Glossary of Terms
Glossary of Terms
A B C D E F G H I L M N O P R S T U V W
Abnormal Not normal. Deviating from the usual structure, position, condition, or behavior. In referring to a growth, abnormal may mean that it is cancerous or premalignant (likely to become cancer).
Acral Lentiginous A kind of lentiginous skin melanoma It is also known as subungual melanoma. Acral lentiginous melanoma is observed on the palms, soles and under the nail. It occurs on non hair-bearing surfaces of the body which may or may not be exposed to sunlight. It is also found on mucous membranes. Unlike other forms of melanoma, acral lentiginous melanoma does not appear to be linked to sun exposure.
Adjuvant Therapy Treatment offered in addition to the surgical removal of melanoma (for instance). Generally, it 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.
Anesthetic A substance that causes lack of feeling or awareness. A local anesthetic causes loss of feeling in a part of the body. A general anesthetic puts the person to sleep.
Atypical: Not typical, not usual, not normal, abnormal. Atypical is often used to refer to the appearance of precancerous or cancerous cells.
Asymmetry: Asymmetry of a skin spot; one half does not match the other.
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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, the outer layer of the skin.
Benign: Not cancer. Not malignant. A benign tumor does not invade surrounding tissue or spread to other parts of the body. A benign tumor may grow but it stays put (in the same place).
Biological response modifiers (BRMs): Substances that stimulate the body’s response to infection and disease. The body naturally produces small amounts of these substances. Scientists can produce some of them in the laboratory in large amounts for use in treating cancer, rheumatoid arthritis, and other diseases.
Biological therapy (Biotherapy): Treatment to stimulate or restore the ability of the immune (defense) system to fight infection and disease. Biological therapy is thus any form of treatment that uses the body’s natural abilities that constitute the immune system to fight infection and disease or to protect the body from some of the side effects of treatment.
Biopsy: The removal of a sample of tissue for purposes of diagnosis. (Many definitions of “biopsy” stipulate that the sample of tissue is removed for examination under a microscope. This may or may not be the case. The diagnosis may be achieved by other means such as by analysis of chromosomes or genes.)
Blood Vessel/Lymphatic Invasion: Blood vessel invasion, (aka angioinvasion) as well as lymphatic invasion are described as being present or absent. If present it means that the melanoma has invaded the blood or lymph system respectively.
Breslow Thickness: Depth a melanoma lesion extends below the skin surface measured in millimeters.
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Carcinogen: Chemical, physical, or biological agent that causes cancer.
Carcinoma: is a tumour which arises from epithelial tissue. These are tissues that form the coverings and linings of much of the body such as the skin or the intestine. Therefore a cancer of the skin, the bowel, the lung or the bladder which arises from the covering or lining cells could also be called a carcinoma.
CAT or CT Scan: X-ray procedure in which a computer produces detailed pictures of areas inside the body.
Cell: The individual unit that makes up all of the tissues of the body.
Cellular Description (the type of melanoma):
- Superficial Spreading Melanoma
- Nodular Melanoma
- Acral Lentiginous
- Lentigo Melanoma
- Other: mucosal melanoma
Chemotherapy: means treatment with chemical substances. These are chemicals which act directly on the cancer cell causing damage which may lead to the death of the cell and disappearance of the tumour. Unfortunately, not all cancer cells are sensitive to chemotherapy and the drug may be only of limited benefit for some people.
Regional Chemotherapy: is a form of treatment in which anti-cancer drugs are infused or perfused into a localised region of the body. This can achieve greater effectiveness whilst at the same time minimising general side effects.
Clark’s Level: Depth a melanoma lesion extends below the skin surface based on involved skin layer (the larger the level number the deeper into the tissue it extends)
- Clark’s Level I—lesion involves the dermis
- Clark’s Level II—lesion involves the papillary dermis
- Clark’s Level III—lesion invades and fills the papillary dermis
- Clark’s Level IV—lesion invades reticular dermis
- Clark’s Level V—lesion invades sub-cutaneous tissue
(Depending upon where the melanoma is located on the body, the millimeters of depth for each Clark level can vary widely, so one person’s Clark’s III may be 1 mm, while another person’s is 2 mm.)
