Each part of the spine is vital in protecting, moving, and supporting the body as a whole. Besides maintaining our upright posture, mobility, and balance, our spines perform several critical functions to safeguard our spinal cord, act as a shock absorber, and ensure mobility.
Malignant spinal tumors are cancerous growths in the spine that can invade and damage surrounding tissues and organ systems or spread to other body parts. When benign tumors (noncancerous) transform into malignant ones, they're categorized as cancerous. More often, cancer starts in other places and spreads into the spine. Symptoms of spinal cancers can start with simple back or neck pain and progress to more severe symptoms, depending on the tumor’s location and size.
Spinal cancer also includes different types of tumors that develop in or around the spinal cord and spinal column. Spinal cancer symptoms largely depend on the location of these tumors, which can significantly impact the central nervous system and physical functions.
Learn more about spinal cancer symptoms, types of tumors, and the crucial role of awareness and early detection to improve outcomes.
What Are the First Symptoms of Spinal Cancer?
Spinal cancer symptoms depend on the type of tumor and the action it takes on the spinal cord — for example, if it pinches the nerves or compresses the spinal column.
Some of the most common symptoms of spinal cancer include:
- Reduced sensitivity to pain, heat, and cold
- Pain at the tumor site due to pressure
- Pain that intensifies at night
- Pain that radiates to other areas
- Loss of sensation or muscle weakness in the arms or legs
- Difficulty walking, potentially causing falls
- Loss of bowel or bladder function (incontinence)
- Paralysis which can be mild or severe
Who Does Spinal Cancer Affect?
It’s estimated that there will be 24,810 new cases of brain and spinal cancer in the U.S. (including adults and children) by the end of 2023.
Overall, the 5-year survival rate is 66%, but for cancer tumors that have not spread to other areas, it increases to 90%. For cancer that has spread to regional areas, the 5-year survival rate is 72%, and for cancer that has metastasized to distant areas, it’s 33%.
The prognosis for patients with spinal tumors can vary greatly as it's influenced by factors such as the type of tumor, its location, and its impact on the central nervous system (which includes the brain and spinal cord).
Understanding the differences in prognosis between benign and malignant tumors — and the potential complications associated with each — is crucial for patients and healthcare providers. Managing these complications effectively is key to improving patient outcomes and quality of life.
What Are the Risk Factors for Spinal Cancer?
Understanding your risk factors is important for the early identification and successful treatment of spinal cancer. The most common risk factors cause abnormal growths in nerve tissues, elevating the risk of both benign and cancerous spinal tumors. Here are a few risk factors for spinal cancer.
Metastatic cancer: This is when cancers start out in the breast, lung, prostate, and myeloma (plasma) and spread to the spine.
Neurofibromatosis type 1: While this condition is characterized by benign tumors, they increase the risk of getting spinal cancer on nerve tissue, leading to various skin and neurological symptoms.
Neurofibromatosis type 2: A rare inherited disorder characterized by the development of tumors on the nerves responsible for hearing and balance, often leading to hearing loss and balance problems
Von Hippel-Lindau disease (VHL): A hereditary condition that causes the growth of tumors and cysts in multiple organs, particularly in the kidneys, eyes, and pancreas, often requiring medical intervention.
Where Does Spine Cancer Usually Start and What Does It Feel Like?
A primary tumor can develop in any of the bones, nerves, or other tissues that make up the spine. However, only 5% of spine tumors start in the spine. Most often, tumors start in other bones and spread to the spine, where they can cause unique symptoms based on their location.
Each section of the spine, from the cervical to the coccyx, plays a unique role in the body's functioning. When tumors develop in these areas, they can disrupt these functions, leading to specific symptoms depending on the tumor's location along the vertebral column.
Cervical spine (C1-C7)
The first two vertebrae, the atlas (C1) and axis (C2), are specialized for head rotation. The rest of the cervical spine supports the head and neck movements and transmits nerve signals from the brain to the body.
Tumors in this area can significantly affect neck mobility and function. Symptoms may include neck pain, stiffness, and restricted movement. Since this section also houses crucial nerves and arteries, tumors here can lead to neurological symptoms like weakness in the arms and hands, tingling, or numbness. In severe cases, it can affect breathing and swallowing.
Thoracic spine (T1-T12)
The thoracic spine provides stability and support for the upper body and aids in protecting the thoracic organs (heart, lungs, esophagus, trachea, thymus). It consists of 12 vertebrae attached to the rib cage, located in the mid-back area.
