Spinal tumor treatments vary based on the tumor’s type and location, as well as other serious health conditions that may be present. Treatments for spinal tumors can range anywhere from just observation/monitoring all the way up to complete surgical removal.
Nonsurgical Treatments for Spinal Tumors
Nonsurgical treatments may be used instead of or in conjunction with surgery for spinal tumors.
External Beam Radiation Therapy
External beam radiation therapy (EBRT) involves using a machine to send a beam of radiation into the body and target the tumor. The goal is to destroy the tumor cells and/or shrink the tumor.
Another form of radiation therapy, called stereotactic radiosurgery, involves sending multiple beams from multiple angles with the purpose of preserving as much healthy tissues as possible while targeting the tumor. Each individual beam of radiation is low power but many such low-power beams can meet at the tumor and intensify there.
Radiation is commonly used after spinal tumor surgery as a way to destroy any remaining tumor cells. It may also be used in cases where the spinal tumor is considered inoperable, or as a way to shrink the tumor before surgery.
Medications that may be considered as part of a treatment plan for spinal tumors may include:
- Corticosteroids may be prescribed to help reduce inflammation and possibly the size of the tumor.
- Pain medications may help reduce pain from a spinal tumor. Examples include nerve pain medications, opioids, and NSAIDs (nonsteroidal anti-inflammatory drugs).
- Chemotherapy drugs, which may be taken intravenously or orally, target cancer cells throughout the body. While chemotherapy has not been shown to specifically target spinal cord tumors, it may be considered as part of an overall treatment plan for cancer.
- Immunotherapy drugs, which aim to stimulate the immune system into attacking abnormal cells, are a newer treatment and still being studied. Some evidence suggests that immunotherapy is capable of shrinking spinal tumors, but more research is needed.
Some patients may be candidates for clinical trials in which experimental drugs may be tested for treating spinal tumors.
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Watching and Waiting
Rarely, a spinal tumor may be discovered without having caused any symptoms yet. For an asymptomatic spinal tumor, it may be best to simply monitor it every few months with imaging to ensure that it is not growing rapidly.
A benign spinal tumor may or may not develop into a problem later. As long as a benign spinal tumor causes no symptoms, no treatment is required. By regularly monitoring the tumor, treatment can begin shortly after symptoms start, which may result in a better outcome.
When a spinal tumor develops as a result of advanced cancer, or alongside other serious health problems, the patient’s overall health and life expectancy may need to be considered. If a patient’s overall health suggests that surgery or other aggressive spinal tumor treatments will not be beneficial, palliative care may be chosen. Palliative care tends to focus on pain management with medications and keeping the patient as comfortable as possible.
Surgery for Spinal Tumors
When surgery is performed on a spinal tumor, there are typically 3 goals:
- Remove all of the tumor (or as much as possible)
- Preserve neurological function
- Maintain spinal stability
Numerous surgical techniques are available, depending on the type of spinal tumor and its location. Some surgeries for spinal tumors can be done using minimally invasive methods, whereas others may require more extensive surgery or a combination of techniques.
One of the most common surgeries for spinal cord tumors is the thoracic laminectomy. This procedure involves removing the back part of a thoracic vertebra, including both laminae and the spinous process.
If any of the tumor remains after surgery, it may be treated with radiation or, less commonly, chemotherapy.
Following metastatic spinal tumor surgery, it may take some time for the nerves to heal. Usually rehabilitation and time help to improve a patient’s neurological function.
Before agreeing to any treatment plan, it is important that the patient has been explained the potential benefits and risks, and whether other treatment options may be considered.