WHAT DOES THIS WORD MEAN?
Glossary / medical dictionary of words commonly associated with primary bone cancer and cancer in general.
If you know the letter that the word begins with, click on the following:
Actinomycin D is given directly into the vein as an infusion, via an Intra Venous drip.Back to top
Chemotherapy given after surgery is called 'adjuvant chemotherapy'. The aim of post-operative adjuvant chemotherapy is to kill any cancer cells that could have spread prior to the operation, and to prevent the tumour growing back in the original site.Back to top
An ALP Test is sometimes carried out as part of a liver function test (LFT). However, in primary bone cancer patients (or people who doctors suspect might have primary bone cancer) ALP levels in the blood are measured because osteosarcoma causes high levels of ALP to be present in the blood.Back to top
It is important to remember that alternative medicines do not have to go through the very careful testing (trials) that conventional medicines do, and therefore may not be safe. Many alternative medicines are not backed up with scientific evidence that they work at all and therefore are a waste of money and time.
Alternative medicine is sometimes mistakenly included alongside complementary medicine under the name of CAMs (see entry for Complementary and Alternative Medicines) as if they were the same thing. They are not the same, there are important differences. Complementary medicines are taken alongside conventional treatments (to complement the conventional therapies) whereas alternative medicines are used instead of conventional therapies.Back to top
Around 1 in 10 primary bone cancer patients, whose tumour is in an arm or leg, need to have all or part of that limb removed. This could be because the tumour has damaged a joint so badly that it cannot be mended by surgery. Alternatively it could be because the cancer has spread to the major blood vessels or nerves in the limb, and the limb wouldn't be able to work without these.
Patients who have an amputation will be supported by their medical team to make sure that they can live a normal life, and when possible patients may be given a prosthesis (artificial arm/leg) to replace the amputated limb.Back to top
An antibody is a small molecule that recognises one particular a target on a virus or bacteria. When the antibody recognises its target it alerts other cells in the immune system, which kill the target bacteria or virus. After a person has had an infection (such as chicken pox) once, the body makes antibodies against the infection virus or bacteria that caused it, so usually the person won't ever get ill with the same infection twice.
A lot of research is being conducted to try to find ways to make cancer patients develop antibodies against their cancer by using vaccines to stimulate their immune system. Some early stage (phase 1) clinical trials are being carried out using these vaccines, but these treatments won't be widely available for patients for some time yet.Back to top
This type of therapy is still at an early stage and there are no antisense DNA therapies available for primary bone cancers at the present time.Back to top
The aim of cancer treatment is to kill or remove the cancer cells so that the no more tumour cells are left in the body. There are two main routes to causing cells to die: necrosis and apoptosis. Necrosis is when the cell is killed by physical damage or being starved of oxygen and/or nutrients.Back to top
The treatment for Askin tumour (surgery/ radiotherapy/ type of chemotherapy drugs) are generally the same as those used to treat Ewing's sarcoma. Back to top
An audiogram usually involves a patient wearing headphones, which play different sounds at different volumes (loud and quiet) and different pitches (low and high) to tell whether the patient's hearing is in the normal range.Back to top
Cancer vaccine are a type of biological therapy. These vaccines stimulate a patient’s immune system to turn against the cancer cells and destroy them. These vaccines are being developed for different kinds of cancer but are not widely available for patients as yet.Back to top
The process of taking a biopsy involves a surgeon taking a small amount of tissue (or sometimes the whole lump) from the patient’s suspected tumour. The small piece of tissue that has been taken out is referred to as a biopsy.
The pathologist looks at the cells from the biopsy under a microscope, and decides what tests to perform to make a diagnosis. By looking closely at the cells of a patient’s biopsy, doctors can discover whether a tumour is malignant or benign, and see whether the tumour has spread to nearby tissues.Back to top
Bisphosphonates are drugs that switch off a kind of cell called an osteoclast, which are found in all bones. Osteoclasts usually help to remove damaged bone by eating away at the damage so that healthy bone can be made to fill in the gap. In osteoporosis, primary bone cancer and secondary cancers in the bones osteoclasts are too active and cause a lot of damage to the bone. Bisphosphonates have been used to treat osteoporosis for a number of years and now clinical trials are running to see whether these drugs might improve the treatment of primary bone cancers as well.Back to top
Types of tests may include:
- Checking the blood chemistry (Us & Es), to examine the amounts (levels) of dissolved salts as well as urea and creatinine (waste products). This test can give clues to how well the kidneys are working.
