Cancers and tumors of the spine and spinal cord are relatively rare. The most common symptom that patients with a spinal tumor have is pain. Because back pain is very common, it is also not a specific symptom of any one disease or medical condition. Therefore, the challenge is to determine how to evaluate back pain with the goal of specifically excluding a tumor as the cause of the pain. Luckily, most back pain is not due to a tumor. However, if a cancer were discovered after a long period of "conservative" management of back pain, most patients would feel that their problem should have been investigated more thoroughly in the beginning. What is the best way to resolve this conflict? There is no easy answer to this question, but the following discussion tries to put spine tumors into perspective.
Over 80 percent of spine tumors will present with pain. Pain symptoms that may suggest that a tumor or a cancer is responsible for the pain include pain that continues to get worse despite treatment, and that may be associated with other symptoms such as fatigue or weight loss. The pain may be worse at night, and not necessarily be related to level of activity. When associated with neurological symptoms such as loss of bowel and bladder control or pain running down the legs, further evaluation is clearly warranted. Be aware of other physical symptoms, such as lumps and bumps, moles on the skin, and any other findings that might suggest that you have a tumor somewhere else in your body.
Most of us are aware of some of the risk factors that are associated with cancer in the United States. Cigarette smoking, an unhealthy diet, chemical and radiation exposure, a family history of certain cancers such as breast cancer or ovarian cancer, and over-exposure to the sun are common risk factors for certain cancers. These cancers generally occur in different parts of the body and then spread to the spine only after the cancer has been growing for a long period of time. The spine and vertebral bodies have a rich blood supply and cancer cells can spread to this part of the body by traveling in the bloodstream. Back pain is usually not the first symptom of a malignant cancer growing somewhere else in your body. Because of this fact, doctors use routine medical tests in order to find certain cancers before they have a chance to spread instead of evaluating every patient with back pain as if they might have a cancer. Regular mammograms to look for breast cancers, pap smears to look for cervical cancer, chest x-rays to look for lung cancers, and fecal occult blood tests for colon cancers should be part of everyone's health maintenance program.
Most spine tumors are found as part of a routine diagnostic evaluation for back pain. This begins with a complete physical exam. If you have concerns that you may have cancer elsewhere, you should discuss this with your spine surgeon who will be able to help you make sure that you are getting the right tests. X-rays of your back are always the initial step in the imaging process. X-rays are a very good way to look at the spine, but they are not foolproof. While many tumors will be visible on regular x-rays, some are much more difficult to see. This is especially true for those cancers involving the soft tissues such as the spinal cord itself or the muscles that surround the spine. When there are reasons to suggest that a cancer may be the cause of back pain, doctors will usually order a bone scan, a CT scan (CAT scan), or an MRI. The combination of a history and physical exam, and the appropriate imaging studies will usually find or exclude the majority of spinal tumors.
The type of tumor, the extent of involvement of the vertebrae, the location, and the prognosis for the patient are all used to decide what type of treatment is best. Many times, this decision is made by a team of surgeons, oncologists, radiologists and other doctors who specialize in taking care of patients with cancer. Many spinal tumors can be treated with very good results, and the pain can also be significantly alleviated. It is very important that you gather as much information as possible about the treatment options for the specific type of cancer that you or your loved one has. The first step in gathering this information is to make sure that you understand what type of cancer you are dealing with, and what your treatment options are. With this knowledge, you can actively participate in the decision making process with your team of doctors.
Doctors use the term "malignant" to indicate that a particular tumor or a cancer often spreads to other parts of the body, can be difficult to cure or treat, and may often be deadly. Read More
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