Glossary

A chemotherapy drug used in the treatment of sarcomas, such as Ewing's sarcoma. It is called an anti-tumour antibiotic. This drug stops cells from dividing properly by damaging (breaking) DNA. Back to top

A treatment given 'after' the main or first (primary) type of treatment. Forexample, primary bone cancer patients will have an operation to remove the tumour, and they will be given another type of cancer treatment called chemotherapy after the surgery, this is called adjuvant chemotherapy. Back to top

The period between the onset of puberty and adulthood. Many physical and mental changes happen during this time. Back to top

This is the name given to cancer that grows or spreads quickly. Back to top

This is an enzyme found in high levels in bone and the liver. An ALP Test is usually carried out as part of a liver function test (LFT) and may be carried out to check the level of ALP in patients with suspected osteosarcoma. It is carried out using a sample of blood. Back to top

Drugs or other substances that interfere with the cell's DNA and slow down or stop cell growth. Some chemotherapy drugs are alkylating agents and are used to inhibit cancer cell growth. Back to top

Alternative medicines or therapies, such as extract of mistletoe (iscador) and laetrile (bitter almonds) are used 'instead' of what are called conventional medicines. Alternative medicines do not have to go through the very careful testing (trials) that conventional medicines do, and therefore may not be safe. Alternative medicine is sometimes mistakenly included alongside complementary medicine under the name of CAMs as if they were the same thing. They are not the same, there are important differences. Back to top

Lower than normal levels of red blood cells or haemoglobin in the blood. Back to top

The opposite of algesia, it means 'not' being able to feel pain, while awake. Some drugs called analgesics stop patients feeling pain. Back to top

Drugs (medicines) that help to stop patients feeling pain. Examples of analgesics include ibuprofen, paracetamol and codeine. Back to top

A group of drugs, which fight infections caused by bacteria. Back to top

Drugs that stop patients from feeling sick (nausea) or being sick (vomiting). Back to top

The collection of blood from a donor or patient, followed by the removal of parts of the collected blood, such as, red blood cells, white blood cells or plasma followed by the return of the remaining blood to the patient or donor. Back to top

Askin tumour is a primitive neuroectodermal tumour (PNET), which belongs to the Ewing's Family of Tumours. It starts in the soft tissue of the chest wall. It was first described in 1974 by an American doctor called Frederic Askin.

The treatments for Askin tumour (surgery/ radiotherapy/ type of chemotherapy drugs) are generally the same as those used to treat Ewing's sarcoma. Back to top

A hearing test done in a soundproof room by a specially trained person called an audiologist (or-DEE-oll-oh-jist). Patients that need chemotherapy will have hearing tests before and during treatment. This is because some chemotherapy drugs can have effects on the hearing. The test before treatment will show doctors how well the hearing is working. This result can be compared to later tests during or after treatment, showing doctors if the drug is affecting the hearing. Back to top

A tumour that does not spread to other parts of the body. Benign tumours are not cancerous. Back to top

A drug used as a painkiller and local anaesthetic in the form of a spray. It is used for numbing a sore mouth (ulcers) or throat. This drug belongs to a group of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs). Back to top

A type of treatment that helps the immune system to fight cancer, for example, a cancer vaccine. Back to top

An investigation or test that can help a doctor called a pathologist (PATH-oll-OH-jist) to look closely at some of a patient's cells or a piece of tissue.

A small amount of tissue (or sometimes the whole lump) is taken by a surgeon from the area, which needs looking at. This is often done using a needle, but can involve a small operation.

The pathologist may look at the cells under a microscope or do other tests on them. Looking at a patient's cells helps the doctors to discover if a tumour is malignant or if it has spread to nearby tissues. Back to top

A blood test involves taking a small sample of blood from a vein using a needle or if a patient has one from a central line, PICC or Portacath®;. The sample of blood is tested in laboratories to check a patient's general health and for levels of certain substances or chemicals in the blood.

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 blood cells; how many

• Red blood cells,
• White blood cells, (totals of each type),
• Platelets,

And levels of a substance called haemoglobin (HEE-moh-GLOW-bin).

