Spinal Cancer - Cancer Institute Overview
(Also Called 'Spinal Tumors')
What are spinal tumors?
Spinal tumors are a diverse group of lesions ranging from benign (non-cancerous) tumors treated with surgical resection, to malignant (cancerous) tumors that require multidisciplinary care involving surgery, radiation therapy and/or chemotherapy.
Benign spinal tumors of the spine include meningiomas, neurofibromas and schwannomas. These most often occur inside the spinal canal, but outside the spinal cord itself. These tumors are most often treated with surgical resection alone, although more complex cases may also require additional therapy such as radiation or chemotherapy.
Malignant spinal tumors of the spinal column may be divided into two categories: the rare primary tumors, which arise in the bones of the spine, such as osteosarcomas, chordomas, and giant cell sarcomas; and the more common secondary, or metastatic tumors.
Metastatic spinal tumors occur when cancer cells from another part of the body from cancers such as lung, breast, prostate and colon spread to the spine either via direct extension or through the bloodstream. Tumors of these types often need an aggressive multidisciplinary approach, possibly including surgery, spinal column reconstruction, radiotherapy, stereotactic radiosurgery and/or chemotherapy. Treatment from an experienced spinal oncologic surgeon is necessary for optimal results if surgery is required.
Spinal Cord Tumors
Primary spinal cord tumors are those that originate in the spinal cord itself. These include astrocytomas, glioblastomas, ependymomas and hemangioblastomas. Differentiation of inflammatory or demyelinating lesions of the spine from spinal cord tumors may be difficult.
For this reason, surgery should be advised only after a thorough evaluation. For selected cases, microsurgical resection with an experienced neuro-oncologic surgeon will limit neurologic problems (morbidity), improve the chance for cure of less aggressive tumors (hemangioblastoma and ependymoma), and potentially improve survival for more aggressive ones (astrocytoma and glioblastoma).
Aggressive spinal cord tumors often require the multidisciplinary approach of the Cleveland Clinic Brain Tumor Institute's radiation therapists and oncologists in order to achieve long-term control.
What are the symptoms?
Symptoms of spine and spinal cord tumors depend upon the location in the spine and upon the nerves that are affected. Many of these tumors present with back or leg pain as their initial symptoms. Others may present with leg or arm weakness, clumsiness, or bowel or bladder problems.
How are they diagnosed?
CT (computed tomography) or MRI (magnetic resonance imaging) scans are most often used in the initial evaluation of spine and spinal cord tumors.
What are the treatment options for spinal tumors?
The Cleveland Clinic Brain Tumor Institute aggressively treats primary and metastatic tumors of the spine and spinal cord. Ultrasound, microsurgery and laser surgery are used by neurosurgeons during tumor removal; state-of-the-art fusion and stabilization techniques, including vertebroplasty and corpectomy, help restore functional mobility and relieve pain.
Pain not amenable to direct surgical approaches may be treated with nerve blocks and catheters delivering medications directly to the spine. When these techniques fail, surgical techniques including intrathecal pumps and cordotomy often give dramatic pain relief to patients with spinal tumors.
Radiation and chemotherapy often play roles in the comprehensive management of malignant spine lesions. Radiation options may include standard fractionated radiotherapy and conformal radiosurgery with the Novalis radiosurgical system.