Glossary of Terms

Acupuncture: The technique of inserting thin needles through the skin at specific points on the body to control pain and other symptoms. It is a type of complementary and alternative medicine.

Adenocarcinoma: The most common type of pancreatic cancer within the exocrine system.

Adenoma: Benign tumor of epithelial tissue with glandular origin, glandular characteristics, or both. Adenomas can grow from many glandular organs, including the adrenal glands, pituitary gland, thyroid, prostate, and others. Although adenomas are benign, over time they may transform to become malignant, at which point they are called adenocarcinomas.

Adjuvant chemotherapy: Adjuvant chemotherapy is given after a pancreatic tumor is removed with surgery to prevent the cancer from coming back.

Ascites: Abnormal buildup of fluid in the abdomen that may cause swelling. In late-stage cancer, tumor cells may be found in the fluid in the abdomen. Ascites also occurs in patients with liver disease who do not have cancer.

Benign: Not cancerous. Benign tumors may grow larger but do not spread to other parts of the body. Also called non-malignant.

Biofeedback: A method of learning to control certain body functions voluntarily such as heartbeat, blood pressure, and muscle tension with the help of a special machine. This method can help control pain.

Biopsy: A test to confirm the diagnosis of pancreatic cancer.

Blood vessel: A tube through which the blood circulates in the body. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins.

Borderline resectable pancreatic cancer: Tumors are given this classification if they are confined to the pancreas, but approach nearby structures such as major blood vessels. It may be possible to remove via surgery, but there is a risk that not all cancerous cells will be removed or that removal may cause severe side effects. Borderline tumors may be treated with neoadjuvant therapy prior to surgery.

BRCA1 and BRCA 2 genes: These are human genes that produce tumor suppressor proteins. These proteins help repair damaged DNA. Those who are positive for BRCA2 gene are at a higher risk for getting ovarian, breast, prostate or pancreatic cancer.

Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids.

Cancer: A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems.

Cancer Antigen (CA 19-9): A protein on the surface of certain types of cells that is shed by tumor cells into the bloodstream. Higher than normal amounts of CA 19-9 in the blood can sometimes be a sign of pancreatic cancer. This test is not used to diagnose pancreatic cancer.

Carcinoembryonic Antigen (CEA): A protein that may sometimes be found in the blood of people that have certain types of cancer.

Cell: The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

Chemotherapy: Treatment with drugs that kill cancer cells.

Clinical trial: A clinical trial is a research study that finds new ways to prevent, diagnose or treat cancer. These treatments investigate promising new drugs, drug combinations, new approaches to surgery, chemotherapy or radiation therapy, and advances in new areas such as gene therapy. Testing of a new cancer drug or treatment is done in an orderly series of steps called phases. This allows researchers to obtain reliable information about the drug or treatment in order to protect patients in each phase of the study.

Common bile duct: The tube in the body that carries bile from the liver and gallbladder into the duodenum (the upper part of the small intestine).

Computed Tomography Scan (CT Scan): A series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an x-ray machine.

Contraindicate: to state something to be inadvisable while taking certain medication because of a likely adverse reaction.

Contrast material: A dye or other substance that helps show abnormal areas inside the body. It is given by injection into a vein, by enema, or by mouth. Contrast material may be used with x-rays, CT scans, MRI, or other imaging tests.

Cyst: A sac or capsule in the body. It is usually filled with fluid or other material.

Cytokine: Soluble factor produced by cells that has an effect on other cells.

Cytology: A branch of biology dealing with the structure, function, multiplication, pathology, and life history of cells.

Diabetes: A disease in which there is a high level of glucose (a type of sugar) in the blood because the pancreas does not make enough insulin or the insulin that is made does not work properly.

Distal Pancreatectomy: A distal pancreatectomy is usually performed when a patient has a tumor in the body or tail (‘thin end’) of the pancreas. This procedure involves having the tail and body of your pancreas removed, leaving the head of the pancreas intact. Your surgeon will normally remove your spleen at the same time because it is located next to the tail of the pancreas.

Duct: In medicine, a tube or vessel of the body through which fluids pass.

Duodenum: The first part of the small intestine into which the food empties as it passes out of the stomach.

Endocrine: Refers to tissue that makes and releases hormones that travel in the bloodstream and control the actions of other cells or organs. Some examples of endocrine tissues are the pancreas, pituitary, thyroid, and adrenal glands.

Endoscope: A thin, tube-like instrument used to look at tissues inside the body. An endoscope has a light and a lens for viewing and may have a tool to remove bits of tissue (biopsy).

