Glossary of Terms:

Adjuvant hormonal ablation: using hormonal manipulation to reduce the size of a tumor before surgery or radiotherapy

Adrenal glands: paired endocrine organs that lie above the kidneys, which secrete several important hormones 

Androgens: hormones, including testosterone, that promote the development and maintenance of male secondary sex characteristics

Androgen (testosterone) deprivation: Removing or suppressing the testicular production of testosterone, which will retard androgen-stimulated prostate cancer tumor growth

Angiogenesis: formation of new blood vessels

Anti-androgen: a class of drugs that block the androgen receptors of prostate cells, preventing their stimulation by testosterone

Apoptosis: programmed cell death in normal cells

Asymptomatic: without any signs or symptoms

Biopsy: a small sample of tissue taken from a diseased area for analysis

Bladder: Organ that holds urine for storage and elimination

Bladder outflow obstruction: a symptom of prostate disease or enlargement, typically with hesitancy, frequency, or poor stream of urine when urinating

Bladder Cancer: The most common sign of a bladder tumor is blood in the urine - either blood that can be seen by the naked eye or blood that is detected by a physician on a urine sample.  Although most bladder cancers cause no symptoms at all, bladder cancers can mimic a urinary tract infection or an “over-active” bladder and can cause frequent urination, pain with urination, or difficulty controlling the urine stream.  Most tumors, however, are “silent.”  Because the diagnosis can be hard to make on symptoms alone, evaluation by a physician is mandatory. Most importantly, all cases of blood in the urine should be evaluated, since blood may be the only sign of a bladder malignancy.

The doctor’s evaluation will include a radiologic study (an ultrasound, a special kidney X-ray called an “IVP”, or a CAT scan) and a cystoscopy.  Cystoscopy is usually performed in the doctor’s office, when the doctor places a small, flexible telescope into the urethra to look at the bladder.  Although most of the evaluations are normal, sometimes they do reveal a tumor, a stone, or a large prostate (in men).

BPH: (benign prostatic hyperplasia) enlargement of the prostate producing difficulty with urination.  The prostate is a walnut-sized gland in a man's reproductive system that is located just below the bladder and surrounds the urethra, the tube that carries urine from the bladder and out through the penis. The prostate gland’s function is to make and store seminal fluid, which is a milky liquid that nourishes sperm and is released during ejaculation.   If the prostate grows too large, it can make it difficult for the bladder to empty the urine.  The gland is only necessary for reproduction and is can be removed or resected if it blocks the bladder or has cancer in it.

Benign Prostatic Hyperplasia (BPH) is the abnormal growth of benign prostate cells. Eventually, the prostate’s increased size will compress the urethra, interfering with the normal flow of urine. More than half of the men in the United States between the ages of 60 and 70 and as many as 90 percent between the ages of 70 and 90 have symptoms of BPH. For some men, the symptoms may be severe enough to require treatment. Benign tumors are not cancer. They can usually be removed and, in most cases, they do not return. Cells from benign tumors do not spread to other parts of the body. Most important, benign tumors of the prostate are not a threat to life.

Condyloma: Warty growth on the external genitalia or at the anus

Cystocele: Herniation of the bladder into the vagina. Often referred to as a “dropped bladder” or a “prolapsed bladder”

Detrusor: Muscle around the bladder that acts to empty the bladder

Digital rectal examination (DRE): examination of the prostate gland by the insertion of an examiner’s finger into the rectum to feel the prostate gland’s size and shape, and to detect any suspicious masses / tumors.  Used as part of routine prostate cancer screening.

Dihydrotestosterone (DHT): an active metabolite of testosterone that stimulates the prostate; production of DHT is blocked by drugs such as Proscar® and Avodart® to shrink the prostate

Dyspareunia: Pain with sexual intercourse

Dysuria: Pain or burning with urination

Enterocele: Herniation of the small bowel into the vagina

Erectile dysfunction (impotence): Erectile Dysfunction (impotence) is the inability to obtain or maintain an erection sufficient for sexual intercourse. It is a condition that affects approximately one in every ten men in the United States. While erectile dysfunction can become more frequent with age, it can also be caused by high blood pressure (hypertension), diabetes, vascular problems, or other disease processes.

Many men experience isolated episodes of erectile dysfunction at some time in their lives, usually as a result of fatigue, stress, or alcohol or drug consumption. If the condition continues to interfere with normal sexual activity, however, a full evaluation is recommended.  There now exist many successful options to treat this condition.  Oral medications, including Viagra®, Levitra®, and Cialis®, are popular and effective for many patients.  MUSE® urethral pellets and Caverject® penile injections have also been successfully employed to achieve erections.  Likewise, vacuum constriction devices, although rarely used, are another alternative.  Ultimately, if these options fail to work or if the patient is unhappy with these treatments, surgery is performed to implant a device into the penis that creates excellent erections on demand.

External beam radiation therapy (XRT): irradiation of a cancerous area using an external source of radiation in order to destroy the diseased tissue

Extirpation: the total removal of a diseased organ or body part

Fistula: (generic) an abnormal passage between two hollow organs in the body; in urologic terms, often includes a vesico-enteric fistula (between the bladder and the bowel) and vescio-vaginal (between the bladder and the vagina)

Gleason system: a pathologic system for grading prostate cancer tumors based on the glandular architecture as seen under the microscope. The higher the gleason grade, the more aggressive the disease.

