Spinal Tumors in Adults
Spinal tumors and brain tumors are closely related and generally referred to as brain and spinal cord tumors or tumors of the central nervous system. The spinal cord is located just below the brain stem and contains long nerve fibers with signals that control muscles, feeling, and the bladder and bowel. Many different types of tumor can arise in the spinal cord, ranging from low-grade and relatively treatable to high-grade, very serious, tumors with poor outcomes. (Spinal tumors in children have very different characteristics and treatments than those of adults and are not included in this discussion.)
Spinal tumors, unlike other cancers, almost never spread to other organs. However, they often spread – finger-like – to other parts of the spine, or to the brain. Even non-cancerous tumors can lead to serious complications unless removed.
Survival is most often determined by a person's age, the type of tumor, its size and location, whether it can be surgically removed and how far it has spread. In general, younger people (under 45) have significantly better survival rates than those over 55 and those diagnosed with lower grade tumors face better chances than those with aggressive tumors.
It is important to note that in adults, metastatic spinal tumors (that spread to the spine from another organ) are actually more common than primary spinal tumors and require different treatment.
Risk Factors and Prevention
Doctors discuss care at NewYork-Presbyterian's Spine Centers.
There are very few obvious risk factors associated with spinal cord tumors, therefore they are difficult to prevent. Radiation exposure, most commonly due to radiation therapy used to treat other cancers, can increase a person's risk for these tumors. Most people with spinal cord tumors do not have a family history of the disease, but brain and spinal cord cancers run in families of people with rare diseases like Neurofibromatosis, tuberous sclerosis, and other inherited genetic conditions. People with impaired immune systems also may be at increased risk. Currently, there are no blood or other screening tests that can reliably detect these tumors at an early stage.
Symptoms
Symptoms of brain or spinal cord tumors can be fairly general, with specific symptoms depending on the exact location of the tumor. Symptoms may occur gradually and become worse over time, or they can happen suddenly, as with a seizure. Symptoms associated with spinal cord tumors include numbness, weakness, coordination problems in the limbs, and bladder or bowel problems. More general symptoms are headaches, nausea, vomiting, blurred vision, speech or comprehension difficulties, personality or behavior changes, seizures, and drowsiness. All of those symptoms can also be caused by other conditions and do not necessarily indicate a tumor, but any concerns should lead to a neurologic exam to evaluate brain and spinal cord function.
Treatment
The treatment for spinal cord tumors varies depending on the tumor. Meningiomas (tumors that start in the tissues that line and protect the brain and spinal cord) can often be cured, either through surgery alone or surgery with radiation. The same is true for some, but not all, ependymomas (tumors that begin in the ependymal cells, which line the ventricles). Other tumors, including astrocytomas (a type of glioma, formed in the brain's glial cells) normally cannot be completely removed by surgery, but may be treated surgically to reduce the tumor and followed by radiation therapy. Some tumors are treated with radiation therapy alone, or less frequently, combined with chemotherapy. Researchers are continually working on clinical trials and targeted therapies to better understand the formation of these tumors and improve treatment.