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National Academy of Sciences. All rights reserved. 500 Fifth St. N.W., Washington, D.C. 20001.<br> Terms of Use and Privacy Statement</a> </div> </td> </tr> </table> <p><p style="font-size:x-small"> Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.<br>Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.</p><p style="font-size:6pt"> Do not use for reproduction, copying, pasting, or reading; exclusively for search engines. <p style="font-size:6pt"> OCR for page 477<br> Glossary adjuvant therapy--treatment given after the primary treatment to increase the chances of survival. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, or biological therapy. allogenic marrow transplant--bone marrow transplant in which the donor marrow is obtained from a person who is not an identical twin and then given to the patient. ambulatory care--the use of outpatient facilities--doctors' offices, home care, outpatient hospital clinics and day-care facilities--to provide care without the need for hospitalization. Often refers to any care outside a hospital. amenorrhea--abnormal suppression or absence of menstruation. atherosclerosis--a form of arteriosclerosis in which the arteries become clogged by the buildup of fatty substances, which eventually reduces the flow of blood to the tissues. These fatty substances, called plaque, are made up largely of cholesterol. autonomic neuropathy--a disease of the non-voluntary, non-sensory ner- vous system affecting mostly the internal organs such as the bladder muscles, the cardiovascular system, the digestive tract, and the genital organs. axillary dissection--surgery to remove lymph nodes found in the armpit region. Also called axillary lymph node dissection. axillary lymph nodes--lymph nodes in the armpit region. BRCA mutations--BRCA genes normally help suppress cell growth. When 477 <p style="font-size:6pt"> OCR for page 478<br> 478 FROM CANCER PATIENT TO CANCER SURVIVOR damaged (mutated), a person is at a higher risk of developing breast, ovarian, or prostate cancer. cachexia--loss of body weight and muscle mass, and weakness that may occur in patients with cancer, AIDS, or other chronic diseases. chemoprevention--the use of natural or laboratory-made substances to pre- vent cancer. chemotherapy--the treatment of disease by means of chemicals that have a specific toxic effect on the disease-producing microorganisms (antibiot- ics) or that selectively destroy cancerous tissue (anticancer therapy). chronic condition--a condition that is continuous or persistent over an ex- tended period of time. A chronic condition is one that is longstanding, and not easily or quickly resolved. clinical practice guidelines--systematically defined statements to assist prac- titioner and patient decisions about appropriate health care for specific clinical circumstances. clinical trial--a formal study carried out according to a prospectively de- fined protocol that is intended to discover or verify the safety and effec- tiveness of procedures or interventions in humans. cohort study--a research study that compares a particular outcome (such as lung cancer) in groups of individuals who are alike in many ways but differ by a certain characteristic (for example, female nurses who smoke compared with those who do not smoke). colonoscopy--an examination of the inside of the colon using a thin, lighted tube, called a colonoscope, inserted into the rectum. Samples of tissues may be collected for examination under a microscope. colostomy--an opening into the colon from the outside of the body. A colostomy provides a new path for waste material to leave the body after part of the colon has been removed. comorbid conditions--disorders or syndromes occurring at the same time in the same patient. comorbidity--refers to the co-occurrence of two or more disorders or syn- dromes (not symptoms) in the same patient. dental caries--tooth decay. edema--swelling caused by excess fluid in body tissues. end-of-life care--care provided during the period of time in which an indi- vidual copes with declining health from an ultimately terminal illness. endoscopy--the use of a thin, lighted tube (called an endoscope) to examine the inside of the body. enterostomal nurses--nurses that specialize in the care of ostomies. They help patients adjust to an ostomy and learn to manage it. <p style="font-size:6pt"> OCR for page 479<br> GLOSSARY 479 epidemiology--science concerned with defining and explaining the inter- relationships of factors that determine disease frequency and distribu- tion. estradiol--a form of the hormone estrogen. etiology--the cause or origin of disease. evidence-based--based on systematically reviewed clinical research findings. exogenous--originating outside the body. fibrosis--the growth of fibrous tissue. first-degree relatives--genetically-related parents, children, and full siblings. gene therapy--treatment that alters a gene. In studies of gene therapy for cancer, researchers are trying to improve the body's natural ability to fight the disease or to make the cancer cells more sensitive to other kinds of therapy. genetic testing--analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. grade--the grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. hematologic cancers--a cancer of the blood or bone marrow, such as leuke- mia or lymphoma. Also called hematologic malignancy. hemicolectomy--surgical removal of the right or left side of the colon. hepatic--of or relating to the liver. hormonal status--the presence or absence of hormone receptors on the sur- face of cancer cells. hormonal therapy--treatment that adds, blocks, or removes hormones. