What is Spine Cancer?
Spine cancer is an abnormal growth of cells in or around the spinal cord resulting in a tumor. If the abnormal cells originated from cells in the tissues of the spine, the resulting collection of cells is called a primary spine tumor. If the abnormal cells originated in another part of the body, such as the lung or breast, and were carried to the spine by the blood or other bodily fluid, then it is considered a metastatic spine tumor. More than 18,000 cases of primary spine tumors and more than 162,000 spine metastases are diagnosed in United States each year. Spinal metastases can occur in up to 40 percent of cancer patients.
Primary Spine Tumors
Primary spine tumors are relatively rare types of tumors that originate in or around the spine itself. They can either be benign (non-cancerous) or malignant (cancerous). Benign tumors include meningiomas, neurofibromas and schwannoma, while malignant ones include astrocytomas and ependymomas.
Metastatic spine tumors
Metastatic tumors can spread to the spine through the bloodstream, along nerves or within the fluid that surrounds the spinal cord and brain. These cells most commonly originate from tumors within the lung, breast, skin and colon, and are deposited in the spine, eventually growing into a tumor or tumors.
Both primary and metastatic spine tumors are very dangerous because they can compress the spinal cord and/or destroy the bone and surrounding tissue in the spine. These tumors cause patients to experience pain, gait and posture problems, and other neurological issues. As these tumors grow larger, patients can become paralyzed if the tumor cuts the spinal cord completely.
How are Spinal Tumors detected?
Spine tumors are usually detected because a patient will have symptoms, such as back pain, difficulty walking, sexual dysfunction and limb weakness. Patients often experience pain that either is in the spine itself or radiates from the nerves in the spine. Because none of these symptoms are unique to spine tumors, the diagnosis must be confirmed through a combination of a physical examination and imaging, such as magnetic resonance imaging (MRI) and computed tomography (CT) scans. Once a spine tumor has been diagnosed, more tests may be needed to identify the specific type of tumor and determine the proper treatment for the patient.
How is Spine Cancer treated?
Generally, treatment of spine tumors requires a multidisciplinary approach. Often a combination of treatments – such as surgery, radiation therapy and/or chemotherapy – is most effective in fighting the disease.
For solitary tumors that are not embedded near the spinal cord, surgery is commonly used. Surgery may be followed by radiation therapy to eliminate any microscopic traces of the tumor that remain. If the vertebrae of the spine are eroded by the tumor, stabilization of the spine may be required. Stabilization can be accomplished through use of metal hardware or by injecting bone cement into the affected vertebra. When the tumor is impinging on the spinal cord, the neurosurgeon may cut away the tumor to relieve the pressure in a special procedure called spinal cord decompression.
If the patient suffers from multiple tumors, which is often the case with metastatic spine cancer, he or she will typically undergo radiation therapy. Radiation therapy uses low doses of radiation to treat the tumor, in order to minimize damage to healthy tissues, including the spinal cord and nerves. Conventional radiation therapy is generally given in 20 to 40 treatment sessions over four to six weeks.
Chemotherapy medication is delivered orally or through an IV. It affects both normal tissue and the cancer cells, so patients may experience side effects, such as severe nausea and vomiting, infections, fatigue and weight loss. Chemotherapy often is given to a patient in combination with other types of spine cancer treatment.
Radiosurgery devices, such as the CyberKnife, offer patients a new option for spine cancer treatment5. Unlike conventional radiation therapy, during which low doses of radiation are delivered over weeks and months, the CyberKnife can treat a tumor in one to five days by delivering a high dose of radiation with extreme accuracy.