If your doctor confirms that you do have metastatic spinal tumors, there are treatment options to consider, and many factors to account for, in selecting a treatment plan in conjunction with your oncologist, primary care physician, or other members of your healthcare team.
Some important factors to consider when a metastatic spinal tumor is involved:
- Type, size, and location of the tumor
- Site(s) to which the disease has metastasized (spread)
- Presence of a fracture in the vertebra(e) affeted
- Strength of the spinal vertebra(e) bone affected
- Presence of any neurologic deficit
- Treatments you are undergoing or have undergone
- Your overall health and energy level
Keeping these and other factors in mind, spinal tumor treatment options that should be considered may include: systemic pharmaceutical regimens (chemotherapy), radiation therapy and radiosurgery, surgery, and minimally invasive spine procedures, such as radiofrequency ablation.
Radiofrequency (RF) Ablation
Radiofrequency (RF) Ablation has been used to treat cancer in soft tissue organs throughout the body. RF energy does not directly stimulate nerves or muscles, as do many other types of energy, making it an alternative option for destroying tumors located near important elements of the nervous system. Recent technological advances in targeted delivery of RF energy make ablation a viable option for treating metastatic bone tumors in the vertebral bodies that make up the spine.
Used in combination with other treatments, RF ablation technology offers acute pain relief and other quality of life improvements for cancer patients.1, 2 Because RF ablation is localized (focused on only a small area of the body) and performed in a single treatment, it can allow for the simultaneous primary cancer treatments, such as chemotherapy. RFablation may also offer a treatment option for patients who have reached their maximum radiation dose limits or those with radiotherapy-resistant tumors.
How is Radiofrequency (RF) ablation used to treat a painful metastatic spinal tumor?
RF energy is delivered directly into the metastatic spinal tumor to heat and destroy the tumor cells. This can be done in conjunction with other minimally invasive procedures, such as tumor biopsy.
Systemic treatments often used for bone metastases include RANKL Inhibitors (denosumab) and bisphosphonates (zoledronic acid and others). These may be prescribed to minimize the risks of bone fragility that are often associated with metastatic disease in the skeleton.
Radiation Therapy and Radiosurgery
Radiotherapy, including radiosurgery, remains a common treatment for patients with metastatic spinal tumors. However, radiotherapy may not provide pain relief until after treatment has been completed for several weeks or months, resulting in discomfort during the course of radiotherapy.
The source of the tumor affects a patient’s treatment options, as some cancers may be more sensitive to radiotherapy than other cancers. This sensitivity to the radiotherapy impacts the treatment’s overall effectiveness. Metastatic lesions resulting from breast, lung, kidney, thyroid, and prostate cancer are often sensitive to radiotherapy, while those secondary to melanoma, renal cell carcinoma, and sarcoma are found to be less affected by radiotherapy.
Additional factors to be considered may include the need to discontinue systemic primary cancer treatments, such as chemotherapy, in order to deliver a radiotherapy regimen. Additional considerations are a reported increased risk of bone weakness, or instability, in the portions of the spine treated with radiotherapy.
Invasive surgical procedures for the treatment of spine tumors may be considered options for patients with neurological disorders, significant spinal weakness, and longer life expectancy. Given the longer recovery times involved, however, such invasive surgical procedures are often avoided.