Glossary

Glossary

A

 

ABCDE rule – Acronym for the general guidelines used to identify an atypical mole or melanoma based on the following features: Asymmetry, irregular Border, multiple or unusual Color, large Diameter, and evidence that the mole is Evolving.

Acetaminophen – A generic name of a type of medicine used to relieve pain. Tylenol is a brand name of a product that contains acetaminophen.

Acquired Nevi – Moles that appear during childhood or adulthood.

Acral Lentiginous Melanoma – Melanoma that typically appears on the palms, soles, or under the nails. It accounts for less than 5 % of all melanomas. It can occur in any ethnicity, but is the most common melanoma in African Americans and Asians.

Actinic Keratosis – Small, scaly red patch caused by sun exposure; it is considered a pre-cancer of a non-melanoma type of skin cancer called squamous cell carcinoma.

Adenovirus – A virus that can cause respiratory and eye infections, and that is being investigated as a part of a strategy known as gene therapy. It is used to deliver one of a number of genes that may have a role in treating cancer including melanoma, as well as other diseases.

Adjuvant – A substance added to a vaccine to improve the body’s immune response. Used in reference to immunization.

Adjuvant Therapy – A treatment whose objective it is to prevent or stop the spread of cancer to other parts of the body. Often used after surgical removal of the primary lesion. These can include chemotherapy, immunotherapy, radiation, and vaccine therapy.

Advanced Melanoma – Melanoma that has moved (metastasized) from its original location, usually to lymph nodes or to other internal organs. When melanoma becomes very advanced, it is no longer capable of being cured by surgery alone.

Albinism – The result of having a defect that prevents the body’s melanocytes from producing melanin which results in a lack of pigment in the skin, hair, or eyes.

Allogeneic Vaccines - Vaccines made from tumor cells taken from individuals other than the patient.

Allovection-7 - A gene-based immunotherapy under investigation as a treatment for metastatic melanoma.

Alpha Interferon – One of the 3 major species of interferon produced by the body. It has been found to be the most useful in treating forms of cancer, including melanoma, leukemia, and kidney cancer.

American Joint Committee on Cancer (AJCC) – A distinguished group of experts responsible for developing and updating guidelines on cancer staging. Member organizations include national health care organizations and major cancer centers around the country, such as the American Cancer Society, the American College of Surgeons, the American Society of Clinical Oncology, and the Centers for Disease Control and Prevention.

Amino Acids – The building blocks for proteins.

Anemia – Having too few red blood cells in the bloodstream. This results in decreased energy and stamina because of a reduced capacity to carry oxygen to tissues and organs.

Anesthetic – A substance that causes loss of feeling or awareness. A local anesthetic causes loss of feeling in a specific part of the body into which the anesthetic has been applied or injected. A general anesthetic puts the person to sleep and is often used for surgical procedures.

Angiogenesis – The process by which new blood vessels are produced.

Angiogenesis Inhibitors – A family of drugs able to prevent the growth of new blood vessels that supply malignant tumors.

Antiangiogenesis Therapy – A type of biological therapy that uses angiogenesis inhibitors to prevent or alter the growth of new blood vessels that feed malignant tumors.

Antibiotics – Drugs used to kill bacteria.

Antibodies – Proteins made by the white blood cells (lymphocytes) that attach to an antigen and may as a result inactivate or destroy it, or allow other parts of the immune system to do so.

Antiemetic – A medication to prevent or alleviate nausea and vomiting.

Antigen – A substance (such as a protein) that is identified by the immune system as “foreign” and can therefore stimulate white blood cells to produce antibodies and initiate an immune response. The presence of certain antigens can indicate the presence of cancer in the body.

Antigen-Presenting Cell (APC) – A specialized type of white blood cell that engulfs antigens and breaks them down into smaller fragments. These fragments are transported to the surface of the APC, where they are linked to special marker proteins and “presented” to a T-cell. This process results in instructing the T-cell to recognize that substance or component.

Antisense – A mirror-image segment of DNA that can bind to a specific gene and prevent that gene from being used. This effectively “turns off” that gene.

Antisense Drug Therapy - A type of gene therapy in which drugs made of antisense DNA turn off the function of genes found in cancer cells.

Apoptotic Bodies - Fragments of cells that have died a natural death; used in tumor cell vaccines.

Asymptomatic – Without obvious signs or symptoms of disease.

Atypical Moles - Moles whose appearance differs from that of common moles in one or more ways. Atypical moles may be larger than ordinary moles, and may have irregular or indistinct borders, with variations of color within the mole. They usually are flat, but parts may be raised above the skin surface. Also known as Dysplastic Nevi.

Augmerosen (G-418) – An intense drug being investigated as a treatment for metastatic melanoma.

Autoimmune – Making antibodies against ones’ own cells.

Autologous Vaccines - Vaccines made from tumor antigens taken from a patient’s own cancer cells.

AVAX – An autologous whole tumor cell vaccine currently in phase 3 trials for patients with surgically resected high-risk melanoma.

 

B

 

B-Cells – A major class of lymphocytes (white blood cells) whose main function is to produce and secrete antibodies when they have been activated.

Basal Cells – Small, round cells found in the innermost layer of the epidermis. These cells divide to produce new skin cells, replacing those that die and slough off the surface of the skin.

Basal Layer – The innermost layer of the epidermis.

Basal-Cell Carcinoma – One of the 2 most-common kinds of nonmelanoma cancer. It almost never metastasizes and is made up of the cells at the bottom layer of the epidermis that give rise to keratinocytes.

Benign – Noncancerous.

Biochemotherapy – The combination of chemotherapy and immunotherapy being investigated as a treatment approach for advanced melanoma and as an adjuvant treatment for high-risk melanoma.

Biological Therapy (Biotherapy) – The use of natural and manufactured substances derived from the body in order to fight cancer. Biological therapies include immunotherapy, antiangiogenesis therapy, gene therapy, and hormonal therapy.

Biopsy – Removing a sample of tissue so that it can be evaluated under a microscope for purposes of diagnosis.

Biotherapy – See Biological Therapy

Bleomycin – A chemotherapeutic agent currently under investigation in combination with other chemotherapeutic agents for the treatment of metastatic melanoma.

Blood Count – The number of red blood cells, white cells, and platelets in a given blood sample.

Blood Smear – A blood test that provides information about the number and shape of blood cells by visual inspection.

