Glossary

A

Adenocarcinoma: a malignant epithelial tumor arranged in glandular patterns or originating from glandular epithelial tissue.

Adenoma: formation of well-differentiated benign tumor cells with a low propensity to progress toward a malignant form.

Adjuvant therapy: chemotherapy, radiation therapy, hormone or biological therapy administered after surgery and/or radiation therapy for cancer treatment, aiming at reducing the risk of recurrence and increasing patient survival.

Anamnesis: a record of a patient’s medical history, including information on past/present illnesses as well as the medical history of the patient’s close family, with the purpose of identifying a pattern of certain diseases.

Angioma: a benign proliferation of tangled blood vessels forming blood-filled masses that are still connected with the vascular system. Angioma cells have a low propensity to progress toward a malignant form.

Angiosarcoma: a malignant tumor originating from blood vessels or angiomas.

Antibody: a protein produced by a type of white blood cells (plasma cells) in response to a specific antigen.

Antigene: a substance that the immune system recognizes as foreign and potentially dangerous, and triggers the formation of antibodies. Most antigens can evoke a specific immune response that aims at antigen removal and is coordinated by T cells and B cells.

Autoimmune diseases: a group of diseases which may differ in terms of clinical presentations, but whose common feature is an immune system defect that triggers a potent reaction against the body’s cells, organs and tissues that are regarded as foreign invaders and potential enemies.

B

B cell: a type of immune cell. Once activated, B cells produce antibodies that can recognize and bind to a specific antigen and help suppress antigen-expressing cells.

Bacteria: single-cell microorganisms that are found in the human body and the surrounding environment.

Basal cell carcinoma: the most common form of malignant skin tumor, mainly found on the face and on areas of the body exposed to the sun. It is characterized by a rather slow growth and a low propensity to spread.

Biotherapy (biological therapy): drugs that specifically target a protein in cancer cells or in the bloodstream (also called molecular target) without damaging healthy cells.

Bladder: an organ that collects the urine filtered by kidneys before disposal through the urethra, that is part of the urinary system.

Blood chemistry tests: group of tests that measure the levels of certain substances released by some body organs and tissues. An abnormal value of a given substance may be the sign of a disease in the organ or tissue that produces such substance.

Blood: a fluid that circulates into the body through a system of channels, called blood vessels, that include arteries, veins and capillaries, under the thrust exerted by cardiac contractions. The primary function of blood is to transport and provide all body tissues and organs with the substances that are necessary to perform cell metabolic activities, and to carry away waste products.

Bone marrow: soft tissue that lies within the hollow interior of bones.

Brenner tumor: a rare type of ovarian tumor.

Bronchioloalveolar carcinoma: an un common type of lung cancer.

Bronchoscopy: a diagnostic technique of visualizing the inside structures of the windpipe and the lungs to identify possible abnormalities.

C

Cancer: an umbrella term covering over a hundred different diseases whose common feature is an abnormal cell growth.

Carcinoma: a malignant tumor arising from the epithelial cells of the breast, lung, skin and intestine.

CAT (Computed Axial Tomography) scan: a diagnostic procedure that combines the use of X-rays and computers to obtain cross-sectional, three-dimensional, detailed images of the body. CAT scans ensure a better definition of images as compared to traditional X-rays.

Cell clone: a group of identical cells.

Cell division: the process by which a parent cell divides into two daughter cells. Cell division enables “worn out” or “old” cells to be replaced and tissues and organs to grow properly.

Cell: the basic unit of all body structures and tissues. Over 200 types of cells are present in the human body.

Checkpoints (immune checkpoints): metabolic pathways that inhibit the activity of the cells involved in the body’s defense system and prevent autoimmune responses.

Chemotherapy: a therapy based on the use of drugs to destroy tumor cells.

Clinical trial: a clinical study conducted in patients and involving accurate planning, conduct, collection and interpretation of data to evaluate the effects of a drug, a medical treatment or a combination therapy.