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body's natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone. Also called hormone therapy, hor- mone treatment, or endocrine therapy. hypothyroidism--too little thyroid hormone. Symptoms include weight gain, constipation, dry skin, and sensitivity to the cold. Also called un- deractive thyroid. incident cases--the number of newly diagnosed cancer cases. intestinal stricture--abnormal narrowing of the intestines. invasive cancer--cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer. <p style="font-size:6pt"> OCR for page 480<br> 480 FROM CANCER PATIENT TO CANCER SURVIVOR ischemia--a decrease in the blood supply to a bodily organ, tissue, or part caused by constriction or obstruction of the blood vessels. 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. latent disease--a condition that is present but not active or causing symptoms. longitudinal study--study that follows subjects for an extended period of time. lumpectomy--surgery to remove the tumor and a small amount of normal tissue around it. lymphedema--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. malabsorption syndrome--a group of symptoms such as gas, bloating, ab- dominal pain, and diarrhea resulting from the body's inability to prop- erly absorb nutrients. mantle irradiation--radiation to areas above the diaphragm. marker--a diagnostic indication that disease may develop. mastectomy--surgery to remove the breast (or as much of the breast tissue as possible). metastases--the spread of cancer from one part of the body to another. A tumor formed by cells that have spread is called a "metastatic tumor" or a "metastasis." The metastatic tumor contains cells that are like those in the original (primary) tumor. The plural form of metastasis is metastases. morbidity--a disease or the incidence of disease within a population. Mor- bidity also refers to adverse effects caused by a treatment. motility--rhythmic contractions of smooth muscle that move food along the digestive tract. Motility disorders can cause either slow contrac- tions (hypomotility), rapid contractions (hypermotility), or both. myelodysplasia--abnormal bone marrow cells that may lead to myelog- enous leukemia. myocardial infarction--the death of heart muscle from the sudden blockage of a coronary artery. Commonly known as a heart attack. neoplasm--an abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be be- nign (not cancerous), or malignant (cancerous). Also called tumor. <p style="font-size:6pt"> OCR for page 481<br> GLOSSARY 481 neuropathic pain--pain which is the result of nervous system injury or mal- function, which may not have any external cause. nuclear grade--an evaluation of the size and shape of the nucleus in tumor cells and the percentage of tumor cells that are in the process of divid- ing or growing. Cancers with low nuclear grade grow and spread less quickly than cancers with high nuclear grade. oncology--the study of cancer. oophorectomy--surgical removal of the ovaries. ophthalmology--branch of medicine that deals with the anatomy, func- tions, pathology, and treatment of the eye. orthotist--professional who specializes in mechanical devices to support or supplement weakened or abnormal joints or limbs. osteopenia--decreased calcification, decreased density, or reduced mass of bone. ostomy--an operation to create an opening (a stoma) from an area inside the body to the outside. Colostomy and urostomy are types of ostomies. palliative care--treatment of symptoms associated with the effects of can- cer and its treatment. peripheral neuropathy--a condition of the nervous system that causes numbness, tingling, burning or weakness. It usually begins in the hands or feet, and can be caused by certain anticancer drugs. physiatrists--a physician specializing in physical medicine and rehabilitation. polypectomy--surgery to remove a polyp. prevalent cases--the number of people who are alive and have ever had a diagnosis of cancer. primary cancer--original cancer. primary care provider--provider who manages a 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. primary treatment--Primary treatment consists of the therapeutic interven- tions provided with the intention to cure cancer. In clinical situations in which the treatment of recurrent disease may be curative, the therapeu- tic approaches may be viewed as "primary treatment" which if success- ful will be followed by a phase of post-treatment survivorship. prostate-specific antigen (PSA)--a substance produced by the prostate that may be found in an increased amount in the blood of men who have prostate cancer, benign prostatic hyperplasia, or infection or inflamma- tion of the prostate. <p style="font-size:6pt"> OCR for page 482<br> 482 FROM CANCER PATIENT TO CANCER SURVIVOR psychosocial services--services relating to the psychological, social, behav- ioral, and spiritual aspects of cancer, including education, prevention, and treatment of problems in those areas. pulmonary--having to do with the lungs. quality measure--quantitative indicators that reflect the degree to which care is consistent with the best available, evidence-based clinical standards. quality of care--the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. quality of life--the overall enjoyment of life. 