Help

Do you have any additional resources from which I can learn more about NCDB data?

For more information on the NCDB, you can read the following manuscript:

Boffa DJ, Rosen JE, Mallin K, Loomis A, Gay G, Palis B, Thoburn K, Gress D, McKellar DP, Shulman LN, Facktor MA, Winchester DP. Using the National Cancer Database for Outcomes Research: A Review. JAMA Oncol. 2017 Feb 23. doi: 10.1001/jamaoncol.2016.6905. PMID: 28241198.

How did you account for missing variables?

Facilities are responsible for maintaining the quality of their data, and each facility creates its own Quality Control Plan, per Standard 1.6 of the CoC Standards (see page 35). For more information about data quality checks, please consult the registrar at your facility. They also receive Completeness Reports from the NCDB detailing missing data after the data submission period each year. However, there may still be minor inconsistencies in some variables due to human error.

Does the MyCancerJourney data include cases treated at more than one hospital?

Yes. A varying proportion of cases by disease site will have treatment administered across programs, such as those receiving surgery at one hospital followed with adjuvant treatment at another. To simplify your analysis, the NCDB has selected the best analytic record from multiple case submissions across hospitals so that each unique case is represented as one row in the registry database. All registries at CoC- accredited programs follow-up with patients and will report the treatment as either “summary” (treatment at any hospital) or “at this reporting facility.”

Why are there data missing for the Site-Specific Factor I am analyzing for certain diagnosis years?

Site-Specific Factors were first collected in 2004 as part of the Collaborative Stage Data Collection System. As new factors are added, we may include them in future versions of MyCancerJourney. For more detailed information about the Site-Specific Factors, go to the Data Dictionary Page at http://ncdbpuf.facs.org/node/367

Are data on salvage therapy available from MyCancerJourney?

No. Only first-course treatment is collected by the cancer registrars and included in the MyCancerJourney database. First-course treatment is defined as all methods of treatment recorded in the treatment plan and administered to the patient before disease progression or recurrence.

How is comorbidity defined?

Comorbidities present at the time of diagnosis were collected using the Adult Comorbidity Evaluation-27 index (ACE-27).  ACE-27 is a validated comorbidity instrument that provides a score (0–3) based on the number and severity of medical comorbidities.

ACE-27 resources:

Does the MyCancerJourney data include recurrence data?

No. Although the cancer registrars collect recurrence data, it is not included in the MyCancerJourney because there is a large percentage of missing data. See the following article for more information: https://www.ncbi.nlm.nih.gov/pubmed/24504926.

Which cancer sites and histologies are included?

Check our site-histology groupings: http://ncdbpuf.facs.org/node/416

What are some of the cancer type-specific grading systems?

Prostate cancer. The Gleason scoring system is used to grade prostate cancer. The Gleason score is based on biopsy samples taken from the prostate. The pathologist checks the samples to see how similar the tumor tissue looks to normal prostate tissue. Both a primary and a secondary pattern of tissue organization are identified. The primary pattern represents the most common tissue pattern seen in the tumor, and the secondary pattern represents the next most common pattern. Each pattern is given a grade from 1 to 5, with 1 looking the most like normal prostate tissue and 5 looking the most abnormal. The two grades are then added to give a Gleason score.

The American Joint Committee on Cancer recommends grouping Gleason scores into the following categories (1):

·       Gleason X: Gleason score cannot be determined
·       Gleason 2–6: The tumor tissue is well-differentiated
·       Gleason 7: The tumor tissue is moderately differentiated
·       Gleason 8–10: The tumor tissue is poorly differentiated or undifferentiated

Kidney cancer. The Fuhrman grading system is used for RCC are shown below:

Grade I: Nuclei appear round and uniform, 10 μm; nucleoli are inconspicuous or absent.
Grade II: Nuclei have an irregular appearance with signs of lobe formation, 15 μm; nucleoli are evident.
Grade III: Nuclei appear very irregular, 20 μm; nucleoli are large and prominent.
Grade IV: Nuclei appear bizarre and multilobulated, 20 μm or more; nucleoli are prominent.