Tests to see how the liver is working (LFTs).

Tests to look for signs of inflammation (CRP, ESR), these tests can help to detect infection and disease processes that cause inflammation.

Test (ALP) to check the level of a substance called alkaline phosphatase (AL-kuh-line FOSS-fuh-taze) in patients with suspected osteosarcoma. Back to top

Bones make up the skeleton, which gives the body shape, protects organs and aids movement. The skeleton is made up of around 200 bones. Bones also help to fight disease.

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

Bone marrow is found at the centre of some of the long bones of the body such as the femur, ribs, skull and pelvis. It is a fatty spongy tissue, which produces blood cells. Back to top

A procedure in which a small sample of bone marrow is removed, usually from the hip bone, breastbone, or thigh bone. The bone marrow is sent to a laboratory to be looked at under a microscope. Back to top

Bone scans are used to look for abnormalities in bones. Patients have a suspected primary bone cancer will usually have a full body bone scan. A tiny amount of radioactive substance (radionuclide) is injected into the patient's blood, which is then taken up by the bones fairly quickly (~2-4 hours). During the scan the radioactivity is detected by a specialised camera called a gamma camera.

The radioactivity will collect more at areas of high activity (breakdown and repair) in the bone. This could 'suggest' a cancer or secondary cancers (metastases). 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. 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

CAM is short for Complementary and Alternative Medicine. Back to top

Cancer is a disease of the body's cells. Throughout a person's life but especially when they are developing and growing, their cells will divide (split in two) to make more cells (growth). This helps to make new bone or muscle as they grow up and also to replace old or damaged cells. Usually, cells only divide when the body sends them special signals and the cells 'know' when to stop dividing.

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, often called a 'growth.' Or the doctor may use the word 'neoplasm' (NEE-oh-PLA-zum), this is a Latin word meaning 'new growth.'

In bone cancer, cells within bones start to divide and grow uncontrollably. Back to top

You are carrying out cancer research by reading this. Research means looking for or finding knowledge. Most medical research is carried out to firstly understand how our bodies function normally when people are well. This in turn helps us to understand what happens when things are not functioning normally (illness).

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).

Back to top

There are two main types of cancer vaccine:

• 'Cancer prevention vaccines,' such as the HPV vaccine given to young women to help prevent cervical cancer.
• 'Cancer treatment vaccine' 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. There are five main types: antigen vaccines, whole cell vaccines, dendritic cell vaccines, DNA vaccines and anti idiotype vaccines. Back to top

All living things are made up of cells. They are the building blocks of the body. Cells are very small, and can usually only be seen under a microscope.

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 cell, like bacteria, humans are made up of about 100 trillion (100, 000,000,000,000) cells. Back to top

The process of cell growth and division. The cell cycle is made up of three major phases called Interphase (inter-FAZE), Mitosis (my-TOH-siss), and Cytokinesis (sy-TOH-ki-NEE-siss).

During Interphase the cell 'gets ready' to divide by copying its DNA and making all the things the cell needs for division. Mitosis is the phase during which the cell nucleus divides into two and gives an exact copy of its DNA to the two newly forming 'daughter' cells. During Cytokinesis the forming daughter cells fully divide into two new 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 or 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

Long, flexible, plastic tubes that go into a 'central' blood vessel in the chest near the heart; that is why they are called central lines. They are used to give fluids, nutrition, chemotherapy and other drugs directly into the blood, and to take blood samples. Central lines may also be referred to as a Hickman®; this is a 'make' of central line.

The central line is put in using a local 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

The treatment of cancer with medicines that stop the growth of, or kill cancer cells. Chemotherapy is quite often shortened to 'chemo' (KEY-mo).

Primary bone cancer patients will often be 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.

When you are given chemotherapy directly into your blood, the drug is given through a cannula (tube), which sits in a vein in the arm or hand. Alternatively, patients may have a central line, PICC or Portacath®. The drug is pumped slowly into the vein, this is called infusion. Chemotherapy is given in 'cycles.'

