Tea and Antioxidant properties

Introduction

Increasing evidence is highlighting the role antioxidants may have in protecting against certain conditions such as heart disease, stroke and cancers. It has been proposed that the mechanisms leading to these diseases may be promoted by free radicals and that antioxidants may oppose the action of these molecules. In addition to the well known antioxidants such as Vitamins C and E, there is growing research demonstrating the potentially beneficial effects of plant-derived antioxidants, polyphenols, found in fruits, vegetables, nuts, cereals and drinks such as tea and red wine.

Free radicals explained

Free radicals are unstable molecules that include the hydrogen atom, nitric oxide (NO) and molecular oxygen (O₂). These naturally occur in the body as a result of chemical reactions during normal cellular processes. They can also be formed in response to excess pollution, too much UV sunlight and exposure to cigarette smoke. In an attempt to stabilise, they attack other molecules in the body potentially leading to cell damage and triggering the formation of another free radical resulting in a chain reaction. Some scientists believe that this type of free radical action has been implicated in certain chronic and ageing diseases such as cancer, heart disease, stroke, rheumatoid arthritis, cataracts and Alzheimer’s disease.

Protective mechanisms of antioxidants

Antioxidants are compounds that help to inhibit the many oxidation reactions caused by free radicals thereby preventing or delaying damage to the cells and tissues. Their mechanisms of action include:-

• Scavenging reactive oxygen and nitrogen free radical species
• Decreasing the localised oxygen concentration thereby reducing molecular oxygen’s oxidation potential
• Metabolising lipid peroxides to non-radical products
• Chelating metal ions to prevent the generation of free radicals

In this way antioxidants limit the free radical damage from:-

• Oxidising Low Density Lipoprotein (LDL) cholesterol, which may increase the risk of athersclerosis
• Promoting platelet adhesion, which can lead to thrombosis thereby increasing the risk of heart disease or stroke
• Damaging the cell’s DNA, which may lead to cancer
• Blocking the normal endothelial cell function and vasodilatation in response to nitric oxide, a potential mechanism for heart disease and cancer
• Triggering inflammation
• Impairing immune function

Some antioxidants are synthesised within the cells themselves (endogenous) and others need to be provided in the diet. Table 1 gives examples of antioxidants with established or proposed activity in the body.

Table 1

Endogenous Antioxidants	Antioxidants provided in the diet
Polyamines Melatonin Oestrogen Superoxide dismutase Glutathione peroxidase Catalase Lipoic Acid Caeruloplasmin Albumin Lactoferrin Transferrin	Vitamin E Vitamin C Carotenoids Polyphenols Copper

Sources of dietary antioxidants

Traditionally dietary antioxidants were thought of as Vitamin E and C and the carotenoid - carotene. In recent years there has been particular interest in the antioxidant activity and health benefits of other phytochemicals. Table 2 lists two examples of phytochemicals and their food sources.

Table 2

Phytochemical	Categories	Sub-category	Food Sources
Carotenoids	Carotene	-carotene	Carrots, pumpkins, avocados
		b- carotene	Carrots, red peppers, apricots, spinach
	Lycopene		Tomatoes, pink grapefruit, watermelons
	Lutein		Spinach, kale, brussel sprouts
Polyphenols	Flavonoids	Anthocyanins	Berries, red wine, black grapes
		Flavones	Celery, parsley, olives
		Flavonols; Quercetin, Rutin	Tea, apples, onions, wine, garlic
		Flavonols; Catechins	Tea, wine, pears, apples, chocolate
		Flavanones	Citrus fruit
		Isoflavones	Legumes
	Phenolic Acids	Hydroxybenzoic Acid; Gallic Acid, Ellagic Acid, Salicylic Acid	Berries, Tea, Grapes, Walnuts
	Other Phenolic compounds	Capsaicin	Chillies, Peppers
		Tannins	Tea, red wine, grapes

Tea has one of the highest total flavonoid contents of all plants at 15% of the leaf by dry weight¹ and is also the major source of flavonoids in the UK diet, providing approximately 80% of dietary flavonoids for the population as a whole.¹

Tea Flavonoids

The types and amounts of flavonoids present in tea will differ dependent on the variety of leaf, growing environment, processing, manufacturing, particle size of ground tea leaves and infusion preparation. ^2-4 Typically 93% of total tea phenolic compounds are flavonoids ¹. Green teas contain more of the simple flavonoids called catechins, while the oxidisation that the leaves undergo to make black tea converts these simple flavonoids to the more complex varieties called theaflavins and thearubigins. For more information about green and black teas please refer to the fact sheet ‘Black and Green Tea: How do they differ?’

Tea flavonoids are water-soluble and one study¹ has shown that a cup of UK tea that has been allowed to brew for 40-60 seconds will typically deliver approximately 140mg of flavonoids whilst a second carried out by the UK Tea Trade Technical Committee² using typical UK consumer brewing conditions and encompassing the range of blends and bag weights commonly on sale in the UK gives a figure of 125mg/235ml serving. The longer the tea is left to brew, the higher the concentration of flavonoids.⁴

Tea flavonoids demonstrate antioxidant activity ^5-8 and while not a replacement for fruit and vegetables, the antioxidant activity of tea has been compared to that of fruit and vegetables in a number of studies. One study concluded that at the typical UK daily consumption of 3 cups a day,⁹ tea has approximately the same antioxidant power as eating six apples.¹⁰ Another study found that one or two cups of tea has the same ‘radical scavenging capacity’ as five portions of fruit and vegetables or 400mg vitamin C equivalents.¹¹

Health benefits of tea flavonoids

For many years it has been known that the plant polyphenols are antioxidant in vitro, in fact many common flavonoids are several times more potent than Vitamin C or E^12,13. This growing interest in the antioxidant activity of phenolic compounds has led to increased research into their potential health benefits e.g.

