Many people new to this disease and new to this board can get lost in the alphabet soup of the terminology. It's almost impossible to read an abstract of a clinical trial without some of these terms and abbreviations.

This thread is an attempt to offer a primer in "colon-cancer-speak."

I have combined the various posts into a semi-alphabetical list. If you have any additions, please post them and I will insert them into the list. Thank you, thank you, thank you to the MANY people who have contributed to this thread!!!

-justsing

ACRONYM ABBREVIATIONS:

ac = before mealsADL = activities of daily life (eating, dressing, showering, etc.)Anti-angiogenesis - the process of stopping new blood vessels from formingAPR = Abdomino-Perineal Resection (abdominoperineal resection)Bevacizumab (Avastin) - a drug used to stop new blood vessels from formingBID = twice a dayCBC – Complete Blood Count – see expanded explanation belowCEA - Carcino-embryonic Antigen - this is a tumor marker for Colon Cancer.Cetuximab (Erbitux) - HELP!CR = Complete response to chemotherapyCR = Complete response to chemotherapyCRC - colorectal cancerDH - Dear HusbandDFS - disease free survival - used to describe the time that a patient is NEDDX - diagnosisEGFR - Epithelial Growth Factor Receptor - the key to Erbitux and Vectibix's actionsFOLFIRI - chemo regimen using 5-FU, Leucovorin and Irinotecan (Camptosar)FOLFOX - chemo regimen using 5-FU, Leucovorin, and Oxaliplatin (Eloxatin)HIPEC - heated chemotherapy used to wash out the peritoneal/abdominal cavityhs = at bed timeHNPCC - a genetic condition which runs in families and indicates a predisposition to GI and OB-GYN cancers.KRAS - a part of the DNA of the cancer cell which they now know has a connection to whether the EGFR class of drugs will be effective on your cancer.KRASmt - Mutant Type - means that the cancer's KRAS gene HAS mutated, and thus is unlikely to respond to the EGFR drugsKRASwt - Wild Type - means that the cancer's KRAS gene has not mutated and will respond to the EGFR drugsLAR – Low Anterior Resection – surgery used for rectal cancerLAR = low anterior resectionLN - Lymph nodemCRC - metastatic colorectal cancerMet - metastasisMRD - minimal residual diseaseNED - no evidence of diseaseNG tube (nasogastric tube)OS - overall survivalOxi - shorthand for OxaliplatinPanitumibab (Vectibix) - HELP!pc = after mealsPD = Progressive disease while on chemotherapyPD = Progressive disease while on chemotherapyPFS - progression free survival - used to describe the time that a patient is stable, or showing no worsening/progression of the diseasePR = Partial response to chemotherapyPR = Partial response to chemotherapyPRN - 'pro ne rata' meaning when necessaryPS - Performance Status - a term used to describe your overall ability to function, dressing yourself, eating, physical activity, etc.PSD - peritoneal surface disease - means that the cancer has spread to the abdominal cavity and is on the surface of the organs rather than within the organsPX - prognosisQD = every dayQID = four times a dayQOD = every other dayRCa = rectal cancerRFA - Radio Frequency AblationTemp = temporary, as in “temp ileo”TID - three times a dayTNM – a system of staging cancerTPE or CPE = total (or complete) pelvic exenteration (used to be called pelvic evisceration). It's complete removal of all remaining organs in the pelvis, including the bladder, and usually requires double ostomies.TPN = total parenteral nutrition, or nutrient liquid delivered via IV or PICC line.TX - treatmentVEGF - Vascular endothelial growth factor - the part of the cancer cell dealing with new blood vessel formationXELIRI - Xeloda and IrinotecanXeloda (Capecitabine) - Oral 5-FU (pill form)XELOX - Xeloda and Oxaliplatin - also called CAPOX for CAPecitabine and OXaliplatin

Definition of Anatomic orientation terms

Anatomic orientation terms: In anatomy, certain terms are used to denote orientation. For example, a structure may be horizontal, as opposed to vertical.

