Spinal Tumours: Comprehensive Cancer Information

Spinal Tumours: A Comprehensive Guide

This information is intended to provide a general overview of spinal tumours. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for any health concerns or before making any decisions related to your health.

General Information

Spinal tumours are abnormal growths that can affect the neck, back, and lower back (lumbar region). These tumours can originate in various types of cells, including the nerve cells within the spinal cord, the soft tissues or muscles that support the spine, and the bones (vertebrae) that form the spinal column.

Spinal tumours can be hazardous even if they are not malignant (cancerous). As a tumour grows, it can cause severe problems by pressing against crucial nerves and structures of the spine.

Types of Spinal Tumours

Primary Spinal Tumours

Those that begin in the spine itself.

Metastatic Tumours

(or secondary spinal tumours) are those that have spread to the spine from cancer in another part of the body.

Spinal Anatomy

The spine is a vital structure composed of bones, muscles, and ligaments. These components work together to provide structural support to the body and protect the nerves that control essential body functions, movement, and sensation.

Vertebrae

These are the bones of the spine, stacked from the base of the brain downwards. Nerves, joints, muscles, and cartilage are located around and between the vertebrae. The lower back includes five fused vertebrae called the sacrum, and the bottom three vertebrae form the tailbone (coccyx).

Spinal Cord

The inner part of the spine, the spinal cord, contains blood vessels, nerve cells, and glial cells, which are supportive cells that aid brain function.

Meninges

The spinal cord is protected by three layers of tissue called the meninges:

  • Pia mater: The innermost layer.
  • Arachnoid: The middle layer.
  • Dura mater: The outermost layer.

Classification of Spinal Tumours

Spinal tumours are classified based on the types of cells they contain, and the location in which they arise. Each type grows and is treated differently.

Intramedullary Spinal Tumours

These tumours grow within the spinal cord itself. Examples include Astrocytomas, Ependymomas, and Hemangioblastomas.

Intradural Extramedullary Spinal Tumours

These are located within the spinal cord's covering (the dura mater) but outside the spinal cord. Examples include Meningiomas, Neurofibromas, and Schwannomas.

Extradural Spinal Tumours (Vertebral Column Tumours)

These typically involve the bone and cartilage of the vertebrae. They can be benign (non-cancerous) or malignant (cancerous).

Benign examples: Osteoblastoma, Enchondromas, Aneurysmal bone cysts, Giant cell tumours, Hangiomas, and Eosinophilic granulomas.

Malignant examples: Osteosarcoma, Chordoma, Chondrosarcoma, Ewing's sarcoma, and Plasmacytoma.

Metastatic Cancer (Spread to the Spine)

Cancers that spread to the spine most commonly originate from the:

  • Lungs
  • Breasts
  • Prostate
  • Kidneys
  • Thyroid

Lymphomas (cancers of the blood system) can also spread to the spine, potentially compressing the spinal cord.

Spinal Tumour Risk Factors

A risk factor is anything that increases your likelihood of developing a spinal tumour. Although little is known about the direct causes of most spinal tumours, certain hereditary disorders are known to increase the risk of brain or spinal tumours. These include:

Neurofibromatosis type 2

Von Hippel-Lindau disease

Immune system disorders

May also be a factor in spinal cord lymphomas.

Not every individual with risk factors will develop a spinal tumour. If you have any risk factors, it is advisable to discuss them with your healthcare provider.

Symptoms

The symptoms of spinal tumours vary from one person to another, depending on the tumour's type, size, and location. They are primarily caused by the pressure the tumour places on the spinal cord or nerve roots.

If a spinal tumour presses on the spinal cord or nerve roots, it may cause:

  • Back pain that progressively worsens, is unrelated to physical activity, and is often worse when lying down.
  • Muscle weakness or numbness in the arms or legs that increases over time.
  • A general loss of sensation, or feelings of numbness and tingling.
  • Loss of feeling in specific areas of the body.
  • Loss of bowel and bladder control.
  • Paralysis to varying degrees.
  • Spinal deformities.
  • Pain or difficulty with standing.
  • Erectile dysfunction (in men).

