What Is Spinal Cancer?

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Spinal cancer involves abnormal cell growth found in the tissues that make up the spine (including the spinal canal and the vertebrae), forming a malignant (cancerous) tumor. There are many types of spine tumors.

Tumors that begin in the spine (including the bones, nerves, and other tissues) are called primary tumors. Spinal cancer may involve low-grade tumors that grow slowly or high-grade tumors that grow quickly. 

Most spine tumors are metastatic, meaning they have spread from cancer in a different part of the body. Lung, breast, and prostate cancer are the primary sources of metastatic spinal cancer in most cases.

Doctor discusses X-ray with patient

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Metastatic cancer is more serious than primary tumors due to the nature of spread throughout the body. Spinal cancer can develop in any part of the spine, from the neck all the way down to the sacrum (bone at the bottom of the spine) and hip bones.

According to the American Cancer Society, approximately 24,530 malignant tumors of the brain or spinal cord will be diagnosed in 2021.

Types of Spinal Cancer

There are two types of spinal tumors:

  • Primary spinal tumors originate in the spinal column, growing in the bones, discs, nerves, and other tissues within the spine. Multiple myeloma and osteosarcoma are two of the more common primary cancerous spinal tumors.
  • Secondary spinal tumors—metastatic tumors—have spread to the spine from cancer that began elsewhere in the body (e.g., breast, lungs, prostate). These tumors are the most common type found in the spine and can spread to other parts of the body as well. Over 90% of diagnosed spinal tumors are of metastatic origin. 

Spinal Cancer Symptoms

Symptoms of spinal cancer can vary depending on the tumor location and type. Some symptoms may come on slowly. Other times, they may come on suddenly and progress quickly. These symptoms may include, but are not limited to: 

  • Back and/or neck pain
  • Arm and/or leg pain
  • Changes in sexual function
  • Difficulty standing and/or walking
  • Fatigue 
  • Loss of bowel or bladder function
  • Loss of feeling in parts of the body
  • Muscle weakness
  • Numbness in extremities 
  • Paralysis
  • Spinal deformities (e.g., hunchback)

Causes

The potential causes of spinal cancer are not yet known. Some forms of metastatic cancer can be prevented or cured before they spread to the spine. For example, the risk of lung cancer is reduced by not smoking. When detected early enough through screening, breast cancer may be cured before it spreads to the spine.

Known risk factors for developing spinal cancer include: 

  • History of cancer: Cancers more likely to spread to the spine include breast, lung, and prostate cancer. 
  • Compromised immune system: According to the American Association of Neurological Surgeons, spinal cord lymphomas—cancers that affect a type of immune cell—are more common in people with compromised immune systems.
  • Hereditary disorders: Von Hippel-Lindau disease and neurofibromatosis (NF2) are inherited conditions that may be associated with spinal cord tumors. 
  • Chemical and/or radiation exposure: The likelihood of developing spinal cancer may increase in individuals who have been exposed to radiation therapy or carcinogenic industrial chemicals.

Diagnosis

Diagnosing a spine tumor usually starts with a thorough medical examination to assess your symptoms. Your doctor will ask questions about any back pain and/or neurological symptoms you are experiencing.

Diagnostic imaging tests such as X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) may be ordered to enable your doctor to see the spinal cord and surrounding areas in detail to detect tumors. One or more of these tests will be required for an accurate diagnosis. 

If a tumor is detected on any imaging scans, a biopsy will be required to determine if the tumor is benign or malignant (cancerous). Spine tumor biopsies are often performed using a minimally invasive procedure. Doctors use a CT scan to guide the placement of a thin needle to extract a sample of the tumor.

If the tumor is determined to be malignant, a biopsy can identify the type of cancer, which helps determine treatment options. 

Treatment

Treatments for spinal cancer vary, depending on the type of cancer, stage, and location of the disease. Common treatments for spinal cancer include:

Surgery

Surgery is often the gold-standard treatment for tumors that can be removed without the risk of injury to the spinal cord or nerves.

New surgical techniques involving high-powered microscopes and other technologies allow neurosurgeons to distinguish tumors from healthy tissues and remove tumors from areas of the spine that were once thought to be inaccessible.

In some cases, high-frequency sound waves may be used to break up tumors and remove the fragments during surgery.

Chemotherapy

When a tumor can’t be removed safely or entirely, surgery may be followed by other treatment options, such as chemotherapy. Chemotherapy involves using medications to destroy cancer cells or stop them from growing. It has long been a standard treatment for many types of cancer.