Heart Disease and Stroke

Several reports indicate that tea flavonoids inhibit the oxidation of LDL cholesterol in vitro^12,14-17

A reduction in blood lipids has been demonstrated in animal studies ^18-20

Certain tea flavonoids exhibit anti-inflammatory actions in animals.^21,22 Athersclerosis is a disease with a strong inflammatory component

Improvements in blood vessel function, specifically the vascular endothelium, has been seen in patients with established CHD²³

Several in vitro studies^24-27 and one human trial²⁸ have found that platelet aggregation can be inhibited by various flavonoids

The antioxidant activity of tea flavonoids may account for the results of a number of epidemiological studies suggesting that they may have a protective role in conditions such as cardiovascular disease.^29-36

Cancer

In vitro studies have demonstrated that the initiation stage of cancer can be prevented by the action of tea flavonoids^37-45

Tea polyphenols have been shown to inhibit DNA synthesis of leukaemia cells and lung carcinoma cells^46,47

Animal studies have shown that tea and its flavonoids protects against many types of cancer e.g. skin tumors in mice^48-50, lung cancer in mice^51-53 and digestive cancer in mice and rats⁵⁴

Antibacterial effects

Tea extracts exhibit inhibitory effects against Salmonella typhi, Campilobacter jejuni, Campilobacter coli, Helicobacter pylori, Shigella, Clostridium, Pseudomonas, Candida and others^55-58

Dental Caries

Green tea and various catechins have exhibited inhibitory effects on the growth of cariogenic bacteria by preventing the adherence and growth of bacteria at the tooth surface^59,60

Absorption of tea flavonoids

Until recently the majority of the research demonstrating the antioxidant activity of tea flavonoids was either using animal models or laboratory cellular studies. Emerging evidence is concluding that the body does in fact absorb some of these antioxidants,^61-67 e.g. when green tea extract is consumed by healthy human volunteers, various catechins are found in the plasma in a dose-dependent concentration varying between 0.2-2.0% of the ingested amount, with a maximum concentration being achieved 1.4 to 2.4 hours after consumption^65-67. Some studies have shown that plasma antioxidant activity peaks 30-60 minutes after tea consumption and returns close to baseline by 90 minutes^62,68,69. Further research is currently being undertaken on the metabolism, distribution and excretion of tea flavonoids and its metabolites.

The addition of milk to tea, as enjoyed by the majority of the UK population, does not appear to affect the bioavailabilty of the tea flavonoids.^61,62,70

In summary…

It is well known that fruit and vegetables are good sources of antioxidants, however, what is less well known is the amount of antioxidants present in tea. The major group of antioxidants in tea are flavonoids that appear to be digested, absorbed and metabolised by the body. There is a wealth of evidence demonstrating that tea and flavonoids exhibit beneficial effects in animal and in vitro studies and provide a promising area of research for future human studies.

So as well as eating more fruit and vegetables, antioxidant intake can be topped up by drinking more tea, helping to promote overall health and well-being.

References:

1. Lakenbrink C et al. (2000) Flavonoids and other polyphenols in consumer brews of tea and other caffeinated beverages. J Agric Food Chem, 48, 2848-2852

2. Personal communication from UK Tea Trade Technical Committee

3. Astill C, et al (2001) Factors affecting the caffeine and poyphenol contents of black and green tea infusions. J Agric Food Chem; 49 (11): 5340-7

4. Englehardt, U et al (1999) Caffeinated Beverages Symposium, 219 th American Chemical Society Meeting. Anaheim, USA.

5. Sarkar A, et al (2001) Black tea is a powerful chemopreventor of reactive oxygen and nitrogen species: comparison with its individual catechin constituents in green tea. Biochem. Biophyss. Res. Commun; 284 (1): 173-178

6. Karakaya S, et al (2001) Antioxidant activity of some foods containing phenolic compounds. Int J Food Science; 52(6): 501-8

7. Paquay JB, et al (2001) Protection against nitric oxide toxicity by tea. J Agric Food Chem 48(11): 5768-5772

8. Leung LK, et al (2001) Theaflavins in black tea and catechins in green tea are equally effective antioxidants. J Nutr 131(9); 2248-51

9. National Drinks Survey 2001

10. Papanga G, et al (1999) The polyphenolic content of fruit and vegetables and their antioxidant activities. What does a serving constitute? Free Rad Res; 30(2): 153-162

11. Du Toit R, et al (2001) Comparison of the antioxidant content of fruits, vegetables and teas measured as Vitamin C equivalents. Toxicology; 166 (1-2): 63-9

12. Vinson JA, et al (1995) Plant flavonoids, especially tea flavonols, are powerful antioxidants using an in vitro oxidation model for heart disease. J Agric Food Chem; 43 (11):2800-2802

13. Rice- Evans CA, et al (1995) The relative antioxidant activities of plant derived polyphenolic flavonoids. Free Rad Res; 2214 (4): 375-383

14. De Whalley, et al (1990) Flavonoids inhibit the oxidative modification of Low Density Lipoproteins by macrophages. Biochem Pharmacol 39; 1743-1750

15. Yoshida H, et al (1999) Inhibitory effect of tea flavonoids on the ability of cells to oxidise low density lipoprotein. Biochem Pharmacol 58; 1695-703 Biochem Pharmacol 39; 1743-1750

16. Pearson DA, et al (1998) Inhibition of endothelial cell mediated low density lipoprotein oxidation by green tea extracts. J Agric Food Chem 46; 1445-9

17. Zhu QY, et al (2000) Interaction between flavonoids and alpha-tocopherol in human low density lipoprotein. J Nutr Biochem 11; 14-21

18. Yang TTC, et al (1997) Hypocholesterolemic effects of Chinese tea. Pharmacol res 35; 505-12

19. Lin YL, et al (1998) Hypolipidemic effect of green tea leaves through induction of antioxidant and Phase II enzymes including superoxidase dismutase, catalase, and glutathione S-transferase in rats. J Agric food Chem 46; 1893-9

20. Vinson JA, et al (1998) Effect of green and black tea supplementation on lipids, lipid oxidation and fibrinogen in hamster: mechanisms for the epidemiological benefits of tea drinking. FEBS Lett 433; 44-6

21. Tijburg LBM (1997) Tea flavonoids and cardiovascular diseases a review. Crit Rev Food Sci. Nutr 37; 771-85

22. Hofbauer R, et al (1999) The green tea extract epigallocatechin is able to reduce neutrophil transmigration through monolayers of endothelial cells. Wiener Klinische Wochenschrift 111; 278-82

23. Duffy SJ, et al. (2001) Short and long-term black tea consumption reverses endothelial dysfunction in patients with coronary artery disease. Circulation, 10, 104, 2, 151

24. Corvazier E, et al (1985) Interference of some flavonoids and non-steroidal anti-inflammatory drugs with oxidative metabolism of arachidonic acid by human platelets and neutraphils. Biochemica at Biophysica Acta 835; 315-321

25. Polette A, et al (1996) N-3 fatty acid-induced lipid peroxidation in human platelets is prevented by catechins. Thrombosis and Haemostasis 95; 945-9

26. Kelly C, et al (1996) Modulation of human platelet function by food flavonoids. Biochemical Soc transactions 24; 197

27. Tzeng SH, et al (1991) Inhibition of platelet aggregation by some flavonoids. Thromb Res; 64: 91-100

28. Hodgson JM, et al (2001) Effects of regular ingestion of black tea on haemostasis and cell adhesion molecules in humans. Eur J Clin Nutr; 55 (10): 881-6

29. Sesso HD, et al. (1999) Coffee and tea intake and the risk of myocardial infarction. Am J Epidemiol, Jan 15, 149(2), 162-167

30. Keli SO, et al. (1996) Dietary flavonoids, antioxidant vitamins, and incidence of stroke: the Zutphen study. Arch Intern Med, 156(6), 637-642

31. Knekt P, et al. Flavonoid intake and coronary mortality in Finland: a cohort study. BMJ, 312, 478-81, 1996

32. Stensvold I, et al. Tea consumption. Relationship to cholesterol, blood pressure and coronary and total mortality. Preventative Med,21,546,1992.