How are tumor grades classified?

Grading systems differ depending on the type of cancer. In general, tumors are graded as 1, 2, 3, or 4, depending on the amount of abnormality. In Grade 1 tumors, the tumor cells and the organization of the tumor tissue appear close to normal. These tumors tend to grow and spread slowly. In contrast, the cells and tissue of Grade 3 and Grade 4 tumors do not look like normal cells and tissue. Grade 3 and Grade 4 tumors tend to grow rapidly and spread faster than tumors with a lower grade.

If a grading system for a tumor type is not specified, the following system is generally used (1):

·       GX: Grade cannot be assessed (undetermined grade)

·       G1: Well-differentiated (low grade)

·       G2: Moderately differentiated (intermediate grade)

·       G3: Poorly differentiated (high grade)

·       G4: Undifferentiated (high grade)

How is tumor grade determined?

If a tumor is suspected to be malignant, a doctor removes all or part of it during a procedure called a biopsy. A pathologist (a doctor who identifies diseases by studying cells and tissues under a microscope) then examines the biopsied tissue to determine whether the tumor is benign or malignant. The pathologist also determines the tumor’s grade and identifies other characteristics of the tumor. The NCI fact sheet Pathology Reports describes the type of information that can be found in a pathologist’s report about the visual and microscopic examination of tissue removed during a biopsy or other surgery.

What is tumor grade?

Tumor grade is the description of a tumor based on how abnormal the tumor cells and the tumor tissue look under a microscope. It is an indicator of how quickly a tumor is likely to grow and spread. If the cells of the tumor and the organization of the tumor’s tissue are close to those of normal cells and tissue, the tumor is called “well-differentiated .” These tumors tend to grow and spread at a slower rate than tumors that are “undifferentiated” or “poorly differentiated,” which have abnormal-looking cells and may lack normal tissue structures. Based on these and other differences in microscopic appearance, doctors assign a numerical “grade” to most cancers. The factors used to determine tumor grade can vary between different types of cancer.

Tumor grade is not the same as the stage of a cancer. Cancer stage refers to the size and/or extent (reach) of the original (primary) tumor and whether or not cancer cells have spread in the body. Cancer stage is based on factors such as the location of the primary tumor, tumor size, regional lymph node involvement (the spread of cancer to nearby lymph nodes), and the number of tumors present. More information about cancer staging is available on the Staging page.

Where can I find information on case counts for primary sites?

Case counts for primary sites, histology, and select variables, such as demographic and treatment items.

Are MyCancerJourney outcomes data population-based?

No. MCJ references clinical data registries that are hospital-based, not population-based.

Clinical validation?

In addition to statistical validation, the models have also been reviewed by surgical, medical, and radiation oncologist.  In addition, reviews specialist in the different types of cancer represented.  

Please describe the model performance.

The model’s likelihood and concordance were used to evaluate the performance of each cancer-site specific  model. The concordance, which also assesses predictive performance, is calculated as the proportion of all usable patient pairs in which the prediction and actual outcome agree. The perfect model will have a concordance of 1 and the non-informative model will have a concordance of 0.5.

Goodness of fit of the model, which refers to the amount of agreement between observed and predicted probability of survival estimates, was assessed through the calibration slope as well as the likelihood.

All statistical analyses were performed using the Lifelines library (version 0.22.3)  for Python version 3.6.

How has the accuracy of these calculators been validated?

Survival estimates have been verified against cancer patients diagnosed between 2011-2016 by. The estimates have also been validated against a large database of cancer patients over the past 10-years.

Statistical accuracy has been estimated using the model’s concordance as well as an external validation of the methods used.  The model’s clinical significance was validated through reviews by oncologists.

How are the estimates calculated?

