Fundamentals of Cancer Care

By EBN Health

• a practice-focused guide for staff working in clinical practice in primary and acute cancer care, particularly nursing
• a valuable tool for learners at multiple levels of practice, from pre-registration to specialized cancer care roles
• <

• Language: English
• Publisher: EBN Health
• Release date: Dec 17, 2021
• ISBN: 9781739881412

Book preview

Abbreviations

Glossary

Acquired immune response Immunity acquired after exposure to an infection or vaccination, or by being given antibodies (by immunization or from maternal blood or breast milk).

Adenine Purine nucleotide that pairs with thymine in DNA.

Adenocarcinoma Cancer derived from mucus-producing epithelial cells.

Adipose Specialized connective tissue used for storing fat.

Adjuvant Therapy given after surgery, as opposed to neo-adjuvant therapy given before surgery.

ALARP As low as reasonably practicable (pronounced ‘alarp’). Often used in the context of a risk assessment, especially in radiation-protection regulations. Minimizing the dose to the lowest level consistent with maximizing the benefits and achieving a balance between benefit and harm.

Alopecia Hair loss, from any part of the body, often in clumps, to produce bare patches that may merge to give widespread baldness.

Amino acid Molecule that is the building block of proteins. There are 20 different types of natural amino acids. Amino acid units are joined together by peptide bonds to form polypeptide chains, which fold into proteins.

Anaemic Less than the normal quantity of haemoglobin in the blood, usually caused by a decrease in the number of red blood cells.

Analgesic Pain reducing or pain killing medication.

Anaphase Late stage in the division of a cell. During anaphase the chromosomes separate between the daughter cells.

Anaplastic Cancer cells having little or no resemblance to normal cells.

Androgen Sex hormone made from cholesterol in the body.

Angiogenesis Growth of new blood vessels from pre-existing vessels. Angiogenesis occurs during growth, wound healing and cancer development.

Ann Arbor classification System of staging used for lymphoma.

Antagonist Drug which blocks the action of a receptor, preventing it from functioning correctly in response to its signal molecule.

Antecubital fossa Triangle of tissue on the inside of the arm, forming the transition between the upper and the lower arm.

Antibody Special protein made by B lymphocytes to recognize antigens in the immune response. Also called an immunoglobulin.

Anti-embolus Intervention preventing the formation of blood clots.

Antigen Molecule recognized by antibodies or major histocompatibility complex (MHC) receptors of immune system cells as part of the immune response.

Anti-metabolite Prevents the synthesis of DNA building blocks.

Anxiolytic Drug which helps to combat anxiety.

Apoptosis Process of programmed cell death.

Arthralgia Joint pain.

Ascites Abnormal build-up of fluid.

Aspirate A liquid, e.g. tissue sample or secretory fluid, that is collected by suction.

Axilla Armpit, the region under the arm where a number of lymph nodes are found.

Bacteria Large group of single-celled organisms that are prokaryotic (no enclosed nucleus). Some species are pathogenic and cause infections.

Basal cell Cell forming the bottom layer of the epidermis (the outer layer of the skin).

Basement membrane Sheet of thin fibres under epithelial cells that line cavities and surfaces.

Base pair Two complementary nucleotides, either DNA or RNA, connected by hydrogen bonds; for example, A and T, or G and C.

Basophil Type of granular white blood cell involved in the inflammatory immune response.

Benign tumour Tumour or lump of tissue that is not malignant.

Biochemical A chemical that has a biological function.

Biopsy Small tissue sample taken for testing.

Biphasic anaphylactic reaction Second occurrence of an anaphylactic reaction that occurs without a second exposure to the material that caused the reaction.

Bone marrow Tissue in the interior of hollow bones where new blood cells are made.

BRCA Breast cancer protein (BRCA1 and BRCA2), a critical protein involved in suppressing cancer formation. A mutation in the BRCA gene can lead to failure of this tumour control mechanism, making cancer more likely. Mutated BRCA is inherited in some families, leading to a family history of breast cancer.

Bristol Stool Chart Graduated system for describing stools, ranging from type 1 (small, hard pieces akin to rabbit or sheep droppings) through to type 7 (watery with no solid components).

Bronchial Describing something happening in the air tubes from the trachea (windpipe) to the lungs.

Cadherin Calcium-dependent protein used to bind cells to each other.

Cancer Collective name given to over 200 diseases characterized by abnormal cells undergoing uncontrolled cell division. In addition, these diseases share other characteristics. See also Hallmarks of cancer.

