - The amount of space occupied by a three-dimensional object or region of space. The treatment volume of radiated tissue may be the diseased tissue only, but in cancer treatment it usually includes the cancer and tissues around. These surrounding tissues may harbor microscopic extensions of cancer.


Trigeminal neurolgia - Trigeminal neuralgia is very painful swelling (inflammation) of the nerve (trigeminal nerve) that delivers feeling to the face and "surface" of the eye.


Trismus - Reduced or tightened jaw motion with difficulty in opening the mouth. This can be caused by scarring in the masticatory muscles or motor disturbance of the trigeminal nerve from surgical or radiation treatment procedures or fibrosis.


Tumor - An abnormal growth or mass of tissue. Tumors are either benign or malignant.


Tumor Marker - Tumor markers are substances produced by tumor cells or by other cells of the body in response to cancer or certain benign (noncancerous) conditions. These substances can be found in the blood, in the urine, in the tumor tissue, or in other tissues. Tumor markers are used in the detection, diagnosis, and management of some types of cancer. Although an abnormal tumor marker level may suggest cancer, this alone is usually not enough to diagnose cancer. Therefore, measurements of tumor markers are usually combined with other tests, such as a biopsy, to diagnose cancer.


Unilateral - One-sided, affecting only one side.


Vascular - Relating to blood vessels.


Vascularity - The blood supply of an area of tissue or a tumor.


VATS - see Thoracoscopy


Ventricle - A chamber of an organ. For example, the four connected cavities (hollow spaces) in the central portion of the brain and the lower two chambers of the heart are called ventricles.


Vertebral - Pertaining to the spinal column.


Vertigo, Dizziness - an illusion or sensation of the world revolving around a person. A common side effect of a chemo.


Vestibular damage - The vestibular system, which consists of the semicircular canals and otolith organs, is located in the inner ear. For the most part, people are unfamiliar with the term "vestibular", but almost certainly have heard of motion sickness. Have you ever gotten sick from riding in the car or even playing an intense racing game? If you have, then your vestibular system is in operation.


Vestibulocochlear (VIII cranial) nerve damage - Damage to the VIII cranial nerve can be responsible for loss of hearing or balance.


Wedge resection - Removal of a small, localized, wedge shaped area of the lung, normally near the surface with little or no affect on pulmonary structures or functioning after healing.


Xerostomia - Dryness of the mouth caused by lack of salivary gland function. Sometimes caused by salivary gland resection.


X-rays - High-energy, ionizing, electromagnetic radiation that can be used at low doses to diagnose disease, or at highly accelerated doses of electrons moving in a linear stream to treat cancer.