Estimates are derived using Cox proportional-hazards models (Cox, 1972) a regression model commonly used statistical in medical research for investigating the association between the survival time of patients and one or more predictor variables. Proportional hazards models are a class of survival models in statistics. Survival models relate the time that passes, before some event occurs, to one or more covariates that may be associated with that quantity of time. In a proportional hazards model, the unique effect of a unit increase in a covariate is multiplicative with respect to the hazard rate. For example, taking a drug may halve one’s hazard rate for a stroke occurring, or, changing the material from which a manufactured component is constructed may double its hazard rate for failure. Other types of survival models such as accelerated failure time models do not exhibit proportional hazards. The accelerated failure time model describes a situation where the biological or mechanical life history of an event is accelerated (or decelerated).

How do I get a mortality estimate which excludes the chance of non-cancer death?

Our survival estimates include information on survival in the general population adjusted for age, race, and sex. This information obtained from the office of vital statistics.    

How often are the models updated?

Annually

Do the survival estimates reflect the outcomes of new treatments?

Survival estimates are based on observed outcomes for cancer patients from 2011-2016, with greater weight given to more recent patients. Thus, they are based on data including all treatments used during this time period, and the relative frequency of a given treatment for a given tumor type. However, the calculator may not reflect the full impact of treatments developed later in that time period, or not widely used until later in that period. 

How recent is the data?

Survival estimates are based on observed outcomes for United States cancer patients from 2011-2016, with greater weight given to more recent patients. 

Where does the data come from?

Estimates are derived from over 2-million cases from 500 hospitals and cancer treatment centers, ambulatory surgery centers, clinical laboratories, as well as physician and other outpatient offices.  Collection and reporting standards are in accordance with the National Program of Cancer Registries (NPCR); Centers for Disease Control and Prevention (CDC); North American Association of Central Cancer Registries (NAACCR); Surveillance, Epidemiology, and End Results Program (SEER) of the National Cancer Institute (NCI); and the American College of Surgeons (ACoS).

Do the estimates pull from clinical trial information?

No.  Because treatment trials limited by recruitment, typically exclude patients with comorbidity, and fail to differentiate populations based on gender, age and race their outcomes are of limited benefit to individuals.

Where was MyCancerJourney developed?

MyCancerJourney was developed at the Washington University School of Medicine in St. Louis. MyCancerJourney survival estimates have been validated by experts at Erasmus Medical Center, Rotterdam, Netherlands.

How do I get access to MCJ?

Email admin@mycancerjourney.com to request access to the system.

Is there any documentation to help me use MCJ?

Absolutely. The following user guides are designed to help Physicians add and manage patients, generate survival curves and print shared decision-making reports.

Download PDFGetting Started with MyCancerJourney

Download PDFAdding New Patients

Download PDFPreparing for your Patient’s Visit

Download PDFDuring your Patient’s Visit

How do I login to MyCancerJourney?


Go to: https://app.mycancerjourney.com, click “Login” on the top right. Use your designated username and password to login.

Why haven’t I received my email with login credentials from the MyCancerJourney Administrator?

Check your spam folder. The email will be from “MyCancerJourney Administrator <do_not_reply@mycancerjourney.com>” and will be sent via the Amazon SES service (amazonses.com). Search your mail for “MyCancerJourney.”

How do I reset my password?

Navigate to https://app.mycancerjourney.com/forgot, enter your email address, and click “Send Password Reset Link.” You will receive an email from “MyCancerJourney Administrator <do_not_reply@mycancerjourney.com>” with instructions on how to reset your password. If you don’t receive this email in a few minutes, check your spam folder to make sure it didn’t end up there.

Click the “Reset Password” link in the email, and enter a new password. This will set your password. Once your password is reset, you will be redirected to the login screen, where you can use the password you just created to log into the system.

My Shared Decision-Making reports are not displaying. What do I do?

Make sure your pop-up blocker is turned off.

