86 NCCN Guidelines for Patients ® : Melanoma, 2018 Dictionary chemotherapy Drugs that kill fast-growing cells, including normal cells and cancer cells. Clark level A scale of tumor depth with 5 scores based on which layer of skin the tumor has grown into. clinical stage A rating of the extent of melanoma in the body based on the physical exam and biopsy of the first (primary) tumor. clinical trial Research on a test or treatment to assess its safety or how well it works. combination regimen The use of two or more drugs. computed tomography (CT) scan A test that uses x-rays from many angles to make a picture of the inside of the body. connective tissue Supporting and binding tissue that surrounds other tissues and organs. contrast dye A dye put into your body to make clearer pictures during tests that take pictures of the inside of the body. cytokines Substances made in the body that boost or activate the immune system (the body’s natural defense against disease). Cytokines can also be made in a lab. deep margin status Presence or absence of cancer cells in the normal-looking tissue under a tumor removed during surgery. dermal mitotic rate A measure of how many cancer cells are actually growing and dividing. dermatologist A doctor who’s an expert in diseases of the skin. dermatopathologist A doctor who’s an expert in testing skin cells and tissues for disease. dermis The second layer of skin that is beneath the top layer (epidermis). desmoplastic melanoma A melanoma tumor with dense connective tissue. diagnosis Identification of a disease. distant metastasis Cancer cells have spread to a part of the body far away from the first (primary) melanoma tumor. epidermis The outer layer of skin. excision Removal by surgery. excisional biopsy Surgery that removes the entire skin tumor or abnormal- looking area (lesion) to test for cancer cells. excisional lymph node biopsy Surgery that removes the entire enlarged lymph node(s) through a surgical cut in the skin to test for cancer cells. external beam radiation therapy Radiation therapy (use of high-energy rays to destroy cancer cells) received from a machine outside the body. fatigue Severe tiredness despite getting enough sleep that limits one’s ability to function. fine-needle aspiration (FNA) biopsy Use of a thin needle to remove fluid or tissue from the body to be tested for disease. follow-up tests Tests done after treatment to check for signs of cancer return (recurrence) or spread (metastasis). genes A set of coded instructions in cells for making new cells and controlling how cells behave. general anesthesia A controlled loss of wakefulness from drugs.