Clinical Trial: A type of research study that tests how well new medical treatments or other interventions work in people. May also be called a clinical study.
Cluster: In epidemiology, an aggregation of cases of a disease or another health-related condition, such as a cancer or birth defect, closely grouped in time and place. The number of cases in the cluster may or may not exceed the expected number. This is determined by cluster analysis, a set of statistical methods used to analyze clusters.
Congenital Nevi: Moles that are present at birth, sometimes called birthmarks.
Cutaneous: Pertaining to the skin.
Cytokines: A class of substances that are produced by cells of the immune system and can affect the immune response. Cytokines can also be produced in the lab by recombinant DNA technology and given to people to affect immune responses.
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Dermatologist: A doctor who specializes in the diagnosis and treatment of skin problems.
Dermatopathologist: Physician who has special training in diagnosing disease on the basis of microscopic examination of the skin.
Dermis: The lower or inner layer of the two main layers of tissue that make up the skin. The layer of skin directly beneath the epidermis.
Diagnosis: The determination of the nature of a case of a disease or the distinguishing of one disease from another.
Disease: Illness or sickness often characterized by typical patient problems (symptoms) and physical findings (signs).
Dysplastic nevi: Atypical moles whose appearance is different from that of a common ordinary mole. Dysplastic nevi tend to be larger than ordinary moles, have more irregular borders, are often mixed in color and present in large numbers. A dysplastic nevus can give rise to malignant melanoma.
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Epidermis: The outermost layer of skin. The upper or outer layer of the two main layers of cells that make up the skin . The epidermis is mostly made up of flat, scale-like cells called squamous cells . Under the squamous cells are round cells called basal cells. The deepest part of the epidermis also contains melanocytes. These cells produce melanin, which gives the skin its color.
Excise: To cut out. A laser beam may be used to excise a tumor, much as a scalpel does. The terms excise and resect are not synonymous. Excise implies total removal whereas resect does not.
Excisional Biopsy: Technique in which a lesion is removed from the skin by cutting out the affected area as well as a portion of normal skin surrounding the lesion. This technique is also used to remove larger lesions.
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Fatigue: A condition characterized by a lessened capacity for work and reduced efficiency of accomplishment, usually accompanied by a feeling of weariness and tiredness. Fatigue can be acute and come on suddenly or chronic and persist.
Fever: Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C).
Fine Needle Aspirate (FNA): Technique in which a needle is inserted into the tissue or tumor to aspirate (take out) fluid and cells. This tissue/fluid is smeared onto a slide and is then looked at under a microscope. FNA can be performed in the office or under radiology guidance.
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Graft: Healthy skin, bone, or other tissue taken from one part of the body to replace diseased or injured tissue removed from another part of the body.
Gray: A unit of absorbed radiation equal to the dose of one joule of energy absorbed per kilogram of matter, or 100 rad . The unit is named for the British physician L. Harold Gray (1905-1965), an authority on the use of radiation in the treatment of cancer. The abbreviation for a gray is Gy.
Growth: in the sense of “a growth”, implies a localised mass of tissue and means the same as tumour. A growth is not a technical term.
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Health: As officially defined by the World Health Organization, a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.
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Immune system: A complex system that is responsible for distinguishing us from everything foreign to us, and for protecting us against infections and foreign substances. The immune system works to seek and kill invaders.
Immunotherapy: Treatment to stimulate or restore the ability of the immune (defense) system to fight infection and disease. Biological therapy is thus any form of treatment that uses the body’s natural abilities that constitute the immune system to fight infection and disease or to protect the body from some of the side effects of treatment.
In Situ: In its normal place; confined to the site of origin.