For Chrome:

By default, Chrome will notify you when a pop-up is blocked and give you an option to see it. To turn off pop-up blocker, follow these instructions:

  1. Click the three dots to the right of the address bar
  2. Select “Settings
  3. Click “Advanced” at the bottom of the page
  4. Under “Privacy and Security“, click the “Content Settings” button
  5. Select Pop-ups and redirects
  6. To disable the pop-up blocker uncheck the “Blocked (recommended)” box

For Safari:

  1. From the “Safari” menu, select “Preferences
  2. Click “Websites” at the top of the window
  3. Select “Pop-up Windows
  4. Select “Allow” next to the “When visiting other websites” option

For Firefox:

  1. Select “Preferences” from the Firefox menu.
  2. Select “Privacy and Security
  3. Uncheck the “Block Pop-Up Windows” box
  4. Close the window.
  5. Click “OK

For Edge:

  1. Click the “Settings and More” button.
  2. Click “Settings
  3. Click “Privacy & Security
  4. Scroll down to “Security
  5. Click the “Block Pop-Ups” switch to “Off”

I didn’t find my question here; where can I go to find the answer to my question?

By Email: support@mycancerjourney.com

Support Hotlines and Websites

This section is a list of resources – both hotlines and websites – that may be of help. This information is not a substitute for professional advice or care. If you are in need of support, please reach out to your doctor, one of these organizations, another local organization near you, a loved one or friend.

Support Hotlines and Websites:

  • American Psychological Oncology Society
    APOS Toll-Free Helpline, part of the Cancer Support Helpline, helps cancer patients and their caregivers with emotional support by phone, and by connecting them with emotional health resources in their community: 866-276-7443 (866-APOS-4-HELP).
  • Livestrong Foundation
    Free services for cancer patients and survivors and advocates for policies that improve their access to care and quality of life: 855-220-7777.
  • National Mental Health Association
    Information on mental health topics and referrals, access to specialists: 800-969-6642.
  • National Suicide Prevention Lifeline
    24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress: 800-273-TALK (8255) or 888-628-9454 (en Espanol).

Other Helpful Sites:

  • https://seer.cancer.gov/registrars/
  • https://www.cancer.gov/
  • https://www.ncra-usa.org/
  • https://www.naaccr.org/
  • https://www.cancer.org/
  • http://cancerbulletin.facs.org/forums/help
  • https://cancercontrolplanet.cancer.gov/
  • https://facs.org/cancer/coc/fordsmanual.html
  • https://cancerstaging.org/CSE/Registrar/Pages/default.aspx
  • https://tools.usps.com/go/ZipLookupAction_input
  • https://www.cdc.gov/niosh/docs/2011-173/
  • https://www.bls.gov/soc/
  • https://www.nccn.org/
  • http://www.breastcancer.org/
  • https://www.nlm.nih.gov/
  • http://www.anatomyatlases.org/
  • https://www.melissa.com/
  • http://oralcancerfoundation.org/
  • http://www.pathologyoutlines.com/
  • https://www.txhima.org/
  • http://www.whonamedit.com/

