Cardiopulmonary Syndrome Overview
Dyspnea and Coughing During Advanced Cancer

General Information about Dyspnea and Coughing Causes of Dyspnea and Coughing Diagnosis of Dyspnea and Coughing Managing Dyspnea and Coughing

Malignant Pleural Effusions

General Information about Malignant Pleural Effusions Causes of Malignant Pleural Effusions Diagnosis of Malignant Pleural Effusion Managing Malignant Pleural Effusions

Malignant Pericardial Effusions

General Information about Malignant Pericardial Effusions Causes of Malignant Pericardial Effusions Diagnosis of Malignant Pericardial Effusion Managing Malignant Pericardial Effusions

Superior Vena Cava Syndrome

General Information about Superior Vena Cava Syndrome Causes of Superior Vena Cava Syndrome Diagnosis of Superior Vena Cava Syndrome Managing Superior Vena Cava Syndrome Social Considerations of Superior Vena Cava Syndrome Superior Vena Cava Syndrome in Children

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Changes to This Summary (09/26/2008)
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Cardiopulmonary Syndrome Overview

Cardiopulmonary syndromes are heart and lung symptoms, such as dyspnea (shortness of breath), cough, chest pain, irregular heartbeats, and excess fluid around the lungs (pleural effusion) and/or heart (pericardial effusion). These may be caused by cancer or by other conditions. Four cardiopulmonary syndromes commonly caused by cancer are covered in this summary:

• Dyspnea.
• Malignant pleural effusion.
• Malignant pericardial effusion.
• Superior vena cava syndrome.

Dyspnea and Coughing During Advanced Cancer

General Information about Dyspnea and Coughing

Dyspnea is difficult, painful breathing or shortness of breath. Patients may use different words to describe the feeling of breathlessness; terms such as "tightness in the chest" and "suffocating" are sometimes used. The distress caused by dyspnea is different for each patient, from mild discomfort in one patient to severe discomfort in another. Dyspnea is common in patients with advanced cancer, lung cancer, and in the last 6 weeks of life.

Many conditions may cause dyspnea and coughing. In cancer patients, causes may include the following:

• A tumor that spreads to the chest cavity, lung, airway, or vein that carries blood through the chest to the heart.



• Blood clots or tumor cells that break loose and block a blood vessel in the lungs.



• Pneumonia, an infection of the lung. Anticancer therapy increases a patient's risk of developing infections.



• Scarring of the lung by radiation therapy or chemotherapy.



• Weakening of the heart by chemotherapy.



• Other conditions the patient may have, such as chronic obstructive airway disease, congestive heart failure, other lung or heart diseases, weakened breathing muscles, or malnutrition.



• A history of smoking.

A diagnosis of the cause of the patient's dyspnea and coughing is helpful in planning treatment. Diagnostic tests and procedures may include the following:

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.



• Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.



• CT scan: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.



• Complete blood count: A procedure in which a sample of blood is drawn and checked for the following:
  • The number of red blood cells, white blood cells, and platelets.
  • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
  • The portion of the blood sample made of red blood cells.



• Oxygen saturation test: A procedure to determine the amount of oxygen being carried by the red blood cells. A lower than normal amount of oxygen may be a sign of lung disease or other medical conditions. One method uses a device clipped to the finger. The device senses the amount of oxygen in the blood flowing through the finger. Another method uses a sample of blood drawn from an artery, usually in the wrist, and tested for the amount of oxygen.



• Maximum inspiratory pressure (MIP) test: The MIP is the highest pressure that can be generated while breathing in. The MIP test measures this pressure and the strength of the muscles used to breathe. The patient breathes through a device called a manometer, which measures the pressure and sends the information to a computer.

Management of Causes of Dyspnea

It may be possible to identify and treat the causes of dyspnea. Treatment may include the following:

• Treatment to shrink or destroy the tumor:
  • Radiation therapy: A cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
  
  
  
  • Hormone therapy: A cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. The presence of some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working.
  
  
  
  • Chemotherapy: A cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas.
  
  
  
  • Laser therapy for tumors inside large airways: Use of a laser beam (a narrow beam of intense light) as a knife to remove the tumor.
  
  
  
  • Cauterization of tumors inside large airways: Use of a hot instrument, an electric current, or a caustic substance to destroy the tumor.
  
  
  



• Stent placement

  If a large airway is blocked by a tumor that is pressing on it from the outside, surgery may be done to place a stent (a thin tube) within the airway to keep it open.




• Medications
  • Steroid drugs to reduce the inflammation and swelling of lymph vessels in the lungs.
  
  
  
  • Bronchodilators, medicines that are inhaled to open up the bronchioles (small airways) in the lungs.
  
  
  
  • Diuretics and other drugs for heart failure.
  
  
  
  • Antibiotics for chest infections. These may be combined with chest physical therapy.
  
  
  



• Procedures to remove fluid that has built up around the lungs (See Managing Malignant Pleural Effusions ¹) or in the abdominal cavity.



• Blood transfusions for anemia

Management of Symptoms of Dyspnea

Management of the symptoms of dyspnea may include the following:

• Oxygen therapy

  Patients who cannot breathe enough oxygen from the air may be given supplemental oxygen to inhale from tanks or cylinders. Devices that concentrate oxygen already in the air may also be prescribed.




