Spinal Tumors Overview
A spinal tumor is an abnormal mass of tissue within or surrounding the spinal cord and spinal column. These cells grow and multiply uncontrollably, seemingly unchecked by the mechanisms that control normal cells. Spinal tumors can be benign (non-cancerous) or malignant (cancerous). Primary tumors originate in the spine or spinal cord, and metastatic or secondary tumors result from cancer spreading from another site to the spine. We have seen and treated this condition throughout Dallas, Irving, Red Oak, Plano, Southlake, Grapevine, Colleyville, Duncanville and throughout the DFW metroplex.
Prompt diagnosis and identification of the primary malignancy is crucial to overall treatment. Numerous factors can affect outcome, including the nature of the primary cancer, the number of lesions, the presence of distant non-skeletal metastases and the presence and/or severity of spinal-cord compression.
The cause of most primary spinal tumors is unknown. Some of them may be attributed to exposure to cancer-causing agents. Spinal cord lymphomas, which are cancers that affect lymphocytes (a type of immune cell), are more common in people with compromised immune systems. There appears to be a higher incidence of spinal tumors in particular families, so there is most likely a genetic component. In a small number of cases, primary tumors may result from presence of these two genetic diseases:
Non-mechanical back pain, especially in the middle or lower back, is the most frequent symptom of both benign and malignant spinal tumors. This back pain is not specifically attributed to injury, stress or physical activity. However, the pain may increase with activity and is often worse at night. Pain may spread beyond the back to the hips, legs, feet or arms and may worsen over time even when treated by conservative, nonsurgical methods that can often help alleviate back pain attributed to mechanical causes.
Depending on the location and type of tumor, other signs and symptoms can develop, especially as a malignant tumor grows and compresses on the spinal cord, the nerve roots, blood vessels or bones of the spine. Impingement of the tumor on the spinal cord can be life-threatening in itself. Additional symptoms can include the following:
- Loss of sensation or muscle weakness in the legs, arms or chest
- Difficulty walking, which may cause falls
- Decreased sensitivity to pain, heat and cold
- Loss of bowel or bladder function
- Paralysis that may occur in varying degrees and in different parts of the body, depending on which nerves are compressed
- Scoliosis or other spinal deformity resulting from a large, but benign tumor
A thorough medical examination with emphasis on back pain and neurological deficits is the first step to diagnosing a spinal tumor. Radiological tests are required for an accurate diagnosis include xray, and possibly a CT or CAT scan and or an MRI scan of the affected region of the spine.
After radiological confirmation of the tumor, the only way to determine whether the tumor is benign or malignant is to examine a small tissue sample (extracted through a biopsy procedure) under a microscope. If the tumor is malignant, a biopsy also helps determine the cancer’s type, which subsequently determines treatment options.
Nonsurgical treatment options include observation, chemotherapy and radiation therapy. Tumors that are asymptomatic or mildly symptomatic and do not appear to be changing or progressing may be observed and monitored with regular MRIs. Some tumors respond well to chemotherapy and others to radiation therapy. However, there are specific types of metastatic tumors that are inherently radioresistant (i.e. gastrointestinal tract and kidney), and in those cases, surgery may be the only viable treatment option.
Indications for surgery vary depending on the type of tumor. Primary spinal tumors may be removed through complete en bloc resection for a possible cure. In patients with metastatic tumors, treatment is primarily palliative, with the goal of restoring or preserving neurological function, stabilizing the spine and alleviating pain. Generally, surgery is only considered as an option for patients with metastases when they are expected to live 12 weeks or longer, and the tumor is resistant to radiation or chemotherapy. Indications for surgery include intractable pain, spinal-cord compression and the need for stabilization of impending pathological fractures.
Outcome depends greatly on the age and overall health of the patient and on whether the spinal tumor is benign or malignant, primary or metastatic. In the case of primary tumors, the goal is to remove the tumor completely, leading optimally to the potential cure of the malignancy. In the case of metastatic tumors, the goal is almost always palliative. At best, treatment may provide the patient with an improved quality of life and prolonged life expectancy.
If you have any questions about treatment for this condition please contact one of our office locations conveniently located to Dallas, Irving, Red Oak, Plano, Southlake, Grapevine, Colleyville and Duncanville.
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