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Colon and Rectal Cancer

Glossary of Terms


The following excerpt is taken from Colon & Rectal Cancer: A Comprehensive Guide for Patients & Families by Lorraine Johnston, copyright 2000 by O'Reilly & Associates, Inc. For book orders/information, call (800) 998-9938. Permission is granted to print and distribute this excerpt for noncommercial use as long as the above source is included. The information in this article is meant to educate and should not be used as an alternative for professional medical care.

This glossary lists only terms specific to colorectal cancers. For a comprehensive glossary of cancer medical terminology, see Roberta Altman's and Michael Sarg's The Cancer Dictionary. For more general medical terms, any one of several inexpensive medical dictionaries available in bookstores and libraries should suffice.

Guides to pronunciation are included.

But first--unusual phrases

Before we list terms you may find when reading about colorectal cancers, we must point out that there are a few specific words and phrases that may be jarring because they mean something other in medicine than they do in everyday usage:
Anecdotal
When used in a medical context does not mean a funny story. It means a single case report not yet substantiated by studies using large numbers of people.

Impressive or not impressive
When used in a medical context does not mean anything derogatory. It means that, when the patient was examined, a particular feature did not strike the examiner as overwhelmingly unusual. For instance, after palpating your abdomen, the doctor may note in your medical record that your spleen was "not impressive." This means it did not feel enlarged, and that you did not report pain when she pressed on it.

Morbid or morbidity
Does not mean that you have a neurotic outlook. These words simply mean illness, and are somewhat the opposite of mortality. You might read, for example, that a treatment resulted in 20 percent low-level morbidity but only 2 percent mortality. Likewise, comorbidity means the illnesses a person has in addition to cancer, such as high blood pressure or diabetes.

"The patient denies… "
Does not mean that the doctor thinks you're lying. It's just used as the opposite of "the patient reports… " For instance, your medical record might read, "The patient reports frequent morning cough, but denies the presence of phlegm."

Pathological
In the context of tissue studies means the study of the appearance of healthy cells, cancerous cells, and affected organs. It does not mean mental or emotional illness, such as would be meant by the phrase "pathological liar" or the word psychopath.

Tolerable
A word often used by medical staff to describe the side effects of treatment. Your idea of what is tolerable may be much lower than their definition, because medicine defines a tolerable side effect as one that can be ameliorated with supportive care and that does not result in permanent organ damage. For you, these side effects may be intolerable.

Colorectal cancer terminology

Absolute neutrophil count (NEW tro fil) or ANC
The total number of neutrophils in the blood, a measure of one's ability to fight infection. Also called absolute granulocyte count. ANC can be suppressed by chemotherapy.

Adenoma (ad en OH muh)
A polyp; an initially benign growth that forms in the colon from the innermost layer of mucin-producing epithelial cells.

Adenopathy (ad en AH path ee)
The enlargement of lymph glands. Its presence in a colorectal cancer survivor might suggest the spread of cancer to the lymphatic system.

Anastomosis (eh nas teh MOW sis)
The rejoining of two ends of tissue after a portion of the tissue between them has been removed.

Anemia (an KNEE me uh)
A lack of adequate numbers of oxygen-carrying red blood cells.

Apoptosis (app uh TOE sis; variant: a pup TOE sis)
Orderly cell death characterized by slow dissolving and reuse of cell parts by neighboring tissue. Some chemotherapy drugs induce apoptosis; others cause cell lysis or bursting.

Ascending colon
The portion of colon that begins in the lower right part of the abdomen, departing from the end of the small intestine. It rises on the right side up to the rib cage, where it turns to cross under the liver as the transverse colon.

Bulky disease
Any cancer that measures greater than ten centimeters in any dimension.

Carcinoma in situ (kar sih NO ma in SEE tyoo; in SIGH tyoo)
A tumor that is still confined to the mucosa.

Cecum (SEE come)
The beginning of the large intestine where the small intestine empties into it. The cecum is located in the lower right abdomen.