Glossary

  • Abscess
    A collection of pus.
  • Acute Withdrawal Syndrome
    Signs and symptoms that occur after stopping a drug or alcohol.
  • AIDS/HIV
    Acquired Immune Deficiency Syndrome (AIDS) is a disease caused by the human immunodeficiency virus (HIV). The virus attacks the body’s own defense or immune system, which may cause certain infections or tumors to develop.
  • Alcohol abuse
    The use of alcoholic beverages despite negative consequences. Ambulatory
    Able to walk around.
  • Amputation
    The surgical removal of a body part, generally a toe, foot, arm or leg.
  • Angina
    Also known as angina pectoris or chronic exertional angina. It is chest pain resulting from less blood flow to the heart; it may occur only during exercise or activity (exertion) and get better with rest (stable angina).
  • AODM
    Adult-Onset Diabetes Mellitus, also known as “Type 2” diabetes or non-insulin-dependent diabetes mellitus (NIDDM). The body can’t use insulin made.
  • Arrhythmias
    Heartbeat or rhythm that is not regular or “even.” It may be too fast or too slow. Arterial insufficiency
    Decreased blood flow in the arteries, often from atherosclerosis or narrowing of the arteries. It is also known as peripheral arterial disease (PAD).
  • Ascites
    Buildup of fluid in the belly; it is often caused by liver failure.
  • Asthma
    Airways within the lungs are narrowed at times, causing less air to get into and out of the lungs. Airways may become narrowed or smaller from allergies, exercise, smoke, colds, or other things. Unlike COPD, the airways recover and the lungs can work normally after an attack.
  • Atrial Fibrillation or Flutter
    Irregular heartbeat or rhythm in the atria, the two top chambers of the heart, which may cause the heart to beat faster than normal.
  • Baseline pO2
    Normal oxygen levels.
  • Bilirubin
    A chemical that is produced in the blood from the breakdown of old red blood cells. Bipolar Disorder
    Also known as manic-depressive illness. It causes extreme shifts in mood, energy, and ability to function.
  • Body Mass Index (BMI)
    Having too much body fat and indicates too much weight for a given height. Using height and weight to calculate a body mass index (BMI), obesity is defined as a BMI greater than 30. A BMI between 25 and 29.9 is considered overweight.
  • Bypass
    An operation done when blood vessels of the heart become narrowed (by plaques or fatty deposits) by creating a detour or bypass around the blockage. Doctors use blood vessels from other parts of the body or with a man-made graft or tube to bypass or detour blood to the heart muscle.
  • Cancer Site
    The type of cancer is often named after the place in the body where it started. For example, lung cancer begins in the lungs, breast cancer begins in the breast, and so on. Cancers found in the blood stream, bone marrow or lymph nodes are called leukemias or lymphomas.
  • CD4+
    A type of white blood cell used to track or monitor HIV infection.
  • Chronic Insufficiency
    Blood flow from the legs back to the heart is slowed, often due to blood clots or varicose veins (leaky valves in the legs).
  • Chronic Malabsorption Syndrome
    The body has trouble absorbing nutrients from food in the gut into the blood. It causes malnutrition.
  • Chronic Supplemental O2
    Oxygen needed at baseline.
  • Chronic Suppressive Therapy
    Medications or drugs used to slow down or stop the growth of cancer cells.
  • Cirrhosis
    A liver disease that results in healthy tissue being replaced by scar tissue so the liver does not work as well.
  • Comorbidity
    These are other diseases or medical problems you may have besides cancer. Include diseases or medical problems that you take medicine for and those that you don’t take medicine for.
  • Congestive Heart Failure
    The heart isn’t working as well as it should and has trouble getting blood to the brain and the rest of the body.
  • CO2 Retention
    High levels of CO2 in the blood; it is seen in patients with COPD.
  • Connective Tissue Disorder
    Any disease of the connective tissue which is the structure of framework that holds the body together.
  • COPD (also called Chronic Obstructive Pulmonary Disease)
    Airways within the lungs are permanently narrowed, causing less air to get into and out of the lungs. Many people have trouble breathing or get shortness of breath.
  • Coronary Artery Bypass Graft (CABG) (or Bypass Surgery)