The chemotherapy will make patients feel quite ill because it can affect the healthy cells of the body (side effects) as well as the cancer cells. Patients will lose their hair (it grows back) and they may feel very tired, sick, experience taste changes (metal and bitter) and mouth sores and suffer with diarrhoea. Back to top

Chondroblastic osteosarcoma is the name given to an osteosarcoma that when looked at under a microscope, the cells can be seen to be producing cartilage. Cartilage is tissue that covers and cushions the ends of bones. Back to top

Chondrosarcoma is a type of bone cancer in which the cells make a tissue called cartilage (KAR-tih-lij). Back to top

Chordomas are a very rare form of primary bone cancer. There are thought to be around 20 cases a year diagnosed in the UK. They start in the notochord, which is a tissue found in embryos, from which the spine develops. Some notochord can remain after fetal development and 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 usually treated using surgery and/or radiotherapy. Back to top

Chromosomes are structures found in the nucleus of cells, which contain all the instructions for growth, development and function of the cells. These instructions are known as genes and they are in the form of a chemical code contained within a very long molecule called DNA or deoxyribonucleic acid. The DNA molecule is around 2 metres long and has to be packaged into a cell nucleus which is around 2 micrometres in diameter (2 millionths of a metre).

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 period of the cell cycle known as mitosis.

Humans have 46 chromosomes in each cell, 23 from our mothers and 23 from our fathers. Back to top

A chromosome translocation is the rearrangement of parts or pieces of chromosomes. In around 90% of Ewing's sarcomas part of chromosome 11 has moved to chromosome 22 and a piece of chromosome 22 has moved to chromosome 11.

You may see this written as t(11;22) when you are reading about Ewing's sarcoma. This means 't' for translocation and the numbers in the brackets tell us which chromosomes are involved. Back to top

Cisplatin is a platinum containing chemotherapy drug that is given as a treatment for osteosarcoma and for some other types of cancer. This drug works by binding or sticking to DNA and starting processes that will kill the cells, this process is called apoptosis (A-pop-TOH-sis). Back to top

This is the medical name for the collar bone. Back to top

Clinical trials are used to test how well new drugs or treatments work in people. Back to top

An antibiotic containing two drugs, sulfamethoxazole (SUL-fa-meth-OX-ah-zole) and trimethoprim (try-METH-oh-prim), often both together called co-trimoxazole. Co-trimoxazole is mainly used to treat bladder infections, pneumonia, bronchitis and ear infections. Back to top

Complementary medicines are used 'alongside' conventional medical treatment often to help with symptoms or to aid relaxation. Back to top

Tissue that helps to support or keep other parts of the body in place and it connects other tissues together. Bone is a type of connective tissue. Back to top

Computerised Tomography contrast agent is a substance that is opaque to x-rays. It is used during CT scans and allows organs and blood vessels, which it fills to show up much more clearly. Contrast can be injected into a vein prior to a scan or can be in the form of an oral solution which is drunk prior to a scan.

Intravenous Magnetic Resonance Imaging contrast agents are usually based on a metal called gadolinium (GAD-oh-LIN-ee-um), which has an effect on particles called protons within atoms in the tissues and blood vessels in which it is located. Back to top

'C-Reactive Protein;' blood tests to measure the levels of CRP are carried out to look for signs of inflammation and infection. Back to top

A machine, which uses X-rays to take very detailed pictures of the inside of the body. This helps doctors called radiologists to check if a patient's cancer has spread or grown.

A CT scanner looks like a large 'doughnut' with a bed for the patient to lie on. The bed will move slowly through the 'doughnut',' 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

This is when a patient is disease free and made well again. In the case of cancer, patients are thought to be cured if they remain cancer free for a period of at least five years. Back to top

A chemotherapy drug used to treat primary bone cancers and some other forms of cancer. 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

A scientist that specialises in the study of chromosomes and chromosomal abnormalities. During the diagnosis stage, cytogeneticists carry out tests to look for damage to chromosomes and genes that help control the cell. Back to top

Toxic to cells; a cytotoxic drug is a cell-killing drug. Back to top

A steroid drug. Dexamethasone is a type of drug known as a corticosteroid (KOR-tih-koh-STEH-royd). The drug has an anti-inflammatory effect and is used to decrease inflammation. Dexamethasone may be used to treat some of the side effects caused by chemotherapy. Back to top

