Johns Hopkins Barrett's Esophagus and Esophageal Cancer Web: Definition of Barrett's Esophagus

Glossary of Terms
A-C| D-E| F-H| I-L| M-O| P-S| T-Z

A - C
Abdomen	The portion of the body between the diaphragm and the pelvis.
Abscess	A pus-filled cavity.
Adenocarcinoma	The form of cancer that most people are talking about when they refer to "cancer of the bile ducts." Microscopically, adenocarcinomas form glands. These tumors can grow large enough to invade nerves which can cause back pain. They also frequently spread (metastasize) to the liver or lymph nodes. If this happens the tumor may be considered unresectable.
Adenoma	A benign (non-cancerous) tumor made up of cells that form glands (collections of cells surrounding an empty space.)
Adjuvant chemotherapy	Chemotherapy given to patients after their cancers have been surgically removed. It is a secondary treatment given to supplement surgical treatment. (see Neoadjuvant chemotherapy)
Anastamosis	A surgical joining of two hollow structures. It is similar to attaching two ends of a garden hose. For example, a gastrojejunostomy is a surgical procedure that connects the stomach and the jejunum (small intestine.)
Anemia	A condition characterized by a deficiency in red blood cells. This can lead to fatigue among other symptoms.
Anorexia	A condition marked by a diminished apetite and aversion to food. Often results in physical signs of wasting.
Angiography	A radiographic technique used to visualize blood vessels. A contrast medium (a dye) is usually injected into the vessels to make them appear white on the x-rays.
Ascites	The collection of excess amounts of fluid in the abdominal cavity (belly). It often is a sign that the cancer has spread to either the liver or the portal vein that goes to the liver. If normal liver function is affected, a complex set of biochemical checks and balances is disrupted and abnormal amounts of fluid are retained.
Barrett's Esophagus	A condition in which the normal lining of the esophagus is replaced by a type of lining normally found in the intestines (this is called intestinal metaplasia). This is believed to be a sequel to chronic reflux (regurgitation) of stomach contents into the esophagus.
Benign tumors	Tumors which are non-cancerous. These generally grow slowly and do not invade adjacent organs or spread (metastasize) beyond the bile ducts or gallbladdder.
Cancer	A malignant tumor. It has the potential of invading into the adjacent tissues, spreading to other organs and may eventually lead to the patient's death.
Carcinogen	A cancer-causing agent.
Carcinoma	A malignant (cancerous) new growth. These tumors infiltrate into surrounding tissues and, if untreated, will spread to other organs, and may eventually lead to the patient's death.
Catheter	A small, flexible tube inserted into the body to inject or suck out fluids.
Chemotherapy	The treatment of a cancer by chemicals. For bile duct and gallbladder cancers these include: 5-flurouracil, leukovorin, mitomicin C, and others.
Computed Tomography (CT) Scan	A series of x-ray pictures taken by a machine that encircles the body like a giant tube. Computers are then used to generate cross-sectional images of the inside of the body.
Contrast agent (or medium)	A dye, taken by mouth or injected, that is sometimes used during x-ray examinations to highlight areas that otherwise might not be seen.
Cyst	A fluid filled sac. Some tumors of the biliary tree, including mucinous cystadenocarcinomas are cystic. These have a distinct appearance in CT scans. They are important to recognize because the treatment of cystic tumors can differ from that for solid tumors.
D - E
Diaphragm	A dome shaped muscle that separates the lungs and heart from the abdomen. This muscle assists in breathing.
DNA (deoxyribonucleic acid)	The part of every cell that carries all genetic information.
Dysplasia	A precancerous condition in which cells which are very similar to cancer cells grow in an organ but have not yet acquired the ability to invade into tissue or metastasize (spread to areas distant from where they started). This is a stage which can be cured.
-ectomy	Surgical removal of a structure or part of a structure. For example, pancreatectomy is the surgical removal of the pancreas (or a portion of it), and esophagectomy is removal of the esophagus.
Endoscopy	A procedure whereby a flexible fiber-optic tube is inserted into the esophagus, stomach or small intestine through the mouth (upper endoscopy) or into the large intestine through the anus (lower endoscopy) to look for abnormalities.