Some of the terms of anatomic orientation are as follows:

* Anterior: The front, as opposed to the posterior. * Anteroposterior: From front to back, as opposed to posteroanterior. * Caudad: Toward the feet (or tail in embryology), as opposed to cranial. * Caudal: Pertaining to, situated in, or toward the tail or the hind part. Or below another structure. * Cranial: Toward the head, as opposed to caudad. * Deep: Away from the exterior surface or further into the body, as opposed to superficial. * Distal: Further from the beginning, as opposed to proximal. * Dorsal: The back, as opposed to ventral. * Horizontal: Parallel to the floor, a plane passing through the standing body parallel to the floor. * Inferior: Below, as opposed to superior. * Inferolateral: Below and to one side. Both inferior and lateral. * Lateral: Toward the left or right side of the body, as opposed to medial. * Medial: In the middle or inside, as opposed to lateral. * Posterior: The back or behind, as opposed to the anterior. * Posteroanterior: From back to front, as opposed to anteroposterior. * Pronation: Rotation of the forearm and hand so that the palm is down (and the corresponding movement of the foot and leg with the sole down), as opposed to supination. * Prone: With the front or ventral surface downward (lying face down), as opposed to supine. * Proximal: Toward the beginning, as opposed to distal. * Sagittal: A vertical plane passing through the standing body from front to back. The mid-sagittal, or median plane, splits the body into left and right halves. * Superficial: On the surface or shallow, as opposed to deep. * Superior: Above, as opposed to inferior. * Supination: Rotation of the forearm and hand so that the palm is upward (and the corresponding movement of the foot and leg), as opposed to pronation. * Supine: With the back or dorsal surface downward (lying face up), as opposed to prone. * Transverse: A horizontal plane passing through the standing body parallel to the ground. * Ventral: Pertaining to the abdomen, as opposed to dorsal. * Vertical: Upright, as opposed to horizontal.

TERMS AND TOPICS IN ATTEMPTED ALPHABETICAL ORDER

Adenoma - Non-cancerous polyps that are considered precursors to colon and rectal cancer.

Adjuvant - chemo treatment that follows surgical removal of all the cancer they can find -- it generally refers to treatment done when the patient is presumably cancer free

Anti-emetic - any kind of drug that is used to combat nausea and vomiting

BLOODWORK:CBC: Complete blood count, including both hematology and serum chemistry analysis. Hematology can usually be run quickly, and checks things like white counts and red blood cell counts. Serum chem analysis takes longer (the machine runs more slowly.)

CBC - complete blood count also known as a hemogram

A complete blood count will normally include:

Red cellsTotal red blood cells - The number of red cells is given as an absolute number per litre.

Hemoglobin - The amount of hemoglobin in the blood, expressed in grams per decilitre. (Low hemoglobin is called anemia.)

Hematocrit or packed cell volume (PCV) - This is the fraction of whole blood volume that consists of red blood cells.

Red blood cell indices:Mean corpuscular volume (MCV) - the average volume of the red cells, measured in femtolitres. Anemia is classified as microcytic or macrocytic based on whether this value is above or below the expected normal range. Other conditions that can affect MCV include thalassemia and reticulocytosis.

Mean corpuscular hemoglobin (MCH) - the average amount of hemoglobin per red blood cell, in picograms.

Mean corpuscular hemoglobin concentration (MCHC) - the average concentration of hemoglobin in the cells.

Red blood cell distribution width (RDW) - a measure of the variation of the RBC population

White cellsTotal white blood cells - All the white cell types are given as a percentage and as an absolute number per litre.

A complete blood count with differential will also include:

Neutrophil granulocytes - May indicate bacterial infection. May also be raised in acute viral infections.Because of the segmented appearance of the nucleus, neutrophils are sometimes referred to as "segs." The nucleus of less mature neutrophils is not segmented, but has a band or rod-like shape. Less mature neutrophils - those that have recently been released from the bone marrow into the bloodstream - are known as "bands" or "stabs". Stab is a German term for rod.

Lymphocytes - Higher with some viral infections such as glandular fever and. Also raised in lymphocytic leukaemia CLL. Can be decreased by HIV infection. In adults, lymphocytes are the second most common WBC type after neutrophils. In young children under age 8, lymphocytes are more common than neutrophils.

Basophil granulocytes- May be increased in bone marrow related conditions such as leukemia or lymphoma.

A manual count will also give information about other cells that are not normally present in peripheral blood, but may be released in certain disease processes.

