Glossary

The substance inside red blood cells that binds or attaches to oxygen in the lungs and carries it to the tissues. Back to top

A type of central line used to give fluids, nutrition, chemotherapy and other drugs directly into the blood, and to take blood samples. Back to top

Intensive cancer treatment using very high doses of chemotherapy drugs to kill cancer cells. The high doses may also destroy the bone marrow, which produces blood cells so patients usually undergo a stem cell harvest prior to and a stem cell transplant after the treatment to restore the production of blood cells. Back to top

A chemotherapy drug that is given as a treatment for primary bone cancers and some other types of cancer. Ifosfamide is given directly into a vein by infusion (drip) or injected into a vein using a cannula. The drug is in the form of a white powder until it is prepared for use, it is then a clear fluid. Ifosfamide is classed as an alkylating (al-kil-lating) agent and works by damaging DNA and preventing it copying itself, interfering with cell division. Back to top

IGF-1R stands for Insulin-Like Growth Factor-1 Receptor. Antibodies, such as Figitumumab against this receptor as treatments for cancer have shown some promising results in studies. Back to top

Around the area or region of the ilium (largest bone of the pelvis). For example the iliac artery. Back to top

In terms of cancer treatment, immunotherapy may be used to prevent cancer or to have a direct anti-tumour effect. Immunotherapy either helps the patient's own immune system recognise cancer cells and destroy them (vaccines), or is used to specifically target molecules on the cancer cells by giving the patient laboratory produced antibodies (mono-clonal antibodies) against the tumour, which recruit the immune system to destroy or disrupt the cancer's growth.

Antibodies are proteins produced by certain white blood cells (lymphocytes), which can recognise foreign molecules that do not belong naturally in the body (non-self). Antibodies are very specific and attach to foreign molecules and recruit the cells of the immune system to destroy the 'invader.'

Because cancer cells are part of the patient (self), the immune system may not see them as foreign and attack them. Antibodies have to be designed that recognise slight differences between the cancer cells and normal cells. This helps to keep the response specific and prevent the immune system attacking healthy cells. Back to top

An infusion or drip is a method of giving a set amount (dose) of I.V. medications such as chemotherapy or painkillers over a set period of time. This period can be hours or days. The infusion can be controlled by an infusion pump, which is connected to a central line or a PICC. Some of the pumps are small enough to fit in a pocket meaning that patients can use them at home. Back to top

This is a name given to healthcare that involves the use of conventional and complementary medicine alongside each other. Back to top

Tests carried out by doctors to find out if people are unwell. If a patient has bone cancer, investigations will help the doctors to find out where the cancer is, how big it is, if it has spread. Knowing 'what it is' and 'where it is' helps the doctors to decide what treatment is needed. Patients may have an x-ray or scan, a small amount of blood (sample) may be taken from a vein, or patients may have something called a biopsy. Back to top

Intravenous (intra-VEEN-us), this word is used to mean giving medicines or fluids directly into the blood through a tube called a cannula or Venflon, which sits inside a vein, usually in the arm or back of the hand. Back to top

A medicine used to treat constipation (difficulty with bowel movements). Medicines used to treat constipation are called 'laxatives.' Back to top

Problems that patients can develop after cancer treatments such as chemotherapy have finished (sometimes months after). For example, the chemotherapy drug cisplatin can cause hearing loss. Back to top

Liver Function Tests; carried out using a blood sample to examine the levels of certain substances released by the liver. These tests help to show how well the liver is working. Back to top

A very rare inherited condition affecting some families, which increases the chances of getting certain cancers. This condition is named after two doctors who described a number of families where several family members had developed different types of cancer.

The condition is caused by damage to a gene called p53. The normal p53 gene helps to keep any abnormal cells under control by helping to kill them and stop them growing. If the gene is damaged then it does not work properly and cannot do this. This may allow abnormal cells to grow and makes cancer more likely to develop. One of the many cancers that can develop is osteosarcoma. Back to top

Also called Limb Sparing Surgery, this type of complicated surgery is carried out to remove bone cancers, avoid amputation and to preserve the patient's appearance. It also helps to keep as much of the limb function as possible. This type of surgery depends on the type and size of the tumour, where it is and if it has spread. Around 20% of patients will require an amputation to remove the tumour. Back to top

The name given to bones that are very much longer than they are wide. The best examples being the bones of the limbs, for example, the thigh bone (femur) or the upper arm bone (humerus). Back to top

Lymph nodes or glands can be found all over the body, they can be felt in the neck, under the arm and groin. They are about the size of a pea and they form part of the immune system, which helps to fight off infections and disease. Lymph nodes are connected to each other by vessels, which are a bit like veins. They are also connected to the blood supply, which means cancer cells can spread from the lymph nodes to other parts of the body. Back to top