- Full blood count (FBC), which gives information about the numbers of the different cells of the blood:
- Red blood cells,
- White blood cells, (totals of each type),
- Levels of haemoglobin (HEE-moh-GLOW-bin) which carries oxygen in the blood, inside red blood cells
- Liver function tests (LFTs) to see how well the liver is working.
- C Reactive Protein (CRP) levels and the Erythrocyte Sedimentation Rate (ESR) may be tested. These tests look for signs of inflammation. Inflammation can be an indication that a patient has an infection or it can be related to certain disease processes.
- Alkaline Phosphatase (AL-kuh-line FOSS-fuh-taze) (ALP) levels can be measured in patients with suspected osteosarcoma, and is also often tested in Ewing's sarcoma patients.
Bones are hard but they are not solid or dead, they are living parts of the body just like muscles or eyes. Bones have lots of spaces and channels inside, filled with bone cells and blood vessels.
There are different types of bone cells that either 'make' or 'remove' bone to make sure only the right amount is produced. The word 'osteo' is the Ancient Greek word for bone; many medical words are Greek or Latin.Back to top
Most surgery for primary bone cancers in England and Wales is carried out at one the Bone Cancer Treatment Centres. These should also be the place where diagnostic tests, including bone biopsies, are carried out.
- North of England Bone and Soft Tissue Tumour Service, Newcastle upon Tyne Hospitals NHS Foundation Trust
- Nuffield Orthopaedic Centre NHS Trust, Oxford
- Royal National Orthopaedic Hospital, Stanmore, Middlesex
- The Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust, Oswestry
- The Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham
The radioactivity will collect more at areas of high activity (breakdown and repair) in the bone. This could be caused by a primary bone cancer or secondary bone cancer . The areas of high activity picked up by the gamma camera are known as 'hot spots.'
The scans are carried out in Radiology and Nuclear Medicine Departments. Patients will need to drink lots of fluids before the scan to help the radioactive substance travel to the bones quickly and to encourage the removal of the radionuclide from the system quickly. The results of the scan will be examined by a radiologist and a report will be produced. This may take a few days. Following the scan, the radionuclide will be passed completely from the body in the urine within 24 hours. Back to top
Sometimes, cells start to divide and grow when they should not and they may not stop dividing. When this happens, they may form a lump called a tumour, or a 'growth.' The doctor may alternatively use the word 'neoplasm' (NEE-oh-PLA-zum), this is a Latin word meaning 'new growth , and means the same as 'tumour'.
In primary bone cancer, a cell that lives inside the bone starts to divide and grow uncontrollably, making a bony lump. The tumour can be benign, meaning that it cannot spread and cause damage to the body. Alternatively it can be malignant, meaning that it can spread and therefore it is cancer. The tumour is described as 'cancerous'. Back to top
Cancer research helps us to learn, for example:
- What causes people to get cancer,
- How many people have it,
- How it can be treated,
- Ways doctors can discover that a patient has cancer and what sort of cancer they have (diagnosis).
BCRT supporters raise money to fund research into primary bone cancers. This is an essential source of funding for this rare and under-funded type of cancer. You can learn more about BCRT's research projects here, in the BCRT Research Projects Section.Back to top
- Preventative vaccines such as the HPV vaccine given to young women to help prevent cervical cancer
- Treatment vaccines are used to treat patients who already have cancer.
Cancer treatment vaccines help the immune system to recognise and kill cancer cells; this is called 'immunotherapy.' Cancer prevention vaccines are targeted against viruses that can cause cancer.
It is difficult to develop cancer treatment vaccines because the immune system does not always recognise cancer cells, cancer cells can 'look' normal to the immune system. Cancer cells can also produce chemical messages to slow down an immune response against them.
