Spinal Tumours and Metastasis
A spine tumor is an abnormal growth of tissue found in and/or around the spinal column and/or spinal cord.
A spinal tumor can be classified as primary or secondary:
Tumors that originate in the spinal tissue are called primary tumors. They can be cancerous or noncancerous. This type of spinal tumor is rare and even when present, the noncancerous type is more common.
Tumors that spread to the spine from cancer that has started elsewhere in the body are called secondary tumors. This type of tumor is cancerous. More than 90% of spinal tumors are metastases. These cancerous tumors may also be referred to as metastatic tumors, metastases, or malignant tumors.
Tumors can grow within the spinal cord, within the dura (protective covering around the spinal cord), or in the vertebral structures; however, spinal cord tumors and tumors within the dura (intradural) tumors are rare.
The most common symptom of a spinal tumor is back pain that is usually worse at night or upon waking. However, most back pain is not caused by tumors and not all tumors are symptomatic.
Neurological symptoms, such as weakness, tingling or numbness in the arms or legs may also develop due to a spinal tumor, but these symptoms tend to occur several weeks or months following the onset of back pain.
Patients may experience one or any combination of the following symptoms, and some people with metastatic spinal tumors do not have any symptoms at all. It is important to document symptoms, as they can be used to help diagnose metastatic spinal tumors.
Metastatic Spinal Tumor Pain
The back pain that is caused by spinal tumors generally tends to be described as severe and is not relieved by rest or pain medication.
There are a number of types of pain that can be caused by spinal tumor growth.
- Aching pain in the bones Tumor growth can result in a number of biological responses, such as local inflammation or stretching of the anatomical structures around the vertebrae. These biological sources of pain are often described by patients as a deep ache that tends to be worse at night, even to the point of causing one to wake up from the pain, and/or pain that is worse first thing in the morning after waking up and improves somewhat after getting up and moving around.
- Pain that shoots down the arm or leg This type of nerve pain, also called radicular pain, travels along the path of the nerve – down the leg if the tumor is in the lumbar spine, or down the arm if the tumor is in the cervical spine. Radicular pain is often described as burning or shooting pain that follows the path of the nerve into the extremities. Radicular pain may be accompanied by neurological symptoms along the affected nerve, such as weakness, tingling or numbness.
- Pain with movement If the tumor is growing within the vertebra, the walls of the vertebra can become thin and weaken. If left untreated, the bones can fracture. A vertebral fracture can result in sudden onset pain that tends to be more severe during movement or when placing pressure on the bone, such as when sitting and standing.