It can be difficult to navigate the waters when you’re making a decision for your spinal cancer treatment – Is surgery always necessary? Or is having your medical care team monitor the tumor an option? Each case of spinal cancer is different and particular to the individual. Factors can depend on the aggressiveness of the tumor, the location and many other details. Once you are armed with information and a definitive diagnosis, you can begin the process of deciding what is best for you and your spinal cancer treatment needs.
The Prevalence and Types of Spinal Cancer
Around 24,000 people in the U.S. alone will develop spinal or brain cancer this year. This is not a trivial number; the one silver lining to this incredible statistic is the fact that treatments and surgical techniques are constantly being revisited and improved upon; research is regularly revealing new and effective means for addressing cancers of all types.
There are a handful of cancers that tend to affect the spinal region, both within the spinal column and along the outer structure. Overall, the most common cancer to affect the spine are cancers that metastasize from other parts of the body. Typically in women, the metastasis spinal tumor originates from the lungs or the breast, and in men, from the prostate or the lungs. These tumors may be treated with surgery, radiation and/or chemotherapy depending on the specifics to the patient’s cancer and condition.
Cancers of the bone marrow include multiple myeloma and lymphoma are also common but are less likely to be treated with surgery because they are very sensitive to radiation.
Tumors that originate from the bones are called primary bone tumors and include chondrosarcoma, chordoma and osteosarcoma. If possible these tumors are usually treated by removing them completely at surgery.
Each type of spinal cancer will require slightly different treatment protocols due to the structure of the tumor, aggressiveness and the rate or chance of metastases. The location of the tumors and the advancement of the disease can also play a major part in which spinal cancer treatment is chosen.
Surgical Removal, Monitoring, and Non-Surgical Treatment
Deciding to proceed with surgery on a spinal tumor should be a decision that is made with your doctor after looking at all angles of your particular situation.
Surgery
Surgery is usually performed if the tumor is causing neurological problems or instability of the spine. In most cases, if surgery is indicated, it will be part of a multi-faceted cancer treatment plan that includes radiation and chemotherapy. Sometimes, if the tumor is large or threatening the spinal cord, your cancer specialist may recommend surgical debulking (reduction via surgical means) to create some space between the tumor and the spinal cord to make subsequent radiation therapy effective and safe. This is called “separation surgery.”
Monitoring
It is uncommon for spinal cancers to be monitored without any treatment whatsoever. If no specific treatment for a tumor to the spine is recommended, this is usually because the oncologist feels confident that their chemotherapy treatment will be effective in treating the spinal tumor in addition to whatever other cancer cells may exist in the body. If this path is chosen it is important for the spine tumor to monitored with periodic imaging to ensure that the tumor is not growing. If it is other treatment may be needed.
Radiotherapy
Radiation is used to slow the growth of a tumor or shrink it. It can be used as a stand-alone procedure, or to reduce a tumor before it is removed or after a tumor is partially removed. Radiation is also known to significantly reduce pain associated with spinal tumors. A real breakthrough in the treatment of spinal cancer has been a high-tech, concentrated form of radiation called radiosurgery. This has enabled doctors to treat metastatic tumors with a single highly specific lethal dose of radiation.
Chemotherapy
Chemotherapy is often used in combination with radiation and/or surgery to assist in shrinking tumors.
Final Thoughts
Deciding whether or not to undergo surgery for your spinal cancer is, ultimately, dependent upon the type of cancer you have, the location, the stage of advancement and whether or not it will respond more favorably to treatments such as chemotherapy and radiation.
Perhaps the most important aspect of treatment is finding the right doctors to address your care needs. Seek an oncology and/or surgical care team you feel at ease with and trust your health and well-being too. Make sure you are able to openly discuss your treatment options and get all of your questions answered to your satisfaction. You have a right to empower yourself for the road ahead – including your spinal cancer treatment.