Cancer treatment vaccines are undergoing trials, although none of these trials have yet looked at primary bone cancer. Back to top
Most animal cells including humans are between 10 and 30 micrometres in diameter. A micrometre (µm) is one millionth of a metre. That means as many as 100 cells could fit on the full stop at the end of this sentence.
Some living things are made up of one single cell, like bacteria or yeast. Humans, like plants and animals, are multi-cellular organisms. Each person is made up of about 100 trillion (100, 000,000,000,000) cells, which work together in a delicate balance to allow us to live and function. Back to top
During Interphase the cell 'gets ready' to divide by making a fresh copy of all of its DNA to give to a new cell, and making all the cell machinery necessary for division. Mitosis is the phase during which the cell nucleus (where the DNA is kept) divides into two, with each nucleus containing an exact copy of the cell's DNA. During Cytokinesis the rest of the cell splits into two cells, each cell getting one nucleus. The new cells are often called 'daughter cells'.
The process of the cell cycle is very tightly regulated. There are checkpoints between each stage of the cycle. For example, if the DNA isn't copied properly, the cell will not go into the mitosis stage until the mistakes are repaired. If the DNA mistakes can't be repaired then the cell sacrifices itself in a process known as apoptosis.
A good way to think of the cell cycle and its checkpoints is to compare it to a washing machine cycle. After washing, the machine will not go straight into the spin cycle until it has checked that the rinse cycle has been completed. A washing machine that goes straight from wash to spin is faulty. It's a similar situation with cells. If the regulation of the cell cycle is disrupted, it can cause problems such as cancer. Back to top
The central line is put in using a local anaesthetic (or sometimes a general anaesthetic) to numb the area and the line runs under the skin and into a vein. There is a small piece of the line left hanging outside of the skin, to which a drip line can be attached. Unlike a cannula (Venflon), central lines can be in place for up to a few months. These lines enable the number of needles required during treatment to be minimised and more than one drug or treatment (such as fluids or nutrition) can be given at the same time because the lines can have multiple openings or 'lumens.'
Whether a central line will best suit the patient's needs, can be discussed with the nurses and the doctor. Other lines called PICCS and Portacaths® may be more suitable for some patients. Back to top
Primary bone cancer patients are given (administered) more than one type of chemotherapy drug, this is called combination chemotherapy.
There are different ways patients can be given chemotherapy, tablets, liquid medicine, injection or directly into the blood through a cannula, central line, PICC or portacath.
Back to top
Chondrosarcoma is the most common type of primary bone cancer, and is most often diagnosed in men and women over the age of 40.Back to top
Although it can occur at any age, chordomas tend to develop in people over the age of 40, affecting men more than women. Chordomas are slow growing tumours and tend to develop in the skull, bones of the face and spine. Chordomas are treated using chemotherapy, surgery and proton therapy. Occasionally, it may be necessary to use radiotherapy when tumours cannot be fully removed by surgery.Back to top
The DNA is wound so tightly around special proteins, and around itself that it can be packaged into a cell's nucleus. The chromosomes are only visible under a microscope during a stage of the cell cycle known as mitosis.
Humans have 23 pairs of chromosomes, which each hold a different section of genetic information. Each chromosome pair is made up of one copy of the mother's chromosome and one copy of the father's, and this is how genetic information is inherited. Back to top
This translocation forces two genes to be joined together. One of these genes is very powerful but rarely switched on, and the other gene is always switched on but less important in the cell. The result is a gene that is very powerful and always switched on, sending out incorrect signals to the rest of the cell. This can result in uncontrolled cell division, which causes cancer.Back to top
Phase 1 clinical trials are the first stage of testing a new drug on patients. Usually there are very few patients enrolled on Phase 1 trials and these are patients who have already tried every other type of treatment but are not getting better. These types of trial check to see whether the drug or treatment is safe for humans, rather than trying to cure the illness.
