Spinal Tumor

Spinal tumors can be inside of your spinal cord, in the tissues (meninges) covering your spinal cord, between the meninges and bones of your spine, and in the bony vertebrae of your spine.

You might not even know you have a spinal tumor at first. They often have no symptoms until they grow big enough to start pressing on your spinal cord nerves. Then, you’ll most likely have nagging back or neck pain that can be mild to severe. And you might have other symptoms, like numbness, spasms, loss of bowel or bladder control, trouble walking and more.  

What to expect at your first visit

At your first appointment, your healthcare provider will ask about your symptoms and how you’ve been feeling. They’ll want to know:

• What kinds of symptoms you’re having.
• How long you’ve had these symptoms.
• If your symptoms are getting worse.
• How your symptoms are affecting your life.
• If you’ve ever had cancer or tumors.
• If anyone else in your family has had cancer or benign spinal tumors.

They’ll also go over your medical history and give you a neurological exam and physical exam to check your overall health.

Next, your provider may order some imaging tests to get a closer look at your tumor from the inside, like:

• Spine X-rays.
• MRI (magnetic resonance imaging).
• CT scan (computed tomography scan).
• Bone scan.

We may do a biopsy to see if the tumor is cancerous or noncancerous. Your provider will take a sample of tumor tissue and send it to our lab, where pathologists will look at it under a microscope.

We may also order blood tests to look for higher levels of calcium and alkaline phosphatase in your blood, which could happen if you have cancer.

Types of spinal tumors

There are two main types of spinal tumors. Primary spinal tumors are ones that begin in or around your spinal cord. These types of spinal tumors are rare.

Secondary spinal tumors (or metastatic spinal tumors) are the most common type. They start as cancer somewhere else in your body and spread (metastasize) to your spine. Lung cancer and breast cancer are most likely to spread to your spine, but other cancers can, too. These include:

• Prostate cancer.
• Leukemia.
• Lymphoma.
• Multiple myeloma.
• Melanoma.
• Sarcoma.
• Kidney cancer.
• Thyroid cancer.
• Gastrointestinal (GI) tract cancers.

Spinal tumors can be malignant (cancerous) or benign (noncancerous). Cancerous spinal tumors we diagnose and treat include:

• Gliobastomas (GBM).
• Malignant peripheral nerve sheath tumors (MPNST).
• Primary bone tumors that affect your spine, like chondrosarcoma, chordoma and osteosarcoma.
• Primary glial tumors, like ependymoma and subependymoma.
• Metastatic spine tumors

Noncancerous spinal tumors we diagnose and treat include:

• Aneurysmal bone cysts (ABC).
• Giant cell tumors.
• Hemangioblastomas.
• Spinal hemangiomas.
• Meningiomas.
• Neurofibromas.
• Osteochondroma.
• Paragangliomas.
• Schwannomas.

We also care for vascular conditions that can affect your spine, like:

• Arteriovenous malformations (AVM).
• Hemangiomas.
• Vertebral hemangiomas.

Second Opinions for Spinal Tumors

Hearing you have a spinal tumor can blindside you. And leave you with all kinds of thoughts and emotions spinning around in your head. So, it’s important you feel confident that you’re working with a team of healthcare providers you trust. That’s why we encourage second opinions.

And because we understand that waiting for care is frustrating, we always try to meet with you as soon as possible. Our skilled, experienced spinal tumor specialists will spend time helping you better understand your diagnosis and what treatment options will best meet your specific needs. Getting a second opinion can help you feel more in control of your treatment. And you’ll have peace of mind knowing you have the most capable and compassionate care team on your side.

Meet Our Spinal Tumor Team

When you come to Cleveland Clinic, you’ll have a team of knowledgeable and supportive healthcare providers on your side. They’ll work closely together and with you to make sure you get an accurate diagnosis and comprehensive treatment. Your care team may include:

• Neurologists.
• Neurosurgeons.
• Medical oncologists.
• Radiation oncologists.
• Orthopaedists.
• Urologists.
• Vascular surgeons.
• Pathologists.
• Physician assistants.
• Nurse practitioners.

At Cleveland Clinic, you’ll play an active role in designing your treatment plan. Your providers will talk with you about your health goals and what’s most important to you so they can personalize your care.

Because there are so many types of spinal tumors, your treatment will be unique. You may have a small or slow-growing tumor that doesn’t need to be treated right away. So, we might do “watchful waiting” and keep a close eye on what’s going on.

Or maybe your tumor’s more aggressive (fast-growing) and needs in-depth, immediate attention. Your care team will work with you to find the best treatments for your needs and diagnosis.

Stereotactic spine radiosurgery (SRS)

Stereotactic spine radiosurgery is a noninvasive procedure that sends beams of radiation to the tumor while protecting nearby healthy tissue. It’s used for both cancerous and noncancerous spinal tumors. SRS is often the treatment of choice for spine tumors. It can also be used in combination with other treatments.

Chemotherapy

Chemotherapy medications get rid of cancer cells in your spine and throughout your body. You can get chemo through an injection into a vein or by taking a pill. Your specialists may recommend chemotherapy before surgery to make the tumor smaller.

Radiation therapy

Radiation therapy sends high doses of X-rays that destroy tumor cells or shrink the tumor. Shrinking the tumor can make it small enough to reduce or eliminate pain or other symptoms.

Surgery

Your providers may only consider surgery as an option if you have a metastatic spinal tumor that doesn’t respond well to radiation or chemotherapy.

Your surgeon may recommend traditional open surgery, or you might have a minimally invasive procedure. Some primary spinal tumors can be surgically removed through complete en bloc resection (complete removal of the tumor). But other types of tumors might not be able to be surgically removed without causing significant neurological damage. Your provider will explain the surgery options to you in detail.

Monitoring

If you have a benign primary tumor that’s not causing any symptoms, or just mild ones, and it doesn’t appear to be changing or progressing, your healthcare provider may recommend keeping an eye on it with regular MRIs.

Taking the Next Step

No one wants to think about cancer spreading to their spinal cord — or a tumor starting there — but if the unthinkable happens, you’ll want to surround yourself with the most qualified and caring providers. You’ll want to feel confident that your care team is doing everything possible to help you handle this next chapter in life. If this is where you are, take a moment to breathe. We’ll be ready to support you.