• Medicines

  Pain medicines may reduce physical and mental distress and exhaustion, and improve the patient's quality of life. Other drugs may be used to treat dyspnea that is related to panic disorder or severe anxiety.




• Support and counseling

  Supportive measures may be effective for some patients. These measures include the following:

  • New breathing techniques.
  • Cold air directed across the cheek.
  • Meditation.
  • Relaxation training.
  • Biofeedback.
  • Psychotherapy.

Management of Chronic Cough

In some patients, chronic (long-term) coughing causes pain, interferes with sleep, and worsens dyspnea and fatigue. Treatments include the following:

• Cough-suppressing medicine.
• Medicines that break down mucus.
• An inhaled drug for chronic coughing related to lung cancer.

Malignant Pleural Effusions

General Information about Malignant Pleural Effusions

The pleural cavity is the space surrounding each lung in the chest. The pleura is the thin layer of tissue that covers the outer surface of each lung and lines the interior wall of the chest cavity, creating a sac that encloses the pleural cavity. Pleural tissue normally produces a small amount of fluid that helps the lungs move smoothly in the chest while a person is breathing. A pleural effusion is an increased amount of fluid in the pleural cavity, which then presses on the lungs and makes breathing difficult.

Pleural effusions may be malignant (caused by cancer) or nonmalignant (caused by a condition that is not cancer). Malignant effusions are a common complication of cancer. Lung cancer, breast cancer, lymphoma, and leukemia cause most malignant effusions. Effusions caused by cancer treatment, such as radiation therapy or chemotherapy, are called paramalignant effusions.

Not all pleural effusions found in cancer patients are malignant. Cancer patients often develop conditions such as congestive heart failure, pneumonia, pulmonary embolism, and malnutrition, and these conditions may cause pleural effusions to occur.

The following symptoms may be caused by malignant pleural effusion:

• Dyspnea.
• Cough.
• Chest pain.

The management of a malignant pleural effusion is different from the management of a nonmalignant effusion, so an accurate diagnosis is important. Diagnostic tests may include the following:

• Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.



• CT scan: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.



• Thoracentesis: The removal of fluid from the pleural cavity using a needle inserted between the ribs. This procedure may be used to reduce pressure on the lungs and/or to check the fluid under a microscope to see if cancer cells are present.



• Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. If thoracentesis is not possible, a biopsy may be done during a thoracoscopy, a surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs and a thoracoscope (a thin, lighted tube) is inserted into the chest. Samples are then taken for biopsy.

Malignant pleural effusions often occur in advanced or unresectable cancer or in the last few weeks of life. The goal of treatment is usually palliative, to relieve the symptoms and improve the quality of life. The goals of therapy will depend on a number of factors, including the following:

• The prognosis (chance of recovery).
• The patient's preferences in regard to the risks and benefits of treatment.
• The patient's ability to perform activities of daily living.
• The type of primary cancer.
• The number and type of previous treatments. For example, patients whose cancer has not responded to chemotherapy are unlikely to obtain symptom relief with additional chemotherapy.

Treatment of the symptoms of malignant pleural effusion may include the following:

• Thoracentesis

  (See Diagnosis of Malignant Pleural Effusion ².) Removal of fluid from the pleural cavity using a needle may help to alleviate severe symptoms in the short-term. A few days after thoracentesis, the effusion will begin to reform. Repeated thoracentesis has risks, however, including bleeding, infection, collapsed lung, fluid in the lungs, and low blood pressure.




• Pleurodesis

  This is a procedure to close the pleural sac so that fluid cannot collect there. Fluid is first removed by thoracentesis. A drug or chemical that causes the sac to close is then inserted into the space through a chest tube. Chemical agents such as bleomycin or talc may be used.




• Surgery

  Surgery may be done to implant a shunt (tube) to transfer the fluid from the pleural cavity to the peritoneal (abdominal) cavity, where the fluid can be more easily removed. Another option is pleurectomy, removal of the part of the pleura that lines the chest.

Malignant Pericardial Effusions

General Information about Malignant Pericardial Effusions

Pericardial effusion is an increased amount of fluid inside the pericardium, the thin layer of tissue that forms a sac surrounding the heart. The excess fluid causes pressure on the heart, which prevents it from pumping blood normally. Lymph vessels may also be blocked, and bacterial or viral infections often develop. If fluid builds up very quickly, a condition called cardiac tamponade may occur, in which the pressure on the heart becomes life-threatening and must be treated promptly.

Pericardial effusions may be malignant or nonmalignant. Malignant pericardial effusions are caused by cancer that begins in the pericardium or the heart muscle, or by cancer that has spread there from the lung, esophagus, thymus, or lymph system. Malignant pericardial effusions are commonly caused by lung cancer in males and breast cancer in females. Nonmalignant causes include infection of the pericardium, heart attack, underactive thyroid gland, lupus, injury, surgery, and AIDS. Infection of the pericardium is a possible side effect of radiation therapy or chemotherapy.

