Metastasis - The spread of a cancer/tumor to another part of the body, not by the formation of a root, but by releasing bad cells into the blood streams or lymph streams that carry the cell(s) to a new location of invasion or growth.

Microscope - A viewing tool used by doctors to look at stained or unstained thinly cut or thinly placed specimens (samples or pieces) of biopsied tissue at powers of ten, hundreds, etc. The microscope is used to see deep into the centers of tissue that has been removed and is dead. Individual cells and parts of cells may be seen.

Misnomer - Wrong name. An improper, although perhaps scientific, name that was used in the past and will continue to be used in the future, merely for convenience. It's just too difficult to change to another term.

MOHS Surgery - MOHS Surgery is a form of excisional surgery that acts as a "perpetual biopsy," a term coined by the author. MOHS Surgery is the most accurate form of skin-cancer removal and spares more normal tissue than any other method. It is, unfortunately, expensive and requires proper training and precision in order to assure that it is being done properly. MOHS Surgery was developed by Dr. Frederick E. Mohs (deceased 2003), at the University of Wisconsin in the early half of this century. Mohs Surgery was recently used to treat skin cancers on both President Reagan and President Bush. Mohs Surgery is a form of horizontal section analysis and involves the removal of a bowl-shaped tissue specimen. MOHS is different from excisional surgery or excisional biopsy removal, which usually implies vertical sectioning. Vertical sections have an inherent failure rate. See Excisional biopsy.

Mole - A term understood by most dermatologists to represent a NEVUS. See Nevus. Unfortunately, many of the public use the term "mole" very loosely, sometimes including nevi (the plural of nevus), seborrheic keratoses and skin tags, among other growths. The public usually understands moles to be "good" or "bad." A "good" mole may best be thought of as a benign (common) nevus or an only slightly dysplastic nevus. See Dysplastic Nevus. A "bad" mole may best be thought of as a severely dysplastic nevus. See Atypical Mole. A mole on the skin does not necessarily mean that the growth will burrow like the animal.

Nevi - More than one nevus, plural of nevus.

Nevo-melanocyte - The cells existing along the spectrum between nevus or mole cells and melanocytes. These cells can be totally benign in nature or they may be more atypical, resulting in dysplastic moles and even melanoma. The true behavior of a nevo-melanocytic lesion can usually be determined by biopsying it and examining it under the microscope, rather than the doctor "eye-balling" it in the clinic. Nevertheless, the clinical examination sets up the more-definitive biopsy.

Nevus - A group of cells commonly referred to by the lay public as a "mole." A nevus may be congenital, meaning the mole probably existed at birth, or finally arose to the surface and became noticeable within the first year or so of life. Other nevi are considered acquired, which is probably best thought of as not being congenital or occurring sometime after the first years of life. The author believes that even acquired nevi are pre-programmed into a patient's genes just as a congenital nevus is. Both types may, in the future, be found to be genetically related. (The author seriously doubts that any external event like poison, radiation or trauma actually causes a nevus and, therefore, considers the term "acquired" to be a misnomer.) Another type of acquired mole is the dysplastic (atypical) mole.

Nevus recurrens - A mole of any type that has grown back after it was partly removed from the body by a surgical biopsy or surgery. Also, trauma such as cutting, tearing, etc., can cause part of a mole to look like nevus recurrens under the microscope and therefore cause concern that it might be melanoma. It helps for the patient to tell the doctor that a mole was previously cut or traumatized so that the doctor can advise the dermatopathologist who will examine the biopsy specimens(s) of the all-important history that may help determine a nevus recurrens.

Nucleus - The genetic control center of a cell, made of DNA. The nucleus is composed of chromosome genes that are tightly packed and pick up the dark purple stain hematoxylin. Cancer or abnormal cells often show irregularities in the nucleus.

Photodynamic therapy (PDT) - The use of a chemical, given orally (by mouth), intravenously (through the blood vessels) or topically (directly to the skin), that can be activated or energized by light to destroy a target tissue. This activation causes the formation of new molecules and free radicals that form other chemicals that, in turn, may destroy the targeted material to a varying extent. PDT is less effective for thick lesions. Skin cancers are usually thicker than precancers and respond less well. PDT has been only modestly successful in treating the simplest forms of skin cancer. Precancers are usually thinner and have a better response to PDT. As of 2001, PDT treatments for precancer with amino-levulinic acid are time consuming and painful and have only gained limited acceptance in mainstream dermatologic therapy. The author foresees a limited role in the use of PDT to treat actinic keratoses and other superficial skin growths in the future if the questions of length of pain and length of therapy are not able to be improved..

