Metastatic Spinal Cancer (Secondary Spinal Tumor)

Overview

Metastatic spinal cancer, or secondary spinal tumors, occur when cancer spreads from another area of the body to the spine. Spinal metastases can cause various significant issues, such as pain and problems with the nervous system (a complex system that controls memory, learning, reflexes, movement and more).

Some of the most common types of spinal tumors are:

• Extradural spinal tumor – this type develops outside the dura, which is the thin membrane covering the spinal cord.
• Intradural-extramedullary spinal tumor – this type develops in the dura but not in the spinal cord itself. This type comprises about 40 percent of all metastatic spinal tumors.
• Intramedullary spinal tumor – this type develops within the spinal cord.

Metastatic spinal cancer causes

Cancer is caused when mutations (changes) occur in cells, and then those cells grow and multiply quickly. When cancerous cells spread from another area of the body to the spine, spinal metastases occur.

Metastatic spinal cancer risk factors

Other types of cancers can turn into secondary spinal tumors. Therefore, if you have a different kind of cancer, you are at risk of developing a metastatic spinal cancer.

The most common types of cancer that metastasize (spread) to the spine are:

• Breast cancer
• Colon cancer
• Lung cancer
• Lymphomas
• Melanoma
• Prostate cancer
• Kidney cancer
• Thyroid cancer

Metastatic spinal cancer symptoms

In their early stages, many metastatic spinal tumors don’t cause any symptoms. When they do occur, signs and symptoms of a secondary spinal tumor can include:

• Decreased ability to feel pain, cold or heat
• Deformity in the spine
• Pain in the back that often worsens at night
• Paralysis (inability to move certain areas of the body)
• Tingling, weakness or numbness in your arms, legs or chest
• Trouble controlling your bladder or bowel (incontinence)
• Trouble with walking or balance

Metastatic spinal cancer diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

• Physical exam – your doctor will perform a complete physical exam – including asking questions about your health history, your symptoms and related risk factors. As part of the physical exam, your doctor may perform a neurological exam, which checks your balance, coordination, reflexes, vision and hearing. Problems in any of these areas could indicate that you have a metastatic spinal tumor.
• Biopsy – in this test, your doctor removes a biopsy (small tissue sample) from the spine. This sample is sent to the laboratory, where a specialist closely checks the biopsy for cancer. The lab may also be able to determine how quickly the tumor is growing or spreading.
• Blood test – your doctor sends a sample of your blood to the laboratory for close analysis. The lab can determine if you have abnormal levels of certain chemicals – including calcium and alkaline phosphatase – in your blood, which can indicate the presence of cancer.
• Bone scan – during this imaging test, your doctor looks for areas of abnormalities in your spine. These areas can indicate a tumor or other problem.
• Computerized tomography (CT) scan – this type of imaging test provides a 3D image of the inside of the body that your doctor can use to determine the location of the metastatic spinal tumor, as well as any other issues with the spine.
• Magnetic resonance imaging (MRI) – this type of imaging test uses high-powered magnets to create detailed images of the inside of your body. Your doctor can closely examine these images to determine the location of the metastatic spinal tumor, as well as any other issues with the spine.

Metastatic spinal cancer treatment

Depending on your personal health history, the extent of the metastatic spinal tumor and other factors, your oncologist may recommend one or more of the following treatment options:

• Ongoing monitoring – if you are not experiencing any bothersome symptoms and your spinal tumor is not growing quickly, your oncologist may recommend ongoing monitoring. For this approach, you will see your doctor at regular appointments for additional testing and surveillance.
• Surgery – if you are experiencing pain or other troublesome symptoms, you may need to undergo surgery to have the tumor removed. Your surgeon will advise whether you can undergo minimally invasive surgery or if you will undergo a traditional open procedure.
• Chemotherapy – you may also need to undergo chemotherapy to destroy any cancerous cells that couldn’t be removed surgically. During this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).
• Radiation therapy – this treatment uses high-powered energy beams to destroy cancerous cells. You may need to undergo radiation therapy to destroy any cancerous cells that couldn’t be removed surgically.
• Stereotactic radiosurgery – during this non-surgical treatment, your doctor uses a specialized machine to directly deliver narrow radiation beams to the spinal tumor. This treatment can help to limit damage to surrounding, healthy tissue.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.