The following symptoms may be caused by malignant pericardial effusions:

• Dyspnea.
• Cough.
• Chest pain.
• Difficulty breathing while lying flat.
• Swelling in the upper abdomen.
• Hiccups.
• Extreme tiredness and weakness.

Because pericardial effusions usually occur in advanced cancer or in the last few weeks of life, extensive diagnostic testing may be less important than relief of symptoms. The following tests and procedure may be used to diagnose pericardial effusion:

• Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.



• Echocardiography: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs of the chest. The echoes form a picture of the heart's position, motion of the walls, and internal parts such as the valves.



• Electrocardiogram (EKG or ECG): A recording of the heart's electrical activity to evaluate its rate and rhythm. A number of small pads (electrodes) are placed on the patient’s chest, arms, and legs, and are connected by wires to the electrocardiograph machine. Heart activity is then recorded as a line graph on paper. Electrical activity that is faster or slower than normal may be a sign of heart disease or damage.



• Pericardiocentesis: The removal of fluid from the pericardium using a needle inserted through the chest wall. The physician may use an echocardiogram to view the movement of the needle inside the chest. This procedure can be used to drain fluid from an effusion and reduce pressure on the heart. To diagnose malignant pericardial effusion, the fluid is examined under a microscope to check for cancer cells. The fluid may also be checked for signs of infection.

Large malignant pericardial effusions are managed by draining the fluid, unless the goals of therapy are to use a less invasive approach that may improve quality of life but not help the patient live longer. The goals of therapy depend on a number of factors, including the following:

• The patient's prognosis.
• The cost, risks, and invasiveness of treatment.
• Whether treatment will relieve symptoms and improve the patient's quality of life.
• Whether treatment will shorten the patient's hospital stay.

Treatment options include the following:

• Pericardiocentesis

  (See Diagnosis of Malignant Pericardial Effusion ³.) In some patients, fluid may again collect in the pericardium after pericardiocentesis. A catheter may be inserted and left in place to allow continued drainage. This procedure may be used for patients with advanced cancer instead of more invasive surgery.




• Pericardial sclerosis

  A procedure to close the pericardium so fluid cannot collect in the cavity. Fluid is first removed by pericardiocentesis. A drug or chemical that causes the pericardium to close is then injected through a catheter into the pericardial space. Three or more treatments may be needed to completely close the pericardium.




• Pericardotomy

  A surgical incision is made in the chest and then in the pericardium to insert a drainage tube. This increases the quantity of fluid that can be drained from the pericardium.




• Pericardiectomy

  Surgery to remove part of the pericardium. This may be done when there are chronic infections of the pericardium or to drain fluid quickly when cardiac tamponade occurs. This surgery is also called pericardial window.




• Balloon pericardiostomy

  A catheter with a balloon tip is inserted through the chest and into the pericardium. The balloon is then inflated to enlarge the pericardial opening and allow fluid to drain into the pleural cavity. This may be used when an effusion has recurred (come back) after pericardiocentesis or as an alternative to more invasive surgery.

Superior Vena Cava Syndrome

General Information about Superior Vena Cava Syndrome

Superior vena cava syndrome (SVCS) is a group of symptoms that occur when the superior vena cava becomes partially blocked.

The right atrium (chamber) of the heart receives blood from two major veins: the superior (upper) vena cava and the inferior (lower) vena cava.

• The superior vena cava returns blood from the upper body to the heart.
• The inferior vena cava returns the blood from the lower body to the heart.

The superior vena cava is thin-walled, and the blood is under low pressure. If a tumor forms in the chest or nearby lymph nodes become swollen (as from lymphoma), the superior vena cava can be squeezed. Blood flow slows. Complete blockage of the vein can occur. Sometimes, the other veins can become larger and take over for the superior vena cava if it is blocked, but this takes time. Superior vena cava syndrome (SVCS) is the group of symptoms that occur when this vein is partially blocked.

The location of the blocked area and how fast the blockage occurs affect the symptoms.

The symptoms will be more severe if the vein becomes blocked quickly. This is because the other veins do not have time to widen and take over the increased blood flow from the superior vena cava.

The location of the blocked area also affects how severe the symptoms will be:

• If the blockage is above where the superior and inferior vena cava veins join, other veins can become larger over time and take over the increased blood flow. The symptoms may be milder.
• If the blockage occurs below where the superior vena cava and inferior vena cava meet, the blood must be returned to the heart by the veins in the upper abdomen and the inferior vena cava, which require higher pressure. Symptoms may be more severe.

Common symptoms of SVCS include breathing problems and coughing.

The most common symptoms are these:

• Problems breathing.



• Coughing.



• Swollen face, neck, upper body, and arms.

Less common symptoms include the following:

• Hoarse voice.



• Chest pain.



• Problems swallowing and/or talking.



• Coughing up blood.



• Swollen veins in the chest or neck.



• Bluish color to the skin.



• Drooping eyelid.

Superior vena cava syndrome (SVCS) is usually caused by cancer. In adults, SVCS most commonly occurs with lung cancer or non-Hodgkin lymphoma. A tumor in the chest or swollen lymph nodes can press on the superior vena cava, blocking the blood flow. There are other less common causes for the superior vena cava to become blocked:

• A blood clot that forms as a side effect from the use of intravenous catheters (a flexible tube used to put fluids into or take blood out of a vein). A clot may also form as a side effect of pacemaker wires.



