Every spinal cancer patient is different. The cancer experts at City of Hope have extensive experience in properly grading and diagnosing spinal cancer, and developing a treatment plan that's tailored to your specific type of spinal cancer.
Spinal tumors are classified according to their location on the spine. Most tumors of the spine are metastatic tumors, which have spread to the spine from another location in the body, such as the breast, prostate or kidney.
Parts of the spine explained
The spine consists of the spinal cord and the spinal vertebrae. The spinal cord is a bundle of nerves that sends signals from your brain to the rest of your body, or transmits signals from your body to the brain. The spinal vertebrae are the bones that make up the spinal column, which protects the cord from damage. Cerebrospinal fluid (CSF) cushions the space between the spinal cord and spinal bones.
Your spinal cord and brain make up the central nervous system, which is your body’s major control center. The spinal cord is made of a few tissue types:
- Nerve cells are the signal transmitting cells, and they rarely form tumors. However, tumors may press on nerve cells and damage or destroy them.
- Glial cells support the nerve cells. They repair nerves if they’re damaged and protect their signals by insulating them with a fatty substance called myelin. If the nerves are like a copper wire, conducting electric signals, the glial cells are like the rubber covering around the wire. Tumors more commonly start in glial cells.
- Notochord cells help the spine develop before birth and aren’t normally found in adults.
- The meninges are tissues that line the spinal cord and brain. One of the layers inside the meninges is called the dura. Cancers may start here as well.
A tumor may form in the spine or spread to the spine from elsewhere.
Spinal tumors
Intradural-extramedullary tumors: These tumors start in the dura layer of the tissue lining the spinal cord. They tend to compress nerves when they grow larger. Though many are benign (noncancerous), some may be difficult to remove and may return, and some may later become malignant (cancerous). Forty percent of spine tumors are found here, according to the American Association of Neurological Surgeons (AANS).
- Symptoms include low back pain, or pain that radiates through the extremities, hips, and/or spine. These symptoms come from the tumor compressing the nerves or bones around it.
- Women are slightly more likely to have them, possibly because of hormonal variation that increases the risk of tumors in this area. Ionizing radiation in childhood increases risk of intradural-extramedullary tumors. Obesity, tobacco use and excess hormone have also been shown to slightly increase risk.
- Magnetic resonance imaging (MRI) scans or computed tomography (CT) scans may be used to take images of the inside of the body and find a spinal tumor.
- Typical treatment includes surgical resection, in which the tumor is completely removed.
Intramedullary tumors: These tumors start inside the bundle of nerves that make up the spinal cord, usually in glial cells. They’re typically benign, but may recur after removal. Spinal tumors occur here about 5 percent of the time, according to the AANS.
- A hereditary disease called neurofibromatosis type 2 increases your risk of developing glial cell tumors.
- Symptoms of tumors here include numbness, weakness in the limbs or inability to move limbs. Spinal tumors in general may cause back pain that is unrelated to injury and that worsens when lying down.
- MRI or CT scans may be used to take images of the inside of the body and find a spinal tumor.
- Surgical resection provides the most appropriate opportunity for treatment of these tumors.
Extradural tumors: Located outside of the dura of the spinal cord, often in the bones, these account for about 55 percent of spinal tumors, according to the AANS.
- Breast, lung, prostate, renal, gastrointestinal and thyroid cancer commonly metastasize to the spine, even during earlier stages of disease.
- Symptoms of these tumors are similar to that of intradural-extramedullary tumors, and result from the compression of spinal nerves. Pain may be localized or may radiate through the extremities, and numbness or weakness in limbs may be felt.
- X-rays or bone scans may be ordered to find tumors in the spinal bones or to search for other sources of spinal pain such as fractures.
- Surgical treatment is preferred to remove the tumor if possible. Radiation and chemotherapy may also be used to shrink the tumor. Metastatic tumors may be treated differently than primary tumors in this location.
When cancer spreads, it often affects the spine. It’s estimated that metastasis reaches the spine in about 30 percent to 70 percent of cancer patients, according to the AANS.
Benign spinal tumors
In many cases, benign tumors are unlikely to cause harm. However, a benign tumor in the brain or spinal cord could cause life-threatening complications, even though it’s not cancer.
Cancerous tumors are risky because they spread to other tissues, grow quickly and could recur. Benign tumors rarely spread into other tissues, but they could recur after removal. Benign tumors may cause many of the same symptoms as cancerous tissues. Benign tumors are typically treated with surgery.
Primary spinal tumors
Overall, primary spinal cancer (cancer that originates in the spine) is fairly rare. Yet, several types of cancer can develop in bones or in cells specifically in the spinal column.
These cancers in the spinal cord often have unknown causes, though some may be from exposure to carcinogens (cancer-causing agents) such as chemicals or pollutants.
Osteosarcoma: The most common form of bone cancer, osteosarcoma typically occurs near the knee or upper arm bone, but it may also form in the spinal bones. It may form at any age but is more common in children, teenagers and young adults.
Chondrosarcoma: This is a type of bone cancer that forms in any bones with cartilage. Risk of developing this type of cancer increases with age, so it’s more common in adults.
Chordoma: When notochord cells don’t get destroyed after birth, they may form tumors in the spine called chordomas. This rare cancer usually forms at the base of the spine (lower back). It’s twice as common in men and usually develops after age 30, according to the American Cancer Society.
Ewing sarcoma: This is the second most common form of childhood bone cancer. These tumors respond better to radiation than some other bone cancers.
Lymphoma: This cancer starts in an immune cell called a lymphocyte. Primary central nervous system (CNS) lymphomas start at or near the brain and central nervous system. This cancer is more common in patients with compromised immune systems, such as those with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). There are many different types of lymphomas, and each has different outlooks and treatment options.
Multiple myeloma: This cancer starts in an immune cell called a plasma cell, which is normally found inside bone marrow. The cancer causes abnormal calcium levels and low blood counts. Symptoms include easily fractured bones, bruising and bleeding, and infections from a weak immune system.
Other neurological cancers
Aside from tumors of the spinal cord or column, cancer can begin in, or spread to, other areas of the central nervous system, such as the brain and the peripheral nerves.
Primary brain cancer develops in brain cells. Primary brain tumors are rare. Metastatic brain cancer, or cancer that has spread to the brain from another location in the body, is more common.
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