A
AASLD: American Association for the Study of Liver Diseases
Ablation: the complete or partial removal of a biological tissue or structure or destruction of its functionality; usually performed surgically but also accomplished via hormones, drugs, radiation, heat, or other methods
Abnormality: condition or behavior that is considered unusual or different from normal physiology
Acetaminophen: a non-asprin pain reliever and anti-inflammatory medication that can, if taken in excess, with alcohol, or by those with impaired liver function, may cause liver damage
Acute: a sudden and often severe onset of an illness
Aflatoxin: toxins produced by Aspergillus fungi spores that grow on some crops (corn, peanuts, etc.); exposure to aflatoxins has been shown to correlate with an increased risk of developing liver cancer
AFP: alpha fetoprotein; a protein secreted by cancerous tumors into the blood
Albumin: a protein made in the liver that circulates through the bloodstream and plays a role in fluid distribution throughout the body
ALP: also ALK-PHOS; alkaline-phosphate; an enzyme mostly produced in the bile ducts and measured in liver function tests but is not specific to the liver; high levels of ALP in the blood may indicate liver injury
Alpha-1 Antitrypsin Deficiency: an inherited disorder that can cause liver disease, jaundice, and cirrhosis
ALT: alanine-aminotransferase; an enzyme mostly produced by liver cells and measured in liver function tests; high levels of ALT in the blood may indicate liver injury; most sensitive indicator to liver injury
Alternative therapy: any type of healing that differentiates from mainstream medicine; including acupuncture, homeopathy, osteopathy
Angiogram: a medical imaging technique (x-ray, CT, or MRI) that helps visualize blood vessels and flow in the body; used to examine and identify tumor vascularity
Ascites: abnormal collection of fluid in the abdomen oftentimes caused by liver failure
AST: aspartate aminotransferase; high levels of AST in the blood may indicate liver damage
Asymptomatic: having no signs or symptoms of disease
Autoimmune hepatitis: a disease that involves the body’s immune system attacking its own liver cells, causing hepatic inflammation and possibly leading to cirrhosis and liver failure
B
Benign: not malignant; benign tumors do not invade surrounding tissue or metastasize to other parts of the body
Bile: yellow-green liquid that is excreted from the liver, stored in the gall bladder and passes into the small intestine to aid in the digestion of food by breaking down fat
Bile duct: tube that carries bile from the liver to the gallbladder for storage and then to the intestines for use in digestion
Biliary atresia: a congenital disorder characterized by malformation of the biliary tract in which biliary ductules fail to adequately form and cannot collect bile from the liver.
Bilirubin: the product of the chemical breakdown of hemoglobin. The liver removes bilirubin from the blood and secretes it as a component of bile.
Biopsy: removal and examination of a small piece of body tissue
Budd-Chiari syndrome: a rare liver disease that occurs as the veins that drain blood from the liver are narrowed or blocked
C
Cancer: a disease in which abnormal cells divide rapidly and uncontrollably, and can invade nearby tissues and sometimes spread to other parts of the body
Carcinogen: substance that can cause cancer, such as tobacco smoke.
Carcinoma: cancers that originate in the skin or in tissues covering internal organs
CEA: carcinoembryonic antigen; a substance present in the blood of people who have certain cancers or who smoke tobacco; CEA levels can be used to help track treatment efficacy and cancer recurrence
Chemoembolization: a procedure that prevents blood flow to tumors after anticancer drugs are administered to the area; a common treatment method for liver cancer
Chemotherapy: a cancer treatment that uses drugs to stop the growth of cancer cells by killing cancer cells or preventing them from dividing; can be given via mouth, injection, infusion, skin.
Child-Pugh score: a score based on five clinical features that can be used to determine prognosis of chronic liver disease and cirrhosis; combined with the MELD score can determine liver transplantation priority; total bilirubin level, serum albumin, international normalized ratio, degree of ascites, and degree of hepatic encephaly
Cholangiocarcinoma: a rare cancer that forms in the bile ducts
Cholangitis: irritated or inflamed bile ducts causing poor bile flow from the liver and potentially causing damage to hepatocytes
Cholecystectomy: surgical procedure done to excise the gallbladder
Cholestasis: interrupted bile flow through the biliary system resulting in reduced bile reaching the intestine
Chronic: disease or condition which persists over a period of time, usually with a gradual onset
Cirrhosis: a condition characterized by scarring of and damage to the liver, inhibiting normal liver function; can be caused by genetic, autoimmune, bacterial, viral, and lifestyle factors or diseases
Clinical trial: research study that aims to answer medical questions and solve health problems; a study that evaluates new drugs, procedures, or devices
Clinical trial phases: Phase I trials investigates the best delivery and dosage of a new treatment; Phase II trials examine the efficacy of a new treatment on the disease; Phase III trials compare health results of people taking a new treatment with the those of patients taking a standard treatment; Phase IV trials test for potential unknown side effects of a treatment in large samples of patients
Clinical stage: determines progression of cancer in the body based on physical examination, imaging tests, and biopsies of cancerous areas.
