Scottish Referral Guidelines for Suspected Cancer 2025

Appendix 6 – Glossary of Terms

5-alpha reductase inhibitors - Medications that treat enlarged prostate glands (like finasteride and dutasteride)

ABCDE - Asymmetry, Border, Colour, Diameter, Evolving

ACRT - Active Clinical Referral Triage

Actinic keratoses - Dry, scaly patches of skin that have been damaged by the sun

Aero-digestive cancers - Collectively, cancers of various human body sites, such as the oral cavity, pharynx, oesophagus and larynx

AHP - Allied Health Professional

Alkylating agents - A class of antineoplastic drug that damage DNA, preventing cell replication - used in cancer treatment

ALP - Alkaline Phosphatase - an enzyme found in the body, particularly in the liver and bones

Amelanotic melanoma - A rare subtype of melanoma that lacks the typical dark pigment (melanin), appearing as pink, red, or skin-coloured

Anal excoriation - The abrasion of the skin around the anus

ANP - Advanced Nurse Practitioner

Ascites - The accumulation of fluid in the peritoneal cavity (the peritoneum is a membrane that lines the inside of the abdomen and pelvis)

Auditory meatus - The ear canal, specifically both the external (leading to the eardrum) and internal (connecting the inner ear to the brain) passages

Axillary lump - A swelling or bump in the axillary area (underarm)

B symptoms - In the context of lymphoma refers to a set of systemic symptoms – fever, night sweats, and unexplained weight loss

Barrett’s oesophagus - A condition where the lower section of the gullet is damaged by acid from the stomach causing the cells to change

Basal cell - A small, round cell found in the lower part (or base) of the epidermis – the outer layer of the skin

Basosquamous carcinoma - A rare, aggressive non-melanoma skin cancer

BCC - Basal Cell Carcinoma

Benign melanocytic naevi - Commonly known as moles, these are harmless, pigmented skin lesions caused by clusters of melanocytes

Blood borne virus screen - A blood test that checks for the presence of certain viruses transmitted through blood, such as HIV, Hepatitis B, and Hepatitis C

Blueberry muffin appearance - Skin appearance in newborns characterised by multiple, raised, blue or purple lesions

BMI - Body Mass Index

BRAN - Benefit, Risk, Alternative, Nothing

BRCA - Breast Cancer genes

Brief intervention - A short, structured conversation designed to motivate patients

Bronchiectasis - A long-term condition where the airways of the lungs become widened

CA125 - Cancer Antigen 125 – a protein found on the surface of ovarian cancer cells and in some normal tissues and some other cancers

Calprotectin - A protein biomarker, specifically a calcium-binding protein, released during inflammation in the gastrointestinal tract

Carcinomas - A cancer arising in the epithelial tissue of the skin or of the lining of internal organs

CfSD - Centre for Sustainable Delivery

Chest x-ray shows consolidation - Indicates that the air-filled spaces in the lungs are replaced with fluid, cells, or other materials, appearing as a white, dense area

Chondrosarcoma - A type of bone cancer that develops in cartilage cells

Clinical Frailty Scale - A way to summarise the overall level of fitness or frailty of an older adult

CLL - Chronic Lymphocytic Leukaemia

CML - Chronic Myeloid Leukaemia

CNS - Central Nervous System

Cognitive change - Alterations in mental processes and abilities

Connective tissue cancers - A group of cancers that originate in the body’s supportive and connective tissues, including bone, cartilage, fat, muscle, blood vessels, and nerves

Corpus uteri - The main body of the uterus (womb)

CPES - National Cancer Patient Experience Survey

CRAB - Raised Calcium, Renal Impairment, Anaemia, Bone pain

Cranial nerve palsy - A condition where one or more of the 12 cranial nerves are damaged or dysfunctional, leading to weakness or paralysis of the muscles they control

CRP - C - Reactive Protein

CRUK - Cancer Research United Kingdom

CT - Computed Tomography

CYP - Children and Young People

Cytopenia - A condition where there’s a lower-than-normal number of blood cells

Dermatoscope - A hand-held magnifying device used to examine skin lesions

DRE - Digital Rectal Examination

DVT - Deep Venous Thrombosis

Dysphagia - Problems swallowing

Early menarche - Starting menstruation before age 12

ECOG - Eastern Co-operative Oncology Group

ECOG/WHO performance status - Describes a patient’s level of functioning in terms of their ability to care for themselves