Phase 3 clinical trials are large studies involving patients in more than one hospital, often in different countries. This phase helps to build up evidence that the drug/treatment is effective in treating patients.Back to top
Combination therapy is when several different drugs are given to a patient over a period of time. This means that the cancer is faced with different kinds of drugs, and so even if the cancer doesn't respond to one of the drugs it will hopefully respond to the other drugs in the combination.Back to top
It is important to check with your doctor before taking any complementary therapy, just to make sure that they won't conflict with the conventional treatment.Back to top
For MRI (Magnetic Resonance Imaging) scans, contrast agents can be injected and these are based on a metal called gadolinium (GAD-oh-LIN-ee-um). This metal affects particles called protons, which changes the properties of the scan. The contrast agent makes the blood vessels show up more clearly.Back to top
Patients who are on chemotherapy for a long period of time, such as Ewing's Sarcoma patients, may be given this antibiotic to take continuously through treatment to prevent a certain infection called pneumocysitis carnii (PCP).Back to top
Some chemotherapy drugs can damage the kidneys so creatinine levels are monitored to check how well the kidneys are functioning.Back to top
A CT scanner looks like a large 'doughnut' with a bed for the patient to lie on. The bed will move slowly through the hole while the machine takes the pictures.
Before the scan, patients may be given a contrast medium. The contrast medium is usually injected into a vein. This contrast medium helps to improve the image of particular tissues and it can also help the radiologist tell the difference between blood vessels and other structures.
CT stands for Computerised Tomography. Another name for this type of scan is CAT, which stands for Computerised Axial Tomography. Back to top
Cyclophosphamide can be given directly into the blood or in the form of tablets. The drug belongs to a class of drugs called alkylating (AL-kuh-LAY-ting) agents. Cyclophosphamide slows the growth of cancer cells by interfering with the actions of DNA. For the treatment of osteosarcoma the drug is given alongside other chemotherapy drugs, this is called combination chemotherapy.Back to top
The digestive tract is lined with healthy cells that divide very quickly. Because they divide quickly, they can be affected by chemotherapy drugs. This can cause side-effects of chemotherapy that include mouth ulcers, sickness and diarrhoea.Back to top
DNA is a bit like an information database that contains the information cells need to carry out their functions to build and maintain the body. The information in DNA is stored as a code made up of four chemicals called bases (called A, C, G and T).
Cancer occurs when there is some form of damage or change to the DNA and therefore the cell's instructionsare made un-readable. If the damaged DNA is in an important gene that is responsible for making sure cells only grow and divide when they need to, then the cell can escape the normal control and grow in an uncontrolled way.Back to top
Doxorubicin works by interfering with the cancer cell's DNA at a time when the cell is getting ready to divide. This prevents the cell from dividing. Doxorubicin targets the rapidly-dividing cells in the body, which includes any cancer cells but can also affect the healthy cells that divide rapidly, such as the hair cells or the lining of the digestive tract. This causes the side effects that are associated with some cancer treatments.Back to top
Patients who need chemotherapy will have echocardiograms before and during treatment. This is because some chemotherapy drugs can have effects on the heart. The test before treatment will show doctors how well your heart is working and give a baseline reading. This result can be compared to later tests during treatment to show doctors whether the chemotherapy is affecting the heart.Back to top
Etoposide works by stopping an enzyme called topoisomerase II (TOH-poh-i-SOM-meh-rays), which helps the cell to copy its DNA DNA during cell division. When topoisomerase can't do its job, the cell cannot divide and so it will self-destruct (apoptosis).Back to top
- Ewing's sarcoma
- Extraosseous Ewing's sarcoma
- Primitive neuroectodermal tumours (PNET),
- Askin tumours
The treatment of Ewing's sarcomas whether they are found in soft tissues or bone is the same; chemotherapy, surgery and radiotherapy. Back to top
The instructions in this fusion gene code for a protein called the EWS-FLI1 fusion protein. This fusion protein is thought to affect many other genes in the cell by switching them on or off at the wrong times.Back to top
- Red blood cells,
- White blood cells, (totals of each type of white white blood cell),
- Levels of haemoglobin (HEE-moh-GLOW-bin) which carries oxygen in the blood, inside red blood cells.