Cancer of unknown primary (CUP) Cancer where metastatic disease is creating symptoms, or has been detected, but the primary site of the initial tumour has not been located even after investigation. Compare with Malignancy of unknown origin (MUO).

Capillary Smallest of the body’s vessels with walls that are only one cell thick.

Carbon monoxide Tasteless, odourless gas formed from combustion taking place with limited oxygen. Carbon monoxide binds irreversibly to haemoglobin in place of oxygen, reducing the oxygen transport capacity of the blood.

Carcinogen Substance that causes cancer. Carcinogens are divided into four classes depending on the strength of the evidence that links them to cancer. Class 1 is the strongest evidence.

Carcinogenesis Process by which a cell becomes cancerous.

Carcinoma Cancer derived from epithelial tissue.

Cardiovascular System of blood vessels and the heart that moves blood around the body.

CD19 Membrane protein that plays an important role in B cell activity and that is used as the target of chimeric antigen receptor (CAR) T cell therapy because of its overexpression in some leukaemias.

Cell cycle Stages a cell goes through in order to divide, producing two daughter cells. Highly ordered and regulated, consisting of four phases: G1 (gathering materials and preparing to copy DNA), S (synthesis of DNA), G2 (gathering materials and preparing to divide the cell) and M (mitosis or highly ordered separation of chromosomes and division of the cell into two). Many human cells are described as G0, being outside the cell cycle (i.e. doing their job for the body but not dividing).

Cell death Process of a cell dying. See alsom Apoptosis.

Cell division Process by which one cell grows and divides forming two new cells.

Cell growth Growth in the numbers of a cell through the process of cell division.

Cell surface membrane Selectively permeable phospholipid bi-layer, containing cytoplasm and organelles, which maintains the integrity of the cell.

Central nervous system Brain and spinal cord.

Checkpoint Point at which a biological process, such as the cell cycle, is regulated prior to the process.

Chemical messenger Any compound that transmits a message between cells (for example, hormones).

Chemotherapy Systemic or local cytotoxic, cytostatic or immunological treatment given to treat cancer.

Chimeric Cell or organism that contains genes from more than one source. An example in cancer medicine is chimeric antigen receptors (CAR) on T cells, known as CAR T cell therapy, where the patient’s own T cells are removed and engineered to produce a protein that better targets the cancer cells.

Cholesterol Steroid metabolite that is an essential component of cell membranes.

Chromatid One of two identical copies of a duplicated chromosome joined at the centromere.

Chromatin Combination of DNA wrapped around histone proteins, like cotton wrapped around a bobbin. Chromatin makes up chromosomes.

Chromosome Length of DNA containing many genes that is coiled with protein molecules to form the characteristic ‘x’ shape in the metaphase of cell division.

Colposcopy Procedure allowing examination of the cervix by a specialist.

Comorbidity Additional independent health condition that may have to be taken into account when planning a course of treatment.

Complementary base pairing See Base pair.

Complete response Following treatment there is no detectable disease.

Conjugate Joining of two molecules, e.g. conjugated antibodies.

Connective tissue One of the four main tissue types, with several sub-types: loose, dense, fluid, fibrous.

Contraindication Clinical observation or measurement that argues against the use of a treatment.

CRAB criteria Scoring system for myeloma: calcium elevation, renal dysfunction, anaemia and bone lesions.

CTCAE Common Terminology Criteria for Adverse Events is a scoring system for treatment-related toxicity, not patient-reported experience/symptoms.

Cytogenetics Characterizing cells by looking for abnormalities in their genes or chromosome structure.

Cytokine Small cell-signalling molecule of the immune and nervous systems.

Cytokinesis Process of the cell dividing into two new cells during the last stage of mitosis.

Cytology Study of cells.

Cytoplasm Clear viscous liquid inside the cell membrane that supports organelles.

Cytosine Pyrimidine nucleotide that pairs with guanine.

Cytoskeleton Network of proteins throughout a cell that gives the cell shape. The cytoskeleton is more dynamic than a human skeleton and can change shape (for example, to generate cell movement during cancer metastasis).

Cytostatic Substance that has the effect of arresting the cell cycle and preventing division. Such substances do not necessarily cause cell death. Contrast with Cytotoxic substances, which may interfere with the cell cycle and do cause cell death.