33. Yochum L, et al. Dietary flavonoid intake and risk of cardiovascular disease in postmenopausal women. Am J Epidemiol, 149(10), 943-9, 1999

34. Hertog MGL, et al. (1993) Dietary antioxidants flavonoids and risk of coronary heart disease: the Zutphen Elderly Study. Lancet,155,381

35. Hertog MGL, et al. (1995) Flavonoid intake and long-term risk of coronary heart disease and cancer in the seven countries study. Hertog, et al, Arch Int Med 155,381

36. Geleijnse JM, et al (1999) Tea flavonoids may protect against atherosclerosis: the Rotterdam study. Arch Intern Med 159; 2170-4

37. Gordon MH (1996) Dietary antioxidants in disease prevention. Nat Prod Rep 13; 265-73

38. Katiyar S, et al (1996) Tea in chemoprevention of cancer: epidemiological and experimental studies (review). Int J Oncol 8; 221-38

39. Yamada J, et al (1994) Antimutagenic activity of water extracts of black tea and oolong tea. Biosci. Biotech. Biochem 12; 2197-200

40. Yen GC, et al (1995) Antioxidant activity of various tea extracts in relation to their antimutagenicity. J Agric Food Chem 43; 27-32

41. Kuroda Y, et al (1999) Antimutagenic and anticarcinogenic activity of tea polyphenols. Mut Res 436; 69-97

42. Surono IS, et al (1996) Bacterial mutagenicity of terasi and anti-mutagenicity of Indonesian jasmine tea against terasi. Int J food Microbiol 32; 49-58

43. Bu-Abbas, A, et al (1997) Fractionation of green tea extracts; correlation antimutagenic effect with flavonol content. J Sci Agric 75; 453-62

44. Hour TC, et al (1999) Inhibition of eleven mutagens by various tea extracts, (-) epigallocatechin-3-gallate, gallic acid and caffeine. Food Chem Toxicol 37; 569-79

45. Steele VE, et al (2000) Comparative chemopreventive mechanisms of green tea, black tea and selected polyphenols extracts measured by in vitro bioassays. Carcinogenesis 21; 63-7

46. Yang GY, et al (1998) Inhibition of growth and induction of apoptosis in human cancer cell lines by tea polyphenols. Carcinogenesis 19; 611-6

47. Smith DM, et al (2001) Green tea induces polyphenols epigallocatechin inhibts DNA replication and consequently induces leukaemia cell apoptosis. Int J Mol Med; 7(6): 645-52

48. Wang ZY, et al (1992) Inhibitory effect of green tea on the growth of established skin papillomas in mice. Cancer Res 52; 6657-65

49. Wang ZY, et al (1992) Inhibitory effect of green tea in the drinking water on tumorigenesis by ultraviolet light and 12-O- tetradecanoylphorbol-13-acetate in the skin of SKH-1 mice. Cancer Res 52; 1162-70

50. Conney H, et al (1999) Inhibitory effect of green and black tea on tumor growth. Proc Soc Exper Biol Med 220; 229-33

51. Cao J, et al (1996) Chemopreventive effects of green and black tea on pulmonary and hepatic carcinogenesis. Fund Appl Toxicol 29; 244-50

52. Xu Y, et al (1992) Inhibition of tobacco-specific nitrosamine-induced lung tumorigenesis in A/J mice by green tea and its major polyphenols as antioxidants. Cancer Res 52; 3875-9

53. Landau JM, et al (1998) Inhibition of spontaneous formation of lung tumors and rhabdomyosarcomas in A/J mice by black and green tea. Carcinogenesis 19; 501-7

54. Steele VE, et al (1999) Preclinical efficacy studies of green and black tea extracts. Proc Soc Exper Biol Med 220; 210-2

55. Diker KS, et al (1994) The bactericidal activity of tea against Helicobacter pylori. Lett Appl Microbiol 19; 299-300

56. Maity S, et al (1998) Role of glutathione in the antiulcer effect of hot water extract of black tea (Camellia sinensis). Jap J Pharmacol 78; 285-292

57. Toda M, et al (1991) The protective activity of tea against infection by Vibrio cholerae 01. J Appl Bacteriol 70; 109-12

58. Diker KS, et al The bactericidal activity of tea against Campylobacter jejuni and Campylobacter coli. Lett Appl Microbiol 12; 34-5

59. Otake S, et al (1991) Anticaries effects of polyphenolic compounds from Japanese green tea. Caries Res, 25(6): 438-43

60. Sakanaka S, et al (1990) Inhibitory effects of green tea polyphenols on glucan synthesis and cellular adherance of cariogenic Streptococci. Agric Biol Chem 54; 2925-9

61. van het Hof K, et al. (1998) Bioavailability of catechins from tea; the effect of milk. Eur J Clin Nut, 52, 356

62. Leenen R, et al. (2000) A single dose of tea with or without milk increases plasma antioxidant activity in humans. Eur J Clin Nutr, 54,87

63. Warden BA, et al. (2001) Catechins are bioavailable in men and women drinking black tea throughout the day. J Nutr, 131(6), 1731-7

64. Sharzad S, et al (2001) Pharmokinetics of gallic acid and its relative bioavailability from tea in healthy humans. J Nutr; 131(4):1207-10

65. Pietta PG, et al (1998) Catechin metabolites after intake of green tea infusions. Biofactor 8; 111-8

66. Nakagawa K, et al (1997) Dose-dependent incorporation of tea catechins, (-)- epigallocatechin-3-gallate and (-)-epigallocatechin, into human plasma. Biosc Biotech Biochem 61; 1981-5

67. Yang CS, et al (1999) Inhibition of carcinogenesis by tea; bioavailability of tea polyphenols and mechanisms of actions. Proc Soc Exper Biol Med 220; 213-7

68. Serafini M, et al (1996) In vivo antioxidant effect of green and black tea in man. Eur J Clin Nutr; 50: 28-32

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Cancer Dictionary (C): Part 3

CCI-779

A drug used to treat advanced renal cell carcinoma (a type of kidney cancer). It is also being studied in the treatment of other types of cancer. CCI-779 blocks a protein involved in cell division, and may kill cancer cells. It is a type of rapamycin analog and serine/threonine kinase inhibitor. Also called temsirolimus and Torisel.

cCLB8

A chimeric (made from human and mouse proteins) monoclonal antibody being studied in the treatment of advanced kidney cancer and other types of cancer. Monoclonal antibodies are made in the laboratory and can locate and bind to substances in the body, including cancer cells. cCLB8 works by blocking inflammation and tumor growth. Also called anti-IL-6 chimeric monoclonal antibody and CNTO 328.

