What to know about spinal cancer

Share on Pinterest

Spinal cancer and tumors can start anywhere along or within the spinal column. The spinal column consists of the vertebrae, spinal cord, and surrounding tissue.

The spinal column is a bone structure that provides support and protects the spinal cord. The spinal cord is the long band of nerves that runs along a person’s back. It transmits signals from the brain to the rest of the body.

Spinal tumors can develop anywhere along the spinal cord or the bones of the spinal column. These are two different types of cancers.

Doctors often describe spinal cancer based on where it started to develop. Cancerous tumors that develop on the spine most often come from another cancer that developed somewhere else within the body.

Preexisting cancer spreads to the bones of the spinal column in an estimated 30–70% of cancer patients.

The American Cancer Society (ACS) estimates that doctors will diagnose just over 25,000 cases of spinal cord or brain tumors in 2022. They note that the chance of developing either of these cancers is less than 1%.

Spinal cancer symptoms can vary based on the location of the tumor.

However, regardless of location, back pain is the most common symptom of spinal cancer. The pain typically gets worse at night and improves with a person’s activity throughout the day.

Other possible symptoms include:

• trouble walking
• tingling, numbness, or weakness in both legs or arms
• sensory issues
• loss of bladder or bowel control
• difficulty balancing

Worsening symptoms can indicate that the tumor is affecting the nerves in the spine.

Learn more about lower back pain and cancer.

There are several different types of spinal cancer. Medical experts differentiate them based on a number of factors, which include:

• the type of tumor
• location
• whether it is primary or secondary

A doctor will be able to provide a person with spinal cancer with information about the type of tumor.

Types of tumors

Several different types of cells and tissue make up the spinal column, resulting in several different types of spinal tumors. They include:

• Chordoma: These are malignant tumors that form in the spine and skull. They often occur around the lower spine and tailbone.
• Astrocytoma: This type forms in the supporting cells inside the spinal cord and may be malignant or benign.
• Meningioma: These are typically benign tumors that form in the meninges, the tissue that covers the spinal cord and brain.
• Hemangioblastoma: This type forms from blood vessels connected to the central nervous system, which consists of the spinal cord and brain.
• Ependymoma: These tumors develop in the lining of the spinal fluid passageways in the spinal cord and brain.
• Glioblastoma: This is an aggressive, malignant tumor that forms from cells called astrocytes, which support nerve cells in the brain and spinal cord.
• Osteosarcoma: This is a type of bone cancer that may start in the spine but is more common in the shin or thigh bones.
• Spinal hemangioma: This type of tumor forms from the tissues of blood vessels inside the spinal column and is usually benign.
• Neurofibroma: This benign tumor grows on nerves found throughout the body, including the spinal column.
• Schwannoma: This is a typically benign tumor. It affects the cells surrounding the nerve fibers of the spinal cord, peripheral nervous system, and cranial nerves.

Location

A spinal tumor can occur anywhere along the spinal column. The exact location can help a doctor classify the tumor. Locations may include:

• the cervical spine, around the neck
• the thoracic or upper- to mid-back area
• the lumbar or lower back area
• the sacrum or bottom of the spine

In addition to the approximate location along the spine, a doctor may describe where the tumor appears within the spine. Descriptions may include:

• Intramedullary tumor: This grows within the spinal cord and accounts for about 5% of all cases.
• Intradural-extramedullary tumor: This grows inside the thin covering of the spinal cord, known as the dura, and outside the actual spinal cord. This type of tumor accounts for about 40% of all cases.
• Extradural tumor: This is located outside the dura and accounts for about 55% of all cases.

Metastatic spinal cancer

Most cases of spinal tumors have spread from other areas of the body. Some of the cancer types that most commonly cause spinal tumors include:

• breast cancer
• prostate cancer
• lung cancer
• kidney cancer
• thyroid cancer
• gastrointestinal tract cancer

The exact cause of primary spinal tumors is still unclear. However, scientists suspect that genetic conditions, such as neurofibromatosis 2 or autoimmune disorders, may affect their development. Exposure to carcinogens may also affect their development.

