Cancer and Tumor Treatments

Cancer may affect nearly every tissue in the body, including those that may up our spine and spinal cord. Some of these tumors originate in the spine itself, while other types of cancers may have originated in one area of the body and spread to the back. In previous articles, we discussed the various types of spinal tumors and how they originated. Here we will discuss the various cancer and tumor treatments, including the latest medications and technologies for reducing and eliminating them from the body.

If any cancer or tumor is found in the spine, various tests will be performed to see what type of condition it is and if it is present elsewhere in the spine or body. The following tests and procedures may be performed:
  • Comprehensive medical history and physical examination
  • Comprehensive neurologic examination
  • Screening for tumors using radiologic medical imaging studies of the chest, spine, and Gastrointestinal (GI) system
  • CAT Scans and MRI imaging of the spine
Treatments for Vertebral Column Tumors: The treatment that is selected for the tumor will be determined by the location of the tumor, how large it is, and what type of tumor/cancer is present. Treatment goals for spinal tumors generally include:
  • Controlling the pain related to these tumors/cancer growths with pain medications or procedures to relieve the pressure on the nerve roots
  • Removing pressure on the spinal cord and the spinal nerves to preserve or restore neurologic function
  • Fixing the structural instability of the spine caused by the cancer or cancer removal. One common procedure done to stabilize the spine is a spinal fusion.

Treating Intradural-Extramedullary and Intramedullary Tumors: Intradural-Extramedullary Tumors are tumors within the spinal canal that grow outside of the nerves. Intramedullary Tumors are tumors inside the spinal canal that may grow within the spinal nerves. These tumors are usually surgically removed. The treatment goal of these procedures is the complete removal of the tumors while preserving neurologic function.

The tissues and nerves of the spinal cord are highly sensitive to damage and may not fully recover if the surgery to remove the tumors results in neurologic damage. For this reason, spinal neurosurgery involves the best doctors using the best pieces of technology available. Monitoring techniques may be used throughout the surgery to determine the function of the spinal cord as the tumors are being removed.

In most cases, the tumor may be completely removed during the spine surgery. In other cases, the some of the tumor adheres to the spinal nerves, making its complete surgical removal to dangerous. In these cases, post-operative radiation therapy may be performed to try to eliminate any remaining tumor material adhering to the nerves. If the tumor is metastatic, chemotherapy may provide patients with a greater chance of eliminating remaining tumor from the spinal canal.

Following the surgery, it may take the patient some time to restore comfort and function as the nerves work to fully heal and for the patient to regain their strength from the surgery itself and any post-operative radiation or chemo therapy that was performed on them. Neurologic function should improve through some combination of rest and physical rehabilitation.

Spinal Cord Compression: Steroids (e.g. corticosteroids) may be used along with the other treatments mentioned to accelerate the rate of spinal cord decompression. These steroids, usually delivered through needle injection, typically are not designed to act on the tumor itself. Rather, this treatment is used to reduce the inflammation reaction around it. If this treatment does reduce the inflammation, the overall mass pressing on the spinal cord should be reduced.

Radiotherapy: Radiation therapy, also known as radiotherapy, is delivered at the levels of the spinal cord that is affected, as well as to one level above and below it.