Plastic surgeon - See also Board certified and Plastic surgery. A doctor who will surgically change, mold or shape a portion of a human being. A plastic surgeon rarely uses plastic. Plastic surgery is practiced by many different branches of medicine including Ear, Nose and Throat Surgeons, General Surgeons, Dermatologists, Ophthalmologists, Oculoplastic (a branch of Ophthalmology) Surgeons and Plastic Surgeons (common, usual variety) Board certification of a Plastic and Reconstructive Surgeon means that an individual has passed a test given by a "board" of "authoritative" individuals. Some board-certification tests may examine only memory by a paper test or computer exam, some tests are oral and some tests are physical, involving the doctor’s treatment or examination of a patient. Board examinations in plastic surgery were originally meant to restrict the practice of a certain portion of medicine to doctors who are "qualified" and have studied at an "approved training center" to perform plastic surgery. A plastic surgeon may sit for the board certification examination after completing 5 years of general surgery (cutting bowels, etc.) followed by just 2 years of plastic surgery training. Some boards have been used as tools to restrain trade or limit other specialists).

Plastic surgery - Surgery to change, mold or shape. It rarely has anything to do with the use of plastic. Plastic surgery is practiced by many different branches of medicine including Ear, Nose and Throat Surgeons, General Surgeons, Dermatologists, Ophthalmologists, Oculoplastic (a branch of Ophthalmology) Surgeons and Plastic Surgeons (common, usual variety). Plastic surgery is also used when doctors repair a defect. It should be performed in a meticulous and fine fashion by whatever type of doctor is doing the work. It was not until the middle of the last century that certain doctors felt that is would be desirable for them to break away as a group from other surgical specialties and form the American Society of Plastic and Reconstructive Surgeons with a TWO year training period (shorter than almost any other specialty). Thus about 50 years ago, the American Board of Plastic and Reconstructive Surgery was formed by many of the same doctors and only allowed doctors who were "grandfathered-in" and doctors completing the TWO year training period just mentioned to sit the board. Unfortunately, passing a board examination does not guarantee that a doctor is gifted with a scalpel, laser, liposuction device or sewing needle.

Prognosis - The predicted outcome of a disease or condition following either treatment or no treatment. Usually for potentially lethal skin cancers, like squamous-cell carcinoma and melanoma, prognosis is often measured in the five-year survival rate, i.e., the percent of patients who will be alive at the end of five years. For skin cancers known to destroy skin and structures locally, like basal-cell cancer, prognosis is usually measured in chances for the tumor to return following either treatment or no treatment, e.g., the recurrence rate at five years.

Process - A natural happening, usually marked by gradual changes, that ends in an expected result. A process may also be a series of actions or operations. As used in this text, a process may be a growth or the way cells are growing, be it normal or abnormal.

Protoporphryn IX - A photoactive (light-active) compound naturally occurring in the human body as a result of the conversion of aminolevulinic acid. Protoporphryn IX may collect in especially actively growing cells that are usually a sign of disorder, like precancer or cancer. Certain wave lengths of light cause Protoporphryn IX to absorb the light energy and to kill cells in which the protoporphryn is present in excess. This is the basis for photodynamic therapy, PDT (please refer to this term in the glossary).

Radiation therapy - The use of x-rays, ultraviolet rays and/or any electromagnetic radiation, possibly even light, in order to treat skin cancer or skin disease. An example of radiation therapy is the use of x-radiation to treat acne in children decades ago, which now causes those same patients to grow skin cancers wildly and aggressively. Another example would be the use of x-radiation or other radiation to destroy a skin cancer, such as a cancer growing into the ear of an 85-year-old patient, in whom major reconstructive surgery could cause a problem with bleeding, stress or heart disease.

Recurrence or Recurrent ­ A description of a tumor that, having FAILED previous medically acceptable and properly performed treatment(s), has re-grown.

Repair - The closing, fixing or covering of a defect (hole in the skin, fat, muscle or bone) where a skin tumor, cancer or growth has been removed, usually using the patient's own natural skin. In the future, skin repair may be accomplished using cloned or grown skin. The term could be loosely applied to repairing the skin with synthetic materials, as well.