A malignant tumour or cancer is a 'lump' or 'growth' of tissue made up from cancer cells, which continue to multiply (increase in number by dividing into two, then 4, then 8 and so on). These cells are able to move in the blood or lymphatic (lim-FAT-ick) system to other parts of the body (spread) such as the lungs, where they can cause damage. Back to top

A chemotherapy adjuvant (a-JOO-vant), which helps to reduce problems in the bladder, which may be caused by the breakdown in the body (metabolism) of ifosfamide and Cyclophosphamide. Mesna has no direct effects but modifies the effect of the chemotherapy drug. Back to top

Malignant cancer cells may break off from the original (primary) tumour and travel to new sites in the body in blood or lymph vessels where they can form new tumours. This means the cancer has spread. The medical word for this is metastasis; the cancer has metastasised (met-AS-tuh-sized. Back to top

A chemotherapy drug that is given as a treatment for primary bone cancers, some other types of cancer and other conditions. Methotrexate is given directly into a vein by infusion or injected into a vein using a cannula. When Methotrexate has been made up ready for infusion it is a yellow fluid. It is also available as 2.5mg and 10mg yellow tablets. The drug is in a class of medications called antimetabolites. Methotrexate treats cancer by slowing the growth of cancer cells, the drug interferes with the production or more accurately the synthesis of DNA. Back to top

A drug used to treat nausea (feeling sick) and vomiting. The drug works by speeding up stomach emptying by increasing the contractions of the stomach and intestines. Metoclopramide may be used to treat nausea and vomiting associated with chemotherapy and radiotherapy. Back to top

Disease or illness. This is a term often used by doctors to describe the health problems encountered by patients with a particular condition. Back to top

A painkilling drug used to treat severe pain. Morphine sulphate belongs to a group of drugs called opioids (OH-pee-oyd). The drug is in the form of tablets or syrup. Back to top

This is a word meaning fatal outcome or death. Mortality is sometimes confused with 'morbidity'; which means disease or illness. Back to top

The number of deaths in a set period, usually for every 100,000 people in a year or sometimes 5 years. You may see the rate written as 2.0 / 100,000 p y. This can sound very confusing; 'p y' refers to 'person years at risk.' But, it is easier to think of it as the number of deaths per 100,000 people. So, if the primary bone cancer mortality rate was 2.0 / 100,000 p y, this means for every 100,000 people in the population, 2 people died of a primary bone cancer. Back to top

MRI stands for Magnetic Resonance Imaging. MRI scans are similar in some ways to a CT scan but the machine uses magnets and radio waves instead of x-rays to take pictures of the body's tissues and organs in a lot of detail. The MRI scanner can be quite noisy and is a tunnel rather than a doughnut. If a patient is thought to have a bone cancer, the doctors can take pictures of the inside of the bones to find out how big the tumour is and if it has spread to other parts of the bone. Back to top

mTOR stands for 'Mammalian Target of Rapamycin.' mTOR is an enzyme involved in switching on and off processes involved in cell division and growth, and cell survival. mTOR inhibitors interfere with this enzyme in tumour cells giving it anti-tumour activity. Back to top

Osteosarcoma can start in more than one bone at the same time; this is called multi-focal osteosarcoma, it is very rare. Back to top

The Multidisciplinary Team (MDT) is made up of people who are expert in different areas of medicine. They work together following National guidelines to work out patient treatment plans, decide on appropriate further tests and referrals, and keep records.

MDTs involved in the care of primary bone cancer patients will include: specialist bone sarcoma surgeons, specialist sarcoma oncologists, specialist sarcoma pathologists, radiologists, histopathologist, cytogeneticists (SY-tow-geh-NET-eh-sist), specialist nurses, palliative care nurses, physiotherapists, occupational therapists, social workers and psychologists (SY-coll-oh-jists). Back to top

A mutation is a permanent change in the DNA sequence of a gene. The information in DNA is stored as a code made up of four chemicals called bases. These bases are Alanine (A) Cytosine (C) Guanine (G) Thymine (T). The bases are strung together in a long chain in a specific sequence for each gene or instruction, a bit like a sentence.

If one of the words in one of the sentences written above is changed, the sentence 'may not' then make sense. So if part of the code found in a gene is changed, it may also no longer make sense to the cell. For example, ATC-GAT-GTG-GCC-ATT might code for a protein that is involved with making sure cells only divide when they are meant to. If the GTG was changed to GAG, the code ATC-GAT-GAG- GCC-ATT may no longer produce a protein that works properly and the cell may not be able to regulate cell division and it may divide when it should not.

Types of mutations can include:

• One single change in a base like the example above,
• Chromosome translocations,
• 'Insertions,' where a base is inserted into the sequence,
• 'Deletions,' where a base is removed from the sequence.

Mutations can be caused by mistakes made by the cell during cell division, viruses, radiation, chemicals and drugs. Back to top

A drug used to treat fungal infections. Mycostatin belongs to a group of drugs called antifungal agents. Back to top