PlateletsPlatelet numbers are given, as well as information about their size and the range of

Interpretation

A healthy patient's view of a Complete Blood Count (CBC) test result as delivered on the Web by Kaiser-Permenente HMO in San Jose, CA. It is formatted through Epic Systems Corporation's MyChart system.Certain disease states are defined by an absolute increase or decrease in the number of a particular type of cell in the bloodstream. For example:

leukocytosis can be a sign of infection.thrombocytopenia can result from drug toxicity.pancytopenia is generally as the result of decreased production from the bone marrow, and is a common complication of cancer chemotherapy.

This isn't exactly a bit of terminology nor is it an abbreviation, But it IS the only 'sticky' we've got, and people do often ask how to find clinical trials.There is a site called TrialX, which differs from clinicaltrials.gov in that it's a little more user-friendly type of search engine, and it works off of Twitter and Facebook.

(thanks, btw, to Darren Rouse for collecting this kind of stuff that doesn't fit anywhere else!)

The important part for cancer patients is this section (scroll down in the blog post):

Nitin from TrialX sent us this: We have just launched a twitter app to increase information availability of clinical trials. The app is simple, and after our initial testing, looks useful. All you need is to QuTweet (query tweets pronounced cute-tweets) us at TrialX (@trialx), put in the keyword “CT” (for Clinical Trial) followed by your health profile. In about a minute we’ll send you a reply tweet with a tinyurl link to the TrialX page containing matching trials as per your QuTweet.█ http://search.twitter.com/search?q=trialx █

From my Twitter homepage, I sent the following update as a reply to TrialX:@trialX CT rectal cancer Northeast US

and within about two minutes I received back this reply:TrialX @Gaelen2 Your Matching Clinical Trials █ http://tinyurl.com/cozbv5 █

Click on the tinyurl link, type in your age and gender. Under "Condition", I added in Stage IV (which is when most of the choices disappeared) but you don't have to add extra info in that column. I also didn't pick a phase for the trials. After you fill out the top row of the chart presented, you can click on each trial in the list and see whether you qualify and what the trial is testing.

Unfortunately, at Stage IV, I don't qualify for most of them--but for those femal stage IIIs out there, there are two trials on sexual health post-treatment which look very interesting.

TrialX is also on FB This is their general url: █ http: //trialx.org/ █They are trying to use social media like Twitter and FB to make clin trial information more accessible to people. Very, very cool.

CEA - Carcino-embryonic Antigen - this is a tumor marker for Colon Cancer. Not all colon cancers emit this marker, so it is not useful for every patient. It if is a good indicator for your cancer, they can monitor the trends in your bloodwork. If it starts to trend up then they generally will go on a hunt to figure out what's up.

Colonoscopy—Investigation of the inside of the colon using a long, flexible fiberoptic tube

Colostomy: An alternative exit from the colon created to divert waste through a hole in the colon and through the wall of the abdomen.

CT or CAT scan: Pictures of structures within the body created by a computer that takes the data from multiple X-ray images and turns them in pictures on a screen. The CAT (computerized axial tomography) scan can reveal some soft-tissue and other structures that cannot even be seen in conventional X-rays.

Cyber Knife radiation treatment

Hand and Foot syndrome - a side effect of 5-FU in which your hands and feet become tender and the skin can crack and peel. Can be more common with oral 5-FU (Xeloda)

Hepatic Artery Infusion (HAI) pump to treat liver mets

“Ileo” or Ileostomy—A surgical procedure in which the lower part of the small intestine (the ileum) is cut and brought to an opening in the abdominal wall, where feces can be passed out of the body.

J Pouch - A reservoir created out of small intestine after removal of the colon and portions of the rectum. This internal pouch holds fecal material (stool) before elimination through the anus. There are two types of j-pouches - colonic j-pouches made from part of your colon (in some cases my sigmoid colon) and ileal j-pouches that are made from your ileum (small intestine) where the colon is completely removed. Many rectal cancer patients that have j-pouches actually have colonic j-pouches and not ileal j-pouches.