• Infection in the chest that causes affected tissues to become thick and hard.



• Other cancers, including metastatic breast cancer, metastatic germ cell tumors, colon cancer, esophageal cancer, Kaposi sarcoma, fibrous mesothelioma (cancer of the epithelium), and Hodgkin lymphoma.



• Bechet syndrome (a disease of the immune system).



• Tumors in the thymus or thyroid.



• Sarcoidosis (a disease of the lymph nodes that acts like tuberculosis).

The following tests may be done to diagnose SVCS and find the location of the blockage:

• Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. A CT scan of the chest will be done to diagnose SVCS.
• Venography: A procedure to x-ray veins. A contrast dye is injected into the veins to outline them on the x-rays.
• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
• Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

The type of cancer can affect the type of treatment needed; for this reason, a diagnosis of suspected cancer should be made before treatment of SVCS is begun. Unless the airway is blocked or the brain is swelling, waiting to start treatment while a diagnosis is made usually presents no problem in adults. If lung cancer is suspected, a sputum sample and a biopsy may be taken.

This summary is about treatment for superior vena cava syndrome (SVCS) caused by cancer. Treatment will depend on the following:

• The type of cancer.
• The cause of the blockage.
• How severe the symptoms are.
• The prognosis (chance of recovery).
• The patient's wishes.

Treatment of SVCS may include the following:

Watchful waiting

Watchful waiting is closely monitoring a patient’s condition without giving any treatment unless symptoms appear or change. A patient who has good blood flow through other veins and mild symptoms may not need treatment.

The following may be used to relieve symptoms and keep the patient comfortable:

• Keeping the upper body raised higher than the lower body.
• Corticosteroids (drugs that reduce swelling).
• Diuretics (drugs that make excess fluid pass from the body in urine). Patients taking diuretics are closely monitored because these drugs can cause dehydration (loss of too much fluid from the body).

Radiation therapy

If the blockage of the superior vena cava is caused by a tumor that is not sensitive to chemotherapy, radiation therapy may be given. Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

Chemotherapy

Chemotherapy is the usual treatment for tumors that respond to anticancer drugs, including small cell lung cancer and lymphoma. This treatment would not be changed for patients who have SVCS. Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).

Thrombolysis

SVCS may occur when a thrombus (blood clot) forms in a partially blocked vein. Thrombolysis is a method used to break up and remove blood clots. This may done using a drug put directly into the clot, through a catheter, or by a thrombectomy (the use of a device inserted into the vein).

Stent placement

A stent may be used to open up the blocked vein. A stent is a tube-like device that is inserted into the blocked area of a vein to allow blood to pass through. This helps most patients. Patients may also receive an anticoagulant to keep more blood clots from forming.

Surgery

Surgery to bypass (go around) the blocked part of the vein is sometimes used for cancer patients, but is used more often for patients without cancer.

Superior vena cava syndrome is serious and the symptoms can be upsetting to the patient and family. It is important that patients and family members receive information about the causes of superior vena cava syndrome and how to treat it. This can help relieve anxiety over symptoms such as swelling, trouble swallowing, coughing, and hoarseness.

When a patient has chosen not to receive aggressive treatment because of terminal cancer, palliative treatment can help keep the patient comfortable by relieving symptoms. Patients and family members can be taught how to provide palliative care to relieve symptoms and improve quality of life.

Superior vena cava syndrome in a child is a serious medical emergency because the child's windpipe can become blocked.

Superior vena cava syndrome (SVCS) in children can be life threatening. This is because blockage of the child's trachea (windpipe) can quickly occur along with SVCS. In adults, the windpipe is fairly hard, but in children, it is softer and can more easily be squeezed shut. Also, the diameter of a child's windpipe is smaller, so any amount of swelling can cause breathing problems. Squeezing of the trachea is called superior mediastinal syndrome (SMS). Because SVCS and SMS often occur together in children, the two syndromes are considered to be the same.

The most common symptoms of SVCS in children are similar to those in adults.

Common symptoms include the following:

• Coughing.
• Hoarseness.
• Problems breathing.
• Chest pain.

There are other less common but more serious symptoms:

• Fainting.
• Anxiety.
• Confusion.
• Tiredness.
• Headache.
• Vision problems.
• A sense of fullness in the ears.

The causes, diagnosis, and treatment of SVCS in children are not the same as in adults.

The most common cause of SVCS in children is non-Hodgkin lymphoma.

SVCS in children is rare; the most common cause is non-Hodgkin lymphoma. As in adults, SVCS may also be caused by a blood clot that forms as a side effect of using an intravenous catheter.

SVCS in children may be diagnosed and treated before a definite diagnosis of cancer is made.

A physical exam, chest x-ray, and medical history are usually all that are needed to diagnose superior vena cava syndrome in children. If cancer is suspected, a biopsy is not done unless the lungs and heart of the child with SVCS are able to handle the anesthesia needed. Other imaging tests may be done to help determine if anesthesia can be safely used. In most cases, treatment will begin before a definite diagnosis of cancer is made.