Embryonal carcinomas - A rare, aggressive type of germ cell tumour that occurs in the ovaries and testes

Endocrine tumours - Growths that develop in the endocrine system - the network of glands that produce hormones

Endometrium - The inner lining of the uterus (womb)

ENT - Ear Nose and Throat

Epidermis - The surface epithelium of the skin, overlying the dermis (the inner layer of the two main layers of the skin)

Epididymo-orchitis - Inflammation of both the epididymis (the tube that stores and transports sperm) and the testicle (testis), often caused by infection

Epigastric mass - A swelling or lump in the upper central part of the abdomen, just below the ribcage

Epistaxis - Bleeding from the nose, caused by damage to the blood vessels of the nasal mucosa (soft tissue that lines the body’s canals and organs)

EQIA - Equality Impact Assessment

ESR - Erythrocyte Sedimentation Rate

Essential thrombocythaemia - A rare blood cancer characterised by the over-production of platelets, which can lead to blood clots and, in some cases, bleeding problems

Ewings Sarcoma - A type of cancer that begins as a growth of cells in the bones and the soft tissue around the bones

Extragonadal germ cell tumours - Germ cell tumours that develop outside the gonads (testicles or ovaries)

Extramedullary leukaemic disease - A rare manifestation of acute myeloid leukaemia (AML) where leukaemic cells form a solid tumour outside of the bone marrow

FBC - Full blood count

Fibrosarcoma - A rare, cancerous tumour that develops from the uncontrolled overgrowth of cells called fibroblasts (a type of cell that plays a crucial role in forming and maintaining connective tissue)

Finger clubbing - Changes in the shape of the ends of the fingers and fingernails

Focal chest signs - Decreased chest expansion, dullness on percussion, decreased entry of air, bronchial breathing, and crackles (none, some, or all of these may be present)

Focal neurological deficit - A localised impairment of nerve, spinal cord, or brain function affecting a specific area of the body or a specific function

FOSSIT - Feeling of Something Stuck In the Throat

Fungating - A tumour that breaks through the skin creating a wound or growing into a fungus-like shape that can also become ulcerated and infected

Gender reassignment - Proposing to undergo, undergoing or having undergone a process to reassign your sex

Germinomas - A type of germ cell tumour, most commonly found in the brain

GI - Gastrointestinal

Globus sensation - The persistent but painless feeling of a lump or foreign body in the throat, even when there’s nothing physically there

Glottis - Part of the larynx (voice box) that contains the vocal cords.

Glycosylated haemoglobin (HBA1c) - A blood test that measures your average blood sugar levels over the past two to three months

GP - General Practitioner

GP gut feeling - An intuitive, often uneasy feeling that a General Practitioner (GP) experiences, suggesting a patient may be seriously ill, even without clear symptoms

Gynaecomastia - An increase in the amount of breast gland tissue in boys or men

Haemachromatosis - An inherited condition where iron levels in the body slowly build up over many years

Haematoma - A localised collection of blood outside of blood vessels, often caused by injury or trauma, where blood leaks into surrounding tissues

Haematospermia - Blood in the semen

Haematuria - Blood in the urine

Haemophagocytic lymphohistiocystosis - A rare, potentially fatal disease characterised by an overactive immune system, leading to inflammation and organ damage, often affecting children but also adults

Haemoptysis - Coughing up blood from the lungs or airways

Help seeking behaviours - Any actions an individual takes to obtain assistance or support

Hepatoblastoma - A rare cancer that forms in the tissues of the liver

Hepatomegaly - Abnormal enlargement of the liver

Hepatosplenomegaly - Simultaneous enlargement of both the liver and spleen

High grade malignancies - Tumours with cells that appear very abnormal under a microscope, indicating a higher likelihood of aggressive growth and spread, often requiring more aggressive treatment

HIS - Health Care Improvement Scotland

Histiocytoses - A group of rare disorders characterised by the accumulation of histiocytes (a type of white blood cell) in various tissues and organs, potentially causing tissue damage or tumour formation

HIV - Human Immunodeficiency Virus

HIV serology - The use of blood tests to detect HIV antibodies and/or antigens

Horner’s syndrome - A rare neurological syndrome that affects your eye and the surrounding area on one side of your face