Board Certified - Refers to a physician who is certified by 1 of the American Boards of Medical Specialties or Subspecialties. To be board certified, a physician must complete years of a specialized residency training program and then pass rigorous testing. A board-certified oncologist is certified by the American Board of Internal Medicine and Oncology. A board-certified dermatologist is certified by the American Board of Dermatology. A board-certified surgeon is certified by the American Board of Surgery

Bone Marrow Biopsy – The bone marrow is a soft tissue that is inside some of the larger bones. The bone marrow produces the red and white blood cells as well as platelets, which help the blood clot. A biopsy is a method of removing a small tissue sample from the body to have it examined under a microscope and possibly analyzed by other tests.

Bone Scan – Used to determine if the bone is damaged, either from cancer or from some other cause. A radioactive tracer is injected into a person’s body. If the bone is damaged, the tracer will concentrate in the bone.

Brachytherapy – See Internal Radiation Tharapy

Breslow Depth (Thickness) – A method, described by Alexander Breslow in 1975, of measuring how deeply a primary melanoma tumor has penetrated the skin, regardless of anatomic layer. Tumor penetration is measured in millimeters from the outermost layer of living cells to the deepest extent of the melanoma. Clark Level, an older measure of tumor invasion, was replaced by Breslow thickness, tumor ulceration, and mitotic count, as the most important factors in determining the prognosis of a primary melanoma by the 2010 AJCC guidelines.

Broad-Spectrum Sunscreen – A sunscreen that offers protection against both UVA and UVB radiation from the sun’s rays.

 

C

 

Cancer – A general term for more than 100 different diseases that involve the uncontrolled growth and division of abnormal cells. These cells form collections called tumors that can destroy surrounding normal tissue and spread throughout the body.

Cancer Vaccines – Proteins containing cancer cells, parts of cells, or pure antigens, which are injected into the bloodstream. These proteins mark tumor cells so they are recognized and attacked by the immune system.

Carcinogen – Any substance that produces a cancer when introduced into the body.

Carmustine (BCNU) – A chemotherapy agent sometimes used to treat metastatic melanoma. It belongs to a class of chemotherapeutic agents called nitrosoureas.

CAT Scan (computed axial tomography) – See CT Scan

Cataract – Clouding of the lens of the eye or its surrounding membrane, which can cause distorted or impaired vision. The development of cataracts is associated with long-term overexposure, without appropriate protection, of the lens to ultraviolet radiation.

CBC – The complete blood count (CBC) is a blood test that measures the number of red blood cells (RBCs), white blood cells (WBCs), the total amount of hemoglobin in the blood, the fraction of the blood composed (hematrocrit), and the size of the red blood cells (MCV, mean corpuscular volume).

CD4 Cells - Another name for helper T-cells.

CD8 Cells – Another name for cytotoxic cells.

Cell – The basic building block of living tissue.

Chemotherapy – The introduction of chemicals/drugs into the body to eliminate cancer.

Cisplatin (cDDP) – A platinum compound sometimes used as a chemotherapeutic agent for metastatic melanoma.

Clark Level - A method of measuring how deeply the primary tumor has penetrated the skin based on anatomic layer. It was used for over 40 years to classify primary melanomas and to determine what treatments were appropriate. In 2009 the AJCC formally replaced the Clark Level with other measures that have now been found to be more informative. Because Clark Level was used for so long it will likely continue to be reported for sometime on pathology reports. Clark level is reported by roman numerals (i.e. I to V) with V being the deepest level of invasion.A level I melanoma is confined to the lower boundary of the epidermis and more commonly called melanoma in situ. Level II-IV melanomas describe different degrees of penetration or invasion into the dermis and fat layers below the skin. A level V melanoma has penetrated the subcutis, the fat layer beneath the skin.

Clinical Trial – An experimental treatment of cancer that tests new ideas and medications in an attempt to find better treatments and/or cures.

Collagen – A connective tissue protein in the dermis made by fibroblasts; it gives the skin its resilience and strength.

Colony-Stimulating Factors – A family of blood growth factors under study to determine their role in the immune response to melanoma.

Complement – A complex series of blood proteins whose action “complements” the work of antibodies. The activation of complement involves a precise sequence of events leading to the recognition and destruction of antigens.

Complete Response - Complete or partial disappearance of a cancer, usually after treatment.

Compound Nevi - Raised, uniformly pigmented moles with melanocytes in both the dermoepidermal junction and the dermis.

Congenital Nevi – Moles that are present at birth, or become apparent in early infancy; sometimes called birthmarks.

Control Group – In a clinical trial, the group of subjects assigned to receive the standard treatment. This group is compared with the group receiving the new treatment to determine which treatment is more effective.

CT Scan (computed tomography) - Also known as CAT Scan. A technique in which a rotating x-ray beam takes a series of pictures of the body from many angles. A computer combines the information from all these pictures and makes a detailed cross-sectional image of the body. A CT scan may be used to see if melanoma has spread to regional lymph nodes or distant sites in the body.

Cutaneous – Related to the skin.

Cutaneous Melanoma – Melanoma that starts in the skin.

CVD – A combination of cisplatin, vinblastine, and dacarbazine used in treating advanced melanoma.

Cytokines – Proteins produced naturally in the body which stimulate the activity of immune cells, including cytotxic T-cells. Forms of cytokines are in use as anticancer drugs, generally made by genetic engineering or recombinant DNA.

Cytotoxic T-Cells – A type of T-cell that kills cancer cells and virus-infected cells; also known as CD8 cells.

 

D

 

Dacarbazine (DTIC) - A chemotherapy agent administered intravenously to treat metastatic melanoma. Dacarbazine is the only chemotherapy agent currently approved for the treatment of advanced inoperable melanoma.

Dactinomycin – A chemotherapeutic agent used for the treatment of a number of cancers, occasionally including pediatric melanoma.

Dartmouth Regimen – A combination of dacarbazine, carmustine cisplatin, and the hormonal therapy drug tamoxifen, sometimes used in the treatment of advanced melanoma.

Dendritic Cell - A powerful and effective antigen-presenting cell (an immune cell) that is especially efficient at alerting resting helper T-cells to the presence of foreign tissue. Dendritic cells get their name from the Greek word dendron (tree) because the cell resembles a tree, with roots and branches spreading out from the main body of the cell.

Dendritic Cell Vaccines – Vaccines that use dendritic cells to carry and present tumor antigens to the immune system, activating an immune response.

Depression – A mental state characterized by sadness, hopelessness, difficulty thinking and concentrating, changes in eating and sleeping habits, and sometimes thoughts of suicide.

Dermatologist – A doctor who specializes in the diagnosis and treatment of skin diseases.

Dermatopathologist – A pathologist who has special training in diagnosing disease based on the microscopic examination of skin samples called biopsies.

Dermis – The layer of skin directly beneath the epidermis. The dermis contains blood and lymph vessels, nerve endings, muscle fibers, oil and sweat glands, and hair follicles.