Endoscopic Retrograde Cholangiopancreateography (ERCP): A procedure that uses an endoscope to examine and x-ray the pancreatic duct, hepatic duct, common bile duct, duodenal papilla, and gallbladder. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. The endoscope is passed through the mouth and down into the first part of the small intestine (duodenum). A smaller tube (catheter) is then inserted through the endoscope into the bile and pancreatic ducts. A dye is injected through the catheter into the ducts, and an x-ray is taken.

Endoscopic UItrasound (EUS): A procedure in which an endoscope is inserted into the body. An endoscope is a thin, tube-like instrument that has a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal organs to make a picture (sonogram).

Enzyme: A protein that speeds up chemical reactions in the body.

Exocrine: Refers to tissue that makes and releases substances into a duct (tube). Some ducts lead to other organs but most lead out of the body. Some examples of exocrine tissues are the tear glands, sweat glands, and the pancreas.

Fine needle aspiration (FNA): A long, thin needle is passed through the abdomen, into the pancreas, to remove cells for examination.

Gallbladder: The pear-shaped organ found below the liver. Bile is concentrated and stored in the gallbladder.

Gastroenterologist: A doctor who specializes in diagnosing and treating disorders of the digestive system, stomach and intestines.

Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein.

General anesthesia: A temporary loss of feeling and a complete loss of awareness that feels like a very deep sleep. It is caused by special drugs or other substances called anesthetics. General anesthesia keeps patients from feeling pain during surgery or other procedures.

Gland: An organ that makes one or more substances, such as hormones, digestive juices, sweat, tears, saliva, or milk. Endocrine glands release the substances directly into the bloodstream. Exocrine glands release the substances into a duct or opening to the inside or outside of the body.

Glucagon: a hormone produced by the pancreas that raises the blood sugar level by promoting the conversion of glycogen to glucose in the liver.

Helical (“Spiral”) CT Scan: A diagnostic technique which provides information about the nature and site of the lesion (e.g., pancreatic vs. other periampullary tumors, bile duct tumors), its resectability (e.g., liver metastases, vascular invasion), and vascular anatomy.

Hepatic: Relating to or affecting the liver.

Hormone: One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.

Hypnosis: A trance-like state in which a person becomes more aware and focused and is more open to suggestion.

Imagery: Technique in which people focus on positive images in their mind.

Immunotherapy: Immunotherapy is treatment that stimulates or enhances your body’s own immune system to help fight cancer.

Incision: A cut made in the body to perform surgery.

Inflammation: Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.

Inherited mutations: Certain inherited changes, or mutations in specific genes, can help explain why pancreatic cancer runs in certain families. About 10 percent of pancreatic cancers result from inherited mutations. Examples include hereditary mutations of the BRCA1 and BRCA2 genes, familial atypical multiple mole melanoma (FAMMM) syndrome, hereditary nonpolyposis colon cancer (HNPCC; Lynch syndrome), and Peutz-Jeghers syndrome (mutations in the STK11 gene).

Insulin: A hormone made by the islet cells of the pancreas. Insulin controls the amount of sugar in the blood by moving it into the cells, where it can be used by the body for energy.

Integrative Medicine: A type of medical care that combines conventional (standard) medical treatment with complementary and alternative (CAM) therapies that have been shown to be safe and to work. CAM therapies treat the mind, body, and spirit.

Intestine: The long, tube-shaped organ in the abdomen that completes the process of digestion. The intestine has two parts, the small intestine and the large intestine. Also called bowel.

Intravenous: Into or within a vein. Intravenous usually refers to a way of giving a drug or other substance through a needle or tube inserted into a vein. Also called IV.

Islet cell: A pancreatic cell that produces hormones (such as insulin and glucagon) that are secreted into the bloodstream. These hormones help control the level of glucose (sugar) in the blood. Also called endocrine pancreas cell and islet of Langerhans cell.

Jaundice: A condition in which the skin and the whites of the eyes become yellow, urine darkens, and the color of stool becomes lighter than normal. Jaundice occurs when the liver is not working properly or when a bile duct is blocked.

Jejunostomy: A surgical operation that creates access from the outside of the body into the middle part of the small intestine so that nourishment can be directly introduced.

Jejunum: The middle part of the small intestine.

Laparoscope: A thin, tube-like instrument used to look at tissues and organs inside the abdomen. A laparoscope has a light and a lens for viewing and may have a tool to remove tissue.

