What are Spine Tumors?

According to the Cleveland Clinic, about 90% of patients who have spinal tumors go to the doctor to be treated for persistent, chronic back pain.¹ Most physicians will include cancer in their differential diagnoses when a patient’s pain does not go away for an extended period of time. A differential diagnosis is how doctors distinguish a particular disease or condition from others when they have similar clinical features. Since back pain affects a very large number of people, tumors may need to be tested for and then ruled out or treated depending upon the diagnosis.²

A primary spinal cord tumor is a tumor that starts in the spinal cord. This year, an estimated 23,880 adults (13,720 men and 10,160 women) in the United States will be diagnosed with primary cancerous tumors of the brain and spinal cord. Brain tumors account for 85% to 90% of all primary CNS tumors.²

Spinal tumors can be classified into three major groups by their location in the spine.

• Intramedullary—tumors that grow inside the spinal cord itself; these tumors are typically astrocytomas, ependymomas or hemangioblastomas.
• Intradural-extramedullary—tumors that grow outside of the actual spinal cord but inside the dura mater, or outermost layer of the spinal cord covering; typically these tumors are meningiomas (on the meninges), or nerve sheath tumors (on the nerve roots).
• Extramedullary or extradural—tumors located outside the dura mater or outermost layer of the meninges also called the spinal cord covering; typically these tumors form in the spine vertebrae and may be called vertebral column tumors. They are oftentimes metastatic but may be primary to the bone.

While most patients with back pain are typically diagnosed with a benign condition, if cancer is present, it could be caused by another cancer that has spread to the spine. In fact, bone, and the spine in particular, is the third most frequent site of metastasis, behind lung and liver.³

Metastasis happens when a patient’s cancer travels from one part of the body to another through the blood stream or lymphatic system. The cancer then grows in the new environment as a tumor or tumors made up of the primary cancer tissue.

It’s estimated that about 20,000 cases of spinal metastasis occur each year in the United States.²

If you are experiencing unrelenting and persistent back pain that gets progressively worse, is not lessened with rest, or gets bad enough at night to awaken you, speak with your doctor right away as this may indicate a more serious condition.

¹ Siemionow, K, Steinmetz, M, Bell, G, Ilaslan, H, McLain RF. Identifying serious causes of back pain: Cancer, infection, fracture. Cleveland Clinic Journal of Medicine. 2008 August;75(8):557-566
² Cancer.net
³ Macedo, F., Ladeira, K., Pinho, F.,  Saraiva, N.,  Bonito, N., Pinto, L., and  Goncalves, F.,Bone Metastases: An Overview. Oncol Rev. 2017 Mar 3; 11(1): 321.
⁴ MedScape