Cytotoxic Drugs which are toxic to cells. In the case of classical chemotherapy these drugs work by damaging DNA or by inhibiting some aspect of DNA replication or repair.

Deletion mutation Part of a chromosome where the gene sequence of DNA is missing, resulting in a genetic mutation.

Desquamation Peeling of the skin in response to physical damage or other irritation such as wind, sun or radiotherapy.

Diagnosis Confirmation of cancer most often based on microscopic examination of cell samples taken by biopsy.

Diathermy Procedure using high-frequency electric currents to create heat, used to remove abnormal cells from the cervix.

DNA Polymer that stores the genetic instructions of all known living organisms.

Dose-limiting toxicity Negative side effect that is sufficiently severe in two patients (normally taking part in a phase I trial) to provide the limit to the amount of treatment that may be given.

Double-stranded DNA DNA consisting of two strands of genetic material bound together by base pairing. Double-stranded is the normal arrangement. DNA may also exist for brief periods in single-stranded forms for copying, repair and transcription.

Drug interaction Medication that may have effects which inhibit or exacerbate the effects of other drugs. Or, two drugs which are fairly benign individually may act on the body in a way that means the combined effects cannot be tolerated even though the two drugs are well tolerated individually.

Duct Channel, often leading to or from a gland.

Ductal Referring to a duct.

Dukes classification System of staging used for colon cancer.

Durie–Salmon staging System of staging used for myeloma.

Dysgeusia Altered taste.

Dysphagia Difficulty swallowing.

Dysplastic Abnormal cell growth. Cells are often characterized by abnormal nuclei.

Emesis Act of vomiting.

Emetic Used as a noun, a substance that causes vomiting; also used as an adjective to describe something that causes vomiting.

Emetogenic Used as an adjective to describe a substance that is an emetic.

Endocrinal Referring to the endocrine system.

Endocrine System of glands that secrete hormones into the blood to maintain homeostasis.

Endoplasmic reticulum Double-layered membrane structure continuous with the nuclear envelope, the site of protein synthesis. Endoplasmic reticulum (ER) also acts as a subcellular transport system.

Enzyme Protein that catalyses chemical reactions.

Eosinophil Type of granular white blood cell that kills parasites and has a role in the inflammatory immune response.

Epidemic When new cases of a certain disease, in a given human population and during a given time period, substantially exceed what is expected based on recent experience.

Epidermal Referring to the epidermis, the thin outer layer of skin visible to the eye.

Epithelial Cells that form one of the four main tissue types that cover surfaces and line cavities.

Epithelium Tissue made from epithelial cells.

Equipoise In a clinical trial, equipoise is the assumption that both the control and experimental groups of patients have a more or less equal chance of a good outcome. This assumption is examined during approval stages; loss of equipoise is grounds for terminating a trial.

Erythema Redness of skin or mucous membranes.

Erythrodysesthesia Pain and redness that can affect the palms of the hands (palmar) or feet (plantar) during systemic anti-cancer therapy (SACT), also known as hand–foot syndrome.

Excretion Process where waste products from metabolism and non-useful substances are eliminated from the body.

Exocytosis Process by which cells secrete membrane-bound vesicles from the cell across the cell membrane.

Extracellular Outside the cell.

Extravasation Special case of infiltration in which a vesicant chemotherapeutic agent or a drug which can cause pain, inflammation or blistering leaks into the tissue adjacent to the puncture site. The effects of extravasation may be severe.

Fallopian tubes Two fine tubes lined with ciliated epithelium that lead from the ovaries to the uterus.

False foot A cell projection used in cell movement including metastasis, also known as a pseudopod.

Fatigue Tiredness and lethargy that cannot be resolved by sleep or rest.

Febrile Having the symptoms of a fever.

Ferritin Protein used by cells to store iron and control its release.

Fibrosis Excessive deposition of connective tissue during repair.

FIGO staging System of staging used for cancers of the female reproductive system.

FISH Fluorescence in situ hybridization is a microscope imaging technique for identifying gene sequences and abnormalities.

Fluorescence Emission of fluorescent light by a substance.

Fluorescence microscope Optical microscope that directs selected wavelengths of light at a fluorescent substance and captures the fluorescence emitted by the substance to form images.

Fluorodeoxyglucose (FDG) Glucose molecule, in which one of the hydroxy (OH) groups has been replaced with an atom of fluorine-18, that can be detected using a positron emission tomography (PET) scanner.

