Glossary of Terms

A

Adjuvant therapy A treatment given in addition to the main treatment (for example, biological therapy as well as surgery) to try to prevent a cancer from coming back.
Advanced cancer This usually means a cancer that has spread from where it started to another part of the body. ‘Locally advanced’ cancer usually means the cancer has grown outside the organ that it started in and into nearby body tissues.
Angiogenesis Growth of blood vessels. Growing cancers can attract new blood vessels to grow towards them so that they can get their own blood supply.
Anti-angiogenic agents Agents that interfere with the development of blood vessels.
Arterial embolisation A procedure in which the blood supply to the area of the kidney containing the tumour is blocked, causing it to shrink.
Assisted robotic surgery A type of keyhole (laparoscopic) surgery that uses a robot to help the surgeon.
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B

Bavencio (Avelumab) is a drug and is a monoclonal antibody against programmed death ligand-1 (PD-L1), a cell-surface protein produced in excessive amounts by several cancers. In healthy cells, the PD-L1 protein binds to its receptor PD-1, found on the surface of immune system cells known as T-cells, to restrain or inhibit their growth and activity. This suppression serves as a check on T-cells, preventing the immune system from becoming overactive and mistaking healthy cells as foreign invaders and attacking them.
Biological therapy Treatment that uses natural body substances or drugs made from natural body substances to treat cancer.
Biomarker are a distinctive biological or biologically derived indicator of a process, event, or condition
Biopsy Removal of a small piece of body tissue so that the cells can be looked at under a microscope.
Birt-Hogg-Dubé (BHD) syndrome A rare inherited genetic condition that is characterised by skin lesions on the face and neck. It is caused by a genetic mutation in the folliculing gene. Patients may also develop lung cysts or experience a collapsed lung, and a few develop kidney cancer.
Bone scan A diagnostic test using a mildly radioactive material to see whether the cancer has spread to your bones.
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C

Catheter Tube that is passed into the body to drain fluid.
Cabozantinib, (Cabometyx) is used to treat renal cell carcinoma. It is a small molecule inhibitor of the tyrosine kinases c-Met and VEGFR2, and also inhibits AXL and RET.
Cells Every part of the body is made up of specialised, individual cells. Cancer starts with one cell becoming cancerous.
Chemotherapy The use of anti-cancer or cytotoxic drugs to destroy cancer cells.
Chromophobe renal cell carcinoma is a rare type of kidney cancer. This type of cancer forms in the cells lining the small tubules in the kidney. These small tubules help filter waste from the blood, making urine.
Clear cell RCC A type of renal cell carcinoma, which originates in the lining of the kidney tubules or the renal parenchyma.
Clinical nurse specialist (CNS) An advanced practice nurse with a graduate qualification; clinical experts in the diagnosis and treatment of illness.
Clinical trial A rigorously controlled research study that finds new ways to prevent, diagnose or treat disease. Clinical trials test new treatments in people with cancer to make sure they are safe and effective at treating cancer.
Collecting duct carcinoma A subtype of renal cell carcinoma, which develops in the cells that line the collecting ducts in the kidney cortex.
Combination therapy Using two or more types of treatment e.g. surgery and chemotherapy or chemotherapy and radiotherapy.
Computerised tomography (CT) A special type of X-ray examination in which a series of X-ray pictures of your body are taken from different angles and put together by a computer to give a detailed image of the inside of your body.
Contrast agent A special dye that is given during an X-ray, CT or IVU/IVP as an injection or in a drink. Contrast agents are opaque to X-rays and are used to give soft tissues and blood vessels contrast on an X-Ray so that they can been seen.
Cryotherapy A method of killing cancer cells by freezing the tumour using a probe through the skin to avoid open surgery.
CTLA4 or CTLA-4 (cytotoxic T-lymphocyte-associated protein 4) is a protein receptor that downregulates the immune system. CTLA4 is found on the surface of T cells, which lead the cellular immune attack on antigens.
Cyst A closed sac that may contain air, fluids, or semi-solid material. Once formed, a cyst could go away on its own or may have to be removed through surgery. Most cysts are benign but some are formed within tumours and may be malignant (cancer).
Cystoscopy An investigation of the bladder. A surgeon puts a tube (or cystoscope) into the bladder and uses it to look inside the bladder and urethra to check if there is anything wrong.
Cytotoxic Substances that are toxic to cells.
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D