Combination therapy: therapy that integrates more than one method of treatment
Comorbidity: a condition where you have two or more simultaneous diseases
Complementary therapy: the use of alternative treatments together with conventional therapies
Contrast: a dye or other substance used during x-rays, CT scans, MRI, or other imaging tests that can highlights abnormal areas inside the body
Creatinine: a substance that made by the body and used to store energy that may have potential as a treatment for weight loss related to cancer
Cryoablation: procedure in which cold liquid or a cryoprobe is used to freeze and destroy abnormal tissue; can be used to treat certain types of cancer; also cryosurgery or cryotherapy
CT Scan: computerized tomography; diagnostic imaging tool that uses x-rays to create detailed pictures of the body
Curative therapy: treatment performed to cure a condition; in localized cancer can be the removal of all cancerous tissue
D
Deferred therapy: withholding therapy or treatment and tracking a patient’s condition over time with tests and and exams to detect early signs of disease appearance or progression
Diagnosis: identification of a disease, condition, or injury from a patient’s signs and symptoms
Distant metastasis: cancer that has spread from the original tumor to different organs or other lymph nodes
DNA: deoxyribonucleic acid; hereditary material present in all cells that carries genetic information and passes it from one generation to the next
Donor: a person who donates an organ, tissue, or blood to another person
Drug resistance: the failure of cancer cells to respond to medicine or treatment
Dysplasia: abnormal changes in the structure or organization of a group of cells which can be an indicator of cancer
E
EBRT: external beam radiation therapy; a type of radiation therapy that uses a machine to aim high-energy rays at cancer from outside of the body
EGF: epidermal growth factor; a protein produced by cells and some tumors that signals cell growth and differentiation
EGFR: epidermal growth factor receptor; a protein found on the surface of cells that binds to EGF and causes cells to divide; EGFR is found at high levels on many cancer cells
Encephalopathy: a disorder of the brain that can be result from disease, injury, drugs, or chemicals
Epidemiology: the study of the patterns, causes, and control of disease in groups of people
ERCP: endoscopic retrograde cholangiopancreatography; an endoscopic x-ray of the pancreatic duct, hepatic duct, common bile duct, duodenal papilla, and gallbladder
EUS: endoscopic ultrasound; a procedure in which an endoscope containing an ultrasound device is inserted into the body to create an image of internal organs
Excision: removal by surgery
Excisional biopsy: a procedure in which the doctor surgically removes a biologic sample, such as a tumor, for analysis and diagnosis
External radiation therapy: a form of radiation therapy where high energy rays are projected at the body from a machine; usually requires outpatient care at a treatment facility for 4-5 days a week for several weeks
Extrahepatic: located or occurring outside the liver
F
Fibrolamellar hepatocellular carcinoma: a rare liver cancer usually diagnosed in adolescents and young adults who have no history or early symptoms of liver disease
FibroScanⓇ: a non-invasive technology quantifying fibrosis and steatosis
Fibrosis: formation of scar tissue in place of normal tissue
Fibrosis score: estimates the amount of scarring in the liver
First line treatment: the first treatment given for a disease; often a group of treatments, such as surgery followed by chemotherapy and radiation; also primary treatment
FNAB: fine needle aspiration biopsy; the removal of tissue or fluid with a thin needle for examination under a microscope; also FNA biopsy
G
Gallium scan: a diagnostic test that involves injecting a chemical called gallium into the veins to detect cancer cells and inflammation
Gene: the functional and physical unit of heredity passed from generation to generation; a segment of DNA that codes information for making specific proteins which can form physical characteristics, such as height or eye color
Gene therapy: a new and rapidly growing field of medicine that inserts foreign or altered genetic material (DNA or RNA) into the body to correct specific disorders or to help fight disease
GGT: gamma glutamyl transpeptidase; enzyme found in the blood that at high levels is usually an indicator of liver injury due to blockage of bile ducts by tumors
Grade: in cancer, indicates how aggressive a cancerous tumor is; lower grade can indicate a slower form of cancer growth and spread; higher grade can indicate more aggressive cancer
H
Hematologist: a doctor who specializes in treating blood disorders
Hemochromatosis: a genetic disorder caused by abnormally high iron absorption in the intestines which leads to high levels of iron storage in the liver and several other organs; can cause cirrhosis and liver failure
Hepatectomy: surgery to remove all or part of the liver
Hepatic artery: the major blood vessel that delivers blood, oxygen, and nutrients to the liver
Hepatic dysfunction: loss of proper liver function
Hepatic encephalopathy: neuropsychological abnormalities due to liver dysfunction
Hepatitis: swelling and inflammation of the liver
Hepatobiliary: having to do with the liver, bile ducts, and/or gallbladder
High-risk: cancer that is likely to recur or spread
Hilar cholangiocarcinoma: a carcinoma that develops at the junction of the right and left hepatic bile ducts.