    An operation done when blood vessels of the heart become narrowed (by plaques or fatty deposits) by creating a detour or bypass around the blockage. Doctors use blood vessels from other parts of the body or with a man-made graft or tube to bypass or detour blood to the heart muscle.
  • Coronary Artery Disease
    Also called atherosclerosis or hardening of the arteries of the heart). A blockage or buildup that thickens the blood vessel walls of the heart and reduces the amount of oxygen and nutrients the heart can get.
  • Coronary Disease
    Heart problems caused by high sugar where the heart doesn’t work as well as it should.
  • Coronary Stent
    A mesh tube placed in the blood vessels of the heart to keep the vessel walls open. It is done during angioplasty when a small catheter with a balloon is used to open up the blood vessels of the heart and improve blood flow.
  • Coumadin
    The generic form is “warfarin”; it is a pill taken to prevent blood clots.
  • Creatine
    A chemical in the body that can show how well the kidneys are working.
  • Delirium Tremnes (DTs)
    “The shakes”; caused by alcohol withdrawal.
  • Dementia
    Also known as “senility”, dementia is not a specific disease, but rather a group of signs that the brain isn’t working well. People with dementia may have trouble thinking, memory problems, trouble making decisions or may not think well enough to do normal activities.
  • Diabetes Mellitus
    High blood sugar caused by too little insulin made in the body or insulin not being properly used in the body.
  • Diabetic Ketoacidosis (DKA)
    Diabetic ketoacidosis; it is a complication of diabetes mellitus characterized by high sugar, too little insulin, or acid in the blood, and ketone bodies.
  • Dialysis
    A machine that filters the blood after the kidneys stop working. It may be for a short time (acute dialysis) until the kidneys get better or for a long time (chronic dialysis) if the kidneys are permanently not working. Diastolic Blood Pressure (DBP)
    The bottom number in the blood pressure reading. It is the pressure found when the heart is filled with blood and before it beats.
  • Disease Out of Control
    Blood cancer not responding to treatment of therapy.
  • DVT (Deep Vein Thrombosis)
    A blood clot in a deep vein, usually in the leg.
  • Dx
    Diagnosis.
  • Dyspnea
    Shortness of breath or trouble breathing.
  • Dyspnea at Rest
    Airways within the lungs are permanently narrowed, causing less air to get into and out of the lungs. Many people have trouble breathing or get shortness of breath.
  • ECG (electrocardiogram or EKG)
    A tool used at the doctor’s office to measure the electrical activity of the heart. Leads are placed on the patient’s chest and a tracing of the heart rhythm is printed out.
  • Ejection Fraction
    This term describes how much blood is pumped out of the heart with each heartbeat. It is expressed as a percentage – 55%, 30%, etc.
  • Encephalopathy
    A change in mental status or alertness caused by the long-term effect of high blood pressure on the brain. Also called hepatic encephalopathy. Changes in the brain due to toxins formed when the liver doesn’t work normally. Patients may have trouble thinking or tremors.
  • End-organ Failure
    Damage to various parts of the body from poor sugar control.
  • End Stage Renal Disease (ESRD)
    The kidneys permanently stop working and you need to be on dialysis.
  • Epistaxis
    Bloody nose.
  • Esophageal Bleeding
    Bleeding from veins or blood vessels in the esophagus, the tube that carries food from the mouth to the stomach. It is often caused by portal hypertension and cirrhosis of the liver.
  • FEV1
    Forced expiratory volume in one second; part of the lung or pulmonary function testing (PFT).
  • Filter
    A filter that sits in the inferior vena cava (IVC – the main vein that carries blood from the legs) and is designed to stop blood clots from getting to the lungs.
  • Fulminant AIDS
    The immune system or the body’s defense is very weak and the patient cannot fight infections. HIV counts are high and CD4+ counts are low.
  • Gangrene
    When part of the body loses its blood supply and tissue death occurs. It generally occurs in toes, feet, fingers or hands.
  • Hemiplegia
    Paralysis or loss of function or movement of one half of the body.
  • Heparin
    A type of shot given to prevent blood clots.
  • Hepatitis
    Inflammation or damage to the liver caused by infections, toxins (such as alcohol), or the immune system. HIV+