K pouch - The continent ileostomy, or K-pouch, is a connection of the end of the small intestine, called the ileum, to the skin of your abdomen. It allows waste to be drained. Unlike other ileostomies, the K-pouch or Kock ileostomy, has a valve made by sewing the intestine in a special way so that waste material doesn't leak out but rather a tube called a catheter is inserted when it's time to empty the pouch

Lesion - something fishy, usually a tumor

Margins - the amount of cancer free tissue surrounding the tumor - they determine this when the resected tissue is sent to the pathology labRadial margin - the amount of colon wall that was left cancer freeLongitudinal margin - the amount of colon - lengthwise - that was left cancer free in the chunk that was removed surgically

mesorectum is a specific anatomical structure, essentially the fat pads and supporting membranes which attach, surround and support the rectum and many important nerves and vessels.

NAUSEA MEDS:

I had a little seminar with the palliative care team and the pharmacist at my cancer center. So here is what I retained:

There are three receptors in your brain that deal with nausea and the various drugs are usually focused on one of the areas.

cesamet (nabilone) synthetic form of marijuana (THC) in pill form

Compazine is usually the first line. Pros: It works well for many people and is relatively inexpensive. Cons: It really knocks me out and I see pink flying monkeys. It is available as a suppository when you can't keep things down.

Zofran: Usually the next upgrade. It is available in orally dissolving tablets - ODT - which is really helpful when you can't keep things down.Pros: It works GREAT for me. Cons: constipation and cost

Kytril: Often given as an IV pre-med with your chemo. It's in the same family as Zofran. It is available orally as well, but it's not cheap.

Decadron: (aka Dexamethazone) a steroid. Often given as an IV pre-med, but also available orally. Pros: works well for many people, can enhance your energy level Cons: Decadron "Buzz" can interfere with sleep, can cause blood sugar issues, the CRASH that follows the buzz can be severe

Emend: a long term, very powerful anti-emetic. Usually given orally over first three days of each chemo cycle. It's VERY expensive, but it can be a miracle. Works on the same brain receptor as the Decadron

Aloxi: also a long acting drug.

Ativan: anti anxiety drug which has some anti-nausea benefits, but it's anti nausea benefit is not too strong. Can relax you and prevent "anticipatory nausea." Also helps to counteract the Decadron buzz.

Haldol: an anti-psychotic drug that also has anti-nausea benefits. Really helped me, but konked me right out!

Marinol: Marijuana in a pill. Helps with appetite, pain and nausea. Expensive, but helpful. Not sure if the pill is better than just rolling your own -- but it's legal!

Phenergan: don’t know which receptor it works on. Can be given as an injection.

Reglan: improves the motility of the digestive system. Has been known to cause seizures.

Stemetil (prochloroperazine) - For treatment of nausea and vomiting, the recommended adult dose of prochlorperazine is usually 5 mg to 10 mg, three or four times daily.

Nasogastric aspiration (suction) is the process of draining the stomach's contents via a rubber tube. Nasogastric aspiration is mainly used to remove gastric secretions and swallowed air in patients with gastrointestinal obstructions. Nasogastric aspiration can also be used for preparation before surgery under anesthesia, and to extract samples of gastric liquid for analysis.

Neo-adjuvant - chemo that is done prior to surgery both to potentially shrink any known lesions and also to offer some systemic treatment to prevent new lesions from cropping upNeoplastic process - potentially cancerous activity

onc = our little term to mean oncologist

Ostomy: An operation to create an opening from an area inside the body to the outside.

Ostomy take-down - surgical closing of the stoma and the skin opening

PALLIATIVE CARE: It is NOT the same as hospice or "Gee, we're just going to keep you comfortable." Palliative Care docs deal with all the SYMPTOMS of cancer and its treatment. So that includes chemo related nausea, neuropathy, pain, mouth sores, etc. They can be there to provide assistance to you in every stage of this disease, not just the end game! If you have access to one, take advantage of it!

Peripheral Neuropathy - a side effect of Oxaliplatin in which the nerves in your extremities are damaged and you experience numbness and some loss of use of your hands and feet

Resection - surgically removing a big chunk of something - like your colon or your liver. It offers the best potential for a curative surgery because they can usually take out the cancer, and also some buffer zone tissue which is referred to as the "margin."

