Home > Conditions Treated > Spine Conditions & Disorders > Metastatic Spinal Tumour

A metastatic spinal tumour is when cancer in another location of the body spreads to the spine.

 This is a common variety of spinal tumour and it usually affects the thoracic spine the most often. More than 30% of patients with cancers in other locations will metastasise to the spine.

Causes of Metastatic Spine Tumours

There are more common subtypes of cancers that spread to the spine.

This includes cancers from:

  • The lung
  • The prostate in men
  • The breast in women

Other less common types include:

  • Renal cell carcinomas
  • Lymphomas
  • Melanomas
  • Cancers from the thyroid
  • Cancers from the gastrointestinal tract

Spinal Metastases Symptoms

The presentation of symptoms depends on few factors which include:

  • Location of the tumour
  • Size of the tumour
  • The pace at which the tumour has grown
  • Whether the tumour is compressing the spinal cord or spinal nerves

Commonly the symptoms include:

  • Pain
  • Numbness
  • Weakness
  • Loss of function
  • Loss of proper control of the bowel of the urinary bladder

The typical pain symptoms are constant and unrelated to activity. Although movement may aggravate pain symptoms further. 

Spinal Metastases Diagnosis 

The first step is to complete a comprehensive neurological and physical examination. This includes a detailed review of the patient’s medical and family history. 

The confirmatory diagnosis comes from performing an MRI scan. It may be necessary to perform a CT scan to understand the extent of bony involvement or destruction if any. A biopsy may also be advised to confirm the specific cancer type. The following are the two categories of biopsies:

Surgical Biopsy

Needle Biopsy

Spinal Metastases Treatment

The treatment of metastatic spinal tumours is usually multidisciplinary. The team at Neuroaxis works closely with oncologists to assist the decision-making process around treatment. Together they will offer the best possible surgical therapy option to achieve the goals of surgical treatment with reduced morbidity. Using keyhole surgery techniques hastens recovery and reduces postoperative complications. The goals of surgery in the setting of a metastatic spinal tumour range from:

  • Achieving a biopsy
  • Decompressing the spinal cord
  • Completely removing a tumour
  • Providing stability to the spine

Spinal Metastasis Risk Factors

The following are the risk factors associated with metastatic spinal tumours:

History of tumour

Types of tumours that are expected to spread to the spine include those of the lung, breast, multiple myeloma, and prostate.

Weak immune system

People who have weak immune systems tend to develop spinal cord lymphomas.

Genetic disorders

The following congenital disorders are sometimes associated with spinal cord tumours:

  • Neurofibromatosis (NF2)
  • Turcot syndrome
  • Cowden syndrome
  • Hereditary retinoblastoma
  • Rubinstein-Taybi syndrome
  • Von Hippel-Lindau disease 

Exposure

Exposure to industrial chemicals or radiation may increase the chance of developing a spinal tumour.

Spinal Metastasis Complications

Complications related to spinal tumours can be divided into the following two categories:

Complications related to the tumour, its metastases, or its recurrence

Neurologic problems including focal weakness or radicular pain from impingement on a nerve root and incomplete or complete paraplegia from spinal cord compression

Complications associated with chemotherapy, radiation, or surgical management of the spinal tumours

Complications that result from the treatment options performed on the patient may be linked to the body structures sacrificed during the surgical resection process to attain clear margins, structures in the path of radiation therapy, or the systemic effects of chemotherapy .

Some of the other complications, that can arise out of the disease include:

  • Spinal cord or other neural element injuries
  • Bleeding
  • Pathological fracture and collapse
  • Resistance to treatment
  • Tumor recurrence
  • Infections secondary to immunosuppressed state

Spinal Metastasis Prevention

Apart from radiation exposure, there are no environmental or lifestyle-related causes yet known of spinal metastatic tumours. There are currently no known ways for prevention against most of such tumours.

Imaging tests like CT scans or X-rays generate much lower levels of radiation than the ones generated for cancer treatment. Early detection through these tests with fewer radiation is better than more radiation used later during the treatment.

Clinical trials or research

A pilot study is currently underway to understand the clinical significance and initial dosimetric evaluation of stereotactic boost for malignant epidural spinal cord compression. The main objective of the clinical study is to determine if stereotactic body radiation therapy (SBRT) is a viable choice. This is in addition to standard 3D conformal radiotherapy (3DCRT) for metastatic epidural spinal cord compression (MESCC) patients. The study aims to consider future randomised trials if the outcome is positive. 

Another clinical study is being conducted to assess clinical outcomes of surgical management for symptomatic metastatic spinal cord compression from prostate cancer. Reconstruction and decompression surgery for symptomatic metastatic spinal cord compression (MSCC) from prostate cancer (PC) might contribute to a favourable functional outcome among men with mHNPC and mCRPC. However, its role in enhancing the oncological outcome is still unclear. The treatment strategy should be shared among patients, radiation oncologists, urologists, and orthopedic surgeons.

Frequently asked questions

What is the differential diagnosis of metastatic spinal tumour?

The major differential diagnoses for spinal metastatic tumour include the following:

  • Primary tumour of the spine include plasmacytoma, myeloma, sarcoma, and lymphoma.
  • Spinal infections include granulomatous and pyogenic (including tuberculosis)

Can spinal metastatic cancer be cured?

Sometimes, patients may be cured using surgery alone, if the whole tumour can be removed. This is not possible in all scenarios. Getting completely cured also sometimes depends on the type of tumour. 

How to find out you have spinal cancer?

The MRI scan is the best way to diagnose any tumour growth. It generally shows the exact location of the tumour, how much it has grown or spread into or near the spinal column. It also outlines if the pain is due to some other condition such as arthritis.