Understanding The Common Cancer Terms

Imaging

Scans that produce detailed pictures of areas inside the body. They may be used to help doctors diagnose cancer, plan treatment, assess treatment effectiveness, or observe disease progression over time.

Examples of imaging include: X-rays, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET).

Biopsy

Refers to the removal of cells or tissues for examination under a microscope. It is an important tool to diagnose many types of cancers.

Common types of biopsy procedures include:

• Incisional biopsy – where only a sample of part of the lump is removed surgically
• Excisional biopsy – where an entire suspected lump/tumour is removed surgically
• Needle biopsy – where a small sample of tissue or fluid is removed with a needle, usually under live image guidance using scans

Staging

Cancer staging refers to a system that is used to describe the extent of the cancer in the body. Information is gathered using various modalities including blood tests, biopsy and imaging tests.

TNM staging is the most commonly used cancer staging system. Cancer stages are generally determined based on the local extent of the primary tumour (T), and the extent of cancer spread to adjacent lymph nodes (N) or other parts of the body (M). The stage of disease is used to plan the most appropriate treatment for the patient.

Early-Stage Cancer

A term used to describe cancer that is at the early stages of its growth, and has not spread to other parts of the body.

Advanced Cancer

Typically used to describe cancers that have spread (i.e. metastatic cancers) and are unlikely to be cured or controlled with treatment. While advanced cancers are unlikely to be cured, treatment may be given to shrink the cancer, slow the growth of cancer cells, help relieve symptoms and prolong life.

Locally advanced cancers refer to bulky cancers, typically with spread to surrounding lymph nodes or adjacent structures, but without spread to other distant organs. Some of these cancers may still be curable with multimodality treatment using effective drugs, radiation therapy and/or surgery

Metastasis

The spread of cancer cells from its primary site to other parts of the body. When cancer cells metastasise, they break away from the primary site of the tumour, and travel through the blood or lymphatic system to form new colonies at other parts of the body.

Surgery

A procedure that aims to surgically remove the tumour from the body. It is the mainstay of treatment for many cancers.

Over the years, surgery has evolved to more precise procedures such as keyhole surgery—also known as laparoscopic surgery—where small incisions are made in the body to access the tumour; and robotic assisted surgery. Compared to open surgery, they offer patients faster recovery times without compromising on effectiveness.

Chemotherapy

Treatment that uses chemicals to kill fast-growing cancer cells in the body. It can be used with curative intent, or for symptom control and prolongation of life.

Radiation Therapy

The use of high-energy radiation such as X-rays, gamma rays and protons to kill cancer cells and shrink tumours.

The main types of radiation therapy are:

• External-beam radiation therapy – where radiation comes from a machine outside the body
• Brachytherapy – where radiation comes from radioactive material placed in the body
• Systemic radiation therapy – where radioactive substances travel in the blood to tissues throughout the body

Neoadjuvant Therapy

Treatment given to shrink a tumour before first-line treatment is carried out. Previously, neoadjuvant therapy was primarily given when a tumour is too large to be operated on. Currently, it is also given to some cancers that are operable, to allow less extensive surgery to be carried out and improve long-term outcomes.

Neoadjuvant therapy should not be confused with adjuvant therapy, which refers to treatment given after first-line treatment to destroy any remaining cancer cells and lower the risk of the cancer coming back.

Disease-Free Survival (DFS)

Also called relapse-free survival (RFS), DFS refers to the length of time after first-line treatment that a patient survives without any signs and symptoms of cancer.

Recurrence

Cancer that has recurred or returned, usually after a period of time during which the cancer is in remission (a decrease in or disappearance of signs and symptoms of cancer). The cancer may return to the same place as the original primary tumour (local recurrence), to nearby tissues or lymph nodes (regional recurrence), or to other parts of the body (distant recurrence).