Patients' Guide to Spinal Cancer

Symptoms of Metastatic Spine Cancer and Spinal Tumor Diagnosis

Metastatic cancer that travels into your back and neck can cause significant symptoms. The tumor may impact spinal structures such as bones and nerves. The spine is an integral part of the body's structural support, biomechanical functions and central and peripheral nervous systems.
Illustration of vertebral column with metastatic tumorBack Pain Can be an Early Symptom
Depending on the size and location of the tumor, you may experience a range of symptoms. But, the first typical sign of a metastatic spinal tumor is back and/or neck pain, depending on the tumor's location in the spine. Most people with a spinal metastasis experience pain in their mid-back or low-back regions, and it’s pain that seemingly has no cause (from an injury, for example). Many patients report the pain may worsen as their activity level increases and during the nighttime hours.

In addition to pain, metastatic spinal tumors can compress your spinal cord. Spinal cord compression (eg, cervical myelopathy) may cause different neurological symptoms, including weakness, tingling, numbness, paralysis, difficulty walking, and loss of bowel/bladder control. The most serious cases of spinal cord compression may even cause death.

Furthermore, a spinal metastasis may cause or contribute to vertebral compression fracture, or other structural changes in the spine that result in deformity, such as scoliosis.

Managing Symptoms
Symptoms related to metastatic spinal cancer may be difficult to manage, but you don’t have to do it alone. Your spinal cancer treatment team may include different medical specialists—such as your primary care physician, spine surgeon, medical oncologist, radiation oncologist, and interventional radiologist. Together with you, a treatment plan is devised that addresses your diagnosis and symptoms.

Diagnostic Steps
An in-depth physical and neurological examination and thorough review of your medical history is the first step. If you’ve had previous tests (eg, blood work) performed by another specialist, your surgeon may need the results. He/she may order additional lab tests to acquire a better understanding of your overall health too.

Imaging tests are necessary—such as x-rays, CT scans, and/or MRI—to identify specifics about the spinal tumor’s location, size, density and other characteristics. CT and MRI studies may be performed with and without contrast. While an x-ray may initially be performed, it’s typically not the only imaging test, as x-ray won’t reveal spinal cord or nerve damage. Most physicians opt for MRI and CT scans, which better define the tumor and its impact on the spine—even in the early stages.
X-ray electronic imagery of the cervical spineA biopsy may be performed to confirm the type of cancer. There are two categories of biopsy: (1) needle and (2) surgical.

  • Needle Biopsy. The doctor extracts several small samples of the spinal tumor using a special type of hollow needle. The procedure is typically performed with a local numbing agent (local anesthetic), although your doctor may have you sedated or under general anesthesia.
  • Surgical Biopsy. If a large tumor sample is required, the doctor may opt to perform a surgical biopsy. During this procedure, the surgeon removes one or more samples through a surgical technique under general anesthesia.
Updated on: 02/28/17
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Understanding Metastatic Spine Cancer and Spinal Tumors
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Understanding Metastatic Spine Cancer and Spinal Tumors

What is the incidence of metastatic spinal cancer? Researchers estimate upwards of 70 percent of people with metastatic cancer will experience spread of cancer to their spine.
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