Centigrey or cGy
A measurement of radiation dose absorbed by the body.

Clear margins
The desirable result of surgery for colorectal cancer. All tissue samples should have clear margins on all edges.

Colectomy (coal EK tow mee)
The removal of part or all of the colon.

Colonoscopy (coal un OSS kow pee)
The examination of the entire length of the colon, up to its juncture with the small intestine, using a flexible tube that has a camera and a light source attached.

Colostomy (coal OSS tow mee)
The temporary or permanent channeling of the remaining open end of colon through the stomach wall and skin, where an ostomy appliance will attach to capture waste.

Complete blood count or CBC
A count of the red, white, and platelet cells in peripheral blood.

Complete remission
The disappearance of all signs of disease for one month or longer.

Cytotoxic (sigh toe TOX ic)
A term for anything that kills cells. Many chemotherapy and radiotherapy regimens are cytotoxic to both healthy and cancerous cells.

Descending colon
The portion of colon that continues down from the upper left part of the abdomen. It descends from the transverse colon at the splenic flexure. It descends on the left side of the abdomen, where it turns inward to become the sigmoid colon.

Differentiation (diff er en she A shun)
The term used to describe the process of cells maturing and developing for a particular task. In general, normal young cells of most organs are undifferentiated and very similar to each other. They differentiate into functional cells of their respective organ types as they age. Cancer cells that fail to differentiate often are characterized as very aggressive, not functional for their organ type, and hard to identify as belonging to a particular type of tissue.

Distal (DISS tul)
The portion of the colon that is closest to the rectum and anus.

Enterostomal therapist (enter OSS tow mull)
A specialist, often an RN, who is trained to help colostomates care for their stoma and ostomy appliances.

Erythrocyte (eh REETH ro site)
A red blood cell. Red blood cells are responsible for carrying oxygen to body tissues.

Erythropenia (eh REETH ro PEA' nee uh)
The condition of having abnormally low numbers of red blood cells.

Event-free survival
The total amount of time that a patient survives, without relapse, following treatment. See Overall survival.

Familial adenomatous polyposis (FAP) (fum ILL yull add eh KNOW muh tus poll ip OH sis)
An inherited condition characterized by the development of many intestinal polyps, often early in life. FAP can lead to colonic malignancies if the entire colon is not removed. Removal of all polyps with a colonoscope is not possible because they are too numerous and are likely to recur.

Fecal occult blood test (FOBT)
A test using agents that can detect certain components of blood (often iron metabolites) in fecal samples. Some oncologists recommend this testing as part of a constellation of follow-up care after treatment for colorectal cancer. The general population is urged to have this testing yearly (in conjunction with other tests) as part of screening for detection of early colonic cancers.

Fluorouracil (5-FU) (floor oh YOUR a sill)
The drug most commonly used in the United States as first-line chemotherapy for several stages of colorectal cancer. 5-FU often is used along with leucovorin.

Granulocytes (GRAN you lo sites)
Types of white blood cells that attack bacteria by engulfing them. Eosinophils, neutrophils, basophils, and mast cells are types of granulocytes.

Grey or Gy
A measurement of radiation dose absorbed by the body.

Hematocrit or Hct (he MAH to crit)
Describes the percentage by volume of red blood cells in whole blood drawn for a CBC.

Hemoglobin (HE muh glow bin)
The iron-containing protein found in the center of a red blood cell that can bind to and transport oxygen.

Hemicolectomy (hem ee coal EK tow me)
A partial colectomy, a partial removal of the colon.

Hepatic flexure (hep ATT ic FLEK sure)
The point at which the ascending colon turns and crosses beneath the liver to the left side of the abdomen. Beyond the hepatic flexure the colon is called the transverse colon.

Ileostomy (ill ee OSS tow mee)
The temporary or permanent channeling of the remaining open end of small intestine through the stomach wall and skin, where an ostomy appliance will attach to capture waste. Ileostomy is the correct term to use when all of the colon has been removed, although some colorectal cancer survivors use the terms colostomy and ileostomy interchangeably.

