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Treatments and drugs
By Mayo Clinic staffIdeally, the goal of spinal tumor treatment is to eliminate the tumor completely, but this goal may be complicated by the risk of permanent damage to the surrounding nerves. Doctors also must take into account your age, overall health, the type of tumor, and whether it is primary or has spread to your spine from elsewhere in your body.
Treatment options for most spinal tumors include:
- Monitoring. Some spinal tumors may be discovered before they cause symptoms — often when you're being evaluated for another condition. If small tumors are noncancerous and aren't growing or pressing on surrounding tissues, watching them carefully may be all that's needed. This is especially true in older adults for whom surgery or radiation therapy may pose special risks. If you decide not to receive treatment for a spinal tumor, your doctor will likely recommend periodic scans to monitor the tumor.
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Surgery. This is often the treatment of choice for tumors that can be removed with an acceptable risk of nerve damage. Newer techniques and instruments allow neurosurgeons to reach tumors that were once considered inaccessible. The high-powered microscopes used in microsurgery make it easier to distinguish tumor from healthy tissue. Doctors also can test different nerves during surgery with electrodes, thus minimizing nerve damage. In some instances, they may use sound waves to break up tumors and remove the fragments. However, even with advances in treatment, not all tumors can be removed completely.
When the tumor can't be removed completely, surgery may be combined with chemotherapy or radiation therapy.
Recovery from spinal surgery may take weeks or longer, depending on the procedure, and you may experience a temporary loss of sensation or other complications, including bleeding and damage to nerve tissue.
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Standard radiation therapy. This may be used following an operation to eliminate the remnants of tumors that can't be completely removed or to treat inoperable tumors. It also may be the first line therapy for metastatic tumors. Radiation may also be used to relieve pain or when surgery poses too great a risk.
Medications can help some of the side effects of radiation, such as nausea and vomiting. And depending on the type of tumor, your doctor may be able to modify your therapy to help prevent damage to surrounding tissue and improve the treatment's effectiveness. Modifications may range from simply changing the dosage of radiation you receive to using sophisticated techniques that offer better protection to healthy tissue, such as 3-D conformal radiation therapy.
- Stereotactic radiosurgery (SRS). This newer method of delivering radiation is capable of delivering a high dose of precisely targeted radiation. In SRS, doctors use computers to focus radiation beams on tumors with pinpoint accuracy and from multiple angles. This approach has proved effective in the treatment of brain tumors, and research is now under way to determine the best technique, radiation dose and schedule for SRS in the treatment of spinal tumors.
- Chemotherapy. A standard treatment for many types of cancer, chemotherapy uses medications to destroy cancer cells or stop them from growing. Your doctor can determine whether chemotherapy might be beneficial for you, either alone or in combination with radiation therapy. Side effects may include fatigue, nausea, vomiting, increased risk of infection and hair loss.
- Other drugs. Because surgery and radiation therapy as well as tumors themselves can cause inflammation inside the spinal cord, doctors sometimes prescribe corticosteroids to reduce the swelling, either following surgery or during radiation treatments. Although corticosteroids reduce inflammation, they are usually used only for short periods to avoid such serious side effects as osteoporosis, high blood pressure, diabetes and an increased susceptibility to infection.
- Donthineni R. Diagnosis and staging of spine tumors. Orthopedic Clinics of North America. 2009;40:1.
- Brain and spinal tumors: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/brainandspinaltumors/detail_brainandspinaltumors.htm#43233060. Accessed Aug. 28, 2011.
- DeAngelis LM. Tumors of the central nervous system and intracranial hypertension and hypotension. In: Goldman L, et al., eds. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed Sept. 2, 2011
- Spinal cord tumors. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/sec17/ch236/ch236g.html. Accessed Aug. 31, 2011.
- Smith ML, et al. Neurosurgery. In: Brunicardi FC, et al., eds. Schwartz's Principles of Surgery. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/content.aspx?aID=5020575. Accessed Sept. 1, 2011.
- Gurd DP. Back pain in the young athlete. Sports Medicine Arthroscopy Review. 2011;19:7
- Detailed guide: Brain and spinal cord tumors in adults. American Cancer Society. http://www.cancer.org/acs/groups/cid/documents/webcontent/003088-pdf.pdf. Accessed Aug. 28, 2011.
- Sundaresen N. Primary malignant tumors of the spine. Orthopedic Clinics of North America. 2009;40:21.
- Chamberlain MC, et al. Adult primary intradural spinal cord tumors: A review. Current Neurology and Neuroscience Report. 2011;11:320.
- Sachdev S, et al. Stereotactic radiosurgery yields long-term control for benign intradural, extramedullary spinal tumors. Neurosurgery. 2011;69:533.
- Sagar SM. Acupuncture as an evidence-based option for symptom control in cancer patients. Current Treatment Options in Oncology. 2008;9:117.
- Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 2, 2011.
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