HPB - Hepato-Pancreato-Biliary

HPV - Human Papilloma Virus

HRT - Hormone Replacement Therapy

Hypercalcaemia - A condition in which the calcium level in the blood becomes too high

Hyperkeratotic - Abnormal thickening of the outer layer of the skin due to an overproduction of keratin

Hypopharynx - The lowest part of the throat (pharynx), located behind the voice box (larynx) and above the oesophagus

IBD - Inflammatory Bowel Disease

ICD - International Classification of Disease

IDA - Iron Deficiency Anaemia

Immunocompromised - A condition where your immune system isn’t working as well as it should

Indolent - A slowly progressing cancer that may not require immediate treatment

Induration - An area of tissue that has become abnormally hard or thickened

Inherited genetic alteration - A change in a gene that is passed down from a parent to their child, present in almost every cell of the body from birth

Intersex - Individuals born with reproductive or sexual anatomy that doesn’t fit typical binary definitions of male or female, encompassing variations in chromosomes, genitals, hormones, or internal reproductive organs

Intra-abdominal - Something situated within, occurring within, or administered by entering the abdomen

Inverse Care Law - The availability of good medical care tends to vary inversely with the need for it in the population served

Irradiation - The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumours

Langerhans’ cell histiocytosis - A rare disorder characterised by the abnormal accumulation of Langerhans cells - a type of immune cell, which can form tumours or damage tissues and organs

LDH - Lactate Dehydrogenase (an enzyme found in almost all body tissues that plays a crucial role in energy production)

LEGO-C - Lung, Endometrial, Gastric, Oesophageal and Colorectal cancer

Lichen sclerosis - A chronic inflammatory skin condition causing thin, white and wrinkled patches, most commonly affecting the genitals and anal areas

Lymphadenopathy - Swelling of lymph nodes

Lymphocyte count - The number of lymphocytes (a type of white blood cell crucial for the immune system) in a blood sample

Lymphocytosis - Having more lymphocytes, a type of white blood cell, in your blood than normal

Lymphoplasmacytic malignancies - A type of lymphoma characterised by the accumulation of abnormal B cells, often in the bone marrow

Lynch syndrome - An inherited condition that increases the risk of developing certain cancers

Lytic - The disintegration of a cell by disruption of its plasma membrane

Malaise - A general feeling of discomfort, illness or unease whose exact cause is difficult to identify

Malignant spinal cord compression - A cancerous tumour that damages or presses on the nerves in the spinal cord, potentially leading to weakness, paralysis, and other neurological issues

Mastitis - Inflammation of the mammary gland in the breast, typically due to bacterial infection

Melanocytic naevi - Commonly known as moles

Merkel’s tumour - A rare, aggressive type of skin cancer that arises from Merkel cells, which are located in the outer layer of the skin near nerve endings

Mesothelioma - A cancer that starts as a growth of cells in the mesothelium – a thin layer of tissue that covers many internal organs

Metastatic cancer - Also known as advanced or secondary cancer, occurs when cancer cells from the primary tumour spread to other parts of the body, forming new tumours

MCN - Managed Clinical Network

Monoclonal gammopathy of unknown significance (MGUS) - Monoclonal Gammopathy of Unknown Significance - a condition where the body produces an abnormal protein (paraprotein) and in some cases can progress to cancer.

Microcytosis - Red blood cells that are smaller than normal

Micronodular - Presence of extremely small nodules, typically less than 3 millimetres in diameter

Missingness lens - A focused approach that identifies and addresses the repeated tendency of individuals to miss or not take up healthcare opportunities

Modifable factors - Behaviours or exposures that can be changed to reduce the risk of developing certain conditions

Myelodysplastic syndromes (MDS) - A group of blood cancers where the bone marrow produces abnormal blood cells that don’t mature properly, leading to low levels of healthy blood cells

Myeloproliferative neoplasms - A group of rare blood cancers characterised by the bone marrow producing too many blood cells, including red blood cells, white blood cells and/or platelets

Nasopharynx - The top part of the throat (pharynx) that connects the nose to the respiratory system

NDD - Neuro-Developmental Difference

Neoplasms - A new and abnormal growth of tissue in a part of the body, especially as a characteristic of cancer