Ileum (ILL ee um)
The small intestine, which empties into the large intestine or colon at the cecum, the beginning of the ascending colon.

J-pouch or ileoanal pouch
Made by folding back on itself the end of the small intestine that remains after the entire colon has been removed. The two parallel folded pieces are stitched together, creating a reservoir that is twice the size of the original, unfolded tissue. A bottom opening in the J-pouch is surgically reconnected to the anus. The intention is to simulate the larger retention capacity of the colon and to preserve fecal continence.

Lamina propria (LAM ih nuh pro PREE uh)
The capillary-fed connective tissue beneath the basement membrane of the colon. It is a sublayer of the mucosa. Going outward, the layers of the bowel are mucosa, submucosa, muscularis propria, subserosa. Serosa is an additional outer layer in areas of the peritoneal cavity where the bowel is freely moving.

Left colon
Same as the descending colon.

Leucovorin (loo KAV uh rin)
A chemotherapy drug used along with fluorouracil to increase the effectiveness of 5-FU.

Leukocyte (LU ko site)
A general term for all white blood cells.

Leukopenia (LU ko PEA nee uh)
The condition of having abnormally low numbers of white blood cells. See also -penia.

Locus (LOW kus)
A position within a gene.

Loci (LOW sigh)
Multiple positions within a gene or genes.

Lumen (LOO men)
The empty interior of the colon through which food waste travels.

Lymphocytopenia (lim foe sit o PEA ne uh)
The condition of having abnormally low numbers of certain white blood cells called lymphocytes. See also -penia.

Mean
Same as an average.

Median
The midpoint. If 81 patients were treated with drug XYZ, and the time for white blood cell counts to recover following this treatment ranged from two to sixty days, after you rank the patients by the number of days required for their white blood cells to recover, the median is the number of days that it took patient number 41's white blood cells to recover.

Metachronous (meh TAH crow nis)
Second tumors that occur independently some time after the primary tumor, not as a result of spread of the first tumor, which is called metastasis.

Metastasis (me TAS te sis)
The spread of cancer to other tissues.

Micrometastasis (MY krow me TAS te sis)
Less than 2 millimeters of detectable cancer at a site other than the original tumor.

Mucosa (myew KO suh)
The inner lining of the colon containing epithelial cells that produce mucin. The mucosa is composed of several sublayers: the epithelium, the basement membrane, the lamina propria, and the muscularis mucosae. Going outward, the layers of the bowel are mucosa, submucosa, muscularis propria, subserosa. The serosa is an additional outer layer in areas of the peritoneal cavity where the bowel is freely moving.

Muscularis mucosa (mus kyew LAR is myew KO suh)
A sublayer of the mucosa, the innermost layer of the colon. Going outward, the layers of the bowel are mucosa, submucosa, muscularis propria, and subserosa. The serosa is an additional outer layer in areas of the peritoneal cavity where the bowel is freely moving.

Muscularis propria (mus kyew LAR is pro PREE uh)
The layer of the colon between the submucosa and the subserosa. Going outward, the layers of the bowel are mucosa, submucosa, muscularis propria, and subserosa. The serosa is an additional outer layer in areas of the peritoneal cavity where the bowel is freely moving.

Neutropenia (nu trow PEA nee uh)
The condition of having abnormally low numbers of one type of white blood cell called neutrophils.

NSAIDs
Nonsteroidal anti-inflammatory drugs, such as aspirin or ibuprofen.

Occult disease
Cancer not detectable by visual exam or by testing strategies such as imaging studies.

Overall survival
The total amount of time that a patient survives following treatment, including relapses that were successfully retreated. See Event-free survival.

Palliation (pal ee A shun)
The relief of pain without an intent to cure disease.

Partial response
Describes a tumor's response to treatment that is 50 percent smaller or more, but still remains. It's not unusual to see a partial response on imaging halfway through treatment, and a total response by the end of treatment.