If this pressure continues, the muscles may atrophy (waste away), and walking can become challenging.

It is important to note that these symptoms are not exclusively indicative of a spinal tumour and can signal other health concerns. Prompt discussion of any persistent symptoms with your doctor is essential.

In rare instances, spinal tumours may be passed down genetically. Our genetic counselling team can help you understand your risk.

Diagnosis

At SSCHRC, our highly trained doctors, including neuropathologists, are specialists in identifying and diagnosing spinal tumours. We utilise the most modern and accurate equipment available to pinpoint spinal tumours and determine the exact extent of the disease.

Achieving an accurate diagnosis for a spinal cancer is crucial, as it helps your doctor plan your care and may increase the chance of successful treatment.

If you have symptoms suggestive of a spinal tumour, your doctor will perform a physical examination and ask you about your overall health, lifestyle, and family medical history.

One or more of the following tests may be used to confirm a spinal tumour, determine if it has spread, and monitor how treatment is working:

MRI (Magnetic Resonance Imaging)

This is the gold standard for visualising all parts of the spinal cord and spine. CT (Computed Tomography) scans may also be used.

Biopsy

A biopsy is usually required to accurately diagnose the type of spinal tumour, especially for primary spine cancer. It may not be necessary for a secondary (metastatic) tumour. A biopsy often involves surgery, but sometimes it can be performed with fine-needle aspiration (FNA), a less invasive procedure.

Getting a Second Opinion at SSCHRC

The neuropathologists at SSCHRC are highly specialised in diagnosing and staging every type of spinal tumour. We welcome the opportunity to provide second opinions for spinal tumour diagnoses.

In rare cases, spinal tumours can be inherited genetically. Our genetic counselling team can help you learn more.

Treatment

We understand that you have the highest chance for a successful outcome when your spinal tumour care is designed specifically for your unique situation. This is why we customise your therapy to include the most advanced treatments with the least possible impact on your body.

Spinal tumour care often involves complex and delicate surgery. The primary goal is to remove as much of the tumour as safely as possible without disturbing the critical parts of the spine and surrounding structures. This requires a high degree of skill and precision.

Surgical Skill is Key

As with any major operation, spinal cancer surgery is most successful when performed by a specialist with considerable experience in the particular procedure. SSCHRC spine surgeons are among the most skilled and recognised in the world. They perform a large number of surgeries for spinal tumours each year, utilising the least-invasive and most advanced techniques available. If surgery is not possible or cannot remove the entire spinal tumour, we are often able to treat the tumour using other leading-edge therapies.

We are also continuously researching newer, safer, and more effective spinal tumour treatments. This means we are able to offer a range of clinical trials for new therapies.

Our Spinal Tumour Treatments

If you are diagnosed with spine cancer, your doctor will discuss the best treatment options. This decision depends on several factors, including the tumour's type and location, and your general health.

One or more of the following therapies may be recommended to treat the tumour or help relieve its symptoms:

Corticosteroids

Drugs such as dexamethasone may be given to reduce swelling if a spinal tumour is pressing against the spinal cord. These tumours are treated as soon as possible, often with surgery.

Surgery

Some spinal tumours can be fully removed by surgery. If the entire tumour cannot be removed, radiation therapy may be administered after surgery to relieve pressure on the spinal cord.

Radiation Therapy

This may be given alone or after surgery to relieve pressure on the spinal cord. Stereotactic radiosurgery is an advanced form of radiation treatment that focuses radiation precisely on the spinal tumour, causing less impact to healthy tissue.

Chemotherapy

SSCHRC offers the most up-to-date and advanced chemotherapy options for spinal tumours. These drugs may be taken orally or by injection, and they may be given alone or combined with other treatments.

Targeted Therapies

These newer agents are used to help fight certain types of spinal tumours. Targeted therapies attack cancer cells by using small molecules to block the cellular pathways that tumours use to survive and multiply.

Our Spinal Tumour Clinical Trials

Because of its status as a premier cancer centre, SSCHRC participates in many clinical trials (research studies) for spinal tumours. These trials can sometimes offer the best treatment option, and they always help researchers learn how to improve the future of cancer treatment.

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