In part 1 of this series, we looked at the potential causes and symptoms of spinal tumors. Read on for part 2 of this series, which explores treatment options.
Few people ever expect to hear they have a tumor on their spine. They might have back pain and weakness in their legs, and go to the doctor expecting to hear they have a herniated disc, a pulled muscle, or arthritis.
If you’re one of the rare people who hears the physician say, “It’s a spinal tumor,” you might wonder what treatment options are available to you.
First, the good news: Diagnostic imaging is better than ever, and advanced technology enables surgeons to get closer than ever before to the problem area. If you need surgery, physicians will have some powerful tools at their disposal.
Looking into the window: What physicians see on your test
The physician will look at the size, location, and type of tumor you have. It could be benign, meaning it is a non-cancerous mass that started on your spine and isn’t going to spread to other parts of your body as cancerous cells might.
However, James Schuster, MD, PhD, Associate Professor of Neurosurgery at Penn Medicine, says the vast majority of spinal cord tumors—90 to 95%—that he sees in clinic have stemmed from cancer somewhere else in the body.
Prostate, lung, and breast cancers are particularly notorious for spreading to the spine, according to the American Association of Neurological Surgeons (AANS).
That would make the mass malignant. But that doesn’t mean you have no options.
“As patients are living longer, we’re getting to be really good at keeping them alive when they have cancer,” says Neil Malhotra, MD, Assistant Professor of Neurosurgery at Penn Medicine. “When spinal tumors are treated, we can maximize patients’ quantity and quality of life.”
Potential treatments for a spinal tumor
For benign spinal tumors that don’t cause symptoms or don’t appear to be progressing, physicians might recommend holding off on surgery. Instead, they will monitor the tumor through regular MRIs, or see if it responds well to chemotherapy or radiation.
“Whenever we can, we’ll treat patients without surgery,” Dr. Malhotra says.
Surgery is often the best option, though. Some spinal tumors resist radiation and chemotherapy, while others are too large or already pressing on nerves and causing other health issues. Surgeons want to avoid tumor growth that will inevitably press on spinal nerves and lead to paralysis. Yet, spinal surgeons don’t make that decision alone.
They work with the patient as well as other physicians and surgeons to develop the best course of action. Dr. Schuster says the multidisciplinary team includes:
- Spinal surgeons
- Medical oncologists
- Radiation oncologists
- Urologists
- Plastic surgeons
- Neurologists
- Orthopedists
- Vascular surgeons
The team approach works well because spinal tumors can be difficult to operate on, he says.
Risks of removing a spinal cord tumor
As Dr. Malhotra explains, “As opposed to knee surgery, for example, spinal surgery has inherent risks. We’re operating around the spinal cord. That could leave any function below that level non-functional. But that’s rare. We’ve done a really good job of nearly eliminating that risk.”
Dr. Malhotra points to targeted radiation, precision tools, and unique surgeries that allow surgeons to access tumors in a less invasive way than ever before.
And while there is a slight risk of damage to the spine due to surgery, there’s definite risk of catastrophic nerve or spine injury if the patient opts out of surgery and the tumor continues to grow.
If a person ends up paralyzed because of tumor growth, he also risks blood clots and other serious health complications. “We try to repair these tumors at the right time,” Dr. Malhotra says. “We’re conservative in the beginning, and then we get aggressive.”
In practice for just shy of a decade, Dr. Malhotra says he has seen the field of spinal surgery evolve quickly. He has done hundreds of spinal tumor surgeries and calls advances in the field “really exciting.”
“We’re doing a nice job of getting patients back to really high-quality levels of life,” he says.
Learn more about spinal cord tumor symptoms, and find out why these tumors can be difficult to diagnose in part 1 of this series.