Pedunculated (peh DUN kyew lay ted)
Describes a polyp on a stalk, the opposite of sessile.

-penia
A suffix denoting abnormally low numbers of blood cells: leukopenia, erythropenia, or thrombocytopenia.

Platelet
A blood cell called a thrombocyte, important in the blood clotting process.

Primary tumor
The original tumor. Metastases may spread from certain malignant primary tumors.

Proctocolectomy (prok tuh ko LEK tuh me)
The surgical removal of all of the colon and rectum.

Prognosis (prog KNOW sis)
The expected or probable outcome.

Proximal (PROX i mull)
Portion of the colon that is closest to the juncture with the small intestine--that is, the portion farthest from the rectum and anus.

Rectum
The last six inches of the colon, the portion just prior to the anus. Feces are stored in the rectum until they are voided. The boundary between the colon and the rectum is difficult to distinguish.

Remission
The tumor-free time period, dated from the first, not the last, therapy session. Patients with tumors that recur within one month of treatment ending are considered to have had no remission. Disappearance of all disease is complete remission; reduction of tumor size by more than 50 percent is considered partial remission.

Right colon
Same as the ascending colon.

Serosa (seer OH suh)
The outermost layer of the bowel in areas where the bowel is freely moving (labile). Going outward, the layers of the bowel are mucosa, submucosa, muscularis propria, and subserosa, and serosa in areas of the peritoneal cavity where the bowel is freely moving.

Sessile (SESS isle or SESS ill)
Describes a polyp or lesion that is lying flat--that is, not pedunculated.

Sigmoid colon (SIG moid)
The portion of the colon on the lower left side of the abdomen between the descending colon and the rectum.

Sigmoidoscopy (sig moid OSS kuh pee)
The examination of the rectum and the lower part of the colon using a flexible tube that has a camera and a light source attached.

Sphincter muscles (SFINK ter)
Muscles that, when healthy and intact, are always somewhat contracted to keep an opening closed. For colorectal cancer survivors, the anal sphincter is the muscle most often mentioned.

Splenic flexure (SPLEN ik)
The point at which the transverse colon turns and descends on the left side of the abdomen, beneath the spleen, becoming the descending colon.

Stable disease
One or more tumors, still visible on imaging, that are not growing.

Stoma (STOW muh)
Greek for mouth. When the context is colorectal surgery, stoma means an opening created in the wall of the abdomen through which a piece of the intestine passes in order to void fecal material.

Submucosa (sub myew KOW suh)
Supportive tissue beneath the inner mucosal layer of the large intestine. Going outward, the layers of the bowel are mucosa, submucosa, muscularis propria, and subserosa. The serosa is an additional outer layer in areas of the peritoneal cavity where the bowel is freely moving.

Subserosa (sub seer OH suh)
The outermost layer of the colon in areas where the bowel is not freely moving (labile). In areas where the bowel is labile, the serosa is the outermost layer of the colon.

Synchronous (SINK run us)
Tumors that appear at the same time. See Metachronous.

Thrombocyte (THROM bow site)
A blood cell commonly called a platelet.

Thrombocytopenia (throm bi sigh toe PEA nee uh)
The condition of having abnormally low numbers of platelets.

Total response
Describes a tumor's response to treatment. The tumor has either completely disappeared, or is so small and stable it may just be scar tissue.

Transverse colon
The portion of horizontal colon between the ascending and descending colon. The transverse colon crosses the abdomen beneath the liver from the patient's right to the patient's left.

Tumor lysis syndrome
Arises from the death of certain large tumors, and may arise shortly after chemotherapy is started. It is characterized by symptoms of kidney failure owing to excessive amounts of calcium, phosphate, and potassium being released by dying tumors.

Vancomycin-resistant enterobacteria or VRE (van kow MY sin)
Intestinal bacteria that are no longer killed by one of the strongest antibiotics, Vancomycin.

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