Diagnosis Finding out what is wrong.
Dialysis An artificial way of filtering waste products and excess water from your blood when your kidneys can’t.
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F

First-line-treatment The first treatment given for a disease, often as part of a standard set of treatments. First-line treatment is usually the one accepted as the best treatment for the disease, and if it doesn’t work or causes severe side-effects, other treatments may be added or used instead.
Fuhrman system A system used for grading renal cell cancer to indicate how quickly or slowly the cancer is likely to grow and spread.
Fractions Daily radiotherapy treatments.
Full blood count (FBC) A blood test that provides important information about the type, number and appearance of cells in the blood, especially red blood cells, white blood cells, and clotting cells.
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G

Gamma knife surgery (stereotactic radiosurgery or radiosurgery) Radiotherapy for brain metastases using high doses of radiation directed at the cancer using a head frame.
Genomics the branch of molecular biology concerned with the structure, function, evolution, and mapping of genomes.
Grade Doctors grade cancers to indicate how quickly or slowly a cancer is likely to grow and spread. Cells from a sample of the cancer (a biopsy) are looked at under the microscope or tested in other ways.
Glutaminase The enzyme glutaminase, which converts glutamine to glutamate, has been identified as a critical choke point in the utilization of glutamine by cancer cells. … CB-839 also has also strong synergy with several kinase inhibitors that target growth factor pathways, checkpoint inhibitors, and other novel cancer drugs.
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H

Haematuria The presence of blood in the urine.
Haemoptysis Coughing-up blood.
High intensity focused ultrasound (HIFU) A method of killing cancer cells by directing a strong beam of sound at the tumour. This technique is done using a probe through the skin thereby avoiding open surgery.
Hypercalcaemia High levels of calcium in the blood.
Hypertension High blood pressure.
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I

Immunotherapy A method to treat cancer using man-made copies of substances found naturally in the body which stimulate the body’s own immune system to attack the cancer cells.
Intravenous urogram (IVU) or intravenous pyelogram (IVP) A special X-ray examination of your urinary system.
Ipilimumab (brand name Yervoy) is a type of targeted cancer drug called a monoclonal antibody. This type of treatment helps the body’s natural defence system (the immune system) to fight cancer cells. Ipilimumab works by stimulating certain immune cells called T-cells. These cells help to flight cancer and other diseases. T-cells have a protein on their surface called CTLA-4. This protein tells the cell when to switch off. Ipilimumab blocks the CTLA-4 protein so that the T-cells stay switched on, and active to attack cancer cells.
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L

Laparoscopic nephrectomy Keyhole surgery to remove the kidney through a small cut in the abdomen. Laparoscopic nephrectomy can be carried out for patients for whom open surgery is not an option.
Lymph nodes or glands Glands which fight infection and filter body fluid (lymph).
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M

Magnetic resonance imaging (MRI) A type of scan that uses magnetism instead of X-rays to construct a detailed picture of the inside of your body.
Mammalian target of rapamycin (mTOR) inhibitors Protein kinase inhibitors that are used to treat cancer by interfering with the signalling pathway that controls tumour cell growth and angiogenesis.
Medical oncologist A doctor who specialises in the medical treatment of cancer.
Metastases or secondaries Areas of cancer spread.
Monocloncal antibody Antibodies that specifically bind to signalling proteins that control various biological functions, such as angiogenesis, and interfere with their actions.
mTOR is a type of protein called a kinase protein. It can make cells produce chemicals such as cyclins that trigger cell growth. It may also make cells produce proteins that trigger the development of new blood vessels. Cancers need new blood vessels in order to grow. In some types of cancer mTOR is switched on, which makes the cancer cells grow and produce new blood vessels. mTOR blockers (inhibitors) are a newer type of cancer growth blocker. They can stop the growth of some types of cancer. mTOR inhibitors include Temsirolimus (Torisel), Everolimus (Afinitor) and Deforolimus.
Multidisciplinary team (MDT) A group of health care and social care professionals who provide different services for patients in a co-ordinated way. Members of the team may vary and will depend on the patient’s needs and the condition or disease being treated.