Foetus Developing human from the 9th week after fertilization (from the embryonic stage) until birth.

Fungi Type of micro-organism, such as yeast.

G0 (Gap 0) Quiescent stage of cell growth where the cell is outside the cell cycle.

G1 (Gap 1) First stage of the cell cycle where the cell receives growth signals and undergoes RNA synthesis and protein translation and increases in size, in preparation for DNA replication. Contains the cell cycle checkpoint called the restriction checkpoint.

G2 (Gap 2) Second major growth phase of the cell cycle that follows the S phase. The cell grows further in size and proteins are synthesized in preparation for mitosis.

Gastrointestinal Referring to the stomach and intestine, but may refer to the digestive tract from the mouth to the anus.

Gell–Coombs Classification scheme for types of hypersensitivity reaction.

Genes Lengths of DNA sequence that when transcribed into mRNA and translated into protein form a functional protein.

Genetic material Material that stores information critical for the growth and function of an organism and its individual cells. This material is stored as a molecular code and may be either basic information (genes), detailing how to build a protein, or regulatory information, which fine-tunes how much and when the information is acted on. Both basic and regulatory information can be inherited from parents.

Gingivitis Inflammation of the gums, often caused by poor oral hygiene. Seen as a risk factor in mucositis.

Gleason score Grading system describing the level of difference between prostate cancer cells and normal prostate tissue. A score of 1 is virtually normal and a score of 5 is highly aggressive. Normally, two assessments are made of the most common and second most common cells and a total score (usually between 6 and 10) is given.

Glial cell Non-neuronal cell that provides support for neurons.

Glucose 6-carbon sugar that is a source of energy when metabolized in cellular respiration. Contrast with Ribose, which has 5-carbon atoms.

Gold standard In the context of a clinical trial, gold standard is often used to mean the best currently available standard of care for a particular patient. It may be used as the standard to beat for a new treatment being tested. The term may also be used to refer to randomized controlled trials as the standard for testing new treatments.

Golgi apparatus Stack of intracellular membranes that store and modify proteins and lipids, regulating secretion and directing membrane-bound vesicles to correct cellular targets.

Granulocyte Type of white blood cell that has granular contents.

Granulocyte colony-stimulating factor (GCSF) Protein that binds to a cell surface receptor protein to stimulate the proliferation of white blood cells.

Growth factor Substance that is capable of stimulating cell growth.

Guanine Purine nucleotide that pairs with cytosine in DNA.

Haematology Study of blood, also used to name the part of a hospital where blood disorders are treated.

Haemoglobin Iron-containing pigmented protein that carries oxygen in red blood cells.

Hallmarks of cancer Collection of cell behaviours associated with competitive survival for the individual cell. Possession of these characteristics is common to the cells of many malignant tumours.

Healthy cell In the context of cancer, a healthy cell is one whose functions are effectively regulated to ensure control over its interactions with other cells and its growth and division to form new cells.

Hepatic flexure Sharp turn between the ascending and transverse colon.

HER2 Human epidermal growth factor receptor 2 is a protein sometimes found in excessive amounts on the surface of breast cancer cells and critical for driving tumour growth.

Histology Study of tissues.

Histone Specialized protein that combines with DNA to form chromatin, so that DNA strands can coil into condensed chromosomes for cell division.

Holistic care A personalised approach to care that encompasses a person’s physical, emotional, psychological, social and economic needs.

Hormone Signalling substance secreted from a glandular cell that is carried around the body in blood to affect the behaviour of cells in other parts of the body.

Hypercalcaemia Excessive levels of calcium in blood serum.

Hyperkalaemia Excessive levels of potassium (from kalium, Latin for potash) in blood serum.

Hyperplasia Growth in the number of cells beyond normal (for example, a benign tumour).

Hyperuricaemia Excessive levels of urea in blood serum.

Hypophysitis Inflammation of the pituitary gland.

Hypotension Abnormally low blood pressure, e.g. below 90/60 mmHg.

Hypothermia Body temperature below approximately 35.5°C.

Immortal Cell that no longer has a limit (the Hayflick limit) on the number of times it can divide into two new cells.

Immune checkpoint protein Protein that acts to regulate the behaviour of immune cells. Immune checkpoint proteins are vital for making sure the immune system is activated when required and stood down when no longer needed. Immune checkpoint proteins may be either stimulators or inhibitors of the immune action of a cell. Cancer therapies act to inhibit the action of the inhibitors, taking the brakes off the immune system that were often engaged by the tumour itself.