RFA - Radio Frequency Ablation - this is a localized treatment for tumors where a probe is inserted into the tumor and heated with radio waves to cook the cancer to death. It is often done when the lesions in question cannot be resected for some reason.Cryoablation - same idea as RFA, but they freeze the tumor instead of cooking it

Salvage surgery is usually after a first or second operation has 'failed', then the surgeon 'salvages' what he/she can. There is no definite procedure associated with this as each case is different and salvage surgery can mean differing degrees of surgery (removal of organs, etc) with each specific case.

Sphincter saving surgery - this usually means that the colorectal surgeon can perform an LAR (lower anterior resection) meaning the surgeon can remove most if not all of the rectum but keep the sphincter muscles intact and then pull down the colon and reconnect it.

STAGING:

TNM = an attempt at universal staging evaluation that attempts to unify across countries analysis tumors and extent of spread of disease. T refers to tumor and can be modified X-4, N refers to node involvement and is modified X-2 and M refers to metastasis to distant organs, modified X, 1 or 0. The number that follows T or N indicates severity; X indicates it can't be assessed yet, and the number that follows M indicates presence (X for not assessed, 1 for present, 0 for not present.). It will be types out as TnNnMn.T4N2M1 means tumor spread to distant organs, node involvement to 4 or more regional lymph nodes, mets-yes and is equal to a Stage IV diagnosis. More explanation of the TNM system: available here and illustrations of the stages : here

How TNM status breaks into stages differs a little from cancer to cancer. In CRC, it's possible to be T1-4/N0/M1, because in the TNM system, lymph nodes are graded differently from spread to other organs.This explanation is from the American Cancer Society site, revised 2011, and it's the guideline which determines treatment in the US:ACS site-----------Stage grouping: Once a person's T, N, and M categories have been determined, usually after surgery, this information is combined in a process called stage grouping. The stage is expressed in Roman numerals from stage I (the least advanced) to stage IV (the most advanced). Some stages are subdivided with letters. The following guide illustrates how TNM categories are grouped together into stages:

Stage 0Tis, N0, M0: The cancer is in the earliest stage. It has not grown beyond the inner layer (mucosa) of the colon or rectum. This stage is also known as carcinoma in situ or intramucosal carcinoma.Stage IT1, N0, M0 or T2, N0, M0: The cancer has grown through the muscularis mucosa into the submucosa (T1) or it may also have grown into the muscularis propria (T2). It has not spread to nearby lymph nodes or distant sites.Stage II AT3, N0, M0: The cancer has grown into the outermost layers of the colon or rectum but has not reached nearby organs. It has not yet spread to the nearby lymph nodes or distant sites.Stage II BT4, N0, M0: The cancer has grown through the wall of the colon or rectum and into other nearby tissues or organs. It has not yet spread to the nearby lymph nodes or distant sites.Stage III AT1, N1, M0 or T2, N1, M0: The cancer has grown through the mucosa into the submucosa (T1) or it may also have grown into the muscularis propria (T2). It has spread to 1 to 3 nearby lymph nodes but not to distant sites.Stage III BT3, N1, M0 or T4, N1, M0: The cancer has grown into the outermost layers of the colon or rectum but has not reached nearby organs (T3) or the cancer has grown through the wall of the colon or rectum and into other nearby tissues or organs (T4). It has spread to 1 to 3 nearby lymph nodes but not distant sites.Stage III CAny T, N2, M0: The cancer may or may not have grown through the wall of the colon or rectum, but it has spread to 4 or more nearby lymph nodes. It has not spread to distant sites.Stage IV AAny T, Any N, M1a: The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have spread to nearby lymph nodes. It has spread to 1 distant organ (such as the liver or lung) or set of lymph nodes (M1a).Stage IV BAny T, Any N, M1b: The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have spread to nearby lymph nodes. It has spread to more than 1 distant organ (such as the liver or lung) or set of lymph nodes, or it has spread to distant parts of the peritoneum (the lining of the abdominal cavity) (M1b).

TomoTherapy - radiation

Urostomy: A surgically created opening (usually on the abdomen) that allows urine to flow out of the body. A urostomy may sometimes be called a urinary diversion or ileal conduit.