Dermoepidermal Junction – The lowest part of the epidermis where it meets the dermis. This is the area where melanocytes are located and melanomas usually develop.

Dermoscope – A special handheld microscope used in dermoscopy to view skin lesions.

Dermoscopy – A technique for viewing skin lesions that increases a physician’s ability to distinguish more accurately between suspicious benign skin lesions. For some dermascopes, a drop of mineral oil is placed on the skin to reduce light reflection and make the skin more translucent. Using a dermoscope, the doctor can view the lesion down to the dermoepidermal junction, the area where melanomas usually develop. This area is not visible to the naked eye.

Desmoplastic Melanoma - Also known as spindle cell melanoma is a rare form of malignant melanoma marked by nonpigmented lesions on a sun-exposed areas of the body, most commonly on the head and neck.

Dietician – A professional who specializes in planning nutritious diets and the support of dietary changes associated with cancer or its treatment.

Digital Rectal Examination (DRE) – An examination of the prostate wherein a doctor inserts a gloved finger into the anus to evaluate the size of the prostate and feel for any lumps or abnormalities.

Distant Site – Once skin cancer spreads beyond the lymph nodes nearest the primary tumor, it has traveled to a “distant site.” A distant site may be an internal organ, skin not near the primary tumor, or lymph nodes other than those closest to the primary tumor.

DNA – Abbreviation for deoxyribonucleic acid. It is a large molecule that carries genetic information and passes it from 1 generation of cells to the next.

Docetaxel – A chemotherapeutic agent that is under investigation for the treatment of metastatic melanoma. It belongs to a class of drugs called taxanes.

Dosimetrist – A member of the radiation treatment team who helps plan the proper radiation dose for the treatment of cancer.

Down and Back Skin Check - A systematic way to perform skin self-examination, starting at the top of the head and moving down the front of the body and up the back.

DTIC – See Dacarbazine

Dysplastic Nevi - Moles associated with an increased risk of melanoma. They are larger than ordinary moles and are usually flat but may have a raised part and indistinct or blurred borders with uneven coloration. Also known as atypical moles.

Dysplastic Nevus Syndrome (DNS) – A condition characterized by the presence of 100 or more moles on the upper trunk and limbs, at least 1 of which is dysplastic. The syndrome may be acquired or inherited. Individuals with DNS are at significantly increased risk of developing melanoma. It is also called the Atypical Nevus Syndrome (ANS).

 

E

 

Elective Lymph Node Dissection (ELND) – A major surgical procedure in which all lymph nodes are removed from the area surrounding a primary melanoma.

Endostatin – An angiogenesis inhibitor currently being investigated for the treatment of stage IV melanoma.

Ephelides – Freckles.

Epidermis – The outermost layer of skin.

Epitopes – Distinctive markers that protrude from the surface of an antigen and that alert the immune system to the antigen’s presence.

Eumelanin – The most abundant type of human melanin, found in brown and black skin and hair.

Excision – The act of surgically removing or cutting out.

Excisional Biopsy – A biopsy in which the goal is to remove all of a tumor that is in evidence.

External Beam Radiation Therapy – Radiation therapy administered from an energy source outside the body and directed to a target inside the body.

Extracapsular – Located or occurring outside the lymph node capsule.

 

 

F

 

Fibroblasts – Skin cells that produce collagen.

Fine Needle Aspiration (FNA) – See Needle Aspiration

Fotemustine – A chemotherapy agent sometimes used to treat metastatic melanoma. It belongs to a class of chemotherapeutic agents called nitrosoureas.

Fraction – A daily dose of radiation; 1 part of a total prescribed dose of radiation.

Fractionated – Divided into fractions, or several daily doses of radiation.

Freckles – Small, tan flat spots that appear on sun-exposed surfaces of the skin; they are caused by exposure to the sun’s ultraviolet radiation.

 

G

 

Gamma Knife – An advanced form of stereotactic or focused radiosurgery for benign processes and metastatic brain tumors that were previously considered inoperable or very high risk for conventional brain surgery. The “knife” is formed by 201 intersecting beams of gamma radiation that deliver a concentrated dose to a precise area of the brain.

Garment Nevus - See Giant Nevus

Gene Therapy - The introduction of new genetic material to damaged genes or cancer cells. The goal of gene therapy is to replace damaged genes with healthy ones or to make cancer cells more sensitive to the effects of the immune system, immunotherapy, and chemotherapy.

Gene-Based Immunotherapy – Type of gene therapy in which antigen genes are introduced into tumor cells in order to stimulate an immune response.

Giant Nevus (Garment Nevus) – A congenital mole that covers a major area of the head or body and is at least 20 cm in diameter.

GM-CSF – Granulocyte macrophage colony-stimulating factor. A naturally produced protein of the immune system that stimulates the production of white blood cells. GM-CSF is currently being investigated as a treatment for metastatic melanoma.

Groin – The area where the upper thigh meets the hip. Also known a the inguinal region.

 

H

 

Hair Follicles - A specialized unit located in the deep dermis where hair is created and moves outward toward the surface of the skin.

Helper T-Cells - A type of T-cell that activates other immune cells, including B-cells and cytotoxic T-cells.

Hemoglobin – A large protein found in red blood cells that carries oxygen from the lungs to the cells of the body.

High-Risk Melanoma – Melanoma that has a greater than 50% probability of recurring in regional lymph nodes or at distant sites.

Hormonal Therapy – A type of biological therapy that adds, blocks, or removes hormones from the body to slow or stop the growth of certain cancers.

Hospice – A special health care program that provides a combination of medical, spiritual, and psychological care to patients and their families during a terminal illness. Hospice care is usually in the home but can also be in a nursing home or hospital.

Hydroxyurea – A chemotherapeutic agent sometimes used for the treatment of malignant melanoma.

Hyperfractionation – The delivery of more than 1 dose of radiation within the same day.

Hyperthermia – A heating process used to enhance a drug’s potency.

Hypofractionation – The delivery of higher doses of radiation in fewer treatments than conventional radiation therapy.

 

I

 

Immune Response – The activity of the various components of the immune system against antigens. The immune response involves B-cells, T-cells, natural killer cells, and antigen-processing cells, and it may be either nonspecific or specific to the antigen.

Immune System - The mechanism of the body that attacks any substance or objects that appear to be foreign, such as viruses, transplanted organs, and sometimes cancerous cells.

Immunoassay – A technique of identifying a substance based on its ability to act as an antigen.

Immunoglobulin G (IgG) – The class of immunoglobulin normally present in the largest amounts in the blood. IgG can enter tissue space. It functions mainly against bacteria and some viruses by coating them, which speeds their uptake by other cells in the immune system.