Incisional Biopsy: Technique in which a lesion is removed from the skin by cutting out the affected area. This technique is often used to remove larger lesions.
Infection: The growth of a parasitic organism within the body. (A parasitic organism is one that lives on or in another organism and draws its nourishment therefrom.) A person with an infection has another organism (a “germ”) growing within him, drawing its nourishment from the person.
Invasive: Having the quality of invasiveness. Involving puncture of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques.
Interferon (INF): A naturally occurring substance that interferes with the ability of viruses to reproduce. Interferon also boosts the immune system A type of protein produced by the immune system. Artifically made treatment is called Intron-A.
Interleukin-2: A type of interleukin, a chemical messenger, a substance that can improve the body’s response to disease. It stimulates the growth of certain disease-fighting blood cells in the immune system . A type of protein molecule produced by lymphocytes that activates other lymphocytes in the immune system.
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Lentigo Melanoma: A melanoma that has evolved from a lentigo malignant. They are usually found on chronically sun damaged skin such as the face and the forearms of the elderly. The nomenclature is very confusing to both patients and physicians alike.
Lesion: is an alteration, structural or functional, due to injury. In common usage it usually means some mark or swelling that is considered abnormal. Thus a melanoma, a nevus, a secondary deposit or a metastasis could all be referred to as “a lesion”. It is a non-specific term.
Local therapy: Treatment that affects only a tumor and the area close to it.
Lymph: Almost all the cells in the body have around them a thin film of clear fluid called lymph. This is the fluid through which nourishment and oxygen can soak from the smallest blood vessels (capillaries). This fluid is collected into very thin tubes called lymphatics and these tubes join together and pass into lymph nodes, often referred to as lymph glands, which function as part of the defence system of the body by acting as filters. It is a matter of common experience to have sustained an infection, say a sore throat, and to subsequently feel a tender swelling in the neck. The swelling is a lymph node which has become enlarged because it has filtered bacteria damaged cells from the lymph fluid which passes through it. The same thing can happen with some cancers when they spread. The cells enter the lymphatics and are filtered out by the lymph node where they may grow and from here may spread elsewhere. The removal of lymph nodes for any cancer does not appear to affect the immune system of the patient. This is presumably because the number of nodes removed (up to 20 – 30) is a very small number compared to the total number in the body.
Lymph Node: Any of the small, oval or round bodies, located along the lymphatic vessels, that supply lymphocytes to the bloodstream and remove bacteria and foreign particles from the lymph. Also called lymph gland, lymphoglandula, lymphonodus.
Lymphatic system: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. The channels that carry lymph are also part of this system.
Lymphedema: A common chronic, debilitating condition in which excess fluid called lymph collects in tissues and causes swelling (edema) in them.
Lymphocyte: Type of white blood cell that plays an important part in immune reactions.
Lymphoscintigraphy: 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.”
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Malignant: When applied to tumours means that the tumour has the ability to spread to other parts of the body and so threaten the patient’s life. However, the term does not imply that the tumour has, or will, spread, merely that it is capable of spreading. Some tumours classed as malignant, e.g. basal cell cancer of the skin, only very rarely spread to other parts of the body, so this event is not usually considered when planning treatment. Other malignant tumours may spread more frequently.
Margin: The edge or border of the tissue removed in cancer surgery. The margin is “negative” or clean when the pathologist finds no cancer cells at the edge of the tissue, suggesting that all of the cancer has been removed. The margin is “positive” or involved when the pathologist finds cancer cells at edge of the tissue, suggesting that all of the cancer has not been removed.
Medical history: In clinical medicine, the patient’s past and present which may contain clues bearing on their health past, present, and future. The medical history, as an account of all medical events and problems a person has experienced, including psychiatric illness, is especially helpful when a differential diagnosis is needed.
Medical Oncologist: A doctor who specializes in diagnosing and treating cancer using chemotherapy, hormonal therapy, biological therapy, and targeted therapy. A medical oncologist often is the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists.