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. radiotherapy--the use of high-energy radiation from x rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Ra- diation 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, implant radia- tion, or brachytherapy). Systemic radiotherapy uses a radioactive sub- stance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiation therapy. recurrence--cancer 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. Also called recurrent cancer. relapse--the return of signs and symptoms of cancer after a period of im- provement. relative survival rate--a specific measurement of survival. For cancer, the rate is calculated by adjusting the survival rate to remove all causes of death except cancer. The rate is determined at specific time intervals, such as 2 years and 5 years after diagnosis. remission--a decrease in or disappearance of signs and symptoms of can- cer. In partial remission, some, but not all, signs and symptoms of can- cer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body. renal--of or relating to the kidneys. resection--a procedure that uses surgery to remove tissue or part or all of an organ. senescence--the process of growing old; aging. <p style="font-size:6pt"> OCR for page 483<br> GLOSSARY 483 sentinel lymph node biopsy--removal and examination of the sentinel node(s) (the first lymph node(s) to which cancer cells are likely to spread from a primary tumor). To identify the sentinel lymph node(s), the sur- geon injects a radioactive substance, blue dye, or both near the tumor. The surgeon then uses a scanner to find the sentinel lymph node(s) containing the radioactive substance or looks for the lymph node(s) stained with dye. The surgeon then removes the sentinel node(s) to check for the presence of cancer cells. sepsis--the presence of bacteria or their toxins in the blood or tissues. sigmoidoscopy--inspection of the lower colon using a thin, lighted tube called a sigmoidoscope. Samples of tissue or cells may be collected for examination under a microscope. Also called proctosigmoidoscopy. 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. stem cell transplantation--a method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells. Surveillance, Epidemiology, and End Results (SEER) Program--a program of the National Cancer Institute that collects and publishes cancer inci- dence and survival data from 14 population-based cancer registries and three supplemental registries covering approximately 26 percent of the U.S. population. survivor--an individual is considered a cancer survivor from the time of cancer diagnosis through the balance of his or her life, according to the National Coalition for Cancer Survivorship and the NCI Office of Can- cer Survivorship. Family members, friends, and caregivers are also im- pacted by the survivorship experience and are therefore included in this definition. In this report, the committee chose to focus on cancer survi- vors who are in the post-treatment phase. survivorship care--as defined in this report, 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) sur- veillance for cancer spread, recurrence, or second cancers; (3) interven- tion 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. survivorship research--cancer survivorship research encompasses the physi- cal, psychosocial, and economic sequelae of cancer diagnosis and its treatment among both pediatric and adult survivors of cancer. It also includes within its domain, issues related to health care delivery, access, and follow-up care, as they relate to survivors. Survivorship research <p style="font-size:6pt"> OCR for page 484<br> 484 FROM CANCER PATIENT TO CANCER SURVIVOR focuses on the health and life of a person with a history of cancer be- yond the acute diagnosis and treatment phase. It seeks to both prevent and control adverse cancer diagnosis and treatment-related outcomes such as late effects of treatment, second cancers, and poor quality of life, to provide a knowledge base regarding optimal follow-up care and surveillance of cancers, and to optimize health after cancer treatment (from OCS). syndrome--a set of symptoms or conditions that occur together and sug- gest the presence of a certain disease or an increased chance of develop- ing the disease. third-party payors--entities that pay for health care, but are not the direct recipient of care. Includes insurers, employers, and the local, state, and federal governments (through Medicare, Medicaid, and other pro- grams). thrombosis--the formation or presence of a blood clot inside a blood vessel. toxicity--a measure of the degree to which something is toxic or poisonous. transplantation--the replacement of tissue with tissue from the person's own body or from another person. <p style="font-size:6pt"> <p style="font-size:6pt"> Representative terms from entire chapter:<p style="font-size:6pt"> cancer survivor