The Cancer Dictionary
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THE CANCER DICTIONARY Third Edition Michael J. Sarg, M.D. Associate Chief of Medical Oncology, St. Vincent’s Hospital, New York City Member of the teaching faculty of the St. Vincent’s Hospital Comprehensive Cancer Center Associate Professor of Clinical Medicine, New York Medical College Ann D. Gross, M.A., Gerontology Medical Writer A. D. Gross & Company, New York The Cancer Dictionary, Third Edition Copyright © 2000 and 1992 by Roberta Altman and Michael J. Sarg, M.D. Copyright © 2007 by Michael J. Sarg All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage or retrieval systems, without permission in writing from the publisher. For information contact: Facts On File, Inc. An imprint of Infobase Publishing 132 West 31st Street New York NY 10001 ISBN-10: 0-8160-6411-3 ISBN-13: 978-0-8160-6411-3 Gross, Ann D. The cancer dictionary / Ann D. Gross, Michael J. Sarg.—Third. ed. p. cm. Includes bibliographical references and index. ISBN 0-8160-6411-3 (alk. paper) 1. Cancer—Dictionaries. I. Sarg, Michael. II. Title. RC262.A39 1999 616.99/4003 22—DC21 99-21201 Facts On File books are available at special discounts when purchased in bulk quantities for businesses, associations, institutions or sales promotions. Please call our Special Sales Department in New York at (212) 967-8800 or (800) 322-8755. You can find Facts On File on the World Wide Web at http://www.factsonfile.com Text design by Cathy Rincon Cover design by Salvatore Luongo Illustrations on pages 43–46, 66, 111, and 183 by Jeremy Eagle Illustrations on pages 38 and 164 by Sholto Ainslie Printed in the United States of America VB Hermitage 10 9 8 7 6 5 4 3 2 1 This book is printed on acid-free paper. This third edition of The Cancer Dictionary is dedicated to the fond memory of Roberta Altman, who left us in 2001, overtaken by a major recurrence of her breast cancer. To the final days she was passionate about living and about her cause to educate people on resisting and doing battle with a disease she fought with courage and with a determination to strengthen others by providing them with in-depth information. CONTENTS Acknowledgments vii Introduction to the Third Edition ix Introduction to the Previous Edition xi Introduction to the First Edition xiii How to Use This Book xv The Cancer Dictionary 1 Appendix I: Noteworthy Web Sites of National Organizations for Cancer and AIDS 343 Appendix II: Comprehensive Cancer Centers by State 358 Appendix III: Clinical Cancer Centers by State 363 Subject Index 366 Bibliography 387 Index 391 ACKNOWLEDGMENTS Ongoing thanks to Laurie Likoff at Facts On File for her understanding of the pressing need to update this Cancer Dictionary; she continues to show a com- mitment that carries the project. Thanks also to agent Joe Vallely and to Janis Vallely for their encouragement and help. Our gratitude also goes out to the hundreds of organizations dedicated to the palliation and cure of cancer and related diseases and the remarkable resources they have put into creating Web sites that are comprehensive, interactive, invaluable tools for researchers, patients, and practitioners alike. And thanks, too, to our spouses, and to Natalie Berger, who understood that work on this third edition would be a long project requiring many hours of excused absences at events and encouraged us to persevere and complete this book in the most thorough way that would be a true service to our readers. vii INTRODUCTION TO THE THIRD EDITION There is no question that the pursuit of a cure for cancers of many organs—including breast, prostate, cancer—or at least the means of turning it into a and lung cancer, as well as some of the leukemias— chronic disease we can live with for decades—con- burst onto the scene. In this, the third edition, my tinues to be a national priority. The National coauthor, Ann Gross, and I found ourselves writing Cancer Institute estimated that it would spend and making entries almost up to the moment when some $4.9 billion in fiscal year 2005, in addition to the book had to go to print. Each time we reviewed all the money that private industry and other state the material, theoretically for a “last glance,” we and federal agencies spent in search of the means to found we were e-mailing and faxing each other the vanquish an enemy that still manages to exact its latest articles in the treatment of so many different toll on too many of all ages. In fact, since the publi- cancers, including cancers of the breast, lung, and, cation of the last edition, Roberta Altman, who was most recently, in January 