Melanin: A skin pigment (substance that gives the skin its color). Dark-skinned people have more melanin than light-skinned people. Melanin also acts as a sunscreen and protects the skin from ultraviolet light.
Melanocytes: 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.
Melanoma: The most dangerous form of skin cancer; a malignancy of the melanocyte, the cell that produces pigment in the skin. Melanoma is most common in people with fair skin, but can occur in people with all skin colors. Most melanomas present as a dark, mole-like spot that spreads and, unlike a mole, has an irregular border. The tendency toward melanoma may be inherited, and the risk increases with overexposure to the sun and sunburn.
Metastasis (Metastic): Means that the disease has transferred itself from the site of origin to another place. For example, if a cancer arises in the skin and a mass of cells spreads to the lymph nodes or to the lung, these deposits of tumour are known as metastases.
Mitotic Rate: This term describes the frequency of division within the melanoma. Higher mitotic rates are associated with more rapidly dividing cells, and therefore larger lesions with greater potential for metastasis.
Mole: A benign growth on the skin (usually tan, brown, or flesh-colored) that contains a cluster of melanocytes and surrounding supportive tissue. When applied to the skin, is the common expression derived from Old English for a mark or blemish on the skin. It often implies a mark life a nevus.
Mucosal Melanoma: Develops in the mucous membrane that lines the nose, mouth, esophagus, anus, urinary tract and vagina. Mucosal melanomas are especially difficult to detect because they can easily be mistaken for other, far more common conditions.
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Naevus: (a word of debatable origin derives from the latin word for birth or the greek word for nest). Technically, naevus implies a skin blemish made up of pigment cells (melanocytes), the cells responsible for suntanning. Different kinds of naevi are given different names which indicate something of their structure, e.g. a junctional naevus means that the naevus cells are collected at the junction of the surface layer (the epidermis) and the deeper layer of the skin (the dermis). A compound naevus is one where the cells are both at the junction and in the dermis and a dermal naevus infers that the naevus cells are all in the dermis.
Neoplasm: is sometimes replaced by “new growth”. The meaning of all these is roughly the same as the implied meaning of “growth” or “tumour”.
Nevus: A benign growth on the skin, such as a mole.
Nodular Melanoma: Is the most aggressive form of melanoma. It grows in vertical direction from the outset and grows very fast (months). Nodular melanoma has no known precursor. It is a small black, or if amelanotic, pink nodule that simply enlarges. The lesions tend to bleed.
No Evidence of Disease (NED): No measureable evidence of disease (cancer) in your body.
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Oncology: Denotes the study of tumours (cancers). An oncologist is a doctor who studies and treats patients who have cancers. A medical oncologist bases his treatments on chemotherapy and other non surgical methods. A surgical oncologist undertakes surgery as an important part of his management of a patient. Patients with very advanced melanoma may be managed by both surgical and medical oncologists.
Oncology Nurse: A nurse who specializes in treating and caring for people who have cancer.
Oncology Social Worker, Counselor, or Patient Navigator: A person with a master’s degree in social work who works with cancer patients. The oncology social worker/counselor provides counseling and assistance. Patient Navigators are health care professionals whose primary focus is to assist cancer patients, caregivers, and families in “bridging the gaps” within the health care system and decreasing barriers to care by utilizing resources.
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Pathologist: A specialist in pathology; one who interprets and diagnoses the changes caused by disease in tissues and body fluids.
Pathology: Science of diagnosing disease by such methods as microscopic analysis of tissue.
Perfusion: A chemotherapy technique that may be used when melanoma occurs on an arm or leg. The flow of blood to and from the limb is stopped for a while with a tourniquet, and anticancer drugs are put directly into the blood of the limb. This allows the patient to receive a high dose of drugs in the area where the melanoma occurred.
PET Scan (Positron emission tomography): Using radioactive tracer attached to a sugar that is injected into the patient to find areas of tumor activity.
Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair.
Pigmented Lesion: Skin spot that has color—brown, black, red, pink or blue.
Plastic Surgeon: A surgeon who specializes in reducing scarring or disfigurement that may occur as a result of accidents, birth defects, or treatment for diseases.
Primary Tumor or Site: Initial tumor or the body site where it forms.
Prognosis: The expected course of a disease. The patient’s chance of recover. The prognosis predicts the outcome of a disease and therefore the future for the patient.
Punch Biopsy: Technique in which a lesion is removed from the skin using a cookie cutter type device. This is used to remove small lesions or to sample a portion of a larger lesion.
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Radial Growth Phase (RGP): The melanoma lesion is described as either having RGP present or absent. If present, RGP indicates that the melanoma is growing horizontally or radially, within a single plane of skin layer. 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 form and no metastases result.
Radiation therapy: The use of high-energy rays to damage cancer cells, stopping them from growing and dividing. Like surgery, radiation therapy is a local treatment that affects cancer cells only in the treated area.
Radiotherapy: Treatment of disease by means of ionizing radiation; tissue may be exposed to a beam of radiation, or a radioactive element may be contained in devices (e.g., needles or wire) and inserted directly into the tissues, or it may be introduced into a natural body cavity.
Recurrence: The return of a sign, symptom or disease after a remission. The reappearance of cancer cells at the same site or in another location is, unfortunately, a familiar form of recurrence.
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.
Regression: Regression is described as either being present or absent. If it is present the extent of regression is identified. Regression describes an area within the melanoma where there is absence of melanocytic growth. When regression is present the total size of the melanoma is hard to characterize.
Remission: Disappearance of the signs and symptoms of cancer or other disease. When this happens, the disease is said to be “in remission.” A remission can be temporary or permanent.
Risk factor: Something that increases a person’s chances of developing a disease.
Risk of recurrence: In medical genetics, the chance that a genetic (inherited) disease present in a family will recur in that family. The concept in general medicine means the chance that an illness we come back again.
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Seborrheic Keratosis: Benign skin lesion associated with aging and sun exposure; not precancerous.
Secondary Deposit: means the same thing as metastasis, i.e. the disease has spread from its site of origin. This does not necessarily mean that the disease is incurable.
Sentinel Lymph Node: The first lymph node to which cancer is likely to spread from the primary tumor.
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. Removal and examination of the first lympth node(s) to which cancer cells are likely to spread from a primary tumor.
Shave Biopsy: Technique in which a portion of a lesion is cut off the surface of the skin using a scalpel in most cases. This is often performed by a dermatologist in the office.
Side effects: Problems that occur when treatment goes beyond the desired effect. Or problems that occur in addition to the desired therapeutic effect.
Skin: The skin is the body’s outer covering. It protects us against heat and light, injury, and infection. It regulates body temperature and stores water, fat, and vitamin D. Weighing about 6 pounds, the skin is the body’s largest organ. It is made up of two main layers; the outer epidermis and the inner dermis.
Skin graft: Skin that is used to cover an area where the patient’s skin has been lost due to a burn, injury, or surgery. The most effective skin grafts involve moving the patient’s own skin from one part of the body to another. The second most effective type are skin grafts between identical twins. Beyond these two procedures, there is a strong chance that the body will reject the new skin, although the graft may give the body time to grow new skin of its own. A skin graft site should be protected and kept moist. Consult with your physician about topical medications and bandaging, if any, that may be appropriate for the type of graft you receive.
SPF (sun protection factor): A number on a scale for rating sunscreens. SPF stands for Sun Protection Factor.
Squamous cells: Flat cells that look like fish scales. The word “squamous” came from the Latin squama meaning “the scale of a fish or serpent.”
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.
Squamous Cell Carcinoma of the Skin: A common, non-melanoma skin cancer that begins in squamous cells, which are thin, flat cells that look like fish scales.