The process of finding out what may be wrong with a patient, such as cancer, from its signs and symptoms. Investigations or tests and physical examinations help doctors to make a specific diagnosis. Back to top

Also called the shaft is the main part of a bone between the epiphyses (epi-FEE-sees), see figure 1, Basic Anatomy of Long Bones. Back to top

A drug used as a painkiller, which belongs to a group of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs). Diclofenac may be used to treat pain following an operation. Back to top

This is a medical word to mean situated or placed farthest from point of attachment to the body or origin. For example, the femur (thigh bone) is attached to the hip; (its point of origin) so the distal part of the femur is the part of the bone furthest from the hip (nearest to the knee joint). The opposite is proximal. Back to top

DNA stands for deoxyribonucleic acid (dee-OK-see-RY-bow-new-KLAY-ick acid). DNA is a long molecule (as long as 2 metres) packaged into the nucleus of cells. DNA is the genetic material of a cell and contains genes or 'instructions' that are passed on from one cell to the next when they grow and divide. DNA is a bit like a database containing 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. An exact copy of the DNA is passed on when cells divide, so almost every cell in the human body contains exactly the same DNA.

Cancer occurs when there is some form of damage or change to the DNA and therefore the cell's instructions, which are responsible for making sure cells only grow and divide when they need to. Back to top

The amount of a drug (medicine) or treatment (radiotherapy) that will be given (administered) to a patient. For example, for chemotherapy the dose is based on body surface area, the amount could be in milligrams or grams per square metre per day (mg/m2/day). Radiation therapy doses are measured in grays (Gy); the total dose is spread out over time or 'fractionated.' Back to top

A chemotherapy drug that is given as a treatment for sarcomas and some other types of cancer. Doxorubicin is a red fluid and is given directly into a vein by infusion. It is a type of drug called an anti-tumour antibiotic. It works by interfering with the cancer cell's DNA at a time when the cell is getting ready to divide. The interference results in the DNA molecule breaking and chromosome damage, which prevents the DNA copying itself and ultimately the cell from dividing. Doxorubicin targets the rapidly dividing cancer cells but can also have an effect on healthy cells that also divide rapidly causing side effects. Back to top

A test, which measures the electrical activity of the heart. This test is usually carried out before and during treatment to see how well the heart is working. Special leads are attached to small sticky discs stuck all across the chest area. These leads pick up the electrical signals of the heart and record the results. It is completely painless. Back to top

This test is often referred to as an 'Echo' and it is used to examine how well the heart is working. The test uses ultrasound waves, which are at a frequency that you can't hear. The sound waves are made by a special machine, which also detects the sound waves back and can build up a detailed picture of the heart on a monitor.

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. This result can be compared to later tests during treatment, showing doctors if the drug is affecting the heart. Back to top

The growth area near the end of a bone; see figure 1, Basic Anatomy of Long Bones. Back to top

'Erythrocyte (eh-REETH-row-site) sedimentation rate.' Erythrocyte is the name given to red blood cells. The ESR is a blood test, which measures the distance red blood cells travel in one hour as they settle to the bottom of a test tube. An increased ESR (increased from the normal range) may be a sign of inflammation or infection. Back to top

A chemotherapy drug that is given as a treatment for primary bone cancers and some other types of cancer. The drug is in the form of a white powder, which is then made into a colourless solution. Etoposide is usually given directly into a vein by infusion. It can also be given by mouth as it is available in capsule form. Etoposide works by stopping an enzyme called Topoisomerase II (TOH-poh-i-SOM-meh-rays), which joins together DNA strands that have been cut or cleaved. This results in the DNA having breaks in it and being unable to copy itself; the cell can then not divide, which ultimately leads to cell death (apoptosis). Back to top

EURAMOS is the European and American Osteosarcoma Study Group. EURAMOS carries out clinical trials of treatments to help improve survival from Osteosarcoma. Back to top

EURO-EWING 99 is a large International study aimed at improving treatment and outcome of Ewing's Family of Tumours. Back to top