Chemotherapy drugs may be injected into the vein or administered orally. For some spinal cancers, the medication may be injected directly into the cerebrospinal fluid. Side effects may include fatigue, nausea, vomiting, decreased appetite, increased risk of infection, and hair loss.

Radiation Therapy

In some cases, radiation therapy is part of the treatment plan for spinal cancers. It is typically used in combination with surgery and/or chemotherapy. After surgery, you may receive radiation therapy to eliminate any remnants of tumors. It is also used to treat inoperable tumors or treat tumors when surgery is too risky.  

The specific plan of your radiation treatment will be based on the type and size of the spinal tumor. External radiation therapy is popular for spinal cancer—the area radiated includes the tumor and surrounding area. For metastatic spinal tumors, radiation is sometimes administered to the entire spine.

If a small spine tumor is detected, stereotactic radiosurgery (SRS)—a precise form of radiation therapy—can target radiation to the tumor only, minimizing radiation exposure to the rest of the spinal cord. Gamma Knife is one kind of SRS. Radiation therapy may cause side effects such as nausea, vomiting, and fatigue.

Other Treatments 

Tumors, surgery, and radiation therapy can all cause inflammation inside the spinal cord, which may cause pain and swelling. Your doctor may prescribe corticosteroids to reduce inflammation, either after surgery or during radiation treatments.

Corticosteroids are used on a short-term basis to avoid serious side effects associated with prolonged use, including muscle weakness, high blood pressure, and a weakened immune system. 

If spinal cancer is caused by multiple myeloma, autologous stem cell transplants (ASCT) may be considered at a certain point during the disease course, in combination with chemotherapy, to treat the disease.

Autologous transplants involve extracting your own stem cells from your bone marrow or peripheral blood before the transplant and storing the cells safely. After the extraction, chemotherapy is administered to destroy multiple myeloma cells. The stored stem cells are then transplanted back into your body through a vein.

Prognosis

The prognosis of spinal cancer depends on the patient’s overall health and whether the spinal tumor is malignant or metastatic. The prognosis with respect to survival depends on the type of spinal tumor.

The two-year survival rates for patients with spinal tumors caused by other cancers range from 9% (lung cancer) to 44% (breast and prostate cancer).

Many patients with metastatic tumors enter palliative treatment aimed to provide an improved quality of life and, potentially, a prolonged lifespan. Treatment and technological advances related to spinal cancer have provided greater odds of controlling metastatic cancer of the spine, offering hope to spinal cancer patients.

Coping 

A diagnosis of spinal cancer can be overwhelming, both physically and emotionally. Your strength, stamina, and the support you receive after diagnosis and throughout treatment are important to your recovery. Consider taking these steps to help cope with your diagnosis: 

Get Support

Lean on your friends and family for physical and emotional support after diagnosis and while receiving treatment. Sharing your feelings and concerns is important, whether with a loved one or a professional counselor.

Speak with your doctor about any local support groups available to you; speaking with others who have a spinal cancer diagnosis or have gone through something similar may be beneficial. Online discussion boards and support groups are also options. 

Learn All You Can About Spinal Cancer

With a spinal cancer diagnosis, you’re likely to have many questions about the tumor, treatment, and life post-treatment. Write down your questions and bring them to your medical appointments. Ask a family member or friend to attend your appointments with you to take notes.

The more you understand about spinal cancer and treatments, the more confident you will feel as you go through the process of removing the tumor.  

Prioritize Self-Care

Choose a well-balanced diet rich in vegetables, fruits, and whole grains. Check with your doctor to discuss a potential exercise program if you’re able to comfortably move your body. Ensure you get plenty of sleep every night so that your mind and body are well rested.

Reduce stress in your life when possible, and take time for relaxing activities you enjoy, such as reading a book, listening to music, or spending time with loved ones. 

A Word From Verywell 

A spinal cancer diagnosis can be scary, but you do not have to go through this alone. As you begin treatment for spinal cancer, you will have a team of medical professionals working with you, often including spine surgeons, oncologists, radiation oncologists, and your primary care provider. They will share goals of successful treatment and remission.

Whether you are still being treated for spinal cancer or have completed treatment, it is important to maintain contact with your healthcare providers. Attending all of your appointments is essential, as your doctors will want to ensure your body is responding to treatment and recovering as it should.

If you’ve been through spinal cancer treatment, the next step after recovery can be both exciting and daunting—getting back to your life and living cancer-free. You may need additional ongoing treatments, including physical therapy, assistive mobility devices, and medication to manage pain and inflammation.

Speak with your doctor about any services and support available to you, including social and emotional needs that often come up during and after cancer treatment. 

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Article Sources
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