Fever is an indication that a patient has an infection and so if the patient has neutropaenia as well as an infection then they will struggle to fight off the infection and so they will need extra care.Back to top
A bone tumour can cause the healthy bone around the tumour to be destroyed by the growing tumour. The bone is left severely weakened and this makes it more likely to fracture, even by a minor knock or fall. Some cases of primary bone cancer are diagnosed when a patient goes to hospital with a fracture. A fracture caused by a disease (such as primary bone cancer or osteoporosis) is called a 'pathological fracture'.Back to top
G-CSF targets a kind of cell called a granulocyte, which is one group of the white blood cells that work together to form the immune system. G-CSF is a signal that causes new granulocytes to be created, and this means that the immune system is given a boost.
Chemotherapy can reduce the numbers of white blood cells in the blood, leaving the patient at an increased risk of infection. Treatment with G-CSF after chemotherapy helps to restore the numbers of white blood cells, which speeds up the recovery of the immune system.
G-CSF may also sometimes be given before high dose chemotherapy to stimulate the production of stem cells, which are collected from the patient and stored until the chemotherapy course has been completed, then returned to the patient to help production of new blood cells. G-CSF is also sometimes given after high dose chemotherapy , to increase the numbers of stem cells.Back to top
Genes are made of a chemical called DNA (which stands for deoxy-ribonucleic acid). The DNA is arranged into letters that spell out a code, and the letters are A, G, T and C. The scientific word for these letters is ‘bases’. Inside the cell there are special molecular machines that can read the code and build molecules according to the exact code.
Our genes are inherited from our parents. For each gene we have one copy from each parent (these come together when a sperm fertilises an egg). This is how we inherit characteristics from our parents.
Every time a new cell is made, the DNA of an existing cell is copied, and the copy is given to the new cell. Sometimes during the process of copying the DNA, a mistake is made in the code. Any mistakes in the code (such as a missing letter or a wrong letter) cause a mistake to be made in the molecule that is built from the instructions in that gene. Sometimes these mistakes are harmless, but sometimes this kind of mistake (called a genetic mutation) can cause health problems.
Two ‘official’ definitions of a gene are ‘the basic biological unit of heredity’ or ‘a segment of deoxyribonucleic acid (DNA) needed to contribute to a function.’Back to top
Some genetic mutations are inherited. The scientific word for this is a 'germline mutation'. Some families have a condition called 'Li-Fraumeni syndrome' which is caused by an inherited mutation in a gene called p53.
In most cases of cancer the mutations are not inherited. Instead they happen during a person's life. These mutations are called 'somatic mutations'. In some cancers we know why these mutations happen, for example UV rays in sunlight can cause mutations that lead to melanoma, a type of skin cancer.
Currently we do not know what causes the gene mutations that cause primary bone cancer to start. Big research studies are underway to try to discover which genes are mutated in primary bone cancer, and this might lead to a better understanding of the diseases as well as giving us a clue as to which genes could be targeted to provide better treatments.Back to top
The kidneys have many important functions, including: keeping the concentrations of various salts and other important blood chemicals constant, keeping the volume of water in the body constant, removing waste products from the body into the urine, keeping the acidity of the blood constant and helping to regulate the blood pressure.
Some drugs given in the treatment of primary bone cancers can affect the kidneys. A kidney test will be done before and during treatment. The test before treatment will show doctors how well the kidneys are working normally. This result can be compared to later tests during treatment, to show whether the drugs are affecting how well the kidneys are functioning.
A GFR test can sometimes involve injecting the patient with a tiny amount of a radioactive dye. Every 1 or 2 hours for the next 4 hours blood samples are taken from the patient and the amount of radioactive dye will be measured. This shows the rate (millilitres per minute) at which the original amount of dye has been removed from the blood by the kidneys and tells doctors how well the kidneys are working.Back to top
Low grade tumours are slow growing and least likely to spread to other parts of the body. High grade tumours are fast growing tumours that can spread to other parts of the body. The type of treatment that a doctor recommends for a patient will depend on the grade of the cancer, amongst other factors.Back to top
This night time pain of the legs (shins/ knees) and more rarely the arms is fairly common in children, usually seen between the ages of 3-12. Many theories have been put forward for the cause of ‘growing pains’ but the exact cause remains unknown.Back to top