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.
Staging: In regard to cancer, the process of doing examinations and tests to learn the extent of the cancer, especially whether it has metastasized (spread) from its original site to other parts of the body.
Subcutis, Subcutaneous Tissue: Layer of fat located under the dermis.
Sunburn: Sunburn is an inflammation of the skin that develops in response to exposure to ultraviolet (UV) radiation from the sun or from tanning beds and booths that emit UV radiation. Sunburn is manifested by reddened, painful skin that may develop blisters.
Superficial Spreading Melanoma: Is usually characterized as the most common form of cutaneous melanoma in Caucasians. The average age at diagnosis is in the fifth decade, and it tends to occur on sun-exposed skin, especially on the backs of males and lower limbs of females.
Surgical Oncologist: A doctor who performs biopsies and other surgical procedures in cancer patients.
Symptom Management: Care given to relieve the problems associated with a disease or its treatment.
Systemic: Affecting the entire body. A systemic disease such as diabetes can affect the whole body. Systemic chemotherapy employs drugs that travel through the bloodstream and reach and affect cells all over the body.
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Tissue: It is a broad term that is applied to any group of cells that perform specific functions. A tissue in medicine need not form a layer. Thus, the bone marrow is a tissue; connective tissue consists of cells that make up fibers in the framework supporting other body tissues; and lymphoid tissue is the part of the body’s immune system that helps protect it from bacteria and other foreign entities.
Tumor: An abnormal mass of tissue. Tumors are a classic sign of inflammation, and can be benign or malignant (cancerous). There are dozens of different types of tumors. Their names usually reflect the kind of tissue they arise in, and may also tell you something about their shape or how they grow. For example, a medulloblastoma is a tumor that arises from embryonic cells (a blastoma) in the inner part of the brain (the medulla). Diagnosis depends on the type and location of the tumor. Tumor marker tests and imaging may be used; some tumors can be seen (for example, tumors on the exterior of the skin) or felt (palpated with the hands).
Tumor-Infiltrating Lymphocytes (TILs): TILs describes the patient’s immune response to the melanoma. When the pathologist examines the melanoma under the microscope he/she looks for the number of lymphocytes within the lesion. This response, or TILs, is usually described as brisk, non-brisk, or absent, although occasionally it can be described as mild or moderate. TILs indicate the immune system’s ability to recognize the melanoma cells as abnormal.
Tumorigenic: Having the capacity to produce spherical collections of cancer cells.
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Ulceration: Ulceration is the sloughing of dead tissue. This can sometimes occur in the center of a melanoma lesion. The presence of ulceration may alter the stage classification of a melanoma. Ulceration is thought to reflect rapid tumor growth, leading to the death of cells in the center of the melanoma.
UV-A and UV-B Rays: Different wavelengths of ultraviolet light. Both are implicated in skin cancer, skin aging, and sunburn.
Ultraviolet radiation: Invisible rays that are part of the energy that comes from the sun. Ultraviolet radiation can burn the skin and cause skin cancer.
UV radiation: Ultraviolet radiation. Invisible rays that are part of the energy that comes from the sun, can burn the skin, and cause skin cancer . UV radiation is made up of three types of rays — ultraviolet A (UVA), ultraviolet B (UVB), and ultraviolet C (UVC).
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Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. A cancer vaccine can help the body recognize and destroy cancer cells or microorganisms.
Vertical Growth Phase (VGP): The melanoma is described as either having VGP present or absent. If present it is an indication that the melanoma is growing vertically or deeper into the tissues. 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.
Vessel: A tube in the body that carries fluids: blood vessels or lymph vessels.
Vitamin D: A steroid vitamin which promotes the intestinal absorption and metabolism of calcium and phosphorus. Deficiency can lead to bone deformity (rickets ) in children and bone weakness (osteomalacia) in adults.
Wide Local Excision (WLE): Re-excision of the primary site after the biopsy results have been interpreted.
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