Gonadotrophin releasing hormone agonists (GnRHa’s) : drugs that mimic the effects of naturally occurring GHRH, but through over-stimulation of the body’s GHRH receptors that control endogenous GHRH secretion, GHRH is actually inhibited, suppressing testosterone production. Drugs such as Lupron®, Zoladex®, and Eligard® are in this category and act as a medical castration, usually for prostate cancer treatment

Hematuria: Blood in the urine (microscopic or gross)

Hesitancy: a symptom of decreased force of the urinary stream, often associated with difficulty in starting flow. This is often part of the symptom complex of BPH (see above).

Hormone-refractory (or hormone-independent) prostate cancer (HRPC): prostate cancer that no longer requires androgens as a growth signal. This term is typically applied to tumors that no longer respond to androgen deprivation

Hydronephrosis: dilation of the kidney, often from obstruction

Hypospadias: Developmental anomaly characterized by the malposition of the urethral opening of the penis along its shaft

Hydrocele: collection of fluid around the testicle

Incontinence: Involuntary loss of urine, especially with coughing (stress incontinence) or urge to urinate (urge incontinence)

Infertility: Inability to produce offspring (sterility)

IVP: X-ray of the kidneys utilizing intravenous dye injection

Intermittency: a symptom of a weak urinary stream, referring to when a patient must hesitate at times during the process of urination. This is often part of the symptom complex of BPH (see above).

Intermittent androgen blockade: periodic interruption of androgen blockade at predetermined intervals for prostate cancer

Kidney: Organ that filters blood and creates urine that travels to the bladder via the ureter

Maximal androgen blockade (MAB) or combined androgen blockade (CAB): complete blockade of both testicular and adrenal androgens (testosterone) by a combination of medical or surgical castration plus treatment with an anti-androgen (see above) for prostate cancer

Metastasis: the spread of malignant tumor cells from its site of origin to a distant site

Neoadjuvant hormonal ablation: reducing the size of a tumor before surgery or radiotherapy via hormonal suppression, particularly for prostate cancer

Nocturia: Nightime urination

Orchalgia: Pain in the testicle, often chronic in nature

Orchiectomy: the removal of the testicle

Palliative therapy: treatment aimed at providing relief from the symptoms and complications resulting from disease, typically cancer. It can include drugs such as analgesics for palliating pain

Prostate: Organ that sits below the bladder in men that functions to produce part of the ejaculate

Prostate Cancer: Prostate cancer is the most commonly diagnosed malignancy in men, excluding skin cancer, and is the second leading cause of cancer death.  In 2002, close to 200,000 cases were diagnosed in the United States.  Moreover, it is estimated that almost 40,000 men will die of the disease this year alone! The risk of developing prostate cancer increases as men age and therefore most urologists recommend routine screening for prostate cancer starting at age 50.  Black men and men with a strong family history of prostate cancer are at even high risk, and screening for these men should begin at age 40. If detected early, using blood (PSA) tests, DRE examination and biopsies, and treated appropriately, survival rates are excellent.

In general it is a slow growing cancer which is primarily under hormonal control i.e. testosterone. When a prostate cancer develops, it is because cells in these tumors are abnormal. They keep dividing and replicating without the usual control of normal cells and they do not die (they have become “immortal”). Because they continue to grow and because they have acquired certain properties unique to cancer cells, they can invade and damage nearby tissues and organs. Just as harmful is their propensity to break away from the organ of origin and enter the bloodstream and lymphatic system and to other organs. This type of spread is called metastasis.

Prognosis: predicted course of a disease

Prostatitis: Inflammation (with or without infection) of the prostate

Prostate specific antigen (PSA): an enzyme secreted by the prostate gland that is used as a screening tool and marker for prostate disease progress as measured by a blood test

Pyuria: Inflammatory cells in the urine, often indicating infection

Rectocele: Herniation of the rectum into the vagina

Stricture: Scar formation

Testicle: Organ that produces sperm and testosterone in men

Ureter: Tube-shaped organ that carries urine from the kidney to the bladder

Urgency: The strong sensation to urinate

Urothelium: Lining of the urinary collecting system (kidney, ureter, bladder)

Varicocele: Dilation of veins along the testicle in the scrotum; often associated with infertility

Vasectomy: Each year, over 500,000 men in the United States choose vasectomy as their method of contraception.  During a vasectomy, a small part of the vas deferens (the tube that carries sperm from the testicle to the urethra) is removed and the ends of the vas are sealed, making it a permanent method of contraception.  It is not immediately effective, however.  Although sperm can no longer exit the testicles, sperm may remain in other parts of the reproductive system.  Any man who has undergone a vasectomy should therefore not have unprotected intercourse until a semen analysis shows that no sperm are reaching the ejaculate.  This can take more than 14-16 weeks to occur.  Just as important to note is that a vasectomy is considered nearly 100% effective, but not completely “fail-safe”.  Indeed, no method of birth control is truly 100% completely effective except for abstinence.