CD34 antigen

A protein found on the surface of some bone marrow and blood cells.

CD40-ligand

A substance that is being studied in the treatment of cancer. It binds to certain immune cells and may suppress cancer growth.

CDDO

A substance being studied in the treatment of some types of cancer. CDDO may block enzymes involved in inflammation and cancer growth. It is a type of antineoplastic plant product.

CDK inhibitor AT7519M (... in-HIH-bih-ter ...)

A substance being studied in the treatment of some types of cancer. CDK inhibitor AT7519M blocks enzymes needed for cells to divide. It is a type of cyclin-dependent kinase inhibitor. Also called AT7519M.

CEA

Carcinoembryonic antigen. A substance that is sometimes found in an increased amount in the blood of people who have certain cancers, other diseases, or who smoke. It is used as a tumor marker for colorectal cancer. Also called carcinoembryonic antigen.

CEA assay

A laboratory test to measure carcinoembryonic antigen (CEA), a substance that is sometimes found in an increased amount in the blood of people who have certain cancers.

cecum (SEE-kum)

A pouch that forms the first part of the large intestine. It connects the small intestine to the colon, which is part of the large intestine.

cedarwood (SEE-der-WOOD)

A type of evergreen tree with hard fragrant wood that is a member of the cypress family. The oil from the wood is used in soaps, shampoos, bath salts, perfumes, aromatherapy, and to keep insects away. The scientific name is Juniperus virginiana. Also called Eastern red cedar and red cedar.

cefepime

A drug used to treat infection. It belongs to the family of drugs called cephalosporin antibiotics.

cefixime

An antibiotic drug used to treat infection. It belongs to the family of drugs called cephalosporins.

ceftriaxone

A drug used to treat infection. It belongs to the family of drugs called cephalosporin antibiotics.

celecoxib (SEL-uh-KOK-sib)

A drug that reduces pain. Celecoxib belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is being studied in the prevention of cancer.

Celexa

A drug used to treat depression. It belongs to the families of drugs called antidepressant agents and selective serotonin reuptake inhibitors (SSRIs). Also called citalopram.

celiac disease

A digestive disease that is caused by an immune response to a protein called gluten, which is found in wheat, rye, barley, and oats. Celiac disease damages the lining of the small intestine and interferes with the absorption of nutrients from food. A person with celiac disease may become malnourished no matter how much food is consumed.

cell (sel)

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

cell culture (SEL KUL-chur)

The growth of microorganisms such as bacteria and yeast, or human, plant, or animal cells in the laboratory. Cell cultures may be used to diagnose infections, to test new drugs, and in research.

cell differentiation

The process during which young, immature (unspecialized) cells take on individual characteristics and reach their mature (specialized) form and function.

cell motility

The ability of a cell to move.

cell proliferation (SEL proh-LIH-fuh-RAY-shun)

An increase in the number of cells as a result of cell growth and cell division.

cell respiration

A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also called oxidative metabolism, aerobic metabolism, and aerobic respiration.

cell-cycle regulation

Any process that controls the series of events by which a cell goes through the cell cycle. During the cell cycle, a cell makes a copy of its DNA and other contents, and divides in two. When cell cycle regulation doesn’t happen correctly, cells may divide in an uncontrolled way, and diseases such as cancer can occur.

cell-to-cell signaling

The transfer of information from one cell to another.

CellCept (SEL-sept)

A drug used to prevent graft-versus-host disease (GVHD) after organ transplants. It is also being studied in the prevention of GVHD after stem cell transplants for cancer, and in the treatment of some autoimmune disorders. CellCept is a type of immunosuppressive agent. Also called mycophenolate mofetil.

cellular adhesion (SEL-yoo-ler ad-HEE-zhun)

The close adherence (bonding) to adjoining cell surfaces.

cellular adoptive immunotherapy (SEL-yoo-ler uh-DOP-tiv IH-myoo-noh-THAYR-uh-pee)

A treatment used to help the immune system fight cancer. A cancer patient’s T cells (a type of white blood cell) are collected and grown in the laboratory to increase the number of T cells that are able to kill the person’s cancer cells. These cancer-specific T cells are given back to the patient to help the immune system fight the cancer.

cellular metabolism (SEL-yoo-ler meh-TA-buh-lih-zum)

The sum of all chemical changes that take place in a cell through which energy and basic components are provided for essential processes, including the synthesis of new molecules and the breakdown and removal of others.

cellulitis

An acute, spreading infection of the deep tissues of the skin and muscle that causes the skin to become warm and tender and may also cause fever, chills, swollen lymph nodes, and blisters.

cellulose (SEL-yoo-lose)

A building block of plant cells and fiber. Cellulose cannot be digested by people, and is used to add bulk to the diet.

centimeter (SEN-tih-MEE-ter)

A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.

central nervous system (SEN-trul NER-vus SIS-tem)

CNS. The brain and spinal cord. Also called CNS.

central nervous system metastasis (SEN-trul NER-vus SIS-tem meh-TAS-tuh-sis)

CNS metastasis. Cancer that has spread from the original (primary) tumor to the central nervous system (CNS). Also called CNS metastasis.

central nervous system primitive neuroectodermal tumor (SEN-trul NER-vus SIS-tem PRI-muh-tiv NOOR-oh-EK-toh-DER-mul TOO-mer)

CNS PNET. A type of cancer that arises from a particular type of cell within the brain or spinal cord. Also called CNS PNET.

central nervous system prophylaxis (SEN-trul NER-vus SIS-tem pro-fih-LAK-sis)

Chemotherapy or radiation therapy given to the central nervous system (CNS) as a preventive treatment. It kills cancer cells that may be in the brain and spinal cord, even though no cancer has been detected there. Also called CNS prophylaxis, central nervous system sanctuary therapy, and CNS sanctuary therapy.

central nervous system sanctuary therapy (SEN-trul NER-vus SIS-tem SANK-choo-WAYR-ee THAYR-uh-pee)

Chemotherapy or radiation therapy given to the central nervous system (CNS) as a preventive treatment. It kills cancer cells that may be in the brain and spinal cord, even though no cancer has been detected there. Also called CNS sanctuary therapy, central nervous system prophylaxis, and CNS prophylaxis.

central nervous system tumor (SEN-trul NER-vus SIS-tem TOO-mer)

CNS tumor. A tumor of the central nervous system, including brain stem glioma, craniopharyngioma, medulloblastoma, and meningioma. Also called CNS tumor.

central venous access catheter

A tube surgically placed into a blood vessel for the purpose of giving intravenous fluid and drugs. It also can be used to obtain blood samples. This device avoids the need for separate needle insertions for each infusion or blood test. Examples of these devices include Hickman catheters, which require clamps to make sure the valve is closed, and Groshong catheters, which have a valve that opens as fluid is withdrawn or infused and remains closed when not in use.