Immunoglobulin M (IgM) - The class of immunoglobulin normally present in the largest amounts in the blood, after IgG. IgM works in the bloodstream and is very effective at killing bacteria.

Immunoglobulins – Specialized proteins (also called antibodies) that are created in response to the immune system’s detection of a “nonself” sustance. Antibodies are designed to only attach to a specific molecular pattern and thus do not harm one’s own cells, while being very effective at targeting foreign material.

Immunological – Pertaining to the body’s immune system.

Immunology – The study of the body’s immune system.

Immunosuppression – A disorder or condition in which the immune response is reduced.

Immunotherapy – The use of natural or manufactured substances to help the body’s immune system fight disease more effectively. Types of immunotherapy include interferon, interleukins, biochemotherapy, vaccine therapy, and antibody-based therapy.

In Situ Cancer - A type of cancer that has not traveled or invaded beyond where the original cells that turned into cancer were located. An in situ cancer is the earliest and most easily treated stage of any cancer.

Incidence – The number of new cases of a disease occurring over a period of time, generally over the course of a year. Incidence rate: Ratio of the number of new cases of a disease to a given population each year.

Incisional Biopsy – A biopsy in which only a portion of a suspicious skin lesion is removed. This method is used when the lesion is too large for excisional biopsy or when excision would destroy important tissue, as on the face or hands.

Informed Consent - An ongoing process in which potential candidates for research studies or clinical trials learn about the study’s key facts, including the purpose of the study, potential risks and benefits, and other treatment alternatives. The purpose of informed consent is to enable candidates to make the most appropriate decisions about beginning or continuing to participate in the study or trial, or pursuing other options.

Inguinal – Pertaining to the groin.

Institutional Review Board (IRB) – An independent committee of doctors, scientists, clergy, and health care consumers located at the institution where a clinical trial is to take place. The IRB reviews the trial to make sure it is ethical and protects the rights and safety of study participants. IRBs approve and monitor almost all clinical trials in the United States.

Interferon Alfa- 2a - A manufactured form of 1 type of interferon alpha. Studies have shown low-dose interferon alfa-2a delays relapse in patients with stage II melanoma and higher-risk stage IIB disease.

Interferon Alfa-2b – A manufactured form of 1 type of interferon alpha. Studies have shown high-dose interferon alfa-2b significantly prolongs disease-free and overall survival in patients with high-risk stage IIB and stage III melanoma. It is an FDA- approved therapy for patients with high-risk operable stage IIB and III melanoma.

Interferon Alpha – One of the 3 major species of interferon produced by the body. Interferon alpha is the type that has been found to be the most useful in treating forms of cancer, including melanoma, leukemia, and kidney cancer.

Interferon Gamma – A type of interferon that is being investigated as a component of isolated limb perfusion.

Interferons – Natural proteins produced by normal cells of the body in response to viral infections and other diseases such as cancer. Interferon affects immune responses and boosts resistance to viral infection. Interferon therapies have been shown to help the body’s immune system fight disease more effectively and may inhibit the growth of blood vessels that feed cancer cells.

Interleukin-2 (IL-2) – A naturally produced protein of the immune system that stimulates the growth of specific types of white blood cells. It is an FDA-approved immunotherapy for advanced inoperable melanoma and is under study for adjuvant treatment of high-risk melanoma.

Interleukins – A family of substances produced naturally by the body’s immune cells in response to infections; they help to coordinate an immune response. Interleukins are signals that immune cells use to increase or decrease the number of different disease- and cancer-fighting cells.

Internal Radiation Therapy – The delivery of radioactive material to a location very close to the tumor from a source placed inside the body. Methods of delivery include injection, ingestion, or implantation. Also known as brachytherapy.

Intervention Group - In a clinical trial, the group assigned to receive the new treatment and to be compared with the control group to determine whether the new treatment is more effective than the standard treatment.

Intradermal – Within the lower layer of the skin. An intradermal injection is given directly into the skin.

Intradermal Nevi - Flesh-colored or light-brown, dome-shaped moles whose melanocytes are confined to the dermis. They are most commonly found in adults. The other name is a dermal nevus.

Intravenous (IV) – Within a vein or administered directly to a vein. Some medications, such as dacarbazine (DTIC) which is used to treat advanced melanoma, are administered in this way.

Invasive Cancer – Cancer that has traveled beyond its site of origin; also known as infiltrating cancer.

Investigational Group – The intervention group in a clinical trial.

Ischemic – When one does not receive enough blood flow.

Isolate Limb Perfusion (ILP) – Chemotherapy treatment in which blood vessel surgery is used to temporarily isolate the circulation of the involved limb from the rest of the body. This blood is then mixed with high doses of chemotherapy, recirculated through a heart-lung machine, and heated for a period of time to enhance the drug’s potency. The treated blood is then returned to the affected limb.

Isolated Limb Infusion – An experimental chemotherapy treatment in which blood flow to the involved limb is stopped temporarily with a tourniquet while high-dose chemotherapy drugs are injected into the artery.

 

J

Junctional Melanocytic Nevi – Acquired moles that arise from groups of melanocytes in the skin’s dermoepidermal junction. They tend to first appear in childhood as flat, frecklelike lesions of brown, dark brown, or black, and are uniform in color. They are most commonly found on the face, arms, legs, trunk, genitals, or soles of the feet.

K

 

Keloid – A thick, irregular scar that grows beyond the boundaries of the original wound. It is caused by excessive connective tissue growth at the site of an incision or wound.

Keratin – A group of proteins that is a primary component of the skin. There are 20 different kinds of keratin, produced by different cells based on the function of the cells. Keratins are resilient proteins that give the outer layers of the skin its toughness.

Keratinocytes – Keratin-producing cells; the outer layer of skin cells and the most abundant cells in the epidermis.

 

L

 

Lactate Dehydrogenase (LDH) – An enzyme found in the blood and many body tissues such as the liver, kidney, brain, and lungs. LDH levels are determined by a simple blood test. Elevated levels of LDH may indicate the presence of metastatic disease.

Laser – An acronym for “light amplification by stimulated emission of radiation.” An intense light focused on a tiny area that can vaporize and cut tissue with very little damage to surrounding structures.

Laser Therapy - A treatment using intense beams of light to precisely cut, burn, or destroy tissue.

Lentigo – A flat, brown spot that is associated with aging or sun damage. Lentigenes are commonly referred to as sunspots, age spots, or liver spots, although they have no relation to the liver or liver function.

Lentigo Maligna Melanoma – Melanoma arising from a lentigo rather than a mole and representing about 5% of all melanomas. It occurs most often in older adults, usually on the face and other chronically sun-exposed areas. The melanomas are generally large, flat, tan-colored lesions containing differing shades of brown. Usually they grow and invade more slowly than other types of melanoma.