Cytokines: a group of proteins mainly secreted by the immune system that have a specific effect on the communication and coordination between immune cells, and between them and different organs and tissues.

Cytotoxic: having the ability to kill cells (potentially, both healthy and tumor cells).

D

DNA (deoxyribonucleic acid): a molecule that carries genetic information on most living organisms.

Dysplasia: a change in the microscopic appearance of some cells that have lost the normal characteristics of their original tissue but do not display the typical features of tumor cells. Such changes may be caused by several factors, including an inflammation or exposure to certain chemical substances. In some cases, dysplasia may be a pre-cancerous condition. When the histologic examination identifies such changes, the physician will make a decision on the measures to be taken following a case-by-case assessment.

E

Early diagnosis: the identification of a disease since its early phase of development. In particular, the early detection of a cancer is associated with higher chances of cure, less aggressive treatments and better quality of life. Early diagnosis can be achieved by carefully assessing the first symptoms of the disease, or through screening programs (e.g. pap smear or mammography, or fecal occult blood test).

Enzyme: a molecule that speeds up a chemical reaction.

Epithelioma: a term used to indicate an abnormal growth of the epithelium that can be a benign tumor (adenoma, papilloma) or a malignant tumor (carcinoma).

Epstein-Barr virus: the virus responsible for infectious mononucleosis and associated with Burkitt’s lymphoma and nasopharyngeal carcinoma.

Esophagectomy: also called esophageal resection, it is a type of surgery involving partial or total removal of the esophagus and sometimes of the lymph nodes near the esophagus and the stomach.

Excision: the surgical removal of tissues or organs.

F

Fatigue: a wide range of physical and psychological symptoms experienced by cancer patients. The most frequent symptoms include asthenia, weakness, muscle and joint pain, lack of appetite, anxiety, stress, anemia, and depression.

Fibroma: a benign tumor of the connective tissue. A fibroadenoma occurs when abnormal proliferation involves both connective tissue cells and epithelial cells.

Follow up: regular observation and monitoring of a patient’s health conditions by means of medical examinations, sometimes with the addition of tests and procedures, in order to evaluate the efficacy of therapies and assess whether or not a certain disease relapsed.

Food and Drug Administration (FDA): US government agency that regulates food and drugs that are put on the market, with the main purpose of protecting and ensuring the health and safety of consumers.

Fungi: living organisms characterized by a typical cell nucleus. Certain fungal species may cause diseases to humans (pathogenic fungi).

G

Gene: a DNA fragment that contains the genetic information to produce a protein. It is also the basic unit of heredity. Genes are located on chromosomes.

Genetic testing: an analysis based on the use of several laboratory techniques to assess whether an individual has a gene mutation associated with a risk of or predisposition to certain diseases, including some types of cancer. Some tests identify genes associated with breast cancer, ovarian cancer, thyroid cancer and other malignant types of cancer.

Genome: the genetic material of an organism; the complete set of genes belonging to an individual.

H

Helicobacter pylori: a type of bacteria that colonizes and grows in the gastric mucosa and causes an inflammation, which, if neglected, may originate digestive diseases such as gastritis and peptic ulcer. The damage caused by Helicobacter pylori may progress to precancerous lesions.

Hematuria: the presence of blood in the urine.

Hemoccult: fecal occult blood test. It may be useful to identify the presence of colorectal cancer.

Hemodialysis: the process of purifying the blood through a machine outside of the body.

Hemoglobin: the protein inside red blood cells that carries oxygen.

Hepatocellular carcinoma: a malignant epithelial tumor of the liver.

Histologic (examination): the analysis of tissue specimens taken during a biopsy; it is performed to identify the nature and characteristics of the cells contained in that tissue.

Histologic examination: a diagnostic technique involving the microscopic observation of a tissue specimen (biopsy) directly taken from a part of the patient’s body where a tumor is suspected.