Histologic grade: in cancer, indicates how aggressive a cancerous tumor is; lower grade can indicate a slower form of cancer growth and spread; higher grade can indicate more aggressive cancer; also grade
Hospice: a special type of care for people who are in the end stages of their disease and have stopped treatment; care, either outpatient or inpatient, is focused on alleviating pain and managing symptoms
Hypofractionation: a treatment schedule in which the total dose of radiation is divided into smaller doses which are given daily
I
IGRT: image-guided radiation therapy; a procedure that uses a CT, X-ray, or other imaging techniques to create a picture of a tumor to help guide the radiation beam during radiation therapy
Icteric: technical term for jaundice
Immuno-oncology: the study and development of treatments that take advantage of the body’s immune system to fight cancer
Imaging studies: non-invasive tests that can produce detailed pictures of the body's organs and structures; include x-rays, CT scans, MRI, and ultrasound
Immune system: network of cells, tissues and organs, which includes white blood cells and lymph nodes, that helps protect the body from disease and prevent infection
Immunosuppression: a condition that causes the body's immune system to decrease in effectiveness; can be caused by disease or certain drugs such as chemotherapy
Immunotherapy: also biologic therapy; a treatment that stimulates or suppresses the body's own immune system to help the body to fight cancer cells
IMRT: intensity-modulated radiation therapy; type of 3D radiation therapy that uses computer-generated images to show the size and shape of the tumor without damaging nearby healthy tissue
In situ: “in its original place”; cancer in which abnormal cells are found only in the original site of formation
Infusion: injection of fluids, including medication, into the bloodstream
Interventional radiology: minimally invasive, image-guided treatment of medical conditions that once required open surgery using ultrasound, X-rays, CAT scans, MRI scans or other innovative methods
Intra-arterial: within an artery
Intrahepatic: within the liver
Internal radiation: radiation therapy in which radioactive material is introduced surgically into a tumor, swallowed, or injected into the bloodstream.
Invasive cancer: cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues
J
Jaundice: a yellow appearance to the skin and sclerae and darkening of urine caused by an excess buildup of bilirubin in the blood due to liver failure or blockage of bile ducts
L
Laparoscopic surgery: surgery done with a laparoscope, a small, thin, tube-like instrument with a light and lens
Lesion: area of abnormal tissue; could be cancerous
Liquid biopsy: test done on a blood sample to look for cancer or DNA fragments of tumor cells
Liver enzyme test: also liver function test; range of blood tests that examine how well the liver and biliary system function
Liver function test: also liver enzyme test; range of blood tests that examine how well the liver and biliary system function
Local cancer: malignant cancer with margins entirely inside the organ where the cancer began
Lymph nodes: small structures that are part of the body’s immune system that filter lymphatic fluid and help fight disease and infection
Lymphadenectomy: procedure in which lymph nodes are removed from the body and a lymph node sample is examined for signs of cancer
M
Malignant: tumor that has the potential to spread to other parts of the body; also cancerous
Margin: the edge or border of tissue removed in cancer surgery; can be negative (no cancer found at the margin and all cancer has been removed) or positive (cancer found at the margin and not all cancer has been removed)
MELD Score: Model for End-Stage Liver Disease; measure of mortality risk in patients with end-stage liver disease used as a disease severity index to help prioritize allocation of organs for transplant
Metabolic syndrome: condition marked by extra fat around the abdomen, high levels of blood glucose, high levels of triglycerides in the blood, low levels of high-density lipoproteins in the blood, and high blood pressure; also metabolic syndrome X
Metastasis: spread of cancer cells to different parts of the body
Microwave therapy: treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make them more sensitive to radiation and anticancer drugs
MRE: magnetic resonance enterography; diagnostic imaging tool used to assess certain gastrointestinal disorders
MRI: magnetic resonance imaging; diagnostic imaging tool that uses magnets, radiofrequencies, and computers to images of structures inside the body; a safe and painless test that uses a magnetic field and radio waves to produce detailed pictures of the body's organs and structures
Multidisciplinary: treatment planning approach or team including a number of doctors and other experts in different specialties