Esophagus	The hollow tube leading from the mouth to the stomach.
F - H
Gastric	Referring to the stomach.
Gastroenterologist	A physician who specializes in digestive diseases, that is, diseases of the gastrointestinal tract. The gastrointestinal tract includes the esophagus, stomach, intestines, and anus. Some gastroenterologists also have expertise in diseases of the liver, gallbladder, and pancreas since these organs are also involved in digestion.
I - L
In situ	A term used to indicate that cancerous cells are present in the lining of an organ but have not spread to the "meat" of the tissue.
Laparoscopy	A technique that surgeons can use to visualize and even biopsy (take tissue samples of) organs inside of the abdomen without making large incisions. Very small incisions are made in the belly and small tubes (called trocars) are then inserted. Gas is pumped in through one of the tubes to create enough space to work in. The surgeon inserts a small camera through one of the tubes and examines the lining and contents of the abdominal cavity by looking at the projected image on the television screen. With specially designed laparascopic instruments, biopsies and fluid samples can be taken for examination. Some surgeons feel that this technique can help "stage" a patient less invasively than with open surgery.
Liver	The largest organ in the body, located in the right upper part of the abdomen. It performs many life-maintaining functions including the production of bile. It detoxifies the blood of drugs, alcohol and other harmful chemical. It processes nutrients absorbed by the intestine and stores essential nutrients, vitamins and minerals. Bilirubin is a chemical produced when old or damaged blood cells breakdown. The liver chemically process the bilirubin so that it can dissolve in water and be excreted through the bile. When this process is disrupted, jaundice can develop.
Loco-regional cancer	A primary cancer that has spread to regional lymph nodes and/or resectable (removable) tissues. Removable tissues include some lymph nodes that are routinely removed in some surgical treatments for cancer.
Lymph nodes	Normal, round, raisin to grape-sized collections of lymphocytes (white blood cells) found throughout the body. Lymph nodes are connected to each other by lymphatic vessels. They normally help fight infection, but also are one of the first sites to which cancers spread. In general, the spread of cancer to lymph nodes portends a worse prognosis for the patient. There are exceptions to this.
M - O
Magnetic Resonance Imaging (MRI)	A painless method for taking pictures of internal organs. A tube-like machine with a powerful magnet generates images of the inside of the body.
Malignant tumor	A cancer that has the potential of invading nearby tissues, spreading to other organs (metastasizing) and possibly leading to the patient's death.
Metaplasia	The replacement of the lining of an organ with the type of lining normally found in another site. For example, in lung bronchi, the normal cell type found is "ciliated columnar epithelium". In smokers, this lining is replaced by a cell type normally found in the mouth (squamous epithelium), and is called "squamous metaplasia". In the esophagus, the normal lining is squamous epithelium, but in patients with reflux (regurgitation of stomach contents into the esophagus), the esophagus lining may be replaced with a cell type normally found in the intestines (intestinal metaplasia). Patients with intestinal metaplasia of the esophagus (Barrett's esophagus) are at an increased risk of developing cancer of the esophagus.
Metastatic cancer	A cancer that has spread from one organ to another. In general, cancers that have metastasized are generally not treated surgically, but instead are treated with chemotherapy and/or radiation therapy.
Mutation	An alteration in the DNA of a cell.
Neoadjuvant chemo and radiation therapy	Chemotherapy and radiation therapy given to patients before surgery. Some centers feel that the use of neoadjuvant therapy improves local and regional control of disease and that it may make more patients surgical candidates.
Neoplasm	An abnormal new growth of tissue that grows more rapidly than normal cells and will continue to grow if not treated. These growths will compete with normal cells for nutrients. This is a general term that can refer to benign or malignant growths. It is almost a synonym for the word tumor, which means a mass or growth.
Oncologist	A medical doctor who specializes in the treatment of tumors.
-ostomy	A surgically created opening in an organ that can also be referred to as an anastamosis.
P - S
Palliative	Any treatment that reduces the severity of a disease or its symptoms.
Pathologist	A medical doctor specially trained to study disease processes.
Primary cancer	A cancer found in the organ it started in. A primary cancer of the esophagus is one that started in the esophagus as opposed to a cancer that started somewhere else and only later spread to the esophagus.
