Spine Cancer

• Spine Cancer involves abnormal cell growth in or around the spinal cord or vertebral column.
• Symptoms often include localized or radiating back pain, weakness, numbness, and changes in bowel or bladder function.
• Causes can be primary (originating in the spine) or metastatic (spreading from other cancers).
• Treatment options range from surgery and radiation to chemotherapy and targeted therapies.
• Early diagnosis and a multidisciplinary approach are vital for improving outcomes and managing symptoms.

What is Spine Cancer?

What is Spine Cancer? It refers to the development of malignant tumors either within the spinal cord itself (intramedullary), in the membranes covering the spinal cord (intradural-extramedullary), or in the bones of the spine (vertebral tumors). These tumors can be primary, meaning they originate in the spine, or metastatic, meaning they have spread to the spine from cancer elsewhere in the body, such as the lung, breast, prostate, or kidney. Metastatic spine tumors are far more common than primary spine tumors. According to the American Cancer Society, an estimated 1.8 million new cancer cases were diagnosed in the United States in 2020, with a significant portion experiencing metastatic spread to bone, including the spine.

Symptoms and Causes of Spine Cancer

Recognizing the signs of spine cancer symptoms is crucial for timely diagnosis. Symptoms can vary widely depending on the tumor’s size, location, and rate of growth, as well as whether it’s pressing on the spinal cord or nerves. Common symptoms often include persistent back pain that may worsen at night or not improve with rest, numbness, tingling, or weakness in the arms, legs, or chest, and difficulty walking. Other signs might include loss of bowel or bladder control, muscle weakness, or sensory changes, which can significantly impact daily life.

The precise causes of spine cancer are not always clear, particularly for primary tumors. For primary spinal tumors, genetic factors or exposure to certain environmental toxins may play a role, though these links are not fully established. Neurofibromatosis type 2, a genetic disorder, is known to increase the risk of developing certain types of spinal tumors. However, the vast majority of spine cancers are metastatic, meaning they originate from another cancer in the body that has spread to the spine. In these cases, the cause is directly linked to the primary cancer, such as lung cancer, breast cancer, prostate cancer, or kidney cancer, which are known to frequently metastasize to bone.

Spine Cancer Treatment Options

A range of spine cancer treatment options are available, tailored to the specific type, location, and stage of the tumor, as well as the patient’s overall health. Treatment goals typically involve relieving pain, preserving neurological function, and controlling tumor growth. A multidisciplinary team, including neurosurgeons, oncologists, radiation oncologists, and rehabilitation specialists, usually collaborates to develop the most effective plan.

Common treatment modalities include:

• Surgery: Often the first line of treatment, especially for tumors that are compressing the spinal cord or nerves. The goal is to remove as much of the tumor as possible while preserving neurological function.
• Radiation Therapy: Uses high-energy rays to kill cancer cells and shrink tumors. It can be used after surgery to eliminate residual cells or as a primary treatment for tumors that cannot be surgically removed. Stereotactic radiosurgery (SRS) is a specialized form of radiation that delivers highly focused beams to the tumor.
• Chemotherapy: Involves drugs that kill cancer cells throughout the body. Its effectiveness for spinal tumors depends on the tumor type; some primary spinal tumors and many metastatic cancers respond well to chemotherapy.
• Targeted Therapy: These drugs specifically target certain molecules involved in cancer growth, often with fewer side effects than traditional chemotherapy. They are used for specific types of cancer that have particular genetic mutations.
• Supportive Care: Includes pain management, physical therapy, and occupational therapy to help patients maintain function and improve quality of life.