Mutation: any change in a gene
N
NAFLD: nonalcoholic fatty liver disease
NASH: nonalcoholic steatohepatitis
Neoadjuvant therapy: first step treatment used to shrink a tumor before secondary treatment, usually surgery; can include chemotherapy, radiation therapy, and hormone therapy
Nivolumab: drug that can be used to treat hepatocellular carcinoma after treatment with Nexavar® (sorafenib); brand name Opdivo®
Nodule: growth or lump that could be cancerous
Noninvasive: in medicine, procedure that doesn’t require inserting any tool through the skin or into a body opening; in cancer, disease that has not spread outside its primary location
O
Obstruction: the blockage of a blood vessel, bile duct, or other body passageway
Oncogenes: genes that cause cells to grow and duplicate, that under certain circumstances can mutate and cause abnormal cell growth and cancer
Oncologist: doctor who treats patients with cancer
Oncology: the medical field that involves the diagnosis and treatment of cancer
Operable: a condition that can be treated with surgery
P
Palliative care: treatment given to relieve the symptoms and reduce the suffering caused by cancer; usually given together with other cancer treatments, from diagnosis, through treatment, survivorship, remission, and end of life
Pathologic stage: cancer stage determined after surgery to remove and examine a tumor or to explore the extent of cancer; usually combines the results of both the clinical staging (physical exam, imaging test) with surgical results
Pathologist: a physician who specializes in diagnosing and classifying diseases by studying cell and tissue samples
PBRT: proton beam radiation therapy; type of radiation therapy that uses streams of protons to kill tumor cells; can reduce the amount of radiation damage to healthy tissue near a tumor
Percutaneous: passing through the skin; injection or a topical medicine
Percutaneous alcohol injection: injection of ethanol through the skin directly into a tumor to kill cancer cells; usually guided by ultrasound or CT scan; also alcohol ablation, ethanol ablation, PEI
Performance status: a measure of how well a patient is able to perform ordinary tasks and carry out daily activities
Peritoneum: the tissue that lines the abdominal wall and covers most of the organs in the abdomen
PET Scan: positron emission tomography scan; imaging test that involves intravenous injection of radioactive glucose and following scan identify and locate cancerous cells in the body
Portal hypertension: high blood pressure in the vein that carries blood to the liver from the stomach, small and large intestines, spleen, pancreas, and gallbladder
Portal vein: blood vessel that carries blood to the liver from the intestines, spleen, pancreas, and gallbladder; also hepatic portal vein
Primary treatment: the first treatment given for a disease; often a group of treatments, such as surgery followed by chemotherapy and radiation; also first line treatment
Primary tumor: the original, first tumor occuring in the body; cancer cells from a primary tumor may spread to other parts of the body and form new, or secondary, tumors
Prognosis: the likely outcome or course of a disease; the chance of recovery or recurrence; an estimate of how well a person's treatment is working and how likely or unlikely it is that cancer will recur
PTC: percutaneous transhepatic cholangiography; a procedure that uses x-ray to examine the hepatic and common bile ducts after a contrasting agent is injected into the liver or bile duct
PTCD: percutaneous transhepatic cholangiodrainage; a procedure used to drain bile and relieve pressure in the bile ducts caused by a blockage
R
Radiation therapy: the use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors
Radiofrequency ablation: procedure that uses radio waves to heat and destroy abnormal cells
Regional lymph nodes: in oncology, a lymph node that drains lymph from the region around a tumor
Regorafenib: drug used to treat hepatocellular carcinoma that was already treated with sorafenib; blocks the action of certain proteins, which may can slow cancer growth and spread, prevent the growth of tumor blood vessels, and may work to kill cancer cells; brand name Stivarga®
Relapse: return of a disease or the signs and symptoms of a disease after a period of improvement
Remission: decrease in or disappearance of signs and symptoms of cancer
Resectable: able to be removed by surgery
Residual disease: cancer cells that remain after attempts to remove the cancer have been made
Restaging: used to determine the extent of the disease if a cancer comes back after treatment
Risk factor: something that increases the chance of developing a disease; cancer risk factors include age, family history, tobacco use, exposure to radiation or other chemicals, infection with certain viruses or bacteria, and certain genetic mutations
S