Immune system System of biological structures and processes within an organism that protects against disease by acting as a barrier to entry or acting to identify and kill pathogens.

Immunochemical Process or test that relies on the chemical interaction of an antibody probe with an antigen present on or in a sample.

Immunology Study of the immune system.

in situ Carcinoma in situ is a tumour confined to its organ of origin with no spread to adjacent tissues (invasion).

Infiltration Leakage of intravenously administered fluid into the adjacent tissue instead of correctly into the vein. Infiltration typically does not cause tissue necrosis, but long-term injuries may be caused. See also Extravasation.

Inflammatory response (reaction) Non-specific immune response that attracts white blood cells to the site of inflammation to launch a specific immune response.

Inguinal Groin area.

Inhibitor Typically, a small molecule drug designed to inhibit a protein in the cell-signalling pathway associated with cancer, e.g. ‘nibs’ (kinase inhibitors), ‘mibs’ (proteasome inhibitors), ‘sibs’ (phosphatidylinositol 3-kinase [PI3K] inhibitors) and ‘ribs’ (poly [adenosine diphosphate-ribose] polymerase [PARP] inhibitors).

Integrin Cell adhesion protein used to join cells to the extracellular matrix.

Intensity-modulated radiotherapy Radiotherapy technique using external beams where the areas of maximum intensity of radiation are shaped to conform to the tumour.

Interferon Proteins secreted by lymphocytes in response to pathogens.

Interim analysis Mid-trial analysis performed to ensure that the treatment on trial is giving benefit to some participants. If the treatment cannot be seen to benefit at least some of the participants then equipoise may be lost and the trial may be discontinued.

Interleukin Cytokine protein secreted by body cells that stimulate the development and differentiation of lymphoid blood cells.

Interphase Period of the cell cycle from Gap 1 (G1) to the end of Gap 2 (G2) phase.

Intracellular Within a cell.

Intrathecally Injection into the cerebrospinal fluid.

Intravasation (cell) Movement of a cell from body tissues into a capillary.

Intussusception Telescoping process where part of the intestine slides inside an adjacent section.

Invasion Movement of cancer cells or growth of tumour from an area of one cell type into an adjacent area containing another cell type. Contrast with Metastasis.

Invasive cancer Cancer that has spread beyond the tissue where it originated and into adjacent tissues.

Kaposi’s sarcoma Rare cancer associated with human herpes virus 8 (HHV-8).

Kidney Organ of the body that produces urine from waste products of the body, such as urea, and maintains osmoregulation.

Kinase Protein that functions by catalysing the transfer of a phosphate group from adenosine triphosphate (ATP) to another protein. The effect is to turn the second protein ‘on’, enabling it to perform its function.

Leukaemia Liquid cancer that results from white blood cells which divide without control and do not perform their function.

Light microscope Optical microscope that uses visible light and lenses to magnify objects. Compare with Fluorescence microscope.

Lipid Fat molecule.

Liquid cancer Cancer consisting of uncontrolled division of cells, where each dividing cell is suspended in a fluid (for example, blood or lymph).

Local commissioning group Group of local GPs tasked with influencing the provision of healthcare for their patients.

Lock and key model Model of enzyme and substrate interaction which is dependent on specific shapes of the molecules being able to interact with a high degree of affinity.

Lymph Plasma-like fluid in the lymphatic system.

Lymph node Small kidney-shaped organ distributed throughout the body. As part of the lymph system, lymph nodes filter lymph, identify pathogens and antigens, and are home to B and T cells.

Lymphatic capillary Vessel with walls that are only one cell thick and that carries lymph.

Lymphatic system System of capillaries, nodes and vessels throughout the body, transporting lymph away from body tissues. Once filtered, lymph returns to the blood supply. The lymphatic system forms part of the immune system.

Lymphatic vessel Vessels that are similar to veins, carrying lymph from body tissues to lymph nodes and then back to the thymus gland, before being returned to the blood.

Lymphocyte Type of white blood cell involved in the acquired immune response. Two main types are B and T lymphocytes.

Lymphoedema Swelling of tissues (often limbs) caused by the lymph system failing to drain the area correctly.

Lymphoid Referring to the lymphatic system.

Lysis Breakdown of a cell often by degradation of the cell membrane by enzymes.

Lysosome Organelle that breaks up cell debris and waste material and recycles essential metabolites of the cell.