Laparoscopy: A diagnostic procedure in which the abdominal cavity is examined by inserting a laparoscope through small incisions in the abdominal wall.

Liver: A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.

Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

Lymphocyte: an important cell class in the immune system that produces antibodies and cancerous cells, and is responsible for rejecting foreign tissue.

Lymph vessel: A thin tube that carries lymph (lymphatic fluid) and white blood cells through the lymphatic system. Also called lymphatic vessel.

Magnetic Resonance Imaging (MRI): A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI may make better images of some organs and soft tissue than other scanning techniques. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones.

Malignant: Cancerous. Malignant tumors can invade and destroy nearby tissue and spread to other parts of the body.

Margins: Margins indicate the border or edge of the tissue removed during cancer surgery. The margins are said to be clear or negative when there are no cancer cells at the edge of the tissue, indicating that all the cancer has been removed.

Medical Oncologist: A doctor who specializes in diagnosing and treating cancer using chemotherapy, hormonal therapy, and biological therapy. A medical oncologist often is the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists.

Mesentery: A membrane that supports an organ or body part, especially the double-layered membrane of the peritoneum attached to the back wall of the abdominal cavity that supports the small intestine.

Metastatic: Having to do with metastasis, which is the spread of cancer from the primary site (place where it started) to other places in the body.

Modified Whipple procedure: Same as the Whipple procedure, except none of the stomach is removed. Also called Pylorus-preserving Whipple procedure.

Morbidity: The incidence of disease.

Myocardial infarction: The death of a segment of heart muscle, caused by a blood clot in the coronary artery interrupting blood supply.

Needle biopsy: The removal of tissue or fluid with a needle for examination under a microscope. When a thick needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

Neoadjuvant chemotherapy: Chemotherapy given before surgery is called neoadjuvant treatment and is generally used for patients with borderline resectable disease, when shrinking the tumor may increase the chance of removing it with surgery.

Nurse Case Manager: A registered nurse who has special training in how to plan, manage, and evaluate all aspects of patient care, especially for patients who get treatment over a long time. Also called case management nurse.

Obesity: A condition marked by an abnormally high, unhealthy amount of body fat.

Oncologist: A doctor who specializes in treating cancer. Some oncologists specialize in a particular type of cancer treatment.

Oncology Nurse: A nurse who specializes in treating and caring for people who have cancer.

Organ: A part of the body that performs a specific function. For example, the heart is an organ.

Pain Management Specialist: is a branch of medicine employing an interdisciplinary approach for easing the suffering and improving the quality of life of those living with pain.

Palliative care: Care given to improve the quality of life of patients who have a life-threatening disease. The goal of palliative care is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called comfort care, supportive care, and symptom management.

Pancreas: A glandular organ located in the abdomen. It makes pancreatic juices, which contain enzymes that aid in digestion, and it produces several hormones, including insulin. The pancreas is surrounded by the stomach, intestines, and other organs.

Pancreatic: Having to do with the pancreas.

Pancreatic duct: Part of a system of ducts (hollow tubes) in the pancreas. Pancreatic juices containing enzymes are released into these ducts, which then flow into the small intestine.

Pancreatic enzymes: Pancreatic enzymes help breakdown food so your body can absorb calories and nutrients. There are various enzymes for digesting proteins, carbohydrates and fats. Pancreatic enzymes, also referred to as pancreatic juices, are part of the exocrine function of the pancreas. If a portion of the pancreas is removed, or the tumor blocks the flow of pancreatic enzymes to the small intestine, there may not be enough digestive juices to break down your food, causing discomfort and other side effects.

Pancreatic juice: Fluid made by the pancreas. Pancreatic juices contain proteins called enzymes that aid in digestion.

Pancreatitis: Inflammation of the pancreas. Chronic pancreatitis may cause diabetes and problems with digestion. Pain is the primary symptom.

Pathologist: A doctor who identifies diseases by studying cells and tissues under a microscope.

Peritoneum: A smooth transparent membrane that lines the abdomen and doubles back over the surfaces of the internal organs to form a continuous sac.

Pharmacist: A person licensed to prepare and dispense (give out) prescription drugs and who has been taught how they work, how to use them, and their side effects.

Placebo: A drug or treatment that is designed to look like the medicine being tested but that doesn’t have the active ingredient. Placebos are sometimes used in clinical trials.

Port: A port is a small disc of metal or plastic placed just under the skin that connects to a large vein via a catheter. A port acts as a vein-access point for administering chemotherapy and drawing blood therefore limiting the number of venipunctures a patient has to experience.