2006, ovarian cancer. And the primary force in creating the prior editions of with each new FDA approval, we both felt strongly this book, succumbed to her long battle with breast that we could not let the book be issued without cancer. adding “just this one new drug.” However, the world of cancer care and therapy As such, I am happy to report that you will find continues to progress at lightning speed. No sooner in this third edition entries for more theapeutic did we publish the revised edition of The Cancer modalities than ever before. Dictionary than advances in the management of — Michael J. Sarg, M.D. ix INTRODUCTION TO THE PREVIOUS EDITION The last five years have seen an explosion of new Over the past years, there has been a rebirth of concepts in basic molecular biology and technol- interest in medical ethics, stimulated by major ogy that have been widely discussed and dissemi- trends in health care, including awareness of eco- nated by the media. Many of these new develop- nomic concerns, issues of access to competent care ments in understanding have led to practical for all Americans, and multiple issues concerning applications—new drugs, new treatments and end-of-life care. At medical schools, more attention treatment strategies, etc. All of this has been ampli- is being given to integrating courses in humanism fied and dispersed by the growth of the World and medical ethics into the already crowded cur- Wide Web. riculum to help future physicians and other health- Many patients, as well as their friends and rela- care workers properly frame these difficult ques- tives, use the Internet to search for the very latest tions. information and treatment options. However, for Among workers in the field of cancer care, there many the plethora of previously inaccessible infor- is evident a real sense of optimism related to the mation has created even greater confusion, fre- application of state-of-the-art care as well as to new quently making it difficult to resolve the issues of prevention strategies. The tide in the “war on can- choice. Information, while often invaluable, is not cer” may finally be turning. of itself a treatment for a serious illness. — Michael J. Sarg, M.D. xi INTRODUCTION TO THE FIRST EDITION CANCER! more interested than ever before in good health in general and in cancer in particular. There is still Few other words in our common experience are so fear; there is still dread; and there is still a great feared, dreaded, and charged with emotion. amount of emotion surrounding cancer. But there Growing up in the late forties, I can recall my fam- is also encouragement, hope, and optimism. ily whispering about the disease, to avoid using the Cancer has come out of the closet. Hardly a day word. They referred to “it” in hushed tones with goes by that there isn’t some report on television, on looks of dismay. To me, those afflicted with it the radio, and in all the newspapers on the progress seemed doomed, the ultimate unfortunate ones. that is being made—the newest drug for cancer Their illness was itself unspeakable, treatment was treatment; the newest way to detect it; what one can “mysterious” and thought to be ineffective, and do to prevent it; and the newest way to “cure” can- their future was to confront unspeakable horror cer. The media are full of articles; talk show hosts until they finally died. If they didn’t die, they would openly discuss with their guests the battle they be disfigured—unable to live any kind of normal fought with cancer. While much of this may be life. They were “better off dead.” attributed to our obsession with “news,” there is no For many, the cause of such monumental mis- doubt that there is an ever-increasing abundance of fortunes, such as cancer, was based on religious information on cancer that is truly newsworthy. beliefs. “Bad” people got cancer. And of course if The mass media exposure of cancer has resulted you “got” cancer, your morality was questioned. in a more informed public and has played a role in Although there are still some people who believe dispelling some of the cancer myths. In the past, this, the number (fortunately) is dwindling. many people would wait before consulting a doc- Many of the old cancer myths—cancer is a tor. Their thinking was, “If I’ve got ‘it,’ there’s noth- death sentence; cancer is contagious; cancer only ing that can be done anyway; I’m just going to die.” happens to “bad” people—have been dispelled in And they would die, because the more advanced the face of tremendous advances in communication any cancer is when it’s diagnosed, the less likely it and technology.