CEP-2563 dihydrochloride (... dy-HY-droh-KLOR-ide)

A substance being studied in the treatment of some types of cancer. CEP-2563 dihyrochloride blocks a protein that increases the growth of some brain tumors and may cause tumor cells to die. It is a type of receptor tyrosine kinase inhibitor.

CEP-701

A drug being studied in the treatment of acute myeloid leukemia and some other types of cancer. It binds to a protein that is present in large amounts on the surface of acute myeloid leukemia cells and stops them from dividing. CEP-701 may also cause cancer cells to die. It is a type of receptor tyrosine kinase inhibitor and a type of indolocarbazole alkaloid. Also called lestaurtinib.

cephalexin

An antibiotic drug that belongs to the family of drugs called cephalosporins.

cephalosporin

A drug used to treat bacterial infections. It belongs to the family of drugs called antibiotics.

ceramide

A type of fat produced in the body. It may cause some types of cells to die and is being studied in cancer treatment.

cerebellar hemangioblastoma (ser-eh-BEH-ler hee-MAN-jee-OH-blas-TOH-muh)

A benign, slow-growing tumor in the cerebellum (part of the brain at the back of the head), made up of abnormal blood vessel growth. People with von Hippel-Landau disease have an increased risk of developing hemangioblastomas.

cerebellopontine (SER-uh-BEL-o-PON-teen)

Having to do with two structures of the brain, the cerebellum (located at the lower back of the brain) and the pons (located at the base of the brain in front of the cerebellum) and the area between them.

cerebellum (ser-uh-BEL-um)

The portion of the brain in the back of the head between the cerebrum and the brain stem. The cerebellum controls balance for walking and standing, and other complex motor functions.

cerebral hemisphere (seh-REE-bral HEM-is-feer)

One half of the cerebrum, the part of the brain that controls muscle functions and also controls speech, thought, emotions, reading, writing, and learning. The right hemisphere controls the muscles on the left side of the body, and the left hemisphere controls the muscles on the right side of the body.

cerebrospinal fluid (seh-REE-broh-SPY-nul...)

The fluid that flows in and around the hollow spaces of the brain and spinal cord, and between two of the meninges (the thin layers of tissue that cover and protect the brain and spinal cord). Cerebrospinal fluid is made by tissue called the choroid plexus in the ventricles (hollow spaces) in the brain. Also called CSF.

cerebrospinal fluid diversion

A process used to drain fluid that has built up around the brain and spinal cord. A shunt (a long, thin tube) is placed in a ventricle of the brain and threaded under the skin to another part of the body, usually the abdomen. The shunt carries excess fluid away from the brain so it may be absorbed elsewhere in the body.

cerebrum (seh-REE-brum)

The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. Areas within the cerebrum control muscle functions and also control speech, thought, emotions, reading, writing, and learning.

Cerubidine (seh-ROO-bih-dine)

A drug used to treat acute leukemias and some other types of cancer. Cerubidine blocks topoisomerases, enzymes that are needed for cell growth and the division and repair of DNA, and may kill cancer cells. It is a type of anthracycline antibiotic and a type of topoisomerase inhibitor. Also called daunorubicin and daunorubicin hydrochloride.

cervical (SER-vih-kul)

Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck. Cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the “neck”) of the uterus.

cervical cancer (SER-vih-kul KAN-ser)

Cancer that forms in tissues of the cervix (the organ connecting the uterus and vagina). It is usually a slow-growing cancer that may not have symptoms but can be found with regular Pap tests (a procedure in which cells are scraped from the cervix and looked at under a microscope).

cervical intraepithelial neoplasia (SER-vih-kul IN-truh-eh-pih-THEE-lee-ul NEE-oh-PLAY-zhuh)

Growth of abnormal cells on the surface of the cervix. Numbers from 1 to 3 may be used to describe how abnormal the cells are and how much of the cervical tissue is involved. Also called CIN.

cervical squamous intraepithelial neoplasia 1 (SER-vih-kul SKWAY-mus IN-truh-eh-pih-THEE-lee-ul NEE-oh-PLAY-zhuh ...)

A condition in which slightly abnormal cells grow on the thin layer of tissue that covers the cervix. These abnormal cells are not malignant (cancerous) but may become cancer. Also called CIN 1.

cervical squamous intraepithelial neoplasia 2 (SER-vih-kul SKWAY-mus IN-truh-eh-pih-THEE-lee-ul NEE-oh-PLAY-zhuh ...)

A condition in which moderately abnormal cells grow on the thin layer of tissue that covers the cervix. These abnormal cells are not malignant (cancerous) but may become cancer. Also called CIN 2.

cervical squamous intraepithelial neoplasia 3 (SER-vih-kul SKWAY-mus IN-truh-eh-pih-THEE-lee-ul NEE-oh-PLAY-zhuh …)

Abnormal cells are found in the cervical epithelium (the innermost lining of the cervix). These abnormal cells may become cancer and spread into nearby normal tissue. Also called stage 0 cervical carcinoma in situ and CIN 3.

cervicectomy (SER-vih-SEK-toh-mee)

Surgery to remove the cervix (the end of the uterus that forms a canal between the uterus and the vagina).The upper part of the vagina and certain pelvic lymph nodes may also be removed. Also called a trachelectomy.

cervix (SER-viks)

The lower, narrow end of the uterus that forms a canal between the uterus and vagina.

cetuximab (seh-TUK-sih-mab)

A monoclonal antibody used to treat certain types of head and neck cancer, and colorectal cancer that has spread to other parts of the body. It is also being studied in the treatment of other types of cancer. Monoclonal antibodies are made in the laboratory and can locate and bind to cancer cells. Cetuximab binds to the epidermal growth factor receptor (EGFR), which is found on the surface of some types of cancer cells. Also called Erbitux.

cevimeline

A substance that increases production of saliva and tears. It is being studied as a treatment for dry mouth caused by radiation therapy to the head and neck. It belongs to the family of drugs called cholinergic enhancers.

CGP 48664

A substance that is being studied in the treatment of cancer. It belongs to the family of drugs called S-adenosylmethionine decarboxylase inhibitors.

