Spine Cancer and Treatment Overview
Spine cancer at a glance
- Spine cancer is aggressively abnormal cell growth in the spinal canal or the vertebrae of the spine that forms a malignant tumor(s).
- Spinal cord tumors and vertebral tumors can be cancerous or noncancerous, but either form can result in disability and even death.
- Cancerous vertebral tumors, which account for about 90 percent of spine cancers, usually spread to the spine from breast and lung cancers in women and from prostate cancer in men.
- CyberKnife radiosurgery effectively treats spinal cord and vertebral tumors by non-invasive, accurately targeted radiation to destroy tumors.
What is spine cancer?
Spinal cancers are divided into primary and secondary types. “Primary” spine cancer develops within the spine column. Spinal cord tumors can also be primary or secondary (metastatic) cancers. It is unclear what causes tumors to develop in the spinal cord or the membranes (meninges) covering the spinal cord.
Cancerous vertebral tumors (in the vertebrae) are “secondary” cancers, or metastatic cancer, that have spread to the vertebrae from another part of the body, such as the breast, prostate or kidney.
Spine cancer affects about 10,000 people a year. About 90 percent of cancerous tumors of the spine are metastatic tumors, originating in another part of the body. Some rare vertebral cancers do originate in the vertebrae and are primary cancers.
The spinal cord is a column of nerve tissue that extends from the base of the brain down the back, and is surrounded by three protective membranes. The spinal cord is part of the central nervous system (CNS).
Normally the cells within the CNS divide and grow in an orderly and controlled way. If this process gets out of control, the cells keep dividing and form a lump or tumor.
Tumors are either benign or malignant. A benign tumor keeps growing but is not cancerous and can’t spread anywhere else in the body. A malignant tumor is cancerous and the cells can grow into and destroy surrounding tissue, as well as spread to other parts of the CNS.
Spinal cord tumors
- Intramedullary tumors — found within the spinal cord, and the most common types are astrocytoma and ependymomas. It is also possible to have an intramedullary tumor that has metastasized from a malignant tumor somewhere else in the body.
- Intradural extramedullary tumors — start inside the coverings of the spinal cord, but outside the cord itself. Meningioma and nerve-sheath tumors, such as schwannomas, are the most common.
Vertebral tumors are also called extradural tumors, meaning outside the spine’s dura, the outer most layer of protective tissue around the spine. Noncancerous and cancerous vertebral tumors can both cause serious damage. Cancerous vertebral tumors usually spread to the spine from breast and lung cancers in women and from prostate cancer in men.
Any vertebral tumor, cancerous or not, can result in loss of sensation or movement in the area below the tumor. Permanent nerve damage is possible. Vertebral tumors can also cause:
- Instability in the spine
- Fractures or spinal collapse that can damage the spinal cord
- Death from tumors that restrict the spinal cord.
What are the symptoms of spine cancer?
Spinal cancer symptoms depend on the tumor type, size, location, health history of the patient, and more. Symptoms can occur very gradually or swiftly, even over a matter of hours or days. Vertebral tumors that have spread from another location in the body to the spine often progress quickly.
Pain is the most noticeable sign of spinal cancer. Pain can come from the tumor pushing on sensitive nerve endings or causing spinal instability in the spinal column.
If the tumor presses on the spinal cord, there may be tingling or numbness in the arms or legs. Symptoms that develop after some time include clumsiness, such as not knowing where the feet are, and fumbling buttons or keys. As the disease progresses, spinal cancer symptoms may include weakness, inability to move the legs and eventually paralysis.
Common signs of spinal cord cancer tumors and vertebral cancer tumors may include the following:
- Back and/or neck pain
- Arm and/or leg pain
- Muscle weakness
- Loss of sensation
- Difficulty walking
- Loss of bowel or bladder function
- Spinal deformities (hunchback)
- Pain or difficulty standing.
Diagnosis and treatment of spine cancers
If a doctor or patient suspects a spinal column or vertebral tumor, the physician will likely recommend tests to determine the type, location and extent of the suspected tumor. These include MRI, CT scan, and biopsy of tumor tissue to determine if it is a cancerous or benign tumor.
Spinal column and vertebral tumor treatment attempts to eliminate the tumor, but this can risk permanent damage to the spinal cord and surrounding nerves. Age, health and the type of tumor will determine treatment. Most treatment options include:
- Monitoring. If tumors are small enough and noncancerous, watching them carefully may be an option. This also relates to adults who have already had radiation therapy. Doctors most likely recommend MRIs or CT scans to monitor the tumor.
- CyberKnife radiosurgery. CyberKnife is an alternative to surgery—radiosurgery precisely targets and kills cancerous cells in tumors while greatly reducing the damage done to healthy cells. Treatment is non-invasive, requires fewer sessions, and is often more effective. Research data supports the use of CyberKnife for spinal column and vertebral tumors.
- Traditional surgery. With newer techniques and instruments, neurosurgeons can reach harder-to-access tumors and use microscopes in surgery. If a tumor can’t be removed completely, surgery might be followed with radiation therapy, chemotherapy or both.
- Radiation therapy. This is often the first line treatment for vertebral cancerous tumors. Radiation can help eliminate remnants of any spinal tumors after surgery. It’s also used to treat inoperable tumors or tumors where surgery is too risky.
- Chemotherapy. A common treatment for many types of cancer that uses strong drugs to destroy tumors or stop cancer cells from growing.
Risks of spine cancer treatments
Most cancer treatments can have side effects. Depending on the type of treatment, the stage of the cancer and personal factors that vary with each patient, they can include:
- Allergic reaction to medications
- Infections from invasive procedures
- Fatigue and nausea from chemo and radiation therapy
- Complications from surgery and accompanying anesthesia
- CyberKnife treatments rarely have any significant side effects