Malignancy of unknown origin (MUO) A cancer where metastatic disease is creating symptoms or has been detected, but the primary site of the initial tumour is not yet located. Compare with Cancer of unknown primary (CUP).

Malignant tumour Tumour that has the ability to invade tissues of the body outside the tissue in which it originated.

Mammogram Low-dose X-ray scan of the breast.

Mast cell Specialized white blood cell that is involved in the inflammatory immune response.

Maximum tolerated dose Amount of a treatment at which participants in a phase I trial reported intolerable side effects. See also Dose-limiting toxicity.

Mediastinum Chest volume between the two lungs.

Meiosis Cell division for sexual reproduction. The daughter cells each have half the number of chromosomes normal for that species.

Melanoma Skin cancer derived from mutated skin cells (melanocytes) that produce dark pigments.

Membrane Selective barrier made of a sheet of lipid molecules.

Memory cell Type of B lymphocyte that forms after exposure to an antigen. It carries the immune memory of that infection and resides in the bone marrow.

Metabolism Chemical reactions to maintain life.

Metaphase Phase of mitosis where condensed chromosomes align across the middle of the cell.

Metastases Secondary malignant tumours, distant from the primary tumour site, formed when a cell, or cells, travels from the primary tumour by a variety of mechanisms.

Metastasis Process by which primary malignant tumours spread through the body to form metastases.

Metastatic Referring to cancer that has spread to form metastases.

Micro-metastases Metastases too small to be detected using diagnostic tools.

Mitochondria Intracellular organelles that are the site of cellular respiration.

Mitosis Asexual cell division where a cell gives rise to two genetically identical cells.

Mitotic spindle Apparatus that forms to facilitate chromosome segregation in mitosis.

Monoclonal antibody (mAb) mAbs (or moAbs) are manufactured proteins which can interact with antigens (for example, cancer cell proteins) and signal to the immune system to target the antigen for destruction. mAbs can be made from mouse proteins (omabs), from chimeras of mouse and human protein (ximabs), from small fragments of mouse protein attached to human proteins (also known as humanized proteins) (zumabs) or from fully human proteins (umabs).

Morbidity Poor health associated with the presence or progression of disease or side effects of treatment.

Morphology Study of structure and shape. Especially in cancer, the structure and shape of cells and sub-structures, particularly the nucleus.

Mortality Death.

M phase Stage in the cell cycle where the genetic material is separated and the cell divides leaving two daughter cells each of which has a complete copy of the DNA.

mRNA Type of nucleic acid that is transcribed from DNA and translated into protein on ribosomes.

Mucosa Epithelial cells that form membranous tissue.

Mucositis Inflammation of mucous tissue, especially in the mouth and gut.

Mucus Lubricant secretion.

Mutation Germ-line mutations are mutations in germ cells and are present systemically throughout the body. Germ-line mutations can be inherited from parents. Somatic mutations occur locally within the body as a result of exposure to cancer-causing agents or the passage of time. Somatic mutations are not inherited.

Myalgia Muscle pain.

Myelitis Swelling of the spinal cord which can disrupt communications between the brain and parts of the body downstream of the swelling site.

Myeloid dendritic cell Specialized type of immune cell also called an antigen-presenting cell.

Myeloid stem cell Stem cell in bone marrow that gives rise to myeloid blood cells.

Nadir Lowest point in a cycle or progression.

Naive In the context of medicine and clinical trials, an individual, population, cancer, bacteria or virus with no previous experience of the treatment, bacteria or virus being discussed. Prior to 2020 the UK population was novel coronavirus naive.

Neoplasm Greek for new growth. Refers to an increase in the number of cells locally forming a tumour that may be benign or malignant.

Nerve Type of sensory tissue/fibre.

Nervous Referring to nerve tissue.

Neuron Specialized sensory cell that forms nerve tissue.

Neutropenia Abnormally low neutrophil (white blood cell) count.

Neutropenic sepsis Overwhelming and potentially life-threatening infection resulting from a low white blood cell count (for example, as a result of chemotherapy).

Neutrophil Type of white blood cell that is involved in a non-specific immune response.

Non-self A molecule, such as a pathogen, that is recognized as not being a cell of the host’s body.

Non-specific immune response Immediate, short-term, innate, generalized response to a pathogen.

Nuclear division Division of the contents of the cell nucleus at mitosis.

Nuclear envelope Phospholipid bi-layer that contains genomic DNA and nucleolus in eukaryotic cells (cells with a nucleus).