Chamberlain procedure (CHAYM-ber-len proh-SEE-jer)

A procedure in which a tube is inserted into the chest to view the tissues and organs in the area between the lungs and between the breastbone and heart. The tube is inserted through an incision next to the breastbone. This procedure is usually used to get a tissue sample from the lymph nodes on the left side of the chest. Also called anterior mediastinotomy.

chamomile (KA-muh-mile)

A family of plants with daisy-like flowers. Two types are German chamomile and Roman or English chamomile. These are used in teas to calm and relax, to improve sleep, and to help with stomach problems. The essential oil (scented liquid taken from plants) of chamomile is used in perfumes, shampoos, lotions, and aromatherapy.

change of life

The time of life when a woman no longer has menstrual periods. Change of life is reached when she hasn't had a period for 12 months in a row. Also called menopause.

Chantix (CHAN-tix)

A drug used to help people stop smoking by acting the same way nicotine acts in the brain. It is a type of nicotine receptor partial agonist. Also called varenicline tartrate.

chaplain (CHA-plin)

A member of the clergy in charge of a chapel or who works with the military or with an institution, such as a hospital.

charged-particle radiation therapy (… PAR-tih-kul RAY-dee-AY-shun THAYR-uh-pee)

A type of external radiation therapy that uses a special machine to make invisible, high-energy particles (protons or helium ions) that kill cancer cells. This type of radiation may cause less damage to nearby healthy tissue than radiation therapy with high-energy x-rays.

chemical imbalance (KEH-mih-kul im-BA-lunts)

Too much or too little of any substance that helps the body work the way it should. A chemical imbalance may be caused by certain tumors and can cause changes in behavior or emotion.

chemoembolization

A procedure in which the blood supply to the tumor is blocked surgically or mechanically and anticancer drugs are administered directly into the tumor. This permits a higher concentration of drug to be in contact with the tumor for a longer period of time.

chemoimmunotherapy (KEE-moh-IH-myoo-noh-THAYR-uh-pee)

Chemotherapy combined with immunotherapy. Chemotherapy uses different drugs to kill or slow the growth of cancer cells; immunotherapy uses treatments to stimulate or restore the ability of the immune system to fight cancer.

chemoprevention (KEE-mo-pre-VEN-shun)

The use of drugs, vitamins, or other agents to try to reduce the risk of, or delay the development or recurrence of, cancer.

chemoprevention study

In cancer prevention, a clinical trial that studies whether taking certain medicines, vitamins, minerals, or food supplements can prevent cancer. Also called agent study.

chemoprotective

A quality of some drugs used in cancer treatment. Chemoprotective agents protect healthy tissue from the toxic effects of anticancer drugs.

chemoradiation

Treatment that combines chemotherapy with radiation therapy. Also called chemoradiotherapy.

chemoradiotherapy (KEE-moh-RAY-dee-oh-THAYR-uh-pee)

Treatment that combines chemotherapy with radiation therapy. Also called chemoradiation.

chemosensitivity

The susceptibility of tumor cells to the cell-killing effects of anticancer drugs.

chemosensitivity assay

A laboratory test that measures the number of tumor cells that are killed by a cancer drug. The test is done after the tumor cells are removed from the body. A chemosensitivity assay may help in choosing the best drug or drugs for the cancer being treated.

chemosensitizer

A drug that makes tumor cells more sensitive to the effects of chemotherapy.

chemotherapeutic agent

A drug used to treat cancer.

chemotherapy (KEE-moh-THAYR-uh-pee)

Treatment with drugs that kill cancer cells.

chest wall

The muscles, bones, and joints that make up the area of the body between the neck and the abdomen.

chest x-ray

An x-ray of the structures inside the chest. An x-ray is a type of high-energy radiation that can go through the body and onto film, making pictures of areas inside the chest, which can be used to diagnose disease.

chiasma (ki-AZ-ma)

An anatomy term for an X-shaped crossing (for example, of nerves or tendons).

child-life worker

A professional who is responsible for making a child's hospital and treatment experience less scary.

Chinese meridian theory (chy-NEEZ meh-RID-ee-un THEER-ee)

In traditional Chinese medicine, meridians are channels that form a network in the body, through which qi (vital energy) flows. Blocked qi causes pain or illness. The flow of qi is restored by using pressure, needles, suction, or heat at hundreds of specific points along the meridians.

Chinese rhubarb (chy-NEEZ ROO-barb)

The root of this plant has been used in some cultures to treat certain medical problems. It may have anti-inflammatory and anticancer effects. The scientific name is Rheum palmatum or Rheum officinale. Also called rhubarb, da-huang, Indian rhubarb, and Turkish rhubarb.

CHIR-265

A substance being studied in the treatment of melanoma. CHIR-265 may block the growth of tumors and the growth of blood vessels from surrounding tissue to the tumor. It is a type of Raf kinase inhibitor and angiogenesis inhibitor.

chitin

A type of polysaccharide (sugar molecule) that is made by some plants and animals. The hard outer shell of shrimp, lobsters, and many insects is made of chitin.

chlorambucil

An anticancer drug that belongs to the family of drugs called alkylating agents.

chlorine

A chemical used to disinfect water and as a bleach.

chloroma

A malignant, green-colored tumor of myeloid cells (a type of immature white blood cell). This tumor is usually associated with myelogenous leukemia. Also called granulocytic sarcoma.

chloroquinoxaline sulfonamide (KLOR-oh-kwih-NOK-sah-leen sul-FAH-nuh-MIDE)

CQS. A substance being studied in the treatment of cancer. It is a type of topoisomerase inhibitor. Also called CQS.

cholangiocarcinoma

A rare type of cancer that develops in cells that line the bile ducts in the liver. Cancer that forms where the right and left ducts meet is called Klatskin tumor.

cholangiosarcoma (ko-LAN-jee-o-sar-KO-ma)

A tumor of the connective tissues of the bile ducts.

cholecalciferol (KOH-leh-kal-SIH-fuh-rol)

A nutrient that helps the body use calcium and phosphorus and make strong bones and teeth. It is found in fatty fish, eggs, and dairy products. The skin can also make cholecalciferol when exposed to sunshine. Not getting enough cholecalciferol can cause a bone disease called rickets. Cholecalciferol is being studied in the prevention and treatment of some types of cancer. Also called vitamin D.

cholelith

Solid material that forms in the gallbladder or common bile duct. Choleliths are made of cholesterol or other substances found in the gallbladder. They may occur as one large stone or as many small ones, and vary from the size of a golf ball to a grain of sand. Also called gallstone.

cholestasis

Any condition in which the release of bile from the liver is blocked. The blockage can occur in the liver (intrahepatic cholestasis) or in the bile ducts (extrahepatic cholestasis).

cholesterol (kuh-LESS-tuh-rawl)