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N

Nephrectomy Surgical removal of a kidney. Either radical (the whole kidney and surrounding tissues) or partial. [from the Greek word nephros, or kidney].
Neuropathic pain Pain that comes from problems with the signalling from nerves.
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O

Oncology and oncologist The study and treatment of cancer. An oncologist is a doctor who specialises in the diagnosis and treatment of cancer.
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P

Palliative care Treatment given to control symptoms and improve quality of life rather than to cure. Includes support for social, spiritual and psychological issues.
Pazopanib (trade name Votrient) is a potent and selective multi-targeted receptor tyrosine kinase inhibitor that blocks tumour growth and inhibits angiogenesis
Pembrolizumab is a type of immunotherapy. It stimulates the body’s immune system to fight cancer cells. Pembrolizumab targets and blocks a protein called PD-1 on the surface of certain immune cells called T-cells. Blocking PD-1 triggers the T-cells to find and kill cancer cells.
Physical examination The process by which a doctor investigates the body of a person for signs of disease.
Polycythaemia Thickening of the blood caused by an increase in red blood cells due to an abnormality in the bone marrow, or a decrease in the volume of plasma, the fluid which carries the red blood cells.
Positron emission tomography (PET) A diagnostic test using mildly radioactive form of glucose to find malignant tumours.
Papillary renal cell carcinoma (PRCC) A type of cancer that forms inside the lining of the kidney’s tubules (the very small tubes that do the filtering). Commonly referred to as “renal cell cancer,” PRCC is the second most common type of kidney cancer.
Primary cancer (primary tumour) Where the cancer started. The type of cell that has become cancerous will be the primary cancer; for example, if a biopsy from the liver or lung contains cancerous kidney cells, then the primary cancer is kidney cancer.
Prognosis The likely outlook for someone with a disease.
Programmed cell death protein 1, also known as PD-1,  is a cell surface receptor that belongs to the immunoglobulin superfamily and is expressed on T cells and pro-B cells. PD-1 binds two ligands, PD-L1 and PD-L2. PD-1 and its ligands play an important role in down regulating the immune system by preventing the activation of T-cells, which in turn reduces autoimmunity and promotes self-tolerance. The inhibitory effect of PD-1 is accomplished through a dual mechanism of promoting apoptosis (programmed cell death) in antigen specific T-cells in lymph nodes while simultaneously reducing apoptosis in regulatory T cells (suppressor T cells). A new class of drugs that block PD-1, the PD-1 inhibitors, activate the immune system to attack tumors and are therefore used to treat cancer.
Protein kinase inhibitors Small molecules that work inside the cell to inhibit kinases – proteins which are part of the signalling system that tells cells when to divide and grow and produce new blood vessels.

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Q

Quality of life This means looking at how a treatment is affecting your life, not just the effect on your cancer.
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R

Radio-frequency ablation (RFA) A method of killing cancer cells using heat from an electric probe through the skin, thereby avoiding the need for open surgery.
Radiotherapy A treatment using high-energy rays to destroy cancer cells. It can be used to shrink a kidney cancer and so control symptoms.
Radiosurgery (or stereotactic radiotherapy or gamma knife surgery) Radiotherapy for brain metastases using high doses of radiation directed at the cancer using a head frame.
Recurrence Cancer that has come back again after treatment.
Remission If a cancer is in remission, there is no sign of it on scans or when the doctor examines you. Doctors use the word ‘remission’ instead of cure when talking about cancer because they cannot be sure that there are no cancer cells at all in the body.
Renal cell carcinoma (RCC) A kidney cancer that originates in the lining of the proximal convoluted tubule, the very small tubes in the kidney that filter the blood and remove waste products.
Renal hilum The concave area of the kidney through which the renal artery enters and the ureter and renal vein exit the kidney.
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S

Sitravatinib is an experimental drug for the treatment of cancer. It is a small molecule inhibitor of multiple tyrosine kinases (TKI).
Staging A system used by doctors to describe how big a cancer is and how far it has already spread.
Stereotactic radiotherapy (or radiosurgery or gamma knife surgery) Radiotherapy for brain metastases using high doses of radiation directed at the cancer using a head frame.
Sunitinib (or Sutent) is a targeted therapy used to treat renal cell carcinoma in the kidney, gastrointestinal stromal tumours (GISTs) and pancreatic neuroendocrine tumours. It may be used in research trials for other cancers too. It works by blocking (inhibiting) signals in the cancer cells that make them grow. Blocking the signals causes the cells to die. Sunitinib can also stop cancer cells from developing new blood vessels. This reduces their supply of oxygen and nutrients so the tumour shrinks or stops growing. Drugs that interfere with blood vessel growth are called angiogenesis inhibitors or anti-angiogenics.
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T