SBRT: stereotactic body radiation therapy; a type of external radiation therapy that uses special equipment to position a patient and precisely deliver radiation to tumors in the body, sparing healthy tissue
Sclerae: whites of the eyes
Screening: checking for disease when there are no symptoms with the hope of finding disease at early stages
Second opinion: seeking a diagnosis and/or treatment plan from another doctor after initial diagnosis and treatment planning
Secondary cancer: cancer that has spread from the place where it originated to another part of the body; secondary cancers are the same type of cancer as the original cancer
Side effects: a problem that occurs when treatment affects healthy tissues or organs; can include nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss, and mouth sores
Sonography: also ultrasound; diagnostic imaging tool that uses high-frequency sound waves and computers to create images of tissue, organs, and vessels
Sorafenib: drug used to treat nonresectable liver cancer by slowing cancer growth and preventing growth of tumor blood vessels; brand name Nexavar®
Staging: performing exams and tests to determine the extent of the cancer within the body, especially to determine whether the disease has spread from where it first formed to other parts of the body
Supportive care: care given to improve the quality of life of patients who have a serious or life-threatening disease
Surgery: a procedure used to remove or repair a part of the body or to find out whether disease is present
Surveillance: closely watching a patient’s condition but not treating it unless there are changes in test results
Survival rate: the percentage of people in a study or treatment group who are still alive for a certain period of time after they were diagnosed with or started treatment for a disease
Survivorship: the health and life of a person with cancer post treatment until the end of life; covers the physical, psychosocial, and economic issues of cancer, beyond the diagnosis and treatment phases
Symptom: a physical or mental problem that a person experiences that may indicate a disease or condition; cannot be seen and do not show up on medical tests; include headache, fatigue, nausea, and pain
Systemic chemotherapy: treatment with anticancer drugs that travel through the blood to cells throughout the body
Systemic disease: disease that affects the whole body
T
TACE: transarterial chemoembolization; procedure in which anticancer drugs are placed near a tumor’s vessels to block its blood supply in the hopes of slowing tumor growth or killing the tumor
TAE: transarterial embolization; procedure in which small gelatin sponges or beads are placed in a tumor’s vessels to block its blood supply in the hopes of slowing tumor growth or killing the tumor
Targeted therapy: drugs or other substances that block the growth and spread of cancer by interfering with specific molecules involved in the growth, progression, or spread of cancer
Terminal cancer: cancer that cannot be cured will lead to death; also end-stage cancer
Thermal ablation: procedure that uses heat to remove a tissue or destroy its function
Transfusion: procedure in which blood or parts of blood are injected into a patient’s bloodstream through a vein; also blood transfusion
Transplant: surgical procedure that involves removing a diseased liver and replacing it with a liver, or part of a liver, that functions adequately
Tumor: mass of abnormal cells
Tumor burden: number of cancer cells, the size of a tumor, or the amount of cancer in the body; lso tumor load
U
Ultrasound: also sonography; diagnostic imaging tool that uses high-frequency sound waves and computers to create images of tissue, organs, and vessels
V
Vaccine: a substance or group of substances that may cause the immune system to respond to a tumor, bacteria, or virus. Vaccines can help the body recognize and destroy cancer cells or prevent or reduce the severity of a disease
Vaccine therapy: a treatment that uses a substance or group of substances to stimulate the immune system to destroy a tumor
Varices: veins that are stretched and thinned as a result of impaired liver function. Varices are often found in the digestive tract, especially in the esophagus as esophageal varices.
Viral therapy: also oncolytic virotherapy, oncolytic virus therapy, virotherapy; a type of targeted treatment that uses a virus altered in a lab to find and destroy cancer cells without harming healthy cells
Viral hepatitis: liver inflammation caused by a virus
W
Wilson’s disease: an inherited disease characterized by excess accumulation of copper in the liver and other organs
Y
Yttrium-90: a radioactive form of yttrium that is used in radiation therapy to treat some types of tumors; can bind to molecules in the body, such as cancer cells, after which the radiation may kill them
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