It is important that treatment begins right away.

The following treatments may be used for SVCS in children:

• Radiation therapy

  Radiation therapy is usually used to treat a tumor that is causing the blocked vein. After radiation therapy, breathing may become more difficult because swelling narrows the windpipe. A drug to reduce swelling may be given.




• Drugs

  Anticancer drugs, steroids, and/or other drugs may be used. If the tumor does not respond, it may be benign (not cancer).




• Surgery

  This may include surgery to bypass (go around) the blocked part of the vein or to place a stent to open the vein.

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Changes to This Summary (09/26/2008)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Editorial changes were made to this summary.

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PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site ⁵. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

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Glossary Terms

The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.

Not normal. An abnormal lesion or growth may be cancerous, premalignant (likely to become cancer), or benign.

ADL. The tasks of everyday life. These activities include eating, dressing, getting into or out of a bed or chair, taking a bath or shower, and using the toilet. Instrumental activities of daily living are activities related to independent living and include preparing meals, managing money, shopping, doing housework, and using a telephone. Also called ADL.

Cancer that has spread to other places in the body and usually cannot be cured or controlled with treatment.

A quickly growing cancer.

Acquired immunodeficiency syndrome. A disease caused by the human immunodeficiency virus (HIV). People with AIDS are at an increased risk for developing certain cancers and for infections that usually occur only in individuals with a weak immune system. Also called acquired immunodeficiency syndrome.

Drugs or substances that cause loss of feeling or awareness. Local anesthetics cause loss of feeling in a part of the body. General anesthetics put the person to sleep.

A drug used to treat infections caused by bacteria and other microorganisms.

A drug that helps prevent blood clots from forming. Also called a blood thinner.

Feelings of fear, dread, and uneasiness that may occur as a reaction to stress. A person with anxiety may sweat, feel restless and tense, and have a rapid heart beat. Extreme anxiety that happens often over time may be a sign of an anxiety disorder.

A blood vessel that carries blood from the heart to tissues and organs in the body.

A large group of single-cell microorganisms. Some cause infections and disease in animals and humans. The singular of bacteria is bacterium.

Not cancerous. Benign tumors may grow larger but do not spread to other parts of the body.

A method of learning to voluntarily control certain body functions such as heartbeat, blood pressure, and muscle tension with the help of a special machine. This method can help control pain.

The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

An anticancer drug that belongs to the family of drugs called antitumor antibiotics.

A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.

A mass of blood that forms when blood platelets, proteins, and cells stick together. When a blood clot is attached to the wall of a blood vessel, it is called a thrombus. When it moves through the bloodstream and blocks the flow of blood in another part of the body, it is called an embolus.

The force of circulating blood on the walls of the arteries. Blood pressure is taken using two measurements: systolic (measured when the heart beats, when blood pressure is at its highest) and diastolic (measured between heart beats, when blood pressure is at its lowest). Blood pressure is written with the systolic blood pressure first, followed by the diastolic blood pressure (for example 120/80).

A tube through which the blood circulates in the body. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins.

Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.

Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.

A tiny branch of air tubes in the lungs.

A type of drug that causes small airways in the lungs to open up. Bronchodilators are inhaled and are used to treat breathing disorders, such as asthma or emphysema.

A surgical procedure in which the doctor creates a new pathway for the flow of body fluids.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

Having to do with the heart.

Having to do with the heart and lungs.

A flexible tube used to deliver fluids into or withdraw fluids from the body.

To destroy tissue using a hot or cold instrument, an electrical current, or a chemical that burns or dissolves the tissue. This process may be used to kill certain types of small tumors or to seal off blood vessels to stop bleeding.

A hollow area or hole. It may describe a body cavity (such as the space within the abdomen) or a hole in a tooth caused by decay.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

Treatment with drugs that kill cancer cells.

The muscles, bones, and joints that make up the area of the body between the neck and the abdomen.

An x-ray of the structures inside the chest. An x-ray is a type of high-energy radiation that can go through the body and onto film, making pictures of areas inside the chest, which can be used to diagnose disease.

A disease or condition that persists or progresses over a long period of time.

COPD. A type of lung disease marked by permanent damage to tissues in the lungs, making it hard to breathe. Chronic obstructive pulmonary disease includes chronic bronchitis, in which the bronchi (large air passages) are inflamed and scarred, and emphysema, in which the alveoli (tiny air sacs) are damaged. It develops over many years and is usually caused by cigarette smoking. Also called COPD.

Cancer that forms in the tissues of the colon (the longest part of the large intestine). Most colon cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids).

CBC. A test to check the number of red blood cells, white blood cells, and platelets in a sample of blood. Also called blood cell count and CBC.

In medicine, a medical problem that occurs during a disease, or after a procedure or treatment. The complication may be caused by the disease, procedure, or treatment or may be unrelated to them.

A mental state in which one is not thinking clearly.

Weakness of the heart muscle that leads to a buildup of fluid in body tissues.

A dye or other substance that helps show abnormal areas inside the body. It is given by injection into a vein, by enema, or by mouth. Contrast material may be used with x-rays, CT scans, MRI, or other imaging tests.