    An infection with the Human Immunodeficiency Virus (HIV), which attacks the body’s defense system and may lead to Acquired Immune Deficiency Syndrome (AIDS).
  • Hypertension
    High blood pressure.
  • IDDM
    Insulin Dependent Diabetes Mellitus, also known as “Type 1” diabetes. IDDM usually begins in childhood and is caused by the body to stop making insulin. Patients need to take insulin in the form of shots or pills.
  • Immunosuppressant Medication
    Medications or drugs that lower the immune system or the body’s defense system.
  • Inflammatory Bowel Disease (IBD)
    Intestines become red and swollen (inflamed) at times and cause vomiting, diarrhea, belly pain, and weight loss. Crohn’s Disease and Ulcerative Colitis (UC) are both part of IBD.
  • Intermittent Claudication
    Pain in the lower legs (calf pain), when walking or exercising that, is relieved by rest.
  • Jaundice
    Yellowish coloring of the skin and/or the whites of the eyes.
  • Kaposi’s Sarcoma (KS)
    A type of cancer found on the skin or lining of mouth and nose in patients with very weak immune systems. It is caused by a virus and often seen in AIDS patients.
  • Leukemia
    Cancer of the blood or bone marrow, where too many blood cells are made.
  • Lymphoma
    A blood cancer of cells that are part of the lymph system; they are divided into either Hodgkin Lymphoma or Non-Hodgkin Lymphoma (NHL).
  • Major Depression
    Also known as clinical or unipolar depression. A medical illness that may include feeling sad or hopeless, little or no interest or happiness in normal activities, and trouble eating or sleeping.
  • Malignant Papilledema
    Very high blood pressure causing swelling of the optic nerve, which is the nerve to the eye needed for sight. It may cause blurriness or loss of vision.
  • Metastatic
    Cancer that has spread from the original or first site to nearby tissue or other parts of the body.
  • Morbid Obesity
    Being more than 100 lbs over ideal body weight or have a BMI >38; it is also known as “severe obesity.”
  • Multiple Sclerosis (MS)
    A disease that affects the brain and spinal cord and may cause vision changes, numbness, or trouble moving. It is caused by the body’s own defense system (the immune system) attacking the covering around certain nerves. Attacks come and go and may worsen over time.
  • Myasthenia Gravis
    A disease-causing tiredness and muscle weakness, generally seen in eye, mouth or face muscles.
  • Mycobacterium Avium Intracellulare (MAI)
    A form of tuberculosis (TB) seen in patients with very weak immune systems. It is often seen in AIDS patients.
  • Myeloma
    Cancer of plasma cells, which are cells that are part of the immune system and are found in the bone marrow.
  • Myocardial Infarction (MI)
    (MI) – heart attack.
  • Nephropathy
    Kidney problems from high sugar that cause the kidneys not to work well. Patients may need dialysis.
  • Neurologic Deficit
    Brain, spinal cord, muscles or nerves don’t work as well as they should because of a stroke. Examples include trouble speaking or trouble moving one part or side of the body.
  • Neurologic Residual
    Part of the brain damaged in a stroke doesn’t work as well as it used to. Examples include trouble speaking or trouble moving one part or side of the body.
  • Neuropathy
    Nerve problems from high sugar that may cause numbness or less sensation of a body part.
  • NSAIDS
    Non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen or naproxen.
  • Obesity
    Having too much body fat and indicates too much weight for a given height. Using height and weight to calculate a body mass index (BMI), obesity is defined as a BMI greater than 30. A BMI between 25 and 29.9 is considered overweight.
  • Oral Agents
    Pills taken to help control diabetes or “sugar”.
  • Pacemaker
    A medical device placed under the skin of the chest that helps the heart maintain a stable or “normal” heartbeat.
  • Pancreatitis
    Inflammation or damage to the pancreas. It may be caused by gallstones, alcohol or other causes.
  • Paralysis
    Muscles aren’t working and there may be loss of feeling or movement. It may be caused by damage to the brain, spine or other parts of the nervous system.
  • Paraplegia
    Paralysis or loss of function or movement of the legs.
  • Parkinson’s Disease
    A brain disorder that may cause trouble with movement, balance or speech. People with Parkinson’s Disease often have a tremor.
  • Paroxysmal Nocturnal Dyspnea
    Shortness of breath that wakes someone from sleeping; it generally occurs about one to two hours after sleeping.
