Cancer - Cause of Back Pain

Back pain is a symptom of disease. The actual disease itself that is causing the symptom of pain may be due to inflammation of a joint, a heightened sensitivity to pain due to emotional problems, a strain of the muscle, or a host of other reasons. In rare cases, the cause of back pain may be due to other, more serious conditions, such as cancer. Let's take a look at some of the types of cancer that may first present with the symptom of back pain.

Tumors in and around the spine may affect the spine by causing changes in the bone and by expanding towards the spinal nerves and pressing against them, which is a cause of pain that we will experience. Spinal tumors may occur in and on the outside of the vertebral bones, and even within the spinal cord itself. Tumors in the spinal column may affect the bones by causing them to weaken and prone to fracture, or they may cause a thickening and expansion of the bones. The expansion of the bones may restrict the size of the vertebral foramen, which houses the spinal canal and spinal cord.

Symptoms of Cancer/Tumors In and Around the Spine: Below is a list of some of the most common symptoms of spinal tumors:
  • Pain along with constitutional systems, such as shakes, chills, fever, vomiting, nausea, and unexplained weight loss
  • Pain in the back or neck, accompanied by other neurologic problems, such as the loss of bowel/bladder control, and numbness or weakness in the arms or legs
  • Focal spine pain that is worse upon awakening. (focal pain is pain that us easily identified as being specific to a single location)
  • Pain in a particular spot in the back that is significantly increased when pressure is directly applied there
  • Pain that may be worse at night than during the day, and pain that does not lessen with rest.
Here are some additional facts and statistics related to spinal tumors.
  • For patients that currently have cancer or a history of cancer in another area of the body, reports of back pain will require immediate evaluation from a doctor to make sure that the cancer did not metastasize and spread to the spine.
  • Most metastatic tumors that occur in the spine did not originate in the spine, but spread from another region of the body
  • Primary tumors (tumors that originate in the spine) are very rare
  • Though all tumors are to be taken seriously and monitored, in most cases they are benign and slow growing. Most primary tumors occur in young adults.

Types of Spinal Tumors: The three most common types of tumors that produce back pain symptoms are vertebral column Tumors, intradural-extramedullary tumors, and intramedullary tumors. Let's look at each of these types of tumors, what types of patient populations they affect, and how they may be diagnosed and treated.
  1. Vertebral Column Tumors: Vertebral column tumors may be benign or metastatic. These are tumors that occur in the vertebral bones or intervertebral discs (the discs between the vertebral bones that cushion the spine). These tumors usually present for the first time in younger adults. These tumors have a slow growth rate and are very rare. The most common malignant bone tumor is osteosarcoma (Osteogenic sarcoma).

    Metastatic tumors: In most cases, these tumors have spread from another region of the body and become lodged in the vertebral bones or disc elements of the spine. These tumors produce pain as well as other red flag symptoms (such as nausea or vomiting, fever/chills/shakes, and unexplained weight loss). In men, these metastatic tumors usually originate in the lungs or prostate. In women, these metastatic tumors usually originate in the breast or lung.

  2. Intra-Extramedullary Tumors: Intra-Extramedullary Tumors grow within the membranes of the spinal canal, but outside of the spinal cord itself. These tumors are slow growing and benign, but may cause symptoms such as weakness and pain. The majority of intra-extramedullary tumors are classified as nerve sheath tumors (neurofibromas andschwannomas) and Meningiomas.
    • Nerve sheath tumors (neurofibromas andschwannomas): These tumors originate and arise from the nerve roots that come off of the spinal cord. These tumors may develop slowly, over a period of several years before symptoms are experienced for the first time.
    • Meningiomas: These tumors, which are usually benign, originate within the membranes that surround the spinal cord. In rare cases, these tumors may be malignant.
  3. Intramedullary Tumors: These tumors grow from inside the spinal cord and within the spinal nerves themselves. These tumors arise from the cells which support the spinal nerves, such as the glial cells. These tumors may occur throughout the spine, but most often occur in the cervical spine (neck). The most common types of intramedullary tumors are ependymomas and astrocytomas.