Protocol: An action plan for a clinical trial that includes detailed description of patients who may join the trial, the therapy that will be given, and the care the patients will receive during and after the trial. It also refers to a detailed plan of treatment and how it will be administered.

Positron Emission Tomography (PET scan): A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body.

Psychologist: A specialist who can talk with patients and their families about emotional and personal matters, and can help them make decisions.

Pulmonary: Concerning, affecting or associated with the lungs.

Pylorus: The thick muscular ring (sphincter) surrounding the outlet of the stomach into the duodenum.

Pylorus Preserving Pancreatoduodectomy: This is a Modified Whipple Procedure. It involves removal of all or part of the pancreas and the duodenum with preservation of the pylorus (the part of the stomach that connects to the duodenum); usually limited to the head and neck of the pancreas and most often performed for pancreatic carcinoma.

Radiation Oncologist: A doctor who specializes in using radiation to treat cancer.

Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

Radioactive: Giving off radiation.

Randomization: A method used to prevent bias in research; a computer or a table of random numbers generates treatment assignments, and participants have an equal chance to be assigned to one of two or more groups (e.g., the control group or the investigational group)

Red blood cell: Oxygen-transporting blood cell.

Registered Dietitian: A health professional with special training in the use of diet and nutrition to keep the body healthy. A registered dietitian may help the medical team improve the nutritional health of a patient.

Relapse: Return of disease or disease progression.

Remission: The period during which no evidence of disease is present.

Renal: Relating to or affecting the kidneys.

Resect: To surgically remove.

Resectable pancreatic cancer: Resectable means that the tumor is able to be removed, or resected, by surgery. This is often the case when the cancer is caught in the early stages and has not grown far outside the pancreas and does not involve other critical structures such as veins and arteries.

Risk factor: Something that increases the chance of developing a disease. Some examples of risk factors for cancer are age, a family history of certain cancers, use of tobacco products, being exposed to radiation or certain chemicals, infection with certain viruses or bacteria, and certain genetic changes.

Side effect: A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.

Small intestine: The part of the digestive tract that is located between the stomach and the large intestine.

Social Worker: A professional trained to talk with people and their families about emotional or physical needs, and to find them support services.

Spleen: An organ that is part of the lymphatic system. The spleen makes lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach.

Staging: Staging describes the extent or severity of a person’s cancer based on the size of the primary tumor, lymph node involvement, and if the tumor has spread to other organs. Stages range from the tumor being localized without anything spreading in stage I to a tumor that has spread outside its primary origin, or stage IV. Knowing the stage of disease helps the doctor plan treatment.

Stem cell: Parent cell that grows and divides to produce red blood cells, white blood cells, and platelets. Found primarily in the bone marrow, but also in the peripheral blood.

Stem cell transplantation: Therapeutic procedure in which bone marrow or peripheral blood stem cells are collected, stored, and infused into a patient following high-dose chemotherapy to restore blood cell production.

Stent: A stent is a plastic or metal tube inserted to relieve an obstruction or to open a blocked duct. Doctors might place a stent in your pancreatic duct or your bile duct (a biliary stent) to help treat jaundice. If the tumor blocks the duodenum thereby preventing food from passing from the stomach to the intestine, a duodenal stent may be placed to alleviate discomfort and restore appetite.

Supportive care: Care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of supportive care is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called comfort care, palliative care, and symptom management.

Surgeon: A doctor who removes or repairs a part of the body by operating on the patient.

Surgery: A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

Surgical Oncologist: A doctor who performs biopsies and other surgical procedures in cancer patients.

Targeted therapy: A type of treatment that uses drugs or other substances, such as monoclonal antibodies, to identify and attack specific cancer cells.

Tissue: A group or layer of cells that work together to perform a specific function.

Translational research: Takes findings from basic science to enhance human health and well-being. This is done by applying discoveries generated during research in the laboratory and in preclinical studies to the development of trials and studies in humans.

Tumor: An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.

Tumor Marker: A substance found in tissue, blood, or other body fluids that may be a sign of cancer or certain benign (noncancerous) conditions. Most tumor markers are made by both normal cells and cancer cells, but they are made in larger amounts by cancer cells.

Ultrasound: A procedure in which high-energy sound waves are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasonography.

Whipple procedure: A type of surgery used to treat pancreatic cancer. The head of the pancreas, the duodenum, a portion of the stomach, and other nearby tissues are removed.

White blood cell: Also called a leukocyte. One of the major cell types in the blood. Responsible for immune defenses.

X-ray: A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.