Hormone receptors: molecules found in the tumor cells of some types of cancer (e.g. breast cancer, prostate cancer), which react to specific hormones and play an important role in the regulation of several functions. In some types of cancer, the presence of hormone receptors on tumor cells is usually associated with a better prognosis as compared to cancer types that do not express hormone receptors, and may imply a response to hormone therapy.

Hormone: a substance secreted by an organ or gland and then carried by the blood to produce specific effects on other organs and glands.

HPV (Human Papilloma Virus): HPV infections are very common and may cause diseases of the skin and mucous membranes. Usually, HPV infections do not cause alterations and are self-limited. In a minority of cases, however, they may give rise to cervical lesions, which, if left untreated, may progress to cancer.

Hysterectomy: the surgical removal of a woman’s uterus and cervix. When the surgery is performed through the vagina, the procedure is called vaginal hysterectomy; when the surgeon makes a long incision in the abdomen, the procedure is called abdominal hysterectomy.

I

Immune system: a powerful and adaptive network of cells and signaling pathways that is primarily responsible for the identification and destruction of bacteria, parasites, viruses and other foreign substances in the body that may cause a disease. The immune system protects the body against both foreign invaders (bacteria, viruses, etc.) and abnormal cells such as cancer cells.

Immunodepression: a condition characterized by a functional deficiency in immune system mechanisms, resulting in a lower resistance of the body to exogenous (external) and endogenous (internal) pathogens.

Immunological memory: a mechanism through which the body “remembers” a previous contact with an antigen and is able to react more rapidly and effectively when a second encounter occurs.

Immunotherapy/immuno-oncology/immune-cancer therapy: a treatment that stimulates a patient’s immune system to destroy tumor cells. It can be used either alone or in combination with other conventional treatments such as chemotherapy, radiation therapy or surgery.

Incidence: the proportion of a population that is diagnosed with a disease in a given time period (e.g. number of new cases of lung cancer in one year in Italy).

Interleukin: a general term covering a group of proteins produced by different types of cells, including lymphocytes and macrophages, which regulate many functions of the immune system. Interleukin-2 is used to treat metastatic forms of renal cancer and melanoma.

K

Kidney: a bean-shaped organ, about the size of a fist, located in the posterior part of the abdomen. The human body has two kidneys that are part of the urinary system; they are responsible for cleaning the blood and generating urine to eliminate toxic substances from the body.

L

Latency (latency time): Immunotherapy does not provide instantly visible results, because it does not act on tumor cells directly, but stimulates the immune system to trigger a defensive response. Therefore, the real clinical benefit of immunotherapy should not be evaluated according to the traditional time lines typically used with conventional anti-cancer therapies. In certain cases, 16-20 weeks may be required before a response to treatment and a tumor mass reduction are observed.

Leukemia: a cancer of white blood cells originating in the bone marrow. There are two types of leukemia: acute leukemia (a rapidly progressing form, that includes acute lymphoblastic leukemia and acute non-lymphoblastic leukemia) and chronic leukemia (including chronic lymphatic leukemia and chronic myeloid leukemia).

Liver: a large gland located close to the digestive tube; it performs several functions related to food digestion (bile production, transformation of absorbed food), maintenance of the body’s metabolic balance, and defense functions.

Lumpectomy: surgical procedure in which only the tumor is removed.

Lung: the primary organ of respiration. Human body has two lungs located in the chest cavity on either side of the heart. Lungs can expand and relax following the movements of the chest cage and the diaphragm. Lungs are made of a spongy, elastic tissue that is able to adjust to the changes in volume caused by respiratory movements.

Lymph nodes: small clusters of cells or small organs that are located at intervals along lymph vessels; they filter lymph and supply lymphocytes to the immune system.

Lymphatic system: a network formed by lymph nodes and lymph vessels.

Lymphocyte: a type of white blood cell involved in body’s immune response.

Lymphoma: an umbrella term covering a group of lymphocyte tumors originating in the lymphatic system, which includes lymph nodes, spleen and thymus. There are two main types of lymphomas: Hodgkin’s lymphoma, characterized by the presence of abnormal white blood cells, and non-Hodgkin’s lymphoma, caused by proliferation of malignant lymphocytes. These two types of lymphoma have different patterns of growth, spread and response to treatment.