Any steroid hormone made in the adrenal cortex (the outer part of the adrenal gland). They are also made in the laboratory. Corticosteroids have many different effects in the body, and are used to treat many different conditions. They may be used as hormone replacement, to suppress the immune system, and to treat some side effects of cancer and its treatment. Corticosteroids are also used to treat certain lymphomas and lymphoid leukemias.

Computed tomography scan. A series of detailed pictures of areas inside the body taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computed tomography scan, computerized tomography, computerized axial tomography scan, and CAT scan.

A condition caused by the loss of too much water from the body. Severe diarrhea or vomiting can cause dehydration.

The process of identifying a disease, such as cancer, from its signs and symptoms.

A method used to identify a disease.

The length of a straight line that extends from one edge of a tumor or other object, through its center and to the opposite edge. It is usually used to measure the size of round or spherical shapes.

In medicine, a disturbance of normal functioning of the mind or body. Disorders may be caused by genetic factors, disease, or trauma.

Extreme mental or physical pain or suffering.

A drug that increases the production of urine.

In medicine, to remove fluid as it collects; or, a tube or wick-like device used to remove fluid from a body cavity, wound, or infected area.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

Difficult, painful breathing or shortness of breath.

A procedure that uses ultrasonic waves directed over the chest wall to obtain a graphic record of the heart's position, motion of the walls, or internal parts such as the valves.

An abnormal collection of fluid in hollow spaces or between tissues of the body. For example, a pleural effusion is a collection of fluid between the two layers of membrane covering the lungs.

In medicine, a device such as a small metal plate or needle that carries electricity from an instrument to a patient for treatment or surgery. Electrodes can also carry electrical signals from muscles, brain, heart, skin, or other body parts to recording devices to help diagnose certain conditions.

A block in an artery caused by blood clots or other substances, such as fat globules, infected tissue, or cancer cells.

A thin layer of tissue that covers organs, glands, and other structures within the body.

Cancer that forms in tissues lining the esophagus (the muscular tube through which food passes from the throat to the stomach). Two types of esophageal cancer are squamous cell carcinoma (cancer that begins in flat cells lining the esophagus) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids).

The muscular tube through which food passes from the throat to the stomach.

A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body. Also called external-beam radiation therapy.

A condition marked by extreme tiredness and inability to function due lack of energy. Fatigue may be acute or chronic.

Containing or resembling fibers.

Liquid.

A type of tumor that begins in the cells that give rise to sperm or eggs. Germ cell tumors can occur almost anywhere in the body and can be either benign or malignant.

An organ that makes one or more substances, such as hormones, digestive juices, sweat, tears, saliva, or milk. Endocrine glands release the substances directly into the bloodstream. Exocrine glands release the substances into a duct or opening to the inside or outside of the body.

The substance inside red blood cells that binds to oxygen in the lungs and carries it to the tissues.

A cancer of the immune system that is marked by the presence of a type of cell called the Reed-Sternberg cell. The two major types of Hodgkin lymphoma are classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Symptoms include the painless enlargement of lymph nodes, spleen, or other immune tissue. Other symptoms include fever, weight loss, fatigue, or night sweats. Also called Hodgkin disease.

One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.

Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body’s natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone. Also called hormonal therapy, hormone treatment, or endocrine therapy.

In medicine, a process that makes pictures of areas inside the body. Imaging uses methods such as x-rays (high-energy radiation), ultrasound (high-energy sound waves), and radio waves.

The complex group of organs and cells that defends the body against infections and other diseases.

A substance or object that is put in the body as a prosthesis, or for treatment or diagnosis.

A cut made in the body to perform surgery.

Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.

A large vein that empties into the heart. It carries blood from the legs and feet and from organs in the abdomen and pelvis.

Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.

In medicine, refers to the act of taking a substance into the body by breathing.

Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."

A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, radiation brachytherapy, and implant radiation therapy.

Into or within a vein. Intravenous usually refers to a way of giving a drug or other substance through a needle or tube inserted into a vein. Also called I.V.

A medical procedure that invades (enters) the body, usually by cutting or puncturing the skin or by inserting instruments into the body.

A type of cancer characterized by the abnormal growth of blood vessels that develop into skin lesions or occur internally.

A device that concentrates light into an intense, narrow beam used to cut or destroy tissue. It is used in microsurgery, photodynamic therapy, and for a variety of diagnostic purposes.

The use of an intensely powerful beam of light to kill cancer cells.

Cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of blood cells to be produced and enter the bloodstream.

One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.

Cancer that forms in tissues of the lung, usually in the cells lining air passages. The two main types are small cell lung cancer and non-small cell lung cancer. These types are diagnosed based on how the cells look under a microscope.

A chronic, inflammatory, connective tissue disease that can affect the joints and many organs, including the skin, heart, lungs, kidneys, and nervous system. It can cause many different symptoms; however, not everyone with lupus has all of the symptoms. Also called systemic lupus erythematosus and SLE.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

A thin tube that carries lymph (lymphatic fluid) and white blood cells through the lymphatic system. Also called lymphatic vessel.

The tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes, and lymphatic vessels (a network of thin tubes that carry lymph and white blood cells). Lymphatic vessels branch, like blood vessels, into all the tissues of the body.

Cancer that begins in cells of the immune system. There are two basic categories of lymphomas. One kind is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course. These subtypes behave and respond to treatment differently. Both Hodgkin and non-Hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer.

Cancerous. Malignant tumors can invade and destroy nearby tissue and spread to other parts of the body.

A condition in which cancer causes an abnormal amount of fluid to collect between the thin layers of tissue (pleura) lining the outside of the lung and the wall of the chest cavity. Lung cancer, breast cancer, lymphoma, and leukemia cause most malignant pleural effusions.

A disorder caused by a lack of proper nutrition or an inability to absorb nutrients from food.

MIP test. A test that measures the strength of the muscles used in breathing. A person inhales and exhales through a device called a manometer, and the pressures are recorded by a computer. Also called MIP test.

The area between the lungs. The organs in this area include the heart and its large blood vessels, the trachea, the esophagus, the bronchi, and lymph nodes.

Refers to the practices and procedures used for the prevention, treatment, or relief of symptoms of a diseases or abnormal conditions. This term may also refer to a legal drug used for the same purpose.

A benign (noncancerous) or malignant (cancerous) tumor affecting the lining of the chest or abdomen. Exposure to asbestos particles in the air increases the risk of developing malignant mesothelioma.

Having to do with metastasis, which is the spread of cancer from one part of the body to another.

In medicine, to regularly watch and check a person or condition to see if there is any change. Also refers to a device that records and/or displays patient data, such as for an electrocardiogram (EKG).

A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones. Also called magnetic resonance imaging, nuclear magnetic resonance imaging, and NMRI.

A thick, slippery fluid made by the membranes that line certain organs of the body, including the nose, mouth, throat, and vagina.

Any of a large group of cancers of the immune system. Non-Hodgkin lymphomas can occur at any age and are often marked by enlarged lymph nodes, fever, and weight loss. There are many different types of non-Hodgkin lymphoma, which can be divided into aggressive (fast-growing) and indolent (slow-growing) types and can be classified as either B-cell or T-cell non-Hodgkin lymphoma. B-cell non-Hodgkin lymphomas include Burkitt lymphoma, diffuse large B-cell lymphoma, follicular lymphoma, immunoblastic large cell lymphoma, precursor B-lymphoblastic lymphoma, and mantle cell lymphoma. T-cell non-Hodgkin lymphomas include mycosis fungoides, anaplastic large cell lymphoma, and precursor T-lymphoblastic lymphoma. Lymphomas related to lymphoproliferative disorders following bone marrow or stem cell transplantation are usually B-cell non-Hodgkin lymphomas. Prognosis and treatment depend on the stage and type of disease. Also called NHL.

Not cancerous.

A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. Nuclear magnetic resonance imaging makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. Nuclear magnetic resonance imaging is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones. Also called NMRI, magnetic resonance imaging, and MRI.

A part of the body that performs a specific function. For example, the heart is an organ.

A colorless, odorless gas. It is needed for animal and plant life. Oxygen that is breathed in enters the blood from the lungs and travels to the tissues.

A test that measures the amount of oxygen being carried by red blood cells. One method uses a device that shines light through a finger. The device measures the amount of oxygen in the blood based on the way red blood cells carrying oxygen absorb and reflect light. In another method blood is taken from an artery and the amount of oxygen is measured directly. An oxygen level that is lower than normal may be a sign of lung disease or other medical conditions.

An electronic device that is implanted in the body to monitor heart rate and rhythm. It gives the heart electrical stimulation when it does not beat normally. It runs on batteries and has long, thin wires that connect it to the heart. Also called artificial pacemaker and cardiac pacemaker.

Treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases. Palliative cancer therapies are given together with other cancer treatments, from the time of diagnosis, through treatment, survivorship, recurrent or advanced disease, and at the end of life.

Sudden extreme anxiety or fear that may cause irrational thoughts or actions. Panic may include rapid heart rate, flushing (a hot, red face), sweating, and trouble breathing.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

An abnormal collection of fluid inside the sac that covers the heart.

Having to do with the parietal peritoneum (the tissue that lines the abdominal wall and pelvic cavity) and visceral peritoneum (the tissue that covers most of the organs in the abdomen, including the intestines).

An exam of the body to check for general signs of disease.

The use of exercises and physical activities to help condition muscles and restore strength and movement. For example, physical therapy can be used to restore arm and shoulder movement and build back strength after breast cancer surgery.

Medical doctor.

A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called a thrombocyte.

A thin layer of tissue that covers the lungs and lines the interior wall of the chest cavity. It protects and cushions the lungs. This tissue secretes a small amount of fluid that acts as a lubricant, allowing the lungs to move smoothly in the chest cavity while breathing.

The space enclosed by the pleura, which is a thin layer of tissue that covers the lungs and lines the interior wall of the chest cavity.

An abnormal collection of fluid between the thin layers of tissue (pleura) lining the lung and the wall of the chest cavity.

Surgery to remove part of the pleura (a thin layer of tissue that covers the interior wall of the chest cavity).