A waxy, fat-like substance made in the liver, and found in the blood and in all cells of the body. Cholesterol is important for good health and is needed for making cell walls, tissues, hormones, vitamin D, and bile acid. Cholesterol also comes from eating foods taken from animals such as egg yolks, meat, and whole-milk dairy products. Too much cholesterol in the blood may build up in blood vessel walls, block blood flow to tissues and organs, and increase the risk of developing heart disease and stroke.

chondrocyte

Cartilage cell. Chondrocytes make the structural components of cartilage.

chondroitin sulfate

The major glycosaminoglycan (a type of sugar molecule) in cartilage.

chondrosarcoma (KAHN-dro-sar-KO-ma)

A type of cancer that forms in cartilage.

chordoma (kor-DO-ma)

A type of bone cancer that usually starts in the lower spinal cord.

chorioadenoma destruens (KOR-ee-oh-A-deh-NOH-muh des-TROO-ens)

A type of cancer that grows into the muscular wall of the uterus. It is formed after conception (fertilization of an egg by a sperm). It may spread to other parts of the body, such as the vagina, vulva, and lung. Also called invasive hydatidiform mole.

chorioallantoic membrane

The membrane in hens' eggs that helps chicken embryos get enough oxygen and calcium for development. The calcium comes from the egg shell.

chorioblastoma (KOR-ee-oh-blas-TOH-muh)

A malignant, fast-growing tumor that develops from trophoblastic cells (cells that help an embryo attach to the uterus and help form the placenta). Almost all chorioblastomas form in the uterus after fertilization of an egg by a sperm, but a small number form in a testis or an ovary. Chorioblastomas spread through the blood to other organs, especially the lungs. They are a type of gestational trophoblastic disease. Also called choriocarcinoma, chorioepithelioma, and chorionic carcinoma.

choriocarcinoma (KOR-ee-oh-KAR-sih-NOH-muh)

A malignant, fast-growing tumor that develops from trophoblastic cells (cells that help an embryo attach to the uterus and help form the placenta). Almost all choriocarcinomas form in the uterus after fertilization of an egg by a sperm, but a small number form in a testis or an ovary. Choriocarcinomas spread through the blood to other organs, especially the lungs. They are a type of gestational trophoblastic disease. Also called chorioblastoma, chorioepithelioma, and chorionic carcinoma.

chorioepithelioma (KOR-ee-oh-EH-pih-THEE-lee-OH-muh)

A malignant, fast-growing tumor that develops from trophoblastic cells (cells that help an embryo attach to the uterus and help form the placenta). Almost all chorioepitheliomas form in the uterus after fertilization of an egg by a sperm, but a small number form in a testis or an ovary. Chorioepitheliomas spread through the blood to other organs, especially the lungs. They are a type of gestational trophoblastic disease. Also called chorioblastoma, choriocarcinoma, and chorionic carcinoma.

chorionic carcinoma (KOR-ee-AH-nik KAR-sih-NOH-muh)

A malignant, fast-growing tumor that develops from trophoblastic cells (cells that help an embryo attach to the uterus and help form the placenta). Almost all chorionic carcinomas form in the uterus after fertilization of an egg by a sperm, but a small number form in a testis or an ovary. Chorionic carcinomas spread through the blood to other organs, especially the lungs. They are a type of gestational trophoblastic disease. Also called choriocarcinoma, chorioblastoma, and chorioepithelioma.

choroid (KOR-oid)

A thin layer of tissue that is part of the middle layer of the wall of the eye, between the sclera (white outer layer of the eye) and the retina (the inner layer of nerve tissue at the back of the eye). The choriod is filled with blood vessels that bring oxygen and nutrients to the eye.

choroid plexus tumor (KOR-oyd PLEK-sus TOO-mer)

A rare type of cancer that occurs in the ventricles of the brain. It usually occurs in children younger than 2 years.

CHPP

Continuous hyperthermic peritoneal perfusion. A procedure that bathes the abdominal cavity in fluid that contains anticancer drugs. This fluid is warmer than body temperature. This procedure appears to kill cancer cells without harming normal cells. Also called continuous hyperthermic peritoneal perfusion.

chromaffin cell (KROH-muh-fin ...)

A type of cell that makes neurohormones (chemicals that are made by nerve cells and used to send signals to other cells) and releases them into the blood. Chromaffin cells make epinephrine (adrenaline) and norepinephrine (noradrenaline). They are found in the adrenal glands or in groups of nerve cells called ganglia.

chromosome (KROH-muh-some)

Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes.

chronic (KRAHN-ik)

A disease or condition that persists or progresses over a long period of time.

chronic eosinophilic leukemia

A disease in which too many eosinophils (a type of white blood cell) are found in the bone marrow, blood, and other tissues. Chronic eosinophilic leukemia may stay the same for many years, or it may progress quickly to acute leukemia.

chronic fatigue syndrome (KRAH-nik fuh-TEEG SIN-drome)

A condition lasting for more than 6 months in which a person feels tired most of the time and may have trouble concentrating and carrying out daily activities. Other symptoms include sore throat, fever, muscle weakness, headache, and joint pain.

chronic granulocytic leukemia (KRAH-nik GRAN-yoo-loh-SIH-tik loo-KEE-mee-uh)

A slowly progressing disease in which too many white blood cells (not lymphocytes) are made in the bone marrow. Also called chronic myelogenous leukemia, chronic myeloid leukemia, and CML.

chronic idiopathic myelofibrosis (KRAH-nik IH-dee-oh-PA-thik MY-eh-loh-fy-BROH-sis)

A progressive, chronic disease in which the bone marrow is replaced by fibrous tissue and blood is made in organs such as the liver and the spleen, instead of in the bone marrow. This disease is marked by an enlarged spleen and progressive anemia. Also called agnogenic myeloid metaplasia, primary myelofibrosis, myelosclerosis with myeloid metaplasia, and idiopathic myelofibrosis.

chronic leukemia (KRAHN-ik)

A slowly progressing cancer that starts in blood-forming tissues such as the bone marrow, and causes large numbers of white blood cells to be produced and enter the blood stream.

chronic lymphoblastic leukemia (KRAH-nik LIM-foh-BLAS-tik loo-KEE-mee-uh)

CLL. A slow-growing type of leukemia (blood cancer) in which too many lymphoblasts (immature white blood cells) are found in the blood and bone marrow. Also called chronic lymphocytic leukemia and CLL.

chronic lymphocytic leukemia (KRAH-nik LIM-foh-SIH-tik loo-KEE-mee-uh)

CLL. A slow-growing type of leukemia (blood cancer) in which too many lymphoblasts (immature white blood cells) are found in the blood and bone marrow. Also called chronic lymphoblastic leukemia and CLL.

chronic myelogenous leukemia (KRAH-nik MY-eh-LAH-jeh-nus loo-KEE-mee-uh)

CML. A slowly progressing disease in which too many white blood cells (not lymphocytes) are made in the bone marrow. Also called CML, chronic granulocytic leukemia, and chronic myeloid leukemia.

