The spine isn’t only responsible for our movement — it also houses the spinal cord that contains many nerves that help us process and respond to the world around us.
Sometimes, abnormal cells can grow and form tumors in the spine, which can be cancerous or noncancerous. Spinal tumors that contain cancerous cells are referred to as spinal cancer. The most common symptom of spinal cancer is lower back pain.
Here, we’ll review the basics of spinal anatomy and discuss the most common signs and symptoms of spinal cancer. We’ll then talk about ways to diagnose spinal cancer with early detection and how being proactive about your health can lead to better outcomes.
The spinal cord is a long thin structure that starts at the brainstem and continues through the lumbar region of the spine. Together with the brain, the spinal cord comprises the central nervous system (CNS). The spinal cord is primarily protected by the spine, which consists of 33 vertebrae (bones of the spine). These bones are stacked on top of each other with discs in between for cushion and support that are made up of cartilage.
Also in between the vertebrae, nerve roots branch out from the spinal cord that supply messages to the rest of the body. These nerves are responsible for sending motor commands to the muscles as well as receiving information like sensory input.
This complex system allows us to move, feel pain, distinguish temperature and sense vibrations. When it comes to definitions, the term “spinal tumor” generally includes both those of the spinal cord and the spine bones.
Spinal tumors can be either benign (noncancerous) or malignant (cancerous), primary or secondary. Primary tumors are either spinal cord tumors or spinal column tumors that start in the spine itself. Secondary tumors of the spine have spread from a cancer coming from another part of the body. The most common secondary tumors of the spine come from breast cancer, lung cancer, and prostate cancer.
There are many different types of primary spinal tumors. Up to 80% of these are benign tumors. While this is good news, these common types of tumors can still cause symptoms and may require some sort of treatment or surgical intervention.
Benign spinal tumors include:
Malignant spinal tumors include:
Spinal cancer is most commonly due to cancer that has spread from another part of the body. Breast, lung, and prostate cancers are the most common cancers that metastasize to the spine. Some research suggests that people with known breast cancer or prostate cancer who present with back pain may have spinal bone metastases up to 30% of the time.
Spinal tumors can cause many different symptoms depending on their location in the spine and if the spinal cord is involved. For example, a spinal tumor in the neck or cervical region can produce different symptoms than a spinal tumor in the thoraco-lumbar or mid-back region.
But no matter the location, pain is still the most common symptom of spinal cancer. Pain can be deep and aching; it can be worse at night and wake a person from sleep. The pain can also be sharp and shooting if the tumor is pressing on the spinal cord. A serious complication of spinal tumors is spinal cord compression, which apart from pain, can cause symptoms ranging in severity from mild weakness and numbness to complete paralysis.
Other symptoms of spinal cancer may include:
The road to diagnosis can be a scary one. Fortunately, it can be a relatively straightforward process thanks to accurate imaging tests.
When someone first presents with potential symptoms of spinal cancer, a detailed history and physical exam is warranted. A neurological and musculoskeletal exam may show key findings, such as muscle weakness or loss of sensation. Laboratory tests and imaging tests may include:
It’s important to note that masses in the spine do not always mean cancer. There are many other conditions that can cause masses in the spinal column. These can include:
Thankfully, some imaging tests are useful and accurate when it comes to differentiating these possibilities. CT scans (computerized tomography) and MRI (magnetic resonance imaging) of the spine can detect spinal tumors and different characteristics that can point to a certain diagnosis.
When it comes to spinal tumors, pain can be a major and debilitating factor. But there are several ways to manage both the pain and potential complications. Medications can be beneficial in pain control, ranging from non-steroidal anti-inflammatory medications to steroids to narcotics.
Steroids can help decrease swelling and may also decrease the size of some tumors. If the tumors are malignant, cancer treatment may include radiation therapy, chemotherapy, and various types of surgeries. Surgical treatment options may include partial or complete removal of the tumor or relieving pressure on the spinal cord.
People may benefit from having a multidisciplinary team to optimize their care plan and improve their quality of life. These providers may include doctors in oncology, neurosurgery, and orthopedic surgery.
The spine is a complex and important structure that is not only responsible for our mobility, but it also protects the spinal cord which helps control our movements and sensations. Spinal tumors can range in severity depending on whether they’re benign or malignant and where they’re located. Spinal cancer symptoms often include pain, usually in the middle to lower back, while other symptoms can include trouble walking or muscle weakness.
Early detection of primary tumors can not only decrease the risk of metastasis, but early detection of spinal cord compression can also improve prognosis for people with already diagnosed metastatic spinal tumors. Since most people with spinal cancer have cancer that has spread from another part of the body, cancer screening is the key to prevention.
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