This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on June 7, 2022.
Treatments for spinal cancer vary depending on a number of factors, including the type, stage and location of the disease. Common treatments include those listed below.
Spinal cancer treatment sometimes involves surgery. The care team applies similar surgical strategies for brain tumors and spinal column tumors. The goal of spinal cancer surgery depends on several factors, including the location and grade of the tumor, and the symptoms present.
When the tumor is limited to one portion of the spinal column, the care team may perform surgery to remove the cancer. For metastatic spinal tumors, the care team may perform surgery to relieve symptoms. For example, surgical strategies are commonly used to treat spinal column compression and instability, and relieve pain. Spinal cancer surgery may also help remove tissue pressing against the spinal cord and nerves or to relieve the buildup of cerebrospinal fluid.
In the past, surgeries to address spinal tumors were relatively large. With advances in technology, surgeons perform many of these surgeries in a minimally invasive fashion. Minimally invasive spinal surgeries allow the patient to get back on his or her feet and return to normal activities more quickly, with less pain. This also allows the patient to maintain his or her nutritional health and get back to treatment faster.
Medical oncologists treat primary and metastatic spinal cancer with an aggressive and creative approach, selecting spinal cancer chemotherapy drugs and delivery methods based on the patient's individual needs.
Chemotherapy drugs may be administered orally in pill form or injected into the vein. For some spinal tumors, drugs may be given directly into the cerebrospinal fluid. The patient may receive chemotherapy alone, or in combination with other spinal cancer treatments, such as surgery and/or radiation therapy.
Chemotherapy targets rapidly dividing cancer cells. Yet, some healthy cells in the body also divide rapidly, like those in the hair follicles, mouth, stomach and bone marrow. When the drugs damage these healthy cells, the following chemotherapy side effects may result:
Before chemotherapy begins, the care team will meet with the patient to answer questions and talk about what to expect from treatment, including how the care team will help the patient manage chemotherapy side effects. For example, the doctor may prescribe certain drugs before and during treatment to combat nausea or prevent infection. The care team will also do routine blood tests to monitor the patient's blood cell counts, and may prescribe steroids to help improve neurologic functioning and increase appetite.
Supportive care therapies like nutrition therapy, naturopathic support, pain management and oncology rehabilitation may help reduce chemotherapy-related side effects and keep patients strong so they can maintain their quality of life as much as possible during treatment.
The care team will use highly targeted delivery systems that allow them to increase the dose and precision of radiation to a spinal tumor, while reducing damage to healthy tissue.
Spinal cancer radiation therapy is commonly used following surgical resection of a tumor, to destroy microscopic tumor cells left behind. It may also be an option for metastatic spinal tumors (tumors that have spread to the spine from another part of the body).
The specifics of a patient's radiation regimen will be based on several factors, including the type and size of the spinal tumor and the extent of disease. External radiation therapy is commonly used for spinal cancer. The area radiated typically includes the tumor and an area surrounding the tumor. For metastatic spinal tumors, radiation is sometimes given to the entire spine.
Depending on the patient's radiation dose, site and other factors, he or she may experience some side effects of radiation therapy, including fatigue, hair loss, skin irritation and nerve damage.
To reduce the side effects of radiation and help the patient maintain his or her strength and quality of life, the care team will proactively work with the patient to develop solutions based on his or her needs. For example, the care team may prescribe steroids to help reduce swelling, or blood thinners to dissolve blood clots and prevent them from traveling into the lungs.
Patients also have the option to receive supportive care services like nutrition therapy, naturopathic support, pain management, oncology rehabilitation and mind-body medicine. These therapies are designed to help to keep patients strong so they can continue treatment while maintaining quality of life.
With interventional radiology, the care team can visualize tumors and perform real-time image-guided interventional procedures. They can take biopsies, deliver treatment directly to tumors, provide palliative treatment, and monitor the patient's response to treatment.
Kyphoplasty and vertebroplasty are examples of minimally invasive procedures used to treat compression fractures of the spinal vertebrae caused by spinal cancer. Compression fractures of the spinal vertebrae can cause severe back pain, spinal deformity, and loss of height. The care team may perform kyphoplasty or vertebroplasty to rebuild cracked or collapsed vertebrae.
Both kyphoplasty and vertebroplasty involve a short surgical and recovery time, and may help to:
Targeted therapy for spinal cancer targets specific pathways or abnormalities in spinal tumor cells involved in tumor growth. The care team may combine targeted therapy with other spinal cancer treatments, such as chemotherapy. This treatment is often an option for spinal cancer patients who have a tumor recurrence after previous spinal cancer treatments.
One type of targeted therapy used for spinal tumors is a monoclonal antibody, which works to stop the formation of new blood vessels that a tumor needs to grow (a process known as angiogenesis).
Targeted therapy can cause side effects, such as low blood counts, tiredness, mouth sores, nausea, diarrhea, high blood pressure and fluid buildup (usually in the legs). Throughout the patient's spinal cancer treatment, the care team provides various supportive care services to keep the patient strong, reduce side effects and improve quality of life.
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