OURworld is worth saving Question everything. Become your own Advocate.When we find a cure for one cancer it will lead to a cure for ALL cancerCrohn's ColitisRectal Mucosa Resection - Oct 2010Rectal Surgery - Sep 2011Stroke Sep 2012

We should add CTC to the list - circulating tumor cells. Usually tested in Stage IV patients to determine response to treatment. Test results range from 0 to 3. Cell Search is the company that developed the test.

Thank you so very much from one who is new to this cancer stuff. I read and reread your post and feel so much better knowing it is there for me to refer to. Language is tricky day to day. Cancer language is like listening to someone from Mars right now...You really helped!

anterior - front (as in front of the body or organ)posterior - back of, (back of your hand)midline - imaginary line that seperates the body in half going down though the middle of the nose and all the way down.distal - distant frontlateral - the side of the body or body part farthest from the midlinemedial - closest to the midline

There's more on spacial terms but these should help when you real scans because they use them quite a bit. Left lateral knee would mean the left side of the knee farthest from the midline so it would be the outside of the knee. If it was left medial knee it would be left knee closest to the midline so it would be the inside of the left knee.

Under prochlorperazine I would add the name compazine

I don't know how much these are needed but.

po - by mouthSL - sublingual (a pill that dissolves under the tongueIM - injection into the muscleSQ - injection into the fatty tissue (not in the muscle)IV - intravenousIVP - IV push, nurses put medication into your IV with a syringe and push it in over a specific amount of time.IV drip - the IV you get through a bag a certain rategtt - dripz-track - for those of you that get iron injections you get it this way. They have to push up the skin, give the injections and then let go of the skin so the fluid can't run out and destroy the tissue. This way the hole in the skin is away from the underlying hole in the tissue.

This is probably to much info. but I thought I'd throw it in and you can take out what you want Justsing.

Although they are all sometimes referred to as 'ports', there are big differences between intravenous access lines, and implanted chemoports.

CHEMOPORTSA chemoport doesn't have any exterior lines hanging down unless the patient is getting an infusion or otherwise hooked up to an IV. It's a completely self-contained durable medical device made of plastic and metal. It can set off metal detectors, so once implanted, the surgeon gives you a Medic Alert card to carry. Mine's a Bard, and I've had it since 2004.The picture linked above shows some of the several kinds that are in use. Most are about 1 inch in diameter.I also had a second type of chemoport - an hepatic artery infusion pump - which provided a combination of port access and pump to deliver chemo directly to a blood vessel and then into my liver. That pump was approximately the size of a hockey puck. Yeah.

There's no patient maintenance - unless it's accessed for infusion, when the nurses usually plop a transparent bandage over the entire site.

This blog written by Diehl Martin shows the step-by-step process of accessing his chemo port for his infusion. The first photo shows the slightly bruised area on his right chest, and a little lump covered by skin and a scar - that's his port. *warning*Diehl did go step by step - right through the needle access.

INTRAVENOUS ACCESS LINESA Groshong catheter is a venous access line, which isn't precisely a 'port.' Although it can be used to deliver chemo (Lance Armstrong had one), a Groshong is in the class of 'invasive lines' which requires daily patient maintenance. The last picture in this series (slide 6) is the Groshong. Other access lines are shown in these slides. Slide 3 illustrates another common method of temporary access called an invasive sub-clavian line.

Another form of temporary access is a PICC line - also requires patient or home-health care maintenance to flush it. I'll try to find a picture.

Thanks for posting this. You could write a whole book on terms and abbreviations. Some of the abbreviations are perplexing at how they cam up with them. For instance, the abbreviation for "every" is "Q" rather than "E". Is this Latin because it seems easier to learn "Every Other Day" as "EOD" rather than "QOD"?

Not really terminology, but since we don't have a sticky 'resources' thread:

Things to take with you to the hospital is a thread from 2008 that is linked to other threads where the question came up. Lots of helpful stuff to pack and to have with you in the hospital - and some suggestions about what NOT to bring, as well.

Thank you...this will help me alot...I was clueless on alot of things on here, now maybe I will understand better...I was one of those people that didn't ask alot of questions and had the attitude that this thing was either going to take me or not, (plus I didn't want to know alot of stuff that may not even affect me which actually was something my doctor said in the beginning). So again, Thanks for the info.