Nuclei Plural of nucleus.

Nucleotide Basic structural units of DNA and RNA made of a purine or pyrimidine, a sugar group (deoxyribose or ribose) and a phosphate group.

Nucleus Major organelle of eukaryotic cells that contains genomic DNA in the form of chromosomes.

Number staging System for describing cancer using a single number. Stage I refers to a tumour entirely contained in the organ of origin, whereas stage IV indicates the presence of distant metastases.

OLDCART Mnemonic for assisting with the assessment and management of pain. The letters stand for onset, location, duration, character, aggravating factors, relieving factors, and treatment.

Oncogene Mutated gene that drives cell growth in an unregulated manner.

Oncolytic Literally ‘bursting cancer’, refers to viruses that cause cancer cells to burst as part of the life cycle of the virus.

Organ Group of tissues that forms a specialized function (for example, heart, lung and liver).

Organelle Subcellular structure that forms a specialized function (for example, nucleus, Golgi apparatus and mitochondria).

Organism Living system.

Osmolarity Concentration of a substance, expressed as the number of dissolved particles per litre of water. (Concentration is expressed as mass per litre.) Osmolarity is useful because a difference in osmolarity drives diffusion of water (osmosis), while a difference in concentration does not.

Ostomy Opening in the abdomen with a piece of digestive tract protruding through it (for example, a colostomy, where the colon protrudes; also known as an ostomy stoma).

Oxygen Atomic molecule needed for aerobic respiration (to convert food energy into chemical energy).

Palliative care Care or treatment built around improvement in quality of life and reduction in suffering.

Palpate Manipulate and examine with fingers to detect a lump.

Pap test Alternative name for the original cervical smear test, named after its inventor, Dr George Papanicolaou.

Paraesthesia Tingling feeling like pins and needles.

Parasite Organism which lives on or in another organism (the host) and derives its needs from the host at the host’s expense, usually causing harm.

Partial response During treatment the tumour is seen to shrink. Often the threshold is taken to be a 50% reduction in tumour size.

Patent In the context of surgery, patent refers to something being unobstructed or open to free passage (for example, a section of bowel is patent if it is free for the passage of faeces).

Pathogen Harm-causing or disease-causing organism.

Peptide Molecule formed by linking two or more amino acid units together (also known as oligopeptides if there are 2–20 amino acid units). Chains containing substantial numbers of amino acids may be called polypeptides (more than 20 amino acid units), or proteins if they are folded into a definite functional structure.

Peptide bond Covalent chemical bond between two amino acid molecules, such as in a protein structure.

Pericardium Double-walled sac containing the heart and roots of major blood vessels.

Perioperative During surgery.

Peripheral Describing areas or systems of the human body that are away from the core (for example, peripheral nerves and peripheral blood vessels).

Pharmacodynamics Mechanism of action by which a drug acts on the body or cells of the body.

Pharmacokinetics Variation of drug concentration with time, often plotted as a curve of blood concentration against time.

Pharyn- Prefix used to describe the back of the mouth.

Phase In the context of a clinical trial, phase denotes the stage of testing and the hypothesis being tested.

Phenotype Observable characteristics of a cell or organism. In cancer this could be whether and how much protein is being made by the cell.

Phosphate Phosphorous atom surrounded by four oxygen atoms. This group is often transferred between proteins to change the behaviour of the protein to which it is delivered.

Plasma cell Type of B lymphocyte that circulates in the blood plasma and secretes antibodies in response to infection.

Platelet Fragment of membrane (also called a thrombocyte), derived from a megakaryocyte, which produces a blood clot in response to injury.

Pleural Related to the membrane that contains the lungs.

Polydipsia Sensation of extreme thirst that cannot be resolved by drinking water.

Polymerase Protein that assembles long chains of molecules to form a polymer, especially used for proteins which connect the long polymer backbones of DNA and RNA.

Polyp Sac-like structure.

Polyphagia Sensation of extreme hunger not resolved by eating.

Polyuria Need to urinate frequently.

Potassium Chemical element with the symbol K from kalium (Latin for potash). Potassium ions are essential for life.

Practicable Used widely in medicine and radiation protection to mean that something is able to be done successfully and feasibly. Contrast with ‘practical’; for example, it is practical to reduce radiation exposure to background levels by not turning the X-ray machine on, but if you need to image a person it is not practicable.