chronic myeloid leukemia (KRAH-nik MY-eh-loyd loo-KEE-mee-uh)

CML. A slowly progressing disease in which too many white blood cells (not lymphocytes) are made in the bone marrow. Also called chronic myelogenous leukemia, CML, and chronic granulocytic leukemia.

chronic myelomonocytic leukemia (KRAH-nik MY-eh-loh-MAH-noh-SIH-tik loo-KEE-mee-uh)

A slowly progressing type of myelodysplastic/myeloproliferative disease in which too many myelomonocytes (a type of white blood cell) are in the bone marrow, crowding out other normal blood cells, such as other white blood cells, red blood cells, and platelets. Also called CMML.

chronic neutrophilic leukemia

A disease in which too many neutrophils (a type of white blood cell) are found in the blood. The extra neutrophils may cause the spleen and liver to become enlarged. Chronic neutrophilic leukemia may stay the same for many years or it may progress quickly to acute leukemia.

chronic obstructive pulmonary disease (KRAH-nik ob-STRUK-tiv PUL-muh-NAYR-ee dih-ZEEZ)

COPD. A type of lung disease marked by permanent damage to tissues in the lungs, making it hard to breathe. Chronic obstructive pulmonary disease includes chronic bronchitis, in which the bronchi (large air passages) are inflamed and scarred, and emphysema, in which the alveoli (tiny air sacs) are damaged. It develops over many years and is usually caused by cigarette smoking. Also called COPD.

chronic pain

Pain that can range from mild to severe, and persists or progresses over a long period of time.

chronic phase (KRAHN-ik fayz)

Refers to the early stages of chronic myelogenous leukemia or chronic lymphocytic leukemia. The number of mature and immature abnormal white blood cells in the bone marrow and blood is higher than normal, but lower than in the accelerated or blast phase.

chronic phase chronic myelogenous leukemia (KRAH-nik FAYZ KRAH-nik MY-eh-LAH-jeh-nus loo-KEE-mee-uh)

A phase of chronic myelogenous leukemia in which 5% or fewer of the cells in the blood and bone marrow are blast cells (immature blood cells). This phase may last from several months to several years, and there may be no symptoms of leukemia.

CHS 828

A drug that is being studied in the treatment of solid tumors.

CI-1033

A substance being studied in the treatment of some types of cancer. CI-1033 blocks the action of proteins called epidermal growth factor receptors, and may cause cancer cells to die. It is a type of tyrosine kinase inhibitor. Also called canertinib and canertinib dihydrochloride.

CI-958

A substance being studied in the treatment of some types of cancer. CI-958 binds to DNA and inserts itself into the DNA structure. It stops cells from repairing damage to DNA and from making more DNA, RNA, and protein. CI-958 may kill cancer cells. It is a type of DNA intercalator. Also called sedoxantrone trihydrochloride.

CI-980

An anticancer drug that belongs to the family of drugs called mitotic inhibitors. Also called mivobulin isethionate.

CI-994

A substance being studied in the treatment of non-small cell lung cancer. Also called N-acetyldinaline.

cidofovir

A drug used in the treatment of infections caused by viruses.

cilengitide

A substance that is being studied as an anticancer and antiangiogenesis drug. Also called EMD 121974.

ciliary body (SIH-lee-ayr-ee ...)

A part of the middle layer of the wall of the eye. The ciliary body includes the ring-shaped muscle that changes the size of the pupil and the shape of the lens when the eye focuses. It also makes the fluid that fills the eye.

cimetidine

A drug usually used to treat stomach ulcers and heartburn. It is also commonly used in a regimen to prevent allergic reactions.

CIN

Growth of abnormal cells on the surface of the cervix. Numbers from 1 to 3 may be used to describe how abnormal the cells are and how much of the cervical tissue is involved. Also called cervical intraepithelial neoplasia.

CIN 1

A condition in which slightly abnormal cells grow on the thin layer of tissue that covers the cervix. These abnormal cells are not malignant (cancerous) but may become cancer. Also called cervical squamous intraepithelial neoplasia 1.

CIN 2

A condition in which moderately abnormal cells grow on the thin layer of tissue that covers the cervix. These abnormal cells are not malignant (cancerous) but may become cancer. Also called cervical squamous intraepithelial neoplasia 2.

CIN 3

Abnormal cells are found in the cervical epithelium (the innermost lining of the cervix). These abnormal cells may become cancer and spread into nearby normal tissue. Also called stage 0 cervical carcinoma in situ and cervical squamous intraepithelial neoplasia 3.

Cipro

A drug that is used to treat infections caused by bacteria and is being studied in the treatment of bladder cancer. Cipro is a type of fluoroquinolone. Also called ciprofloxacin.

ciprofloxacin (sip-roe-FLOX-a-sin)

A drug that is used to treat infections caused by bacteria and is being studied in the treatment of bladder cancer. Ciprofloxacin is a type of fluoroquinolone. Also called Cipro.

circulation (ser-kyoo-LAY-shun)

In the body, the flow of blood through the heart and blood vessels, and the flow of lymph through the lymph vessels.

circulatory system (SER-kyoo-lah-tor-ee SIS-tem)

The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system.

circumcision (SUR-kum-SIH-zhun)

Surgery to remove part or all of the foreskin (loose skin that covers the head of the penis).

cirrhosis

A type of chronic, progressive liver disease in which liver cells are replaced by scar tissue.

CIS

The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER (1-800-422-6237), or by using the LiveHelp instant-messaging service at https://cissecure.nci.nih.gov/livehelp/welcome.asp. Also called Cancer Information Service.

cisplatin (sis-PLA-tin)

A drug used to treat many types of cancer. Cisplatin contains the metal platinum. It kills cancer cells by damaging their DNA and stopping them from dividing. Cisplatin is a type of alkylating agent.

citalopram (sy-TAL-oh-pram)

A drug used to treat depression. It belongs to the families of drugs called antidepressant agents and selective serotonin reuptake inhibitors (SSRIs). Also called Celexa.

citric acid/potassium-sodium citrate (SIH-trik A-sid/poh-TAH-see-um-SOH-dee-um SIH-trayt)

A drug used in the treatment of metabolic acidosis (a disorder in which the blood is too acidic).

cladribine

An anticancer drug that belongs to the family of drugs called antimetabolites.

clarithromycin

An antibiotic drug used in the treatment of infections. It belongs to the family of drugs called macrolides.

classical Hodgkin lymphoma (KLA-sih-kul HOJ-kin lim-FOH-muh)

The most common type of Hodgkin lymphoma, which is a cancer of the immune system. Classical Hodgkin lymphoma is marked by the presence of a type of cell called the Reed-Sternberg cell.

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