Being the attachment site for the rib cage, tumors in the thoracic spine often present with back pain, especially in the mid-back region. They can also cause symptoms like chest pain, difficulty breathing, or pressure in the chest due to their proximity to the lungs and ribs. If the tumor compresses the spinal cord, it can lead to symptoms like numbness or weakness in the legs.
Lumbar spine (L1-L5)
The lumbar spine comprises five large vertebrae in the lower back, known as the main weight-bearing section. It supports the torso's weight, allows flexibility and movement in the lower back, and plays a crucial role in lower limb movements.
This section bears the most weight, so tumors here often cause lower back pain, which can be exacerbated by standing or walking. Lumbar spine tumors can also lead to sciatica-like symptoms, including sharp pain radiating down the legs. As the lumbar spine is connected to the lower limbs, tumors can also cause muscle weakness or loss of sensation in the legs and feet.
Sacrum (S1-S5)
A triangular bone formed by joining five vertebrae, the sacrum is at the base of the spine. Functions include connecting the spine to the pelvis, supporting the upper body's weight, and distributing this weight across the pelvis and lower limbs.
Tumors in the sacral region can cause pain in the lower back, buttocks, or legs. They may also affect bowel and bladder function due to the proximity of nerves controlling these functions. In some cases, sacral tumors can cause sexual dysfunction.
Coccyx or tailbone
The tailbone comprises four small, fused vertebrae at the very end of the spinal column. This part of the spine acts as a support structure for sitting, provides attachment points for ligaments and muscles of the pelvic region, and supports and stabilizes the pelvis.
Though less common, tumors in the coccyx can cause pain and discomfort, particularly when sitting or when standing from a sitting position. Given its location, coccygeal tumors can also impact bowel movements and, in rare cases, may affect nearby organs.
Types Spinal Cancer Tumors
The most common types of spinal cord cancers include the following:
Astrocytomas: These tumors originate from astrocytes, a type of brain and spinal cord cell. They can vary in malignancy and are more common in the brain than in the spinal cord.
Meningiomas: Tumors that develop in the meninges, the protective membranes surrounding the brain and spinal cord. They are typically benign but can cause problems due to their location.
Ependymomas: Originating from ependymal cells that line the spinal cord and ventricles of the brain, these tumors can occur anywhere along the spinal cord.
Schwannomas: These benign tumors arise from Schwann cells responsible for the myelin sheath covering nerve cells. They often develop in peripheral nerves but can also appear in the spine.
Gliomas: A broad category of tumors that arise from glial cells, gliomas in the spinal cord are less common than those in the brain. They can range from low-grade to high-grade malignancies.
What Are the Symptoms of Spinal Cord Tumors?
Classification of spinal cord tumors is based on their location within the spinal canal, which consists of various layers and components. Here's a breakdown of the four types of spinal tumors.
Intramedullary tumors: Located inside the spinal cord itself, growing within the neural tissue. Often causes neurological symptoms, such as weakness, numbness, and pain, due to direct compression of the spinal cord.
Intradural tumors: Located within the dura mater, the outermost membrane surrounding the spinal cord and cerebrospinal fluid (CSF). Tumors here can cause symptoms by compressing the spinal cord or nerve roots, depending on their location.
Extradural tumors: Located outside the dura mater, within the spinal canal but not involving the spinal cord or nerve roots directly. These tumors often arise from the vertebrae (bones of the spine) or from tissues surrounding the spinal canal. For example, metastatic tumors (cancer that has spread from another part of the body), such as lymphomas and chordomas. It may cause symptoms like pain, weakness, and numbness due to compression of the spinal cord or nerve roots.
Extramedullary tumors: This is a subset of intradural tumors outside the spinal cord but within the dura mater. These tumors are categorized based on their origin, such as nerve sheath tumors, meningiomas, or lipomas. They can cause various symptoms depending on their size, location, and the type of tumor.
Can Spinal Cancer Symptoms Be Diagnosed Early?
There are no recommended screenings for spinal cancer and spinal cord tumors. However, early detection leads to more treatment options. It’s important to be aware of spinal cancer and be vigilant if you’ve had breast cancer, prostate cancer, or lung cancer, which are risk factors for metastatic spinal tumors.
In general, technologies like the Ezra Full Body MRI Scan can be instrumental in early detection efforts. While it is not designed to detect spinal cancer, by engaging in proactive steps, MRI screening can detect abnormalities earlier for more successful treatment options.
To learn more about your risk for getting cancer of any kind, take Ezra’s cancer risk factor quiz and discover how to reduce your risks.