Primary care network Network of GP practices, community-based care, ambulatory services, and health and well-being services.

Primary tumour Tumour that is situated in the tissue site of its origin.

Proctitis Inflammation of the rectum connecting the colon to the anus.

Prognosis Prediction based on data or experience of the likely disease progression or treatment outcome.

Programmed cell death Death of a cell mediated by an intracellular molecular programme. Examples are apoptosis and autophagy.

Progressive disease (1) Disease whose natural course results in worsening of the disease. In the case of cancer, progression may also lead to metastasis and resistance to treatment by a mechanism similar to that of antibiotic resistance. (2) Disease that has worsened since the start of treatment. See also Stable disease, Partial response and Complete response.

Prolactin Hormone involved, among other functions, in milk production.

Proliferation Increase in the number of cells from a common parent, or the act of increasing the number of cells from a common parent.

Prophase Early stage of mitosis where the chromatin condenses to form chromosome structures.

Prophylactic Intervention put in place before an undesired event in order to prevent it, and having the effect of allowing to more serious interventions to be sidestepped which would be needed if the event were allowed to occur.

Protein Polymer of amino acids linked by peptide bonds into a polypeptide chain that folds to form a protein structure.

Protein sequence Order in which amino acids lie in a polypeptide chain.

Protein synthesis Production of protein molecules.

Pruritus Unpleasant sensation provoking the urge to scratch.

PSA Prostate-specific antigen is a protein used for the production of ejaculate, making sure the semen is liquid and sperm can swim freely. The level of PSA in the blood may be elevated in men with prostate cancer but also in other conditions, meaning that raised PSA levels require further investigation.

Purine Type of nitrogen-containing base made of a pyrimidine and an imidazole ring.

Pus Yellow exudate containing white blood cells formed as part of the inflammatory response to an infective agent.

Pyrimidine Type of nitrogen-containing DNA base.

Quiescence When the cell is in a quiescent state and is not undergoing cell growth, also referred to as G0.

Radiotherapy Use of high-energy X-rays to damage and kill cancer cells. May be external, delivered by a machine called a Linac; may be internal, implanted as solid seeds containing small packets of radioactive material; or may be systemic, given as an injection of a liquid radioactive drug.

Receptor protein Specialized type of protein, often localized on the cell surface membrane, which stimulates cell activity on interaction with a signalling molecule.

Renal Referring to the kidney.

Resistance In the context of drug failure, resistance means the failure of cancer cells to respond as expected to a drug at the normal dose levels. Resistance may be intrinsic (the cancer had the resistance from the start) or acquired (the cancer cells evolved the resistance in response to treatment). Resistance can be formed by increased metabolism of the drug, by increased expulsion (efflux) of the drug or by mutation to prevent the drug’s mechanism of action.

ReSPECT Recommended summary plan for emergency care and treatment: a form detailing the care required and desired by an individual.

Respiration May refer to the act of breathing or to the use of sugars by the body to give energy.

Ribose 5-carbon sugar used in the construction of RNA and, after removal of an oxygen atom, DNA. Compare with Glucose, a 6-carbon sugar used in metabolism.

Ribosome Large protein structure that is the site of protein synthesis.

RNA RNA carries short sequences of information transcribed from DNA. It may be structural information about protein synthesis or regulatory information about transferring or when to act on structural information. There are three main types: messenger RNA (mRNA), transfer RNA (tRNA) and ribosomal RNA (rRNA).

RTOG Scoring system for radiotherapy side effects on the skin, ranging in severity from 0 to 4. The RTOG score is based on clinical team observations, not patient-reported experience/symptoms.

Sarcoma Cancer derived from connective tissue.

Screening Process that seeks to detect warning signs associated with cancer or highlight major risk factors prior to an individual presenting with symptoms. Not to be confused with diagnosis, which confirms the presence of disease.

Sealed source Source of radioactivity consisting of a radioactive substance bound into a solid matrix to make it impossible for the radioactive material to escape.

Secondary tumour Tumour that has spread to a distant site of the body from the primary tumour site where it originated.

Secrete Releasing chemicals from a cell to exert function on other cells.

Seeds Sealed source for brachytherapy (internal radiotherapy). Often in the form of a metal rice grain, made of titanium and filled with a radioactive material, often iodine-125 but others are also used.

Selectively permeable Membranes that do not allow free passage of all molecules.

Sensitivity In the context of a test (or screen), sensitivity is the ability of that