T-Cells The white blood cells involved in the acquired immune response are called lymphocytes. There are two main types of lymphocytes – B cells and T cells. B and T lymphocytes are made in the bone marrow, like the other blood cells. Lymphocytes have to fully mature before they can help in the immune response. B cells mature in the bone marrow. But the immature T cells travel through the bloodstream to the thymus gland where they become fully developed. Once they are fully mature, the B and T cells travel to the spleen and lymph nodes ready to fight infection.
Temsirolimus is a type of biological therapy drug treatment called an mTOR inhibitor. It blocks the effects of a particular protein called mTOR that is often over active in cancer cells and makes the cells divide and grow. Temsirolimus also stops the cancer from making blood vessels, which the cells need to be able to grow. It is called an anti angiogenesis treatment. So temsirolimus helps to stop the cancer growing or may slow the growth. Temsirolimus is a treatment for advanced kidney cancer and for mantle cell lymphoma.
Tyrosine kinase inhibitors (TKI) Small molecules that work inside the cell to inhibit tyrosine kinases – proteins which are part of the signalling system that tells cells when to divide and grow and produce new blood vessels.
Tumour A swelling or lesion formed by an abnormal growth of cells. Tumour is not synonymous with cancer and a tumour can be benign (not cancerous) or malignant (cancerous).
TNM staging A system for staging cancer based on the presence of tumours (T), lymph node involvement (N) and metastases (M).
Transitional cell carcinoma (TCC) A type of cancer that develops in the lining of the bladder, urethra and renal pelvis.

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U

Ultrasound scan A real-time, moving test which uses sound waves to detect and differentiate between tumours and cysts. A small probe producing sound waves is rubbed over the area of interest and the sound wave echoes are detected by the probe and turned into a picture of the organs and structures inside your body by a computer.
Urea and electrolytes (U&E) A blood test that tests the function of the kidneys.
Ureter The tube that carries urine from the kidney to the bladder where it is stored.
Urethra The tube through which urine leaves the bladder when we pass urine. The urethra opens immediately in front of the vagina in women and at the tip of the penis in men.
Urinary tract infections (UTIs) Urinary tract infections affect your urinary tract, including your bladder (cystitis), urethra (urethritis) or kidneys (kidney infection). UTIs may be treated with antibiotics, but they’re not always needed.
Urology and urologist The study and treatment of the urinary tract in women and the urogenital system in men. A urologist is a doctor who specialises in the diagnosis and treatment of diseases of the urinary and sex organs in males and the urinary organs in females.
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V

Vaccine Naturally occurring substances that stimulate the body’s immune system to fight disease.
Vascular endothelial growth factor (VEGF) A naturally occurring protein that is part of the signalling pathway that helps cancers to grow blood vessels.
Von Hippel-Lindau (VHL) syndrome A rare inherited genetic condition which causes abnormal growth of blood vessels. VHL is caused by a genetic mutation in the VHL gene and about 28-45% of VHL patients develop kidney cancer. VHL kidney cancer is only clear cell and it can metastasise and become aggressive.
Vascular endothelial growth factor (VEGF) is a signalling protein that promotes the growth of new blood vessels. VEGF forms part of the mechanism that restores the blood supply to cells and tissues when they are deprived of oxygenated blood due to compromised blood circulation.
Some drugs stop the VEGF receptors from sending growth signals into the blood vessel cells. These treatments are also called cancer growth blockers or tyrosine kinase inhibitors (TKIs). Sunitinib (Sutent) is a type of TKI that blocks the growth signals inside blood vessel cells. It is used to treat kidney cancer and a rare type of stomach cancer called gastrointestinal stromal tumour (GIST).

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W

Wilms’ tumour A very rare kidney cancer which affects children.
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X
X-ray A type of electromagnetic radiation used to make images. The image is recorded on a film, called a radiograph. The parts of your body appear light or dark due to the different rates that your tissues absorb the X-rays. Calcium in bones absorbs X-rays the most, so bones look white on the radiograph. Fat and other soft tissues absorb less, and look gray. Air absorbs least, so lungs look black.
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