  • Percutaneous Transluminal Coronary Angioplasty (PTCA)
    Also called balloon angioplasty or angioplasty. A procedure where a small catheter with a balloon is used to open up the blood vessels of the heart. The catheter is generally introduced into blood vessels at the top of your leg, although other sites may be used.
  • Peripheral Artery Disease
    Blockage of arteries or blood vessels that bring blood to the body, especially the legs. It may cause pain in the legs when walking, or at rest when more severe.
  • Phlegmon
    Infection of the pancreas and/or the soft tissues around the pancreas.
  • Pneumocystis Pneumonia (PCP)
    A lung infection in patients with very weak immune systems. It is often seen in AIDS patients.
  • Portal Hypertension
    High blood pressure within blood vessels of the liver, which may cause a fluid collection or swelling of the belly. It is often caused by cirrhosis of the liver.
  • Pseudocyst
    Collection of fluid around the pancreas, generally caused by pancreatitis.
  • Pulmonary Embolism (PE)
    A blood clot in blood vessels of the lungs.
  • Pulmonary Insufficiency
    Breathing problems where the lungs cannot take in enough oxygen for the body.
  • Relapse
    When a disease returns or comes back.
  • Remission
    When a disease (cancer) is responding to treatment or is under control.
  • Renal Insufficiency
    The kidneys aren’t working as well as they should and have trouble getting rid of waste and water. It is also known as renal failure.
  • Restrictive Lung Disease
    Any disease that stiffens the lungs or prevents the lungs from expanding as much as they should.
  • Retinopathy
    Eye problems from high sugar causing trouble seeing or blindness.
  • Rx
    Prescription.
  • Schizophrenia
    A psychiatric or brain disease that may cause unusual thoughts, emotions and behaviors. People with schizophrenia may see or hear things that other people don’t see or hear. They may also believe that others are trying to control their thoughts or trying to hurt them.
  • Secondary End-Organ Failure (renal, cardiac, CNS)
    Other organs or body parts stop working well as the connective tissue disorder gets worse.
  • SEER Stage
    Staging refers to how far your tumor may have spread from the place in your body where it started. Staging looks at tumor spread in three ways: 1) under a microscope on a cellular level, 2) with radiologic imaging (CT scans, MRIs, PET scans, etc.), and 3) with a physical exam or clinical evidence of disease.
  • Sick Sinus Syndrome
    Unusual heartbeat or rhythm caused by a problem with the sinus or sino-atrial (SA) node in the heart, which is the heart’s natural pacemaker.
  • Solid Tumor
    A mass or group of unusual cells in the body which may or may not be cancer. It is generally named by the type of cells that form them. They are NOT cancers of the blood.
  • Stress Test
    Also known as a treadmill test or an exercise test. It is done to see how well your heart works during exercise or activity (exertion). A thallium stress test is when dye is injected into the blood and pictures or images of the heart show how well blood is flowing during exercise or activity.
  • Stroke
    Also known as a “brain attack.” It is caused by not enough blood reaching the brain, from either a blood clot in the brain or an artery in the brain breaks and bleeds.
  • Substance Abuse
    Harmful or hazardous use of certain substances, such as alcohol or illegal drugs.
  • Thoracic or Abdominal Aneurysm
    An enlarged or bulging part of the aorta, the main blood vessel of the body. The bulge is caused by a weakness in the blood vessel wall. The bulge or dilation is generally measured in centimeters (cm).
  • Transfusion
    Blood transfusion; blood is given through an IV line into the body.
  • Transient Ischemic Attack (TIA – or “Mini-Stroke”)
    There is less blood flow to part of the brain. It may cause numbness, vision changes, trouble walking or speaking that lasts less than 24 hours or one day.
  • Ulcers
    Breakdown or hole in the lining of the stomach or intestine caused by acid, bacterial infection, NSAIDs, or smoking.
  • Uncontrolled Cancer
    Cancer that is not responding to treatment or therapy.
  • Unstable Angina
    Severe or prolonged chest pain or chest pain that continues with rest. You should notify your doctor if you have this type of pain.
  • Vertigo
    A type of dizziness; a feeling of spinning or whirling while standing still.

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