Spine-oncology is a branch of medicine that deals with the prevention, diagnosis, and treatment of cancer that develops from cells within the spinal cord or from its surrounding structures. Most tumors often form inside the spinal cord, but outside the spinal cord itself. The malignant (cancerous) tumors need multidisciplinary care including radiation therapy, surgery, and chemotherapy.
The spinal cord and brain area together form a central nervous system (CNS). Malignant spinal tumors of the spinal column are classified into three categories:
The rare primary tumors, which start in the bones of the spine, such as chordomas, sarcomas, and more.
Tumors form in the dural sac area that surrounds the bones of the spinal cord.
Tumors that have metastasized, and occur when cancer cells from another area of the body such as the breast, prostate, lung, and colon spread to the spine either via a direct extension.
The major causes of spinal tumors are still not well known. Although some genetic factors are the reason for the development of spinal cancer, the risk factors include:
Prior History of Cancer: cancers that occur on the spine from other parts of the body including breast, lung, and prostate.
Compromise Immune System: Some individuals whose immune systems are compromised develop spinal cord lymphomas. Hereditary disorders: some of the conditions that occur due to the tumors in the spinal cord region are Von Hippel-Lindau disease and Neurofibromatosis (NF2).
Exposures: continuous exposure to radiation or industrial chemicals may lead to the development of spinal cancer.
The symptoms of spinal cancer will vary based on several factors such as tumor size, location, type, and prior health history of the patient. Some common symptoms are numbness, pain, weakness, and difficulty with urination. In some conditions, the symptom will occur very slowly. Other times, they occur quickly. The metastatic type spinal tumors occur from another location in the body, such as the kidneys or prostate, often develop quickly.
Some of the common symptoms are
Pain in the back, neck, arm, and leg region
Difficulty in walking
Loss of sensation
Difficulty with urination
Paralysis to varying degrees
Difficulty with standing
Diagnosis And Treatment
Spinal cancer can be easily diagnosed with angiography, lumbar puncture, nuclear medicine bone scan, and other imaging tests such as MRI, CT, and PET scan.
The treatment for spinal cancer will vary, based on factors such as the location and extent of the disease. Surgical options for spinal cancer treatment include the less invasive surgical procedures and other aggressive approaches. The most common treatments are:
Surgery: if the tumor is limited only to one portion of the spinal column, surgery may be used to completely remove cancer.
Chemotherapy: These types of drugs can be directly taken orally in the form of a pill, or injected into the vein.
Radiation Therapy: This treatment is used to destroy microscopic tumor cells left behind.
Spine oncology can be treated by experts from multiple departments, including pathology, neurosurgery, medical oncology, medical physics, radiation oncology, radiology, and physical medicine.