The National Cancer Institute estimated that 1,735,350 people in the United States were diagnosed with some form of cancer in 2018 and 609,640 would die. The sad fact is that most everyone has a friend or loved one who has this rapacious disease. While there are many types of cancers that can be found in various parts of the body, spine surgeons understand the intricacies that tumors or spinal cancer can cause. Every day back pain could indicate that there is a more serious issue that might require spine surgery, whether or not cancer is the cause.
Dr. Rob Dickerman is a board-certified neurosurgeon with extensive training in treating conditions of the spine, including spinal cancer. As a member of the referral line at Texas Health Spine & Orthopedic Center, he specializes in minimally invasive spine surgery procedures. Dr. Dickerman received his fellowship training from the National Institutes of Health (N.I.H.) and the Texas Back Institute. Dr. Dickerman is on the medical staff of and the Medical Director of the Minimally Invasive Spine and Back Pain Program at Texas Health Presbyterian Hospital Plano and has over 100 publications and has lectured at conferences around the nation.
Spinal Tumors: Malignant or Benign
With its large population of patients, many people are concerned about developing any form of cancer, especially in a critical area such as the spine. Damage to the spinal column and cord can result in paralysis or death. However, not all tumors on the spine are cancerous. Dr. Dickerman explains what percentage of spinal tumors become malignant and what percentage are benign.
“The easiest way to answer this is to note that the most common tumors found in the spine are from metastasis from other sites in the body,” he said. “In men, these most commonly occur from prostate and lung and in women from breast and lung.
“With regard to what percent are benign versus malignant, if we are focused on spinal tumors, the majority would be malignant because most are metastatic. Statistics show in patients with metastatic cancer up to 70 percent will spread to the spine.
“There are numerous types of spinal tumors that can be benign or malignant as well as certain types of tumors that occur more often in children than in adults.
Tumors can be categorized by where they are located within the spine including:
- Bone tumors (spinal column): these tumors are within the bone itself and can expand into the spinal canal compressing the cord or nerve roots leading to neurological deficits.
- Intradural-extramedullary: these tumors are within the outer layer of the spinal cord called the meninges or dura.
- Intramedullary: these tumors are within the spinal cord (nervous system) and are typically intrinsic tumors arising from the cells within the nervous system.
Surgical Procedures for Treating Spinal Cancer
Discovery, removal, and treatment of spinal cancer requires a skilled spine surgeon. This is because of the potential for the disease to spread through the patient’s blood and other tissue. If a tumor proves to be cancerous, there are several actions that must be undertaken.
“Depending on its location, the tumor surgery is focused on the removal of the tumor and decompression of the spinal cord or nerves,” Dr. Dickerman said. “This is followed by stabilization of the spine – with surgical screws or other architecture – if the tumor and/or surgery caused structural damage or instability.
“Neurosurgeons have a variety of techniques used preoperatively and postoperatively to ensure maximal removal (of the growth tissue) at surgery. Some spinal cancers, as with other cancerous tumors in the body, do require postoperative radiation and/or chemotherapy.
Signs of Spinal Cancer: When to See a Specialist
“There are several signs for this condition that suggest a thorough examination is in order,” Dr. Dickerman said. “Pain anywhere in the spinal column (neck or back) which can often be accompanied with numbness or weakness in the arms or legs shows potential for more serious problems. Numbness or pain radiating from the mid-back (thoracic region) around the ribs is also common in spine cancer. Progressive neurological changes in strength, bowel or bladder control should be seen by a spine surgeon.
“Other symptoms include pain in the spine that does not subside or improve with rest over several days and is worse at night or upon awakening. Pain in the spine that worsens with lifting, twisting or compression of the spine is another concern. Finally, spine pain that is accompanied by unexplained weight loss, nausea, vomiting, loss of appetite, fevers and or chills all suggest that a visit to a neurosurgeon is appropriate.”
Physicians who are members of the referral program practice independently and are not employees or agents of Texas Health Spine & Orthopedic Center.