Glossary of Terms
Acral Lentiginous Melanoma
This melanoma appears among whites and people of color. It is most often found in the thumb and great toe, but also appears on the soles of feet, and palms of hands. It is called subungual when found in the nail bed. Late detection often results in worse prognosis as it is a rare melanoma not often seen by physicians.
Actinic Keratosis (AK)
Small, scaly red patch caused by sun exposure; it is potential precancer of the non-melanoma type.
Treatment offered in addition to the surgical removal of melanoma (for instance). Generally, the therapy affects the whole body and is designed to kill disease that may have traveled to other parts of the body even before the primary tumor or diseased lymph nodes were recognized and removed.
Therapies such as IPI (Ipilimumab) and Yervoy, that act to put the brakes on tumor growth by becoming an immune booster. It blocks a protein called CTLA-4 that acts as a brake on T cells, the soldiers of the immune system. Approved by the FDA in March 2011 for use in Stage IV patients.
Promising therapy akin to Yervoy (anti-CTLA-4).
Basal Cell Carcinoma (BCC)
One of two most common kinds of non-melanoma cancer. It almost never metastasizes and is made up of the cells at the bottom layer of the epidermis that give rise to keratinocytes.
Surgical removal of a sample of tissue for examination under the microscope.
The BRAF protein is a key component of the cellular pathways and may become mutated and cause tumor growth. New BRAF therapies target this mutation to eliminate tumor progression.
Chemical, physical, or biological agent that causes cancer.
CAT or CT Scan
X-ray procedure in which a computer produces detailed pictures of areas inside the body.
Medicines prescribed by medical oncologists that can kill cancer cells directly. Some are given by pill or intravenously. It is considered a systemic therapy since it goes through the bloodstream to the entire body.
Moles that are present at birth, sometimes called birthmarks.
Melanoma of the skin
The layer of skin directly beneath the epidermis.
Physician who has special training in diagnosing disease on the basis of microscopic examination of the skin.
Dysplastic Nevi (DN)
Moles associated with an increased risk of melanoma. Larger than ordinary moles, they are flat or have a flat part, and have indistinct or fuzzy borders and often uneven coloration.
The outermost layer of skin.
A biopsy to take all of a tumor that is in evidence.
Expanded access is a means by which manufacturers make investigational new drugs available, under certain circumstances, to treat a patient(s) with a serious disease or condition who cannot participate in a controlled clinical trial.
Federal Drug Administration. Federal government agency responsible for approval of the use of certain drugs for therapies.
Treatments designed to help your own body’s immune system fight the cancer, similar to how your body fights off infections.
A biopsy done with a knife that samples only a part of a lesion.
Type of protein produced by the immune system. Artificially made treatment sometimes prescribed for Stage III disease is called Intron A and is approved by the FDA.
Type of protein molecule produced by lymphocytes that activates other lymphocytes in the immune system. Artificially made treatment is called IL2 or Proleukin sometimes prescribed for Stage IV disease. Approved by the FDA.
Short for ipilimubab or the commercial name, Yervoy, the anti-ctla-4 immunotherapy.
The commercial name for the PD1 agent, pembrolizumab or also called pembro.
Lactate Dehydrogenase, a non-specific cytosolic enzyme released in the blood stream. Elevations in LDH can be caused by a number of factors that are typically associated with inflammation. An elevated LDH is associated with an worse prognosis for patients with melanoma when compared to patients with a normal LDH.
Well-defined, localized abnormality within an organ— e.g., a pigmented growth on the skin.
Type of white blood cell that plays an important part in immune reactions.
Lymph Gland, Lymph Node
Small bean-shaped organs located in the lymphatic system.
Technique of injecting a small amount of radioactive material near the site of a primary melanoma and then scanning different lymph node areas (armpits and groin for example) to see which group(s) of nodes “light up.”
Magnetic Resonance Imaging (MRI)
Imaging study that uses a magnetic field and a computer to create detailed pictures of the body.
A MEK inhibitor is a chemical or drug that inhibits the mitogen-activated protein kinase kinase enzymes MEK1 and/or MEK2. They can be used to affect the MAPK/ERK pathway which is often overactive in some cancers. (See MAPK/ERK pathway#Clinical significance.) Hence, MEK inhibitors have potential for treatment of some cancers, especially BRAF-mutated melanoma.