A severe inflammation of the lungs in which the alveoli (tiny air sacs) are filled with fluid. This may cause a decrease in the amount of oxygen that blood can absorb from air breathed into the lung. Pneumonia is usually caused by infection but may also be caused by radiation therapy, allergy, or irritation of lung tissue by inhaled substances. It may involve part or all of the lungs.

A doctor's order for medicine or another intervention.

The original tumor.

The likely outcome or course of a disease; the chance of recovery or recurrence.

A molecule made up of amino acids that are needed for the body to function properly. Proteins are the basis of body structures such as skin and hair and of substances such as enzymes, cytokines, and antibodies.

Treatment of mental, emotional, personality, and behavioral disorders using methods such as discussion, listening, and counseling. Also called talk therapy.

Having to do with the lungs.

The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.

Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

Giving off radiation.

A small, radioactive pellet that is placed in or near a tumor. Cancer cells are killed by the energy given off as the radioactive material breaks down and becomes more stable.

A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell.

To come back or to return.

RBC. A cell that carries oxygen to all parts of the body. Also called RBC and erythrocyte.

Treatment with anticancer drugs directed to a specific area of the body.

A method used to reduce tension and anxiety, and control pain.

An inflammatory disease marked by the formation of granulomas (small nodules of immune cells) in the lungs, lymph nodes, and other organs. Sarcoidosis may be acute and go away by itself, or it may be chronic and progressive. Also called sarcoid.

In medicine, a passage that is made to allow blood or other fluid to move from one part of the body to another. For example, a surgeon may implant a tube to drain cerebrospinal fluid from the brain to the abdomen. A surgeon may also change normal blood flow by making a passage that leads from one blood vessel to another.

A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.

An aggressive (fast-growing) cancer that forms in tissues of the lung and can spread to other parts of the body. The cancer cells look small and oval-shaped when looked at under a microscope.

A computer picture of areas inside the body created by bouncing high-energy sound waves (ultrasound) off internal tissues or organs. Also called an ultrasonogram.

The bones, muscles, tendons, and other tissues that reach from the base of the skull to the tailbone. The spinal column encloses the spinal cord and the fluid surrounding the spinal cord. Also called spine, backbone, and vertebral column.

Mucus and other matter brought up from the lungs by coughing.

A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to keep the structure open.

A type of drug used to relieve swelling and inflammation. Some steroid drugs may also have antitumor effects.

The large vein that carries blood from the head, neck, arms, and chest to the heart.

A condition in which a tumor presses against the superior vena cava (the large vein that carries blood from the head, neck, arms, and chest to the heart). This pressure blocks blood flow to the heart and may cause coughing, difficulty in breathing, and swelling of the face, neck, and upper arms.

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

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

A set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.

Treatment with anticancer drugs that travel through the blood to cells all over the body.

A mineral, usually used in a powdered form. In cancer treatment, sterile talc is used to prevent pleural effusions (an abnormal collection of fluid in the space between the lungs and the chest wall). Talc is inserted into the space, causing it to close up, so fluid cannot collect there. Also called sterile talc powder.

Disease that cannot be cured and will cause death.

Treatment.

Removal of fluid from the pleural cavity through a needle inserted between the ribs.

A thin tube-like instrument used to examine the inside of the chest. A thoracoscope has a light and a lens for viewing and may have tool to remove tissue.

Examination of the inside of the chest, using a thoracoscope. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease.

Surgery to remove a thrombus (blood clot) from a blood vessel.

The process of breaking up a thrombus (blood clot) that is blocking blood flow. The blood clot may be dissolved using drugs delivered through a catheter (tube) into the clot.

A blood clot that forms on the wall of a blood vessel or in the heart when blood platelets, proteins, and cells stick together. A thrombus may block the flow of blood.

An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone.

A gland located beneath the voice box (larynx) that makes thyroid hormone and calcitonin. The thyroid helps regulate growth and metabolism.

A gland located beneath the voice box (larynx) that produces thyroid hormone. The thyroid helps regulate growth and metabolism.

A group or layer of cells that work together to perform a specific function.

The airway that leads from the larynx (voice box) to the bronchi (large airways that lead to the lungs). Also called windpipe.

TB. A disease caused by a specific type of bacteria that spreads from one person to another through the air. Tuberculosis can affect many parts of the body, but most often affects the lungs. A person may not have symptoms of tuberculosis for years, but they may appear when the patient becomes ill with a serious condition like diabetes, AIDS, or cancer. Tuberculosis can usually be treated and cured with antibiotics. Also called TB.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasonography.

Unable to be removed with surgery.

Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra.

A blood vessel that carries blood to the heart from tissues and organs in the body.

A procedure in which an x-ray of the veins is taken after a special dye is injected into the bone marrow or veins.

Having to do with a virus.

Closely monitoring a patient's condition but withholding treatment until symptoms appear or change. Also called active surveillance, expectant management, and observation.

Refers to a blood cell that does not contain hemoglobin. White blood cells include lymphocytes, neutrophils, eosinophils, macrophages, and mast cells. These cells are made by bone marrow and help the body fight infections and other diseases. Also called WBC.

A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.