Neuroblastoma - A cancer that starts in cells called neuroblasts

Neuroblasts - Immature nerve cells

NHL - Non-Hodgkin’s Lymphoma

NHS - National Health Service

NHS Scotland - National Health Service Scotland

NICE - National Institute for Clinical Excellence

Nocturia - Waking up more than once each night to urinate

Non binary - People who do not identify as exclusively male or female

Nulliparity - A woman who has never given birth to a live child, even if she has been pregnant or experienced a miscarriage or abortion

Odynophagia - Painful swallowing

OG - Oesophago-Gastric

OGD - Oesophago-Gastro-Duodenoscopy – a medical procedure used to examine the lining of the oesophagus, stomach, and the first part of the small intestine using a thin, flexible tube with a camera

OMFS - Oral Maxillofacial Surgery

Oropharynx - The middle part of the throat

Orthopnoea - Shortness of breath (dyspnoea) that occurs when lying flat

Otitis externa - An inflammation or infection of the skin in the ear canal; also known as “swimmers’ ear”

Papilloedema - Optic nerve head swelling which can be due to raised intracranial pressure

Palpable - Something that can be felt or touched

Paranasal - Structures or conditions located near the nose – often used to describe the sinuses

Paraproteins - A monoclonal immunoglobulin or light chain present in the blood or urine

PCSCI - Primary Care Secondary Care Interface Group

Peau d’orange - Describes a characteristic skin appearance, often appearing as dimpled or pitted, resembling the texture of an orange peel

Peri-ocular - Condition or treatment that involves the structures around the eye

Periorbital bruising - Bruising around the eyes that can indicate a serious underlying condition, such as a skull fracture or can be caused by trauma or other medical conditions

Peripheral neuropathy - Damage to the peripheral nerves, which are located outside the brain and spinal cord, often causing weakness, numbness, and pain, particularly in the hands and feet

Periungual wart - Warts that develop around the fingernails or toenails, often appearing as rough, cauliflower-like bumps, and are caused by the human papillomavirus (HPV)

Persistent intermenstrual bleeding - Bleeding between periods

Petechiae - Tiny spots of bleeding under the skin or in the mucous membranes (mouth or eyelids)

Pharynx - Throat

PHS - Public Health Scotland

Plasma viscosity - A measure of blood thickness

Pleural effusion - A build-up of fluid between the layers of tissue that line the lungs and chest cavity

Polycythaemia Rubra Vera - A rare blood cancer – causes the bone marrow to produce too many red blood cells

Polydipsia - Excessive thirst

Polyposis - The development of numerous polyps (growths that protrude from a mucous membrane)

Polyuria - Production of abnormally large volumes of dilute urine

Post-coital bleeding - Bleeding after sex

Postmenopausal bleeding - Any vaginal bleeding occurring after a year or more of no periods

PPV - Positive Predictive Value

Precocious puberty - The development of secondary sexual characteristics before eight years of age in girls and nine years in boys

Prehabilitation - The process of preparing a person’s body and mind for a medical or surgical intervention, like cancer treatment, to improve outcomes and reduce complications

Primary myelofibrosis - A rare blood cancer where the bone marrow is replaced by scar tissue

Primitive neuroectodermal tumours (PNETs) - A group of rare, malignant tumours that arise from primitive nerve cells

Proptosis - When one or both eyes bulge from their natural position

Pruritus - Itching

PSA - Prostate Specific Antigen

qFIT - Quantitative Faecal Immunochemical Test

RCDS - Rapid Cancer Diagnostic Service

RCGP - Royal College of General Practitioners

RDS - Right Decision Service

Realistic medicine - An approach to healthcare that aims to put the patient at the centre of decisions made about their care

Recurrent laryngeal nerve palsy - Also known as vocal cord paralysis – occurs due to damage to the recurrent laryngeal nerve, leading to vocal cord immobility and symptoms like hoarseness, difficulty breathing, and swallowing problems

Red flag’ or ‘alarm symptoms’ - Warning signs that indicate a potentially serious underlying medical condition requiring prompt evaluation and often, a referral to a specialist or emergency department

Retinoblastomas - A kind of eye cancer that starts as a growth of cells in the retina

Rhabdoid tumours - A rare fast growing childhood cancer

Rhabdomyosarcoma - Soft tissue sarcoma in children

Rhinosinusitis - Commonly known as sinusitis, is inflammation of the sinuses and nasal passages

