Spine Tumors - Types, Symptoms and Treatment

Most tumors that grow in and around the spine are malignant – less than 10% are benign. Spine tumors can be primary, meaning they start in the spine, or metastatic, meaning they result from cancers that originate in other parts of the body and spread or metastasize to the spine. Many types of cancer have the potential to metastasize to the spine. Cancers that are more likely to metastasize to the spine include breast, lung, prostate, kidney, gastrointestinal and thyroid cancers.

Vertebral tumors grow within the bones making up the vertebrae and usually originate from cancers that have spread to the spine from other parts of the body — metastatic. These tumors put pressure on the spinal cord and cause structural problems like vertebral fractures.

Spine Tumor Causes and Risk Factors

The risk of developing a primary spine tumor is very low. The causes are still largely unknown — other than random gene mutations that are not inherited. The only correlation that has been made is that exposure to radiation therapy from treatment for an early childhood cancer may bring a spinal tumor into play 20 or 30 years after treatment. But essentially, there is no way to predict who will develop a primary spine tumor. Spine tumors that spread to the spine from cancer in another part of the body, however, are far more common. About 30 – 70% of cancers will spread to the spine at some point. Cancers that are most likely to spread to the spine include lung, prostate and breast cancers.

Spine Tumor Symptoms

When tumors grow in your spine, they cause many debilitating symptoms. The higher the location of the tumor, the more symptoms you will experience. They can grow in different parts of the spine. The cervical spine is the highest section in your neck. It is followed by the thoracic spine (mid-back) and the lumbar spine (lower back). Symptoms of spinal cancer include:

• Disruptions in your motor functions — problems sitting, standing, walking and running
• Difficulties with fine motor skills like writing or drawing — tasks that use the small muscles of the hands and wrists

Spine tumors can cause various types of pain that limit movement and affect quality of life.

• A sharp pain that radiates into the arms, legs or chest is typically caused by the tumor pinching nerve roots. People often describe this type of pain as searing or electric shock-like. Decompression of the nerve roots can provide relief for pain from tumors that are impinging on nerves.
• Mechanical pain is pain the tumor causes in muscles, joints, bones and tissues. This type of pain reflects spine instability from the tumor. It causes pain in the upright position (sitting or standing), and people experience relief when lying down. Fusion surgery of the spine can enhance spine stability and alleviate mechanical pain.
• Biologic pain is persistent pain in one spot or region that does not change in intensity with a change in position such as sitting, standing or lying down. It is due to swelling and inflammation caused by a tumor that has infiltrated the bones. Biologic pain responds to NSAIDs, steroids and to radiation therapy.

Others symptoms include:

• Sensory deficits such as numbness, tingling and pain in the extremities — the arms, legs and trunk.
• Spine tumors can affect the autonomic nervous system, which controls and regulates bowel and bladder function as well as other bodily functions. When the bowels and bladder are affected, you may experience urinary retention or incontinence, or stool incontinence.

Types of Spine Tumors

Spine tumors are classified based on whether they grow in the spinal cord or in the dura — the protective covering of the spinal cord and nerves.

Intra-Axial (Growing Inside the Spinal Cord)

• Astrocytomas. Spinal astrocytomas are sometimes benign, are slow-growing and don’t spread outside of the spine. A small percentage will be more aggressive or can even turn into cancer if they aren’t treated. Typically, a complete surgical resection is not possible given the tumor’s invasion of the surrounding spinal cord tissue. These tumors require additional treatment with radiation therapy.
   
• Ependymomas. Spinal ependymomas are primary tumors that arise within the spinal cord. They tend to be benign and slow-growing. If they are progressively getting larger or causing neurological decline like paralysis or bladder dysfunction, they may warrant surgical resection with microsurgery techniques. A complete curative resection is sometimes possible because these are well-defined tumors that can be separated from surrounding spinal cord.

Intradural-Extra-Axial (Tumors Growing Inside the Dura but Outside of the Spinal Cord)

• Myxopapillary ependymomas are slow-growing tumors and usually benign. They grow outside of the spinal cord, arising from the fibrous band connecting the spinal cord and the tailbone. They are treated with surgery, which is curative when a complete resection (complete removal of tumor) is performed.
   
• Schwannomas and meningiomas are typically benign but a small percentage can become cancerous. Schwannomas are slow-growing tumors that develop from nerve cell roots in the spine. They are sometimes called neuromas. Meningiomas grow from the dura — the protective lining of the spinal cord.

Get a Second Opinion for Spine Cancer

A second opinion can provide you with peace of mind in knowing that your diagnosis is accurate and that you have explored all treatment options available to you, including clinical trials. Our new patient coordinator will help ease your way by gathering your medical records and scheduling tests and appointments. Learn more about our Cancer Second Opinion Program, which includes virtual as well as in-person options.