The time or period after a treatment in which there is no appearance of the signs, symptoms or effects of the cancer. Back to top

A rare malignant tumour found in bones or sometimes in muscles near to bone. It is named after James Ewing, the doctor who first described it. Ewing's Sarcoma is the second most common primary bone cancer in children and young people; it is more common in boys than girls. Back to top

These tumours are all thought to come from the same type of mesenchymal (ME-zen-KY-mal) stem cell. The Ewing's Family of tumours or EFTs includes:

• 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

This is the joining or fusion of two genes by a chromosome translocation found in more than 90% of Ewing's sarcomas. In this case a gene called FLI1 from chromosome 11 is joined to a gene called EWS on chromosome 22. The protein made or coded for by this gene is called the EWS-FLI1 fusion protein. This fusion protein is thought to affect other genes in the cell by switching them on or off. Back to top

Extraosseous Ewing's sarcoma starts in soft tissue rather than bone. It is one of the Ewing's Family of Tumours. The treatment for extraosseous Ewing's sarcoma is the same as that for Ewing's sarcomas that start in bone. Back to top

A tumour, which appears identical to osteosarcoma but sarts outside of the bone. It is very rare. Back to top

A blood test, which gives information about blood cells; how many

• Red blood cells,
• White blood cells, (totals of each type),
• Platelets,
• And levels of a substance called haemoglobin (HEE-moh-GLOW-bin).

Back to top

Fever (higher than normal temperature) and neutropenia, which is a lower than normal number of a type of white blood cells in the blood called neutrophils. Lower than normal levels of neutrophils increases the patient's risk of infection. The fever may be a result of infection. Back to top

The longest bone in the body. It is found in the leg between the hip and knee. Back to top

If the cancerous cells of an osteosarcoma when viewed under a microscope look like they are producing only a small amount of bone the tumour may be called 'fibroblastic osteosarcoma.' Back to top

A drug that treats fungal infections. Fluconazole belongs to a group of drugs called anti-fungal agents. Back to top

G-CSF is a growth factor that stimulates the bone marrow to produce white blood cells. 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 cuts down the time that the patient has the increased risk of infection.

G-CSF may 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. Back to top

Genes are the instructions that contribute to the function of a cell. The information for these instructions is stored as a code on a long molecule called DNA.

The code is made up of four chemicals called bases. These bases are Alanine (A) Thymine (T) Cytosine (C) Guanine (G). A gene is a sequence (a string) of bases. It is made up of combinations of A, T, C, and G; the specific combinations of these letters form the code for a particular instruction. Humans have around 25000 genes.

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

This can mean there is something wrong with a gene that makes a person more likely to develop a cancer; it does not mean they will. It can also mean a person has a particular combination of forms of specific genes, known as alleles that can make cancer more likely to occur. Genetic predispositions can run in families. Back to top

GFR stands for glomerular (GLOM-eh-rue-lar) filtration rate. It is a test to see how well a patient's kidneys are working. The kidneys have many specialised functions, for example, keeping the concentrations of various salts and other important substances constant, keeping the volume of water in the body constant, removing wastes from the body (urea, ammonia, drugs, toxins), helping to keep the pH of the blood constant and helping to regulate the blood pressure.

Some chemotherapy and other drugs given during 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. This result can be compared to later tests during treatment, showing doctors if the drug is affecting the kidney function.

A GFR sometimes involves the injection of a tiny amount of a radioactive dye into the blood (nuclear medicine). At regular intervals, usually once every 1 or 2 hours for 4 hours, blood will be taken. The amount of radioactive dye will be measured in the blood. 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

The grade of a cancer describes how active the cancer is. Tumours are graded by pathologists who look at tumour samples under the microscope. One of the things they look at is how many dividing cells they can see. This is related to how active the tumour is. This helps doctors to discover how quickly the cancer may grow or spread to other parts of the body. The type of treatment a patient may get will depend on the grade of the cancer. Back to top

The medical name for growing pains is 'recurrent nocturnal limb pains' or 'idiopathic (of unknown cause) limb pains.' 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