Commercial name for the MEK drug, trametinib
Cells located primarily at the bottom of the epidermis whose transfer of pigment to other cells is responsible in part for skin and hair color.
Mucosal melanomas are rare and account for approximately 1 percent of all melanomas. Mucosal melanomas arise primarily in the head and neck, anorectal, and vulvovaginal regions (55, 24, and 18 percent of cases, respectively). Rarer sites of origin include the urinary tract, gall bladder, and small intestine.
National Cancer Institute (NCI)
Federally funded cancer research and treatment center under the National Institutes of Health (NIH)
Nevus (plural nevi)
Nivolumab or Nivo
Name for the PD1 immunotherapy commercially known as Opdivo
No Evidence of Disease (NED)
No measurable evidence of melanoma in your body
Also known as uveal melanoma or melanoma of the eye. Melanoma of the uveal tract (iris, ciliary body, and choroid), though rare, is the most common primary intraocular malignancy in adults.
Science of diagnosing disease by such methods as microscopic analysis of tissue.
Treatment that is intended to relieve symptoms, but not cure disease.
PD1 immunotherapy agent, Keytruda; short for pembrolizumab
PET Scan (Positron emission tomography)
Using radioactive tracer attached to a sugar that is injected into the patient to find areas of tumor activity
Skin spot that has color—brown, black, or blue.
Primary Tumor or Site
Initial tumor or the body site where it forms.
Relatively rare phenomenon seen when using immunotherapies where tumors initially grow but then later respond. This is thought to be secondary to immune infiltrate increasing the size of the tumor. It is a challenge to determine the difference between pseudo progression versus real progression.
Biopsy in which a cookie cutter-like instrument is used to cut out a core of tissue.
Regional Perfusion Therapy
Therapy in which a whole limb is infused with cancer-killing drugs. The drugs are introduced into the artery supplying the limb and are taken out through the vein. The technique may be used for melanoma when there are multiple skin metastases that are apparently confined to the arm or leg that was the site of the primary tumor.
Radial Growth Phase (RGP)
Earliest step in the development of melanoma, in which the disease is confined to the epidermis or barely penetrates the dermis. No cluster of melanoma cells forms and no metastases result.
Benign skin lesion associated with aging and sun exposure; not precancerous.
Biopsy done by shaving off a piece of skin with a sterile razor blade.
Squamous Cell Cancer (SCC)
One of the two common kinds of non-melanoma skin cancer, a malignancy that seldom metastasizes and is made up of keratinocytes in the epidermis.
Sentinel Node Biopsy (SNB or SLNB)
Injecting a small amount of radioactive dye into the area of the primary melanoma to scan for melanoma cells in the sentinel nodes.
Subcutis, Subcutaneous Tissue
Layer of fat located under the dermis.
Stage (of cancer)
Measure of the extent of a malignancy, arrived at by examining features of the primary tumor and searching for evidence of metastasis.
Commercial name for a BRAF drug, dabrafenib.
Newer therapies based on knowing how cancer cells function. These therapies work to stop cancer cells from growing and/or make other therapies work better. some may work by preventing the growth of new blood vessels needed to nourish the cancer. Others work to block the action of molecules on the surface of cancer cells.
Having the capacity to produce spherical collections of cancer cells.
UV-A and UV-B Rays
Different wavelengths of ultraviolet light. Both are implicated in skin cancer, skin aging, and sunburn.
Commercial name for the BRAF therapy, PLX4032
Vertical Growth Phase
Step in the development of melanoma in which the disease shows evidence of growth as a lump in the dermis (see tumorigenic, above). This phase of melanoma may metastasize.
Commercial name for Ipilimumbab (IPI) or anti-CTLA 4 (See Anti-CTLA 4)
Vaccines are medicines that boost the immune system’s natural ability to protect the body against “foreign invaders,” mainly infectious agents, that may cause disease. So far there has not been a successful melanoma vaccine.
Wide Local Excision (WLE)
Re-excision of the primary site after the biopsy results have been interpreted.
Source: Melanoma: Not Just Skin Cancer, by Catherine M. Poole; Contributing editors: Keith Flaherty, MD, DuPont Guerry, MD and Jedd Wolchok, MD, 2015.
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UPDATED: November 23, 2016