A Brief Glossary of Terms Related to Prostate Cancer

Getting screened for prostate cancer, or asking your doctor about it, might bring up terms that you’ve never heard before. Following are common terms related to the prostate, prostate cancer risk factors and symptoms, and prostate cancer screening and diagnosis. (This is not a comprehensive list. See the Prostate Cancer Foundation’s glossary, and the American Cancer Society’s prostate cancer resources, for additional terms and explanations.)

Basics

• Acute–symptoms or signs that begin and worsen quickly; not chronic
• Biomarker (short for “biological marker”)–a biological molecule found in tissue, blood, or other bodily fluids that “is a sign of a normal or abnormal process, or of a condition or disease.”
• Chronic–a condition that lasts over a long period of time, requires ongoing medical attention, or limits activities of daily living; not acute.
• Epithelial–referring to the cells that line the internal and external surfaces of the body.
• Health disparities–types of preventable health differences that are linked with social, political, economic, or environmental factors.
• Prostate–a male reproductive gland about the size of a walnut that surrounds the part of the urethra (the tube that empties the bladder) just below the bladder and produces a fluid that forms part of semen.
• Prostate-specific antigen (PSA)–prostate-specific antigen (PSA) is a protein produced by normal, as well as malignant, cells of the prostate gland.

Screening

• Biomarker test–using a sample of tissue, blood, or urine to check for genes, proteins, or other molecules that may be a sign of a disease or condition.
• Biopsy–a procedure to remove a piece of tissue or a sample of cells from the body so it can be tested in a laboratory. A biopsy can determine whether you have cancer or another condition.
• Digital rectal examination (DRE)–the prostate gland sits just in front of the rectum. In a DRE, your doctor, via the rectum, examines the prostate for any bumps or hard spots.
• Magnetic resonance imaging (MRI)/prostate MRI/guided MRI–Magnetic resonance imaging (MRI) uses a combination of radio waves and magnets to render a detailed picture of your prostate gland. Your doctor may use an MRI scan to assess the presence of prostate cancer and determine if a biopsy is necessary. If so, an MRI scan can help your doctor guide where they should sample tissue. The scan itself is painless.
• PSA test/PSA level–a PSA test is a common blood test to screen for prostate cancer. The higher the PSA, the higher the likelihood of prostate cancer.
• Ultrasound/transrectal ultrasound–One method to get a better view of the prostate is a transrectal ultrasound. An ultrasound probe emits sound waves that bounce off surrounding tissue, including the prostate gland, and these “echoes” produce an image, or sonogram, your doctor can see on a screen. This is an outpatient procedure that takes about 15 to 30 minutes.

Risk factors

• Genetic mutation–some genetic mutations (a mutation is a change in the DNA sequence of an organism) have been linked to an increased risk of prostate cancer, including:
• Risk factors–a risk factor is anything that raises your chances of getting a disease such as cancer. Risks for prostate cancer include:
  • Older age
  • Race/ethnicity
  • Family history
  • Inherited genetic changes (see “Genetic mutation”)

Symptoms

• Early prostate cancer symptoms–While not common, symptoms of early prostate cancer might include:
  • Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night
  • Blood in the urine or semen
• Advanced prostate cancer symptoms–advanced cancer may cause the same symptoms as early prostate cancer, as well as:
  • Trouble getting an erection (erectile dysfunction or ED)
  • Pain in the hips, back (spine), chest (ribs), or other areas, if cancer that has spread to the bones
  • Weakness or numbness in the legs or feet, or loss of bladder or bowel control, if cancer is pressing on the spinal cord
  • Weight loss
  • Extreme fatigue

Diagnoses

• Active surveillance– monitoring cancer closely, with a treatment plan if tests show it’s starting to grow more quickly. Active Surveillance usually includes doctor visits and (PSA) blood tests about every six months, and a DRE about once a year.
• Benign–not cancerous; nonmalignant.
• Benign prostatic hyperplasia (BPH)–also called benign prostatic hypertrophy. a not-cancerous condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine.
• Carcinoma/adenocarcinoma–carcinoma is the most common type of cancer, accounting for 80% to 90% of all cancer diagnoses. It forms in tissue that lines your organs, internal passageways in your body and your skin (epithelial tissue). Adenocarcinoma is cancer that forms in the glandular tissue, which lines certain internal organs and makes and releases substances in the body.
• Clinically significant prostate cancer–prostate cancer that is aggressive, likely to spread if not addressed, and presents a risk to the patient. Doctors recommend patients with clinically significant prostate cancer undergo immediate treatment.
• Gleason score– the Gleason system assigns grades using the numbers 1 through 5, based on how much the cancer looks like normal prostate tissue.
  • A grade of 1 means the cancer looks a lot like normal prostate tissue.
  • A grade of 5 means the cancer looks very abnormal.
  • A grade is assigned to the 2 areas that make up most of the cancer. These grades are added together to produce the Gleason score
  • Based on the Gleason score, prostate cancers are often divided into 3 groups:
    • A Gleason score of 6 or less is “well-differentiated” or “low-grade.” These cancers tend to grow slowly and are unlikely to spread.
    • A Gleason score of 7 is “moderately differentiated” or “intermediate-grade.”
    • Gleason scores of 8 to 10 are “poorly differentiated” or “high-grade.”
• Grade Group– doctors have developed Grade Groups–from 1 (most likely to grow and spread slowly) to 5 (most likely to grow and spread quickly)–as a more specific alternative to the Gleason score. Grade Groups may replace the Gleason score.
  • Grade Group 1 = Gleason 6 (or less)
  • Grade Group 2 = Gleason 3+4=7
  • Grade Group 3 = Gleason 4+3=7
  • Grade Group 4 = Gleason 8
  • Grade Group 5 = Gleason 9-10
• Localized–cancer that is limited to the place where it started, with no sign that it has spread.
• Malignant–cancerous. Malignant cells grow in an uncontrolled way and can spread to nearby tissue and other parts of the body through the blood or lymph.
• Metastasis/metastatic–referring to cancer cells that break away from the original (primary) tumor, travel through the blood or lymph system, and form a new tumor in other organs or tissues of the body. Metastatic tumors are the same type of cancer as the primary tumor (if breast cancer spreads to the lung, the cancer cells in the lung are breast cancer cells, not lung cancer cells).
• Overdiagnosis–After prostate screening, some men may be diagnosed with cancer that they never would have known about otherwise and that would not have led to death or even caused any symptoms. Such a diagnosis, that would never cause problems, is known as overdiagnosis.
• Staging–If you’ve been diagnosed with prostate cancer, your doctors will try to figure out if it has spread, and if so, how far. This process is called staging.
• Watchful waiting–a less intense type of follow-up than active surveillance. It includes fewer tests and relies more on changes in symptoms to decide if treatment is needed.

With prostate cancer, getting screened, tested, or diagnosed opens up a whole world of new words, scores, and acronyms. If you or a loved one wants to speak to a doctor about prostate cancer prevention, risk factors, or other related concerns, refer to this glossary to familiarize yourself with common terms. This glossary represents a brief explanation of common terms and is not a substitute for a consultation with a licensed medical professional.