M

Macrophage: immune system cell that acts as the “human body’s scavenger”. Macrophages originate in the bone marrow and, among other functions, they engulf and digest antigens.

Magnetic resonance imaging: a technique that uses a strong magnetic field to produce diagnostic images of body tissues and organs. Unlike the CT scan and X-rays, the MRI does not involve exposure to radiation.

Mammography: an X-ray imaging procedure used to perform the screening and diagnosis of breast cancer. In some cases, the traditional X-ray technique needs to be performed in combination with breast ultrasound or magnetic resonance imaging.

Mastectomy: the surgical removal of a breast. For many years, mastectomy has been the routine procedure for breast cancer. Today, it is less frequently performed and conservative surgery is usually preferred: quadrantectomy (see) or lumpectomy (removal of the tumor lump only and a margin of surrounding healthy tissue).

Melanocytes: cells located in the lower part of the epidermis, just above the dermis. They make a pigment called melanin, which gives color to the skin, hair, and parts of the eye.

Melanoma: a malignant tumor that develops from the melanin-producing cells of the skin (melanocytes).

Mesothelium: epithelial tissue that forms the lining of serous cavities (pleura, pericardium, peritoneum, etc.)

Metastasis: the spread of cancerous cells from their original site to another organ, also in a distant part of the body. The spread occurs through the bloodstream or lymph system.

Monoclonal antibodies: special types of antibodies produced by recombinant DNA techniques starting from a single type of immune cell; they are able to identify substances that are present on tumor cells, or substances that are usually secreted by the body and that promote the growth of tumor cells. Monoclonal antibodies act by binding to these substances and thus destroying tumor cells or blocking their growth.

N

Natural Killer (NK) cell: a type of lymphocyte capable of destroying malignant cells without prior sensitization or immunization.

Neoplasia: a tumor or tissue that grows in an abnormal manner. Can be either benign or malignant.

Nephrectomy: surgical removal of a kidney. Nephrectomy may be partial (resection of the tumor with a margin of surrounding healthy tissue), simple (removal of the kidney) or radical (removal of the kidney, adrenal gland and often the adjacent lymph nodes).

Nevus (mole): a pigmented lesion or morphologic abnormality of the skin, usually of benign nature. Their size may vary from a few millimeters to several centimeters. Their appearance is also variable: certain nevi are flat, others are raised and sometimes hairy; their color may vary from dark brown to blue and black, depending on the amount of pigment and the location of nevus cells within the skin. Some forms of nevi can rarely progress to a malignant tumor called melanoma.

Nodule: an aggregation of cells that form a small tumor mass; can be either benign or malignant.

NSCLC (non-small cell lung cancer): a term that includes all types of lung cancer, with the exception of small cell lung cancer.

O

Oncogene: a normal gene that undergoes mutation and plays a significant role in the development of cancer.

Oncogenesis: a combination of events leading to transformation of a normal cell into a tumor cell.

Oncology: medical discipline that deals with the study and treatment of cancer.

P

Partial laryngectomy: the surgical removal of a portion of the larynx.

Prevalence: the number of persons within the general population who have received a diagnosis of cancer. It is affected by both the frequency of becoming ill and the duration of the disease (survival): the most frequent types of cancer and those associated with a high proportion of long survivors are also characterized by the highest prevalence.

Prevention: can be primary, secondary or tertiary. Primary prevention includes actions aimed at reducing exposure to factors that cause cancer (e.g. abstention from smoking). Secondary prevention refers to early detection of cancer (e.g. mammography as a screening tool to prevent breast cancer). Tertiary prevention is the medical treatment of the disease after surgery and its follow-up.

Prognosis: a prediction about the course of a disease.

Prostate: a gland located below the bladder in the male genitourinary system; it is about the size of a nut, surrounds the urethra and bladder neck, and is provided with ducts that flow into the urethra.