Sacrococcygeal - The region encompassing the sacrum and coccyx (tailbone)

Serosanguinous - Discharge that contains both blood and a clear, watery fluid known as serum, often appearing as a light pink or red colour

SCC - Squamous Cell Carcinoma

Schwannomas - Benign, slow-growing nerve tumour of the nerve sheath

SCI - Scottish Care Information

Sebaceous cysts - Round lumps often filled with fluid or pus

Seborrheic keratosis - A common non-cancerous (benign) skin growth

Serum immunoglobulins - Proteins produced by plasma cells that play a crucial role in the immune system

Serum protein electrophoresis - A laboratory test that separates and measures different types of proteins in the blood serum

sFLC - Serum Free Light Chains

Skin tethering - A visible dimpling or puckering of the skin

Solid tumours - Abnormal masses of tissue, often cancerous, that typically don’t contain cysts or liquid areas

SPCCG - Scottish Primary Care Cancer Group

Splenomegaly - Abnormal enlargement of the spleen

Squamous - Flat cell that looks like a fish scale under a microscope

SRG - Scottish Referral Guidelines [for Suspected Cancer]

Sternomastoid muscle - A powerful neck muscle that allows a person to bend their neck and turn or tilt their head

Stridor - A high-pitched, harsh, noisy breathing sound, often heard during inhalation, indicating a partial obstruction or narrowing in the upper airway

Subungual - Something situated or occurring under a fingernail or toenail

Superior vena cava obstruction - A condition where blood flow to the heart from the upper body is blocked or restricted

Supraclavicular lymphadenopathy - Swollen lymph nodes above the collarbone

SVFT - Semantic Verbal Fluency Test

Tamoxifen - A hormone therapy drug to treat breast cancer in women and men

Teratomas - A rare type of germ cell tumour that may contain immature or fully formed tissue, including teeth, hair, bone and muscle

Testosterone blockers - Medications that prevent androgens like testosterone from exerting their effects in the body

Thrombocytosis - A condition characterised by having a higher-than-normal platelet count in the blood

Transabdominal USS - A non-invasive procedure used to assess the organs and structures within the abdomen

Transgender - A person whose gender identity does not correspond with the sex registered for them at birth

Transvaginal USS - A common imaging procedure used to diagnose conditions affecting reproductive organs

Tumour markers - Any substance in the body that provides information about a cancer

Unclassified myeloproliferative disorders - A rare blood cancer type, often presenting with features that overlap or are not fully developed

Urinary Bence Jones Proteins - Abnormal proteins (specifically, monoclonal light chains) found in the urine of some patients with myeloma or other lymphoid malignancies

Urine culture - A laboratory test that checks for bacteria or other germs in a urine sample to diagnose a urinary tract infection (UTI) and identify the specific bacteria causing the infection, guiding treatment decisions

Urine dipstick - A thin, plastic stick with strips of chemicals on it – the strips change colour if certain substances are present in the urine, or if levels are above typical levels

Uterine fibroids - Non-cancerous growths that develop in or on the uterus, often causing heavy or painful periods, pelvic pain, or pressure in the lower abdomen

USC - Urgent Suspicion of Cancer

USS - Ultrasound Scan

UTI - Urinary Tract Infection

UV - Ultraviolet

UV-A photochemotherapy - Combines psoralen medication with UVA light exposure to treat various skin conditions, including psoriasis, eczema etc.

Vagino/vulvoplasty - Gender reaffirming surgery that creates the external female genitalia (vulvoplasty) and vaginal canal (vaginoplasty)

Vasculitis - A group of rare conditions, that damage blood vessels by causing inflammation

Virilisation - The development of male physical characteristics

Visual field loss - Loss of part of the usual field of vision

White or absent pupillary red reflex - An abnormal finding that can indicate serious eye conditions

WHO - World Health Organisation

Wilms tumours - The most common type of kidney cancer in children, typically affecting children under five years of age

WoS - West of Scotland

Wry neck - The muscles supporting the neck on one side become painful and stiff, often causing the head to tilt to one side

Yolk-sac tumours - A rare, malignant germ cell tumour that often occurs in the gonads (ovaries or testicles) but can also occur in other areas of the body