Lesion – A general term to describe any irregular area on the skin. A lesion may be a cut or scratch, an insect bite, as well as benign growths such as moles or freckles. Malignant growths, including melanomas and other skin cancers, are also called lesions.

Local Therapy - Treatment that affects cells in the primary tumor and the area close to it.

Localized – In the area of the primary tumor.

Lomustine (CCNU) – A chemotherapy agent occasionally used to treat metastatic melanoma. It belongs to a class of chemotherapeutic agents called nitrosoureas.

Loupe – A magnifying lens that may be handheld or attached to glasses; it is used in skin examinations and surgery.

Lymph – The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease.

Lymph Node Capsule - Membrane of connective tissue surrounding a lymph node.

Lymph Nodes/Lymph Gland – Bean-shaped collections of lymphatic tissue that filter lymph, trap foreign bodies (including cancer cells), and fight infection and disease. Lymph nodes are packed full of immune cells. Since lymph nodes receive drainage from tumor cells, they are potential sites for metastasis.

Lymph System – The network of nodes and vessels in the body that carries lymph throughut the body. It can also be an avenue for the spread of cancer cells.

Lymph Vessels – A network of vessels that circulate lymph and branch into all the tissues of the body.

Lymphatic Mapping – A procedure In which a tiny amount of radioactive tracer is injected into the skin to map the way lymph drains from a tumor to its corresponding lymph nodes.

Lymphedema – A condition in which excess lymph collects in tissue and causes swelling. It may occur in the arm or leg after lymph vessels or lymph nodes in the underarm or groin are removed.

Lymphocele – A pocket of lymph accumulation at the site of lymph node removal.

Lymphocyte – A type of white blood cell that is an important part of the immune system.

Lymphoscintigraphy – See Lymphatic Mapping

 

M

 

Macrometastases – Lymph node metastases that can be felt during medical examination or seen by the naked eye when inspected by a surgeon or pathologist.

Macrophages – Large white blood cells that engulf and digest antigens.

Magnetic Resonance Imaging (MRI) – A diagnostic technique in which magnetic fields create detailed, cross-sectional images of the body. An MRI may be used to see if melanoma has spread to lymph nodes or distant sites in the body.

Major Histocompatibility Complex (MHC) - Special marker proteins that, when linked to antigen fragments on an antigen-presenting cell, enable T-cells to recognize and neutralize the antigen. Cytotoxic T-cells recognize or “see” antigens in the context of MHC class I molecules. Helper T-cells recognize or “see” antigens in the context of MHC class II molecules.

Malignant – Cancerous; describing cells that can invade and destroy nearby tissue and spread to other parts of the body.

Malignant Melanoma – Melanoma that starts in the skin; also called cutaneous melanoma.

Margin – Refers to the amount of normal-appearing tissue to be removed along with the tumor during surgical excision. The margin is usually measured in centimeters. The deeper the Breslow Depth of a primary melanoma the wider the recommended margins will be.

Matted – Connected.

Mediastinum – The space in the chest cavity located between the lungs containing the heart and its large blood vessels, the trachea, the esophagus, the bronchi, and the lymph nodes.

Medical Oncologist – A physician who specializes in the diagnosis, treatment, and management of cancer using chemotherapy, biological therapy, and hormone therapy. Medical oncologists are specialists in internal medicine and often coordinate the cancer treatment provided by other specialists.

Melacine – A manufactured allogeneic vaccine derived from tumor lysates.

Melanin – The pigment protein that gives color to the skin, hair, and parts of the eye and provides protection against the damaging effects of ultraviolet radiation by absorbing energy from UV light.

Melanocytes – Specialized pigment-producing cells located primarily at the bottom of the epidermis that create and transfer pigment to other skin cells and is responsible, at least in part, for skin and hair color.

Melanoma – A type of cancer that arises in melanocytes, the cells that produce melanin. Melanoma occurs most often in the skin but may also develop in the eye or the lining of the nose, mouth, or genitals. Melanoma is the least common but most deadly skin cancer, accounting for only about 4% of all classes but 79% of skin cancer deaths.

Melanoma in situ (Latin for “in place”) – Very early-stage melanoma where the tumor is limited to the epidermis with no invasion of surrounding tissues, lymph nodes, or distant sites. It has the best long term prognosis of any melanoma.

Melanoma-Inhibiting Activity (MIA) – A protein secreted by malignant melanoma cells and being investigated as a tumor marker.

Melphalan – Chemotherapy agent used in isolated limb perfusion.

Metastasis – The spread of cancer from its site of origin to other parts of the body.

Metastatic Melanoma – Melanoma that has spread to other parts of the body by way of the bloodstream or the lymphatic system.

Micrographic Surgery (Mohs Surgery) – A specialized surgical technique in which all visible tumor is excised and then, while the patient waits, the skin is examined under a microscope. If cancer is found to persist, the surgeon then removes more skin, only in that area, and again examines the tissue while the patient waits. The process is repeated until all the cancer is removed. Mohs surgery is used to treat basal- and squamous-cell carcinoma and can be used to treat early-stage melanoma. It is used when the primary tumor is located on the face or another area where it is essential to preserve as much healthy tissue as possible.

Micrometastases – Tiny lymph node metastases that can only be detected by microscopic evaluation.

Mitoses – Refers to cancer cells in the process of dividing. Mitoses can be counted by a pathologist when examining tissue with a microscope. The number of mitoses in an area of a pathological specimen correlates with the rate of cell division.

Mitotic Rate (Mitotic Count) - Pathologists count the average number of cells dividing in a melanoma specimen and use this to determine the mitotic rate. Higher mitotic rates are associated with more rapidly dividing cells and a greater potential for metastasis. Because the mitotic rate has been proven to provide prognostic data, in 2010 the AJCC recommended that mitotic rate be used in determining the stage of thin (Stage I) primary melanomas.

Mole – A pigmented skin growth formed primarily by a cluster of melanocytes and surrounding supportive tissue. The scientific name for a mole is a melanocytic nevus. Moles usually appear as tan, brown, or flesh-colored spots on the skin.

Monoclonal Antibodies - Manufactured antibody proteins, types of which originate in laboratory animal or humans. When injected into the body, they are able to recognize antigens for various medical purposes. Monoclonal antibodies can locate and attach to cancer cells with specific antigens, either to identify them for diagnostic purposes or to kill them in therapy. They may be used alone or to deliver radiation, chemotherapy, or other biological therapies more directly to a tumor.

Mortality Rate – Ratio of the number of deaths to a given population each year.

