AOCNP key terms

The multistep process by which normal cells accumulate genetic and epigenetic changes that permit uncontrolled growth, survival, and eventual invasion. It usually progresses from initiation through promotion to malignant transformation.

A gene that, when mutated, amplified, or overexpressed, pushes cells to divide when they should not. It arises from a normal proto-oncogene and acts dominantly, so one altered copy can contribute to cancer.

A gene whose normal product restrains cell division, repairs damaged DNA, or triggers death of injured cells. Cancer typically requires loss of function in both copies, removing an important brake on growth.

Surveillance points, chiefly at the G1-to-S and G2-to-M transitions, where a cell verifies DNA integrity and chromosome alignment before dividing. Loss of these controls lets damaged DNA be copied and passed on.

Formation of new blood vessels from existing ones. Tumors stimulate this process to obtain oxygen and nutrients and to create routes for cells to enter the bloodstream and spread.

Programmed cell death, an orderly self-destruction that removes damaged or unneeded cells. Many cancers evade it by altering pro- and anti-apoptotic proteins, so injured cells survive and accumulate further mutations.

Spread of malignant cells from the primary tumor through blood or lymphatic channels to distant organs, where secondary tumors develop. It is the leading cause of death from solid tumors.

A standardized description of how far cancer has spread, based on tumor size, regional lymph node involvement, and distant spread. Stage guides prognosis, treatment selection, and trial eligibility.

Microscopic assessment of how closely tumor cells resemble the normal tissue they came from, ranging from well to poorly differentiated. Higher grade generally indicates faster growth and more aggressive behavior.

Removal of a tissue sample for examination under the microscope and for molecular testing. It is the definitive way to confirm cancer, establish histology and grade, and guide treatment selection.

Testing people who have no symptoms to find cancer or precancerous changes at an earlier, more curable stage. It is worthwhile only when the test is accurate and early treatment improves outcomes.

Proteins, hormones, or other substances measured in blood or tissue that may be elevated in certain cancers. They are used mainly to track response and detect recurrence rather than to establish a diagnosis.

An inherited DNA alteration present in nearly every cell of the body and potentially passed to children. Variants such as BRCA1 or BRCA2 mutations raise cancer risk and can influence treatment decisions.

A behavior, exposure, or characteristic linked to a higher likelihood of developing cancer, such as tobacco use, ionizing radiation, obesity, or older age. Some are modifiable and become targets for prevention.

Treatment given before the main local treatment, usually to shrink a tumor so surgery or radiation is more effective or feasible. It also provides an early indication of how sensitive the cancer is.

Treatment given after the primary tumor has been removed when no measurable disease remains. Its purpose is to eliminate microscopic residual cancer and reduce the chance of recurrence.

Cytotoxic drugs that preferentially kill rapidly dividing cells. They are usually given as multi-drug regimens over repeated cycles and act throughout the body, so normal dividing tissues are also injured.

Agents designed to block a specific molecule or pathway that a cancer depends on, such as a mutant kinase or overexpressed receptor. Benefit often requires the tumor to carry the matching biomarker.

Treatment that activates or redirects the immune system to attack cancer. Checkpoint inhibitors that block PD-1, PD-L1, or CTLA-4 are common examples and can produce long-lasting responses in some patients.

A patient's T cells are collected, genetically engineered to carry a receptor that recognizes a tumor antigen, and reinfused after lymphodepleting chemotherapy. It can cause cytokine release syndrome and neurologic toxicity.

Infusion of blood-forming stem cells to restore marrow function after high-dose chemotherapy or radiation. Autologous transplants use the patient's own cells; allogeneic transplants come from a donor and carry graft-versus-host risk.

Use of ionizing radiation to damage DNA and kill cancer cells within a defined volume of tissue. It is delivered by external beams or implanted sources and is often combined with systemic treatment.

Treatment that lowers hormone levels or blocks hormone receptors in cancers that grow in response to hormones, such as many breast and prostate cancers. Examples include tamoxifen, aromatase inhibitors, and androgen deprivation.

A measurable biological feature, such as a gene mutation, protein level, or gene amplification, that informs diagnosis, prognosis, or the likelihood of responding to a specific drug.

Fever occurring with a severely low neutrophil count. It is an oncologic emergency requiring immediate blood cultures and empiric broad-spectrum antibiotics, because infection can progress rapidly to sepsis.

Suppression of bone marrow activity that lowers red cells, white cells, and platelets after chemotherapy or radiation. Counts usually reach their lowest point seven to fourteen days after treatment, raising infection and bleeding risk.

Leakage of a drug, particularly a vesicant, out of the vein into surrounding tissue. It can cause blistering and tissue death, so the infusion is stopped immediately and site-specific measures are started.

Autoimmune toxicities caused by checkpoint inhibitors, commonly affecting skin, colon, liver, lungs, and endocrine glands. They may appear weeks after treatment and are managed with corticosteroids and drug interruption.

A systemic inflammatory reaction after CAR T-cell therapy or bispecific antibodies, marked by fever, hypotension, hypoxia, and organ dysfunction. Severity is graded, and treatment includes supportive care and tocilizumab.

Painful inflammation and ulceration of the mouth or gastrointestinal lining caused by chemotherapy or radiation. It can interfere with eating and speaking and creates a portal for infection.

Nerve damage from drugs such as platinum agents, taxanes, and vinca alkaloids, producing numbness, tingling, burning, or weakness in the hands and feet. It is often dose-limiting and may persist after treatment stops.

Compression of the spinal cord or cauda equina by tumor, causing back pain, weakness, sensory change, or bowel and bladder dysfunction. Urgent corticosteroids and imaging are needed to preserve neurologic function.

Interdisciplinary care that relieves symptoms and addresses physical, emotional, social, and spiritual needs at any stage of serious illness. It is delivered alongside disease-directed treatment, not only near the end of life.

Comfort-focused care for people with a life expectancy of about six months or less who have stopped disease-directed treatment. It emphasizes symptom control, family support, and quality of life.

The shared understanding among patient, family, and clinicians about which outcomes matter most and which treatments fit those priorities. These discussions guide decisions about further therapy versus comfort-focused care.

Ongoing conversation and documentation of a person's wishes for future medical care, including a chosen health care proxy and written directives. It helps ensure decisions reflect the patient's values if they lose capacity.

A standardized rating, such as the ECOG or Karnofsky score, of how independently a patient manages daily activities. It predicts tolerance of treatment and heavily influences whether intensive therapy is offered.

A written summary given to a cancer survivor and their clinicians that lists treatments received, recommended surveillance, and possible late effects. It supports handoff and coordination between oncology and primary care.

Health problems caused by cancer treatment that emerge months to years after therapy, such as heart damage from anthracyclines, infertility, neuropathy, or second cancers. Surveillance depends on the specific treatments received.

Routine use of a brief validated questionnaire to detect emotional, practical, and physical concerns in people with cancer. Positive screens trigger referral to social work, psychology, or other supportive services.