Prognosis	A forecast for the probable outcome of a disease based on the experience of large numbers of other patients with similar stage disease. Importantly, making a prognosis is not an exact science. Some patients with poor prognosis beat the odds and live longer than anyone would have predicted. Steve Dunn's Cancer Guide has an excellent article on statistics and prognoses and stories of other cancer patients.
Proton Pump Inhibitors	A class of powerful drugs which markedly reduce the ability of the stomach to produce acid. For patients with reflux (regurgitation, heartburn), these drugs can be extremely effective in reducing unpleasant symptoms, but these drugs do not reduce the possibility of developing cancer.
Pylorus	A thick ring of muscle (a sphincter) between the stomach and duodenum. This sphincter helps control the release of the stomach contents into the small intestine.
Radiation Therapy	The use of high-energy waves similar to x-rays to treat a cancer. Radiation therapy is usually used to treat a local area of disease and often is given in combination with chemotherapy.
Reflux	This term usually refers to the regurgitation of stomach contents into the esophagus. This causes heartburn and can even cause a laryngitis-like sensation. Patients with esophageal reflux are at increased risk of developing esophageal cancer.
Resectable	Able to be removed surgically.
Sarcoma	A malignant tumor that mimics connective tissues (bone, cartilage, muscle) under the microscope.
Sepsis	An infection of the blood.
Small intestine	A long (20 foot) tube that stretches from the stomach to the large intestine. It helps absorb nutrients from food as the food is transported to the large intestine. There are three sections: the duodenum, the jejunum and the ileum. Due to its proximity to the pancreas, the duodenum is the section most often affected by pancreatic and distal common bile duct cancers.
Spleen	A maroon, rounded organ in the upper left part of the abdomen, near the tail of the pancreas. This organ is part of your immune system and filters the lymph and blood in your body.
Squamous cell	A flat, scale-like cell.
Stage	A classification system used to describe the extent of disease. For esophagus cancer: Stage I tumors The tumor has spread only into loose tissue beneath the lining (submucosa) but not into the esophagus muscular wall or beyond. No lymph nodes are involved. Stage II tumors Tumor has invaded into the muscle wall but has not spread to lymph nodes (IIA) OR the tumor is small (as in stage I) but has spread to lymph nodes. Stage III tumors The tumor has invaded into or through the muscular wall of the esophagus and also involves lymph nodes. Stage IV tumors The tumor can be any size (is usually large) and has spread to distant sites. In general, the lower the stage, the better the prognosis.
Stent	A slender hollow tube inserted into the body to relieve a blockage. For example, bile duct cancers often narrow the bile duct. This can block the flow of bile and cause the patient to become jaundiced. In these cases the flow of bile can be reestablished by placing a stent into the bile duct, through the area of blockage.
T - Z
Thoracic Surgeon	Surgeon specializing in diseases of the thorax (the chest). These include diseases of the lungs, heart, the tissues around the heart, and the esophagus.
Thoracotomy	A surgical incision of the chest.
Thorax	The chest; the contents of the body above the diaphragm (a muscle flap above the abdomen). The thorax contains the heart, lungs, esophagus, and a variety of associated tissues.
Thrombophlebitis	An inflammation of the veins accompanied by thrombus formation. It is sometimes referred to as Trousseau's sign.
Thrombus	A clot within the cardiovascular system. It may occlude (block) the vessel or may be attached to the wall of the vessel without blocking the blood flow.
Tumor	This term simply refers to a mass or neoplasm. For example, a collection of pus is a tumor. This is a general term that can refer to benign or malignant growths.
Ultrasound	A painless procedure in which high frequency sound waves are used to generate pictures of the inside of the body.
Unresectable	Unable to be surgically removed.
Vaccine therapy	This is a new type of treatment, largely still experimental. It is a medication made of killed or weakened cells, organisms or manufactured materials, which is used to boost the body's immune system. Ideally, this will allow the body to fight and kill the cancer cells more effectively. Vaccines include whole killed cancer cells or specific proteins from the cancer.
Reference: The Johns Hopkins Family Health Book; Michael J. Klag Editor, Harper Collins Pub., 1999.

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