Secondary spinal tumors occur due to metastasized cancer from another part of the body. Lung and breast cancers are the two most common cancers that spread to the spine.

Risk factors for developing primary spinal tumors may include having one of the following conditions:

• Neurofibromatosis 2: This is a type of genetic disorder that can cause benign tumors. However, they more commonly develop in the ears and cause hearing loss.
• Von Hippel-Lindau disease: This multisystem disorder causes benign tumors in blood vessels. They may occur in the spine or brain.

For secondary tumors, a person with a number of different cancers, such as breast or lung, may develop tumors in their spine.

A person who receives a cancer diagnosis should discuss their risk of developing a spinal tumor with their doctor.

Sometimes, a doctor may discover a spinal tumor during a routine evaluation. Or they may discover a tumor when a person seeks help for back pain associated with the tumor.

During an evaluation, the doctor will examine the person’s back and may do tests to help determine the person’s neurological functioning.

If the doctor suspects a person may have a spinal tumor, they will likely schedule tests, which may include:

• blood tests to check for cancer markers, which may include looking for increased levels of certain nutrients used to create bone
• imaging tests, such as X-rays, a CT scan, or an MRI scan
• a biopsy
• a bone scan

Spinal cancer stages do not follow the typical standards of cancer staging. Instead, doctors use the following grading system to describe the primary tumors that develop in the spine:

• Grade I: A slow-growing tumor with benign features, which is typically easy to treat with surgery.
• Grade II: A slow-growing tumor containing some abnormal cells that may spread to nearby tissue.
• Grade III: A malignant tumor that grows quickly and will likely spread to nearby cells and tissue.
• Grade IV: A malignant, fast-growing tumor that spreads quickly.

Doctors stage secondary tumors or those that metastasized from another area of the body based on the original cancer. For example, a secondary tumor found in the spine may be stage 4 breast cancer.

A doctor may recommend one or more treatment options for a person based on the tumor’s location and other factors that may affect the outcome.

The primary treatment is usually surgical removal of the tumor. However, a doctor may also recommend one or more of the following treatments to eradicate the cancer:

• targeted therapy
• chemotherapy
• radiation therapy

A medical professional may also prescribe or recommend therapies to help with symptoms associated with the tumor. This may include pain medications.

A person’s outlook for spinal cancer depends on whether it is primary or secondary, where it develops on the spine, their age, overall health, and response to treatment.

A doctor can typically remove lower grades of primary tumors with surgery. Higher grades may require a combination of surgery and other treatments to manage any cancerous cells.

Doctors cannot cure metastasized cancer, but treatment can help put it into remission, allowing a person to live a longer life.

The ACS reports brain and spinal cancer survival rates based on age range and where the cancer develops.

The following table shows the average 5-year survival rates after diagnosis:

Living with spinal cancer

Spinal cancer often causes back pain as the primary symptom. A person should contact a doctor if they experience persistent back pain that does not go away or improve over time.

A doctor will likely review treatment recommendations with someone diagnosed with spinal cancer. A person should discuss their concerns with a doctor and ask for advice on managing their pain.

People may find that lifestyle changes, such as improving their diet and regular exercise may help them to better manage their condition.

It is not always possible to prevent spinal cancer or tumors from forming.

Following treatment recommendations and aggressively treating primary cancer may help secondary tumors.

However, even following treatments, it is still possible for cancer to come back or spread.

Spinal cancer is a rare form of cancer. Most spinal tumors occur due to cancer developing in another part of the body and spreading to the spine.

Primary spinal tumors may be benign and start in the tissue of the spinal cord.

The overall survival rate for spinal cancer is high for most types that start in the spine. A person should talk with their doctor about their survival rate for secondary tumors, as that rate usually relates to the primary cancer’s outlook.