Mutation – A permanent change in the structure of DNA that, if not corrected by the cell, can be passed on to subsequent cells. Mutations that occur in critical areas of the DNA that correlate to the genes that control how often a cell divides can eventually cause the cell to become cancerous.

 

N

 

Natural Killer (NK) Cells – White blood cells that contain granules with enzymes lethal to other cells.

Needle Biopsy - Type of lymph node biopsy in which a small tissue sample is removed using a slender needle placed through the skin and into the suspicious lymph node; also known as fine-needle aspiration (FNA).

Negative – Describing a tissue sample in which no cancer cells are found.

Neoadjuvant Therapy - Treatment given prior to or immediately after the primary treatment. The purpose is to shrink tumors before surgery or to increase tolerance to chemotherapy or immunotherapy drugs.

Neoplasm – Any new abnormal growth. A neoplasm may be benign or malignant.

Neuropsychiatric – Having to do with physical and mental diseases of the nervous system (the brain, spinal cord, and nerves).

Nevus – (Plural – Nevi) a mole.

Nitrosoureas – A class of chemotherapeutic agents, including carmustine and lomustine, that have been studied in the treatment of metastatic melanoma.

Nodular Melanoma – Type of melanoma that usually appears as a blue-black, dome-shaped nodule on the trunk, head, or neck. Nodular melanomas tend to invade more quickly than other types of melanoma and represent 10% to 15% of all melanomas.

 

O

 

Oncogene – A gene that normally encourages cell division. Thus, when an oncogene is activated or deregulated through mutations, it initiates cancerous growth in a cell.

Oncologist – A physician who specializes in treating cancer. Some oncologists specialize in a particular type of cancer treatment based on their training in internal medicine, surgery, or radiation therapy, as well as in dermatology, neurology, or other subspecialties.

Oncology – The study and treatment of cancer.

Open Biopsy – Surgical procedure to remove all or part of a suspicious lymph node for microscopic evaluation.

Open-Label Clinical Trial - Clinical trial in which the study participants know the treatment drug they are taking.

Opsonization – The process by which antigens are altered so that they are more readily and more efficiently engulfed and destroyed by immune cells.

Ozone Holes – Breaks in the protective ozone layer of the atmosphere that significantly increase exposure to ultraviolet radiation. These holes exist over extremely cold areas, particularly over the South Pole and more recently in the Arctic.

Ozone Layer - A region in the upper atmosphere that contains a high concentration of ozone, which absorbs many of the ultraviolet rays from the sun.

 

P

 

Paclitaxel – A chemotherapeutic agent that is approved for treatment of some cancers and currently under investigation for treatment of metastatic melanoma. It belongs to a class of drugs called taxanes; also known as Taxol.

Palliative Care - Relieves symptoms and improves a patient’s quality of life, but does not treat the disease.

Palpate – To examine by pressing on the surface of the body to feel the organs or tissues underneath.

Papillary Dermis – The upper part of dermis (the deeper part of the skin), made up of loose connective tissue.

Pathologist – A doctor who specializes in identifying diseases by studying cells and tissues under a microscope.

Pathology – The study of diseased tissue.

PDQ Information Systems - Physician Data Query. PDQ is an online database developed and maintained by the National Cancer Institute. It is designed to make the most current, credible, and accurate cancer information available to health professionals and the public.

Pegylated (PEG) Interferon – A new form of long-acting interferon that has been FDA approved for treatment of viral hepatitis and is being investigated for the treatment of advanced high-risk melanoma.

Peptide Vaccine – A vaccine in which antigens are produced from synthetic peptides and transported through the bloodstream by an adjuvant in order to stimulate an immune response.

Peptides – Combinations of amino acids. Peptides combine to make proteins, including antigens.

Perfusion – A chemotherapy technique that may be used when melanoma occurs on an arm or leg. The flow of blood to and from the limb is stopped for a while with a tourniquet, and anticancer drugs are put directly into the blood of the limb. This allows the patient to receive a high dose of drugs in the area where the melanoma occurred.

PET Scan – A diagnostic test that produces images of the body by detecting radiation emitted from a radioactive substance that is administered to the patient.

Phase 1 Trial - Clinical trial conducted to find the safest dose and most-effective way to give a new cancer treatment to patients, as well as to identify potential side effects. Phase 1 trials are usually limited to a small number of patients who would not be helped by other known treatments.

Phase 2 Trial - Clinical trial conducted to test how well a new cancer treatment works against a certain type of cancer.

Phase 3 Trial – Clinical trial conducted to compare the new cancer treatment with the standard treatment to discover which treatment is more effective. Phase 3 trials involve large numbers of patients who are assigned at random to receive either the new treatment or the standard treatment. In most cases, studies move into phase 3 only after a treatment seems to work in phases 1 and 2.

Pheomelanin – A red-yellow form of pigment characteristically found in fair-skinned, red-headed people.

Photosensitivity – Sensitivity to the sun and the effects of ultraviolet radiation.

Pigment – A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair.

Pigmented Lesion - A skin spot that has color.

Placebo – A substance that looks the same as, and is administered in the same way as, a drug in a clinical trial, but does not contain any active ingredients.

Plasma – The liquid part of the blood which contains salts minerals and protein and is yellow in color.

Plasma Cells - Large immune cells that produce millions of antibodies identical to those on the parent B-cell that stimulates their production.

Platelets – Small pieces of cells that are found in the blood and are specially designed to form blood clots when correctly stimulated. They are also known as thrombocytes.

Positive – Describing a tissue sample in which cancer cells are found.

Positron Emission Tomography (PET) Scan – A procedure in which radioactive sugar molecules, called tracers, are injected into the body in a low-dose, radioactive form. During the scan, the cancer cells “light up,” because the cancer cells absorb sugar faster than normal cells.

Prevalence – Percentage of a population that is affected by a particular disease at a given time.

Primary Site - The part of the body in which a cancer first appears.

Primary Tumor (Lesion) – The original tumor.

Procarbazine – A chemotherapeutic agent sometimes used in the treatment of pediatric cancers including melanoma.

Prognosis – A prediction of the probable course of the disease.

Protein – A complex molecule that is a basic constituent of all living cells.

Punch Biopsy - A type of incisional biopsy in which the doctor removes a portion of a suspicious lesion by rotating a small cookie-cutter-like tool down through the full thickness of the skin to the underlying fat.

 

Q

R

 

Radial Growth Stage - The earliest step in the development of melanoma. The disease is confined to the epidermis or barely has penetrated into the dermis layer of the skin. There has not yet been a cluster of melanoma cells formed, and there is no metastasis to other parts of the body.

Radiation Oncologist - A physician who specializes in treating cancer with radiation therapy.

Radiation Physicist – A scientist who helps plan complex radiation treatments for cancer and makes sure all treatment-planning calculations are performed correctly.