Q

Quadrantectomy: surgical removal of part of the breast gland, which may correspond to one of the four quarters into which the breast is anatomically divided, or a portion of breast. It is a limited surgery technique with good aesthetic results.

Quality of life: an assessment of the physical, psychological and social well-being usually performed to interpret response to a therapy. In oncology, the impact on patient quality of life is a key factor when evaluating the efficacy of a treatment.

R

Radiation therapy: a therapy that uses a special type of rays to kill cancerous cells.

Red white cells: blood cells that carry oxygen and other substances to body tissues.

Regulatory genes: biological “switches” that turn on and off other genes.

Relapse: the return of cancer after an initial improvement.

Remission: temporary or permanent disappearance of cancer signs and symptoms.

Risk factors: biological characteristics, situations and conditions associated with an increased likelihood of developing a certain disease. Risk factors may be of genetic or environmental nature, or they may be linked to specific life styles.

S

SCLC (small-cell lung cancer): also known as oat cell cancer.

Screening: a check-up performed in the absence of symptoms or manifestations of a disease in an apparently healthy individual, aimed at detecting cancer at an early stage of development. Examples of screening tests include mammography (for breast cancer), smear test (cervical cancer) and fecal occult blood test (colorectal cancer).

Side effects: the unwanted effects or actions of a drug, e.g. nausea, diarrhea, hair loss, etc.

Sputum: the mucus brought up from the lungs.

Surgery: the removal of a tumor during an operation, usually performed in the absence of metastases (i.e. when the cancer has not spread to other body areas other than the primary site).

Symptom: subjective experience of a disease as reported or perceived by a patient (e.g. stomach ache, localized pain or sensation of fatigue).

T

T cell: a type of white blood cell, also called T lymphocyte. It is an immune cell that can attack foreign cells, such as tumor cells and virus-infected cells. T cells can also help control immune responses.

Targeted therapy: a therapy that uses drugs to attack specific molecular targets while preserving as many healthy cells as possible from the toxic effects of treatment.

Thymus: an organ of the lymphatic system located between the neck and the anterior mediastinum, whose function is ensure T-cell maturation.

Tissue: group of similar cells combined to perform a common function (epithelial tissue, connective tissue, muscle tissue, nervous tissue).

Tumor markers: substances that are found in the blood of cancer patients and may be used to assess response to an ongoing treatment or as prognostic factors.

Tumor: a mass of cells whose growth is excessive, more rapid and uncoordinated as compared to normal cells. Tumors can be benign (when they do not have the ability to invade surrounding tissues and develop metastases), malignant (when they spread to surrounding tissues and develop metastases) or borderline (when their characteristics do not allow a clinically reliable identification as a clearly benign or malignant form).

U

Ureter: one of the two symmetrical tubes connecting each kidney to the bladder.

Urethra: a duct, originating in the bladder, through which urine and male semen are carried out of the body.

Urography: an exam of the urinary tract that involves the acquisition of X-ray images following intravenous injection of contrast medium. In oncology, urography is a key procedure for the diagnosis of kidney and bladder cancer.

V

Vaccines: therapeutic agents that stimulate the immune system to recognize and attack specific agents, such as bacteria, viruses, or tumor cells (anti-cancer vaccines). Traditional vaccines against infectious diseases consist of a solution containing weakened, inactivated or dead viruses or bacteria – or parts of them – that induce the immune system to recognize and fight against the agent responsible for the disease.

Virus: very simple biological entity with obligate parasite features, which means that it replicates exclusively within the living cells of other organisms. Viruses can infect all living forms: animals, plants, and microorganisms.

W

White blood cells: blood cells responsible for fighting infections and diseases.

Z

Zollinger-Ellison syndrome: a pathological condition characterized by severe gastric acid hypersecretion, chronic recurrent peptic ulcers – often multiple and sometimes located at atypical sites – and by the presence of a gastrin-secreting endocrine tumor usually located in the pancreas.