Royal National Orthopaedic Hospital NHS Trust

The RNOH will remain the UK’s leading orthopaedic hospital, further enhancing its international profile for outstanding patient care, research and education

Scat - Bone Cancer Trust

Scat is dedicated to the advancement of bone cancer research, to understanding further the causes and process of bone cancer and its management and to working towards a better outcome for patients.

Bone Cancer has many forms, all of them rare and difficult to diagnose. Some types are specific to children, adolescents and young adults while other forms occur predominantly in the adult population. Because of the rarity and difficulty in diagnosis, once suspected, all bone cancers should be referred to a specialist centre for immediate investigation.

The Royal National Orthopaedic Hospital (RNOH) links with the University College London Hospitals (UCLH) to form the London Bone and Soft Tissue Sarcoma Service. The Service is recognised on a national and international level as a centre of excellence for the diagnosis and management of primary bone and soft tissue cancers.

The Surgeons work with a dedicated team of oncologists and other specialists to provide a special package of care for each patient which may include: investigation and staging, chemotherapy, surgical removal of the tumour and radiotherapy. Certain tumours may require amputation of a whole or part of a limb. The RNOH is a pioneering centre for the continuing development of limb sparing surgery (an alternative to amputation). Such surgery may use custom made metal implants (prostheses) to replace the bone and/or joint. These metal implants can now be lengthened without surgery to match normal growth in young people.

Every patient referred to the RNOH has the benefit of a specialist, skilled and caring clinical and rehabilitation team to offer help and support throughout their treatment. The cost of a basic care package for each diagnosed case of bone cancer averages £50,000. To ensure and improve the ongoing range of specialist services funds are urgently required. If you want to help there are many ways in which you can fundraise or donate.

Current Scat Projects

Research
Ongoing research in genetics in the area of chordoma, osteosarcoma and more recently, malignant peripheral nerve sheath tumours.
Wolfson Institute for Biomedical Research and the Cancer Institute, UCL
These are all rare tumours and for this reason do not attract the research funding of larger charities. Cancer is a genetic disease. Abnormalities (mutations) occur in the DNA in cells of the body and these mutations make the affected cells grow more quickly than the non-affected cells. The fast growing cells multiply and form a 'tumour - swelling occurs'. Detection of mutations allows us to work out how that abnormality makes cells grow faster than the normal cells. It is also known now that the effect of mutations can be blocked or even reversed by making new designer drugs against the mutations. So much of our research is focused on the genetics of specific cancers - chordomas, osteosarcomas and malignant nerve sheath tumours. £150,000 has been invested to date in this research and a further £180,000 has now been committed to ensure continuity over the next three years.

Research Project to Diminish the Incidence of Infection in Prosthetic Reconstruction
UCL Institute of Orthopaedics and Musculoskeletal Science, Centre for Biomedical Engineering
The main reason for failure of prosthetic reconstruction is infection. SCAT continues to work in conjunction with the John Scales Scholarship to investigate infection of massive implants used to treat bone cancer patients. Our current project is designed to look at silver ion release from silver-coated prostheses which will reduce the instance of infection, at present standing at 12%. SCAT has to date invested £150,000 into this partnership with the John Scales Trust.

'Live Life to the Full' ... a three-part SCAT project working with amputation and children
While this working title was at first intended for the provision of high performance limbs for children who have had an amputation as a result of bone cancer, it has now been expanded to include research and navigational surgery.

(1) Provision of High Technology Prostheses
Approximately 30 - 40 children have amputations each year as a result of bone cancer. The NHS provide a limb which can be modified for basic activities but which is not suitable for high performance. SCAT now offers children who have had amputations resulting from bone cancer access to the best technology that is available in the manufacture of artificial limbs. This gives them a better chance of an active and full life. An ongoing fund has been committed to fund any such applications.

(2) Research
Amputation is a particularly devastating event and it is probably possible to increase functional outcome by using a new technology (Interosseous Transcutaneous Amputation Prosthesis - ITAP). Previous attempts, mainly based in Sweden, to achieve this goal have been dogged with infection. Recent animal work and to date three human cases show that infection can be avoided by allowing muscle and soft tissue to bind on to the prosthesis. The funding required for each patient is approximately £8,000 for surgical costs and there will be ongoing needs for costing of external prosthesis fitment. SCAT will continue to support this project in conjunction with the Department of Bio-Medical Engineering and Stanmore Implants Worldwide.

(3) Navigational Surgery
Navigational techniques are now established in hip and knee surgery. The SCAT Board consider that there is considerable need to extend this role to the surgery performed for tumours of the pelvis and sacrum. Translational research to allow inter-operative navigation in tumour surgery will be formulated in conjunction with BME. We aim to start the project in the Autumn of 2009, and are looking to raised £250,000 over 5 years.

If you wish to donate online we can accept one off or monthly credit or debit card donations - www.justgiving.com or www.charitychoice.co.uk. For information on how to make donations or to help with fundraising, please download the SCAT leaflet or contact:

Trish McEntee
Fundraiser
SCAT - Bone Cancer Trust
c/o Royal National Orthopaedic Hospital NHS Trust,
Brockley Hill
Stanmore
Middlesex HA7 4LP

Tel: 020 8909 5575
Email: trish.mcentee@rnoh.nhs.uk

Registered Charity Number: 1036549

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Royal National Orthopaedic Hospital Trust