Radiation Therapist – A technician trained in setting up and administering external beam radiation treatments for cancer.

Radiation Therapy - The treatment of cancer with forms of energy, including x-rays and gamma rays; also called radiotherapy

Radioactive Tracer - A radioactive molecule that can be sent through the body’s circulatory or urinary system, with its progress followed by a radiation-sensitive machine.

Randomized, Controlled Clinical Trial – Research study in which patients are randomly assigned to a control group (receiving the standard treatment) or an intervention group (receiving the experimental treatment). Randomized, controlled trials are considered the most reliable and impartial method of determining the most-effective medical treatment.

Recombinant DNA Technology – Techniques used to take apart and recombine a cell’s genetic information; now being investigated for use in melanoma vaccines.

Recombinant Viral Vaccines - Vaccines in which viruses are genetically altered through recombinant DNA technology. These viruses carry tumor-associated or other antigens to stimulate an immune response.

Recurrence – The reappearance of a cancer after a period of complete remission or following definitive surgical treatment of the primary melanoma.

Red Blood Cells – Also called erythrocytes. Red blood cells carry oxygen in their hemoglobin molecules.

Regional Lymph Nodes - Lymph nodes in the region of the primary tumor.

Regional perfusion therapy – Therapy in which a whole limb is infused with cancer- killing drugs. They are introduced into the artery supply of the limb and are taken out through the vein. This has been used in instances where multiple melanoma skin metastases are confined to the arm or leg site that was the site of the primary tumor.

Relapse – In cancer, it is the opposite of remission. The cancer has reappeared after a period of not being detected.

Relative Risk - This is a way of indicating how likely a person who has been exposed to a specific cancer-causing agent is to develop a cancer.

Remission – Complete or partial disappearance of a cancer, usually after treatment.

Resection – The surgical removal of an entire malignant tumor.

Response Rate – Represents the percentage of patients whose cancer shrinks or disappears after treatment.

Reticular Dermis - The lower part of the dermis, made up of dense connective tissue that gives skin its elasticity and strength.

Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) Assay – A molecular biologic technique being investigated for its ability to detect tyronsinase, a possible tumor marker for melanoma.

Risk Factor - Anything that increases the chance of developing a disease, including cancer. Risk factors may include personal traits and habits, a family history of a disease or predisposing condition, and exposure to environmental agents.

 

S

 

S-100 B - A protein secreted by malignant melanoma cells and being investigated as a tumor marker.

Satellite Metastases - Areas of visible tumor growth extending beyond the primary melanoma.

Screening – The process of looking for melanoma while it is still without symptoms and in its most-curable form.

Seborrheic Keratoses – Raised, benign, waxy-looking lesions resulting from excessive growth of keratinocytes. They can appear on either sun-exposed or covered areas and range in color from tan to dark brown or black.

Sentinel Lymph Node – The first lymph node to receive drainage from a given tumor site and therefore the most likely to harbor metastatic disease, if any lymph nodes are involved.

Sentinel Lymph Node Biopsy - A procedure in which the sentinel node is identified and removed for microscopic examination to determine whether the cancer has spread beyond its original location.

Sentinel Lymph Node Mapping – A diagnostic procedure used to determine the first lymph node or nodes that drain a tumor. After being identified, the sentinel lymph node may be removed and examined for possible lymph node involvement.

Shave Biopsy – Type of skin biopsy in which the top layers of the skin are “shaved” off with a surgical blade. Shave biopsies are most useful in diagnosing superficial, benign skin diseases that do not require a deep-tissue sample.

Side Effect – A result of drug or other therapy which is in addition to the desired therapeutic effect.

Site Biopsy – Removal of tissue by a doctor or surgeon using a scalpel or other instrument designed for cutting.

Skin – The outer covering of the body and the body’s largest organ, consisting of an outer layer (epidermis), an inner layer (dermis), and a layer of fatty tissue (subcutis). The skin protects underlying tissue and internal organs from injury and microorganisms, controls the loss of water and other fluids, and regulates body temperature.

Skin Cancer Screening – Examination of apparently healthy individuals in order to detect unrecognized skin cancer or precancerous lesions.

Skin Grafting - A procedure in which skin from another part of the body is taken to cover a surgical excision.

Skin Lesion – Any benign or malignant growth on the skin. Benign growths include moles and freckles; malignant growths include skin cancer, such as melanomas.

Skin Self-Examination - Checking one’s own skin from head to toe for signs of melanoma, including changes in existing moles and the development of new moles. Self-examination is the most effective way to find melanoma in its early, most-treatable stages.

SPF – Sun protection factor.

Squamous Cells - Flat cells located in the middle layer of the epidermis that make keratin, an important skin protection. Squamous cells are a type of keratinocyte.

Squamous-Cell Carcinoma – A type of skin cancer arising from squamous cells.

Stage – The extent of a cancer within the body; especially whether the disease has spread from the original site to other parts of the body. The stage of disease usually correlates with prognosis. The system for staging melanoma has 4 main stages: stages I and II for melanoma confined to the skin; stage III for lymph node involvement; and stage IV for spread of melanoma to other organs.

Staging – A process of determining how far melanoma has advanced.

Stereotactic Radiosurgery – A high-precision method of radiation therapy in which several powerful beams of radiation located at different angles around the head come together to focus precisely on a brain tumor.

Subcutis, Subcutaneous Tissue - Layer of fat located under the dermis. The subcutis conserves heat and helps protect the body’s organs from injury. Also known as the subcutaneous layer.

Subungual Melanoma – See Acral Lentiginous Melanoma (ALM)

Sun Protection Factor (SPF) – A scale for measuring how long a sunscreen protects the skin from UVB rays before sunburn occurs compared with how long it takes to burn without protection. Sunscreens with an SPF of 30 or higher provide the best protection from the sun’s harmful rays.

Sunblock – A substance that physically deflects ultraviolet rays and is recommended for people who are out in intense sun for long periods of time.

Sunburn – A reddening of the skin caused when ultraviolet radiation damages blood vessels close to the skin’s surface. Sunburn occurs when the skin cannot produce protective melanin quickly enough or in sufficient quantity.

Sunscreen – A substance that helps to absorb, reflect, or scatter most of the sun’s harmful rays. Recommended sunscreens offer protection against both UVA and UVB rays and have an SPF of at least 30. Using lotions or creams that contain sunscreens can help protect the skin from premature aging and damage that may lead to cancer.

Superficial Spreading Melanoma – The most-common type of melanoma, spreading along the epidermis for a period of months to years before penetrating more deeply into the skin. The melanoma appears as a flat or barely raised lesion, often with irregular borders and variations in color. Lesions most commonly appear on the trunks of men, the legs of women, and the upper back of both sexes.

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

Surgical Oncologist - A surgeon who specializes in treating patients who have cancer and who has usually received subspecialty training in cancer management.

Symptomatic – Producing obvious signs or symptoms of disease.

Systemic Treatment - A treatment using substances that travel through the bloodstream to reach and affect cancer cells all over the body. Systemic treatments include chemotherapy and immunotherapy.

 

T

 

T-Cells – A major class of lymphocytes. There are 2 types of T-cells: cytotoxic T-cells and helper T-cells. They play a vital role in the immune response.

Tamoxifen – An antihormonal agent that has been investigated alone and with other chemotherapy agents for the treatment of metastatic melanoma and found not to add benefit.

Tan – A darkening of the skin caused by increased melanin production. Tanning is the skin’s response to damage done to it by ultraviolet light. The skin tans in an attempt to defend against further exposure to ultraviolet radiation and sunburn.

Taxanes – A class of chemotherapeutic agents including paclitaxel and docetaxel.

Temozolomide (Temodar) - A chemotherapeutic agent currently under investigation for the treatment of metastatic melanoma, including brain metastases, and approved for treatment of some kinds of cancer that begin in the brain.

TH1 – A subset of helper T-cells that produce a particular profile of cytokines including interferon gamma and interleukin-2.

TH2 – A subset of helper T-cells that produces a particular profile of cytokines including interleukin 4 and 5 and helps prime B-cells for antibody production.

Thalidomide – An angiogenesis inhibitor drug being studied for the treatment of several cancers, including metastatic melanoma. The drug was used as a sedative and antinausea drug for pregnant women in the 1950s, but it caused severe birth defects. It was taken off the market until it was approved for the treatment of leprosy in 1996. Thalidomide has relatively few serious side effects when not taken by pregnant women.

Therapeutic Lymph Node Dissection (TLND) – Surgery to remove all regional lymph nodes from the area where cancerous lymph nodes were found on clinical examination. The goal is to prevent further spread of the disease through the lymphatic system.

Thickness – The thickness of a melanoma is how deep the tumor extends into the skin generally measured in millimeters (mm).

Thrombocytopenia – A decrease in the number of platelets in the blood.

Thymus – An organ of the lymphatic system, located in the chest behind the sternum, and the site where T-cells mature.

TNF – Tumor Necrosis Factor. A protein produced by the immune system that improves the immune response and that can destroy some types of cancer cells.

TNM (Tumors-Node-Metastasis) System - The most widely used system for cancer staging in the world. Created by the American Joint Committee on Cancer (AJCC), the TNM system defines cancer by features of the primary tumors, the presence or absence of tumor spread to nearby lymph nodes, and the presence or absence of metastasis to distant sites.

Transduced Tumor Cells – Cancer cells altered through genetic engineering to include genetic material from cytokines; used in tumor cell vaccines.

Tumor – An abnormal mass of tissue that results from excessive cell division. Tumors perform no useful body function. They may either be benign or malignant.

Tumor Board - A panel of many different kinds of medical specialists who work together to determine how best to help a cancer patient.

Tumor Lysates - Fragments of destroyed tumor cells; used in tumor cell vaccines.

Tumor Markers – Substances such as proteins or enzymes produced by tumor cells or by the body in response to tumor cells. When tumor cells multiply, tumor markers increase and enter the bloodstream. Theoretically, tumor marker levels in the blood may help to evaluate whether treatment is working or if the disease is progressing.

Tumor Necrosis Factor – An experimental immunotherapy being investigated as an agent in isolated limb perfusion.

Tumor Oncolysates – An extract made from cancer cells infected with a strain of virus destructive to the cancer cells; used in tumor cell vaccines.

Tumor-Infiltrating Lymphocytes (TILs) - TILs describes the patient’s immune response to the melanoma. TILs indicate the immune system’s ability to recognize the melanoma cells as abnormal. A brisk immune response has been associated with a better prognosis.

Tumorigenic – Having the capacity to produce cancer.

Tyronsinase – An enzyme associated with the production of melanin and a possible tumor marker for melanoma.

 

U

 

Ulceration – A condition in which the epidermis that covers a portion of the primary melanoma is not intact. Ulceration is determined by microscopic evaluation of the tissue by a pathologist.

Ultrasound – A procedure using sound waves that allows physicians to get an inside view of soft tissues and body cavities.

Ultraviolet (UV) Radiation (Ultraviolet Light) – Also called ultarviolet light. The part of sunlight that is invisible to the human eye. Some wavelengths of UV radiation filter through the earth’s atmosphere and enter the body through the skin and eyes. UV radiation can burn the skin and cause melanoma and other types of skin cancer.

Ultraviolet Light - See Ultraviolet Radiation

UV Index - A daily prediction of the strength of the sun’s ultraviolet rays for a region.

UVA Rays - Long-wavelength ultraviolet (UV) rays (320 to 400 nm) given off by the sun, tanning beds, and sunlamps. They enter the skin more deeply than UVB rays, cause premature aging of the skin, and are believed to cause skin cancer.

UVB Rays – Medium-wavelength (290 to 320 nm) “burning rays” of the sun that are the primary cause of sunburn. They are considered the main cause of basal- and squamous-cell carcinoma, as well as a significant cause of melanoma.

UVC Rays – Short-wavelength ultraviolet rays (200 to 290 nm) absorbed by the earth’s ozone layer, which do not reach the earth.

 

V

 

Vaccine – A treatment that introduces small amounts of inactivated “foreign” substances into the immune system so that it can recognize and fight that substance during an active infection.

Vertical Growth Phase - A step in the development of melanoma in which the disease shows evidence of growth as a lump in the dermis. This phase may metastasize.

 

W

 

White Blood Cells (Leukocytes) – Blood cells that are critical tools in the body’s immune system, which fights infection.

Wide Local Excision – The standard surgical procedure for early-stage primary melanoma, in which the tumor, including the biopsy site and a surgical margin, are removed. The goal is complete removal of the tumor.

 

X

 

X-ray - A form of electromagnetic radiation capable of penetrating tissue. It is focused through the body and onto film and causes a picture to be made of a part of the body.

Xeroderma Pigmentosum - A rare, inherited condition associated with an inability to repair DNA damage caused by ultraviolet radiation.

 

Y

Yervoy – Yervoy is approved by the FDA for the treatment of unresctable or metastatic Stage III or IV melanoma. Yervoy is designed to restore and strengthen the immune system by successfully activating T-cells, a critical component of the immune system, thereby sustaining an active immune response to fight the cancer cells. Studies indicate it improves overall median survival by 4 months.

Z

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