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Spine Conditions

Metistatic Spinal Tumors

Metastatic spinal tumors are cancerous lesions that have spread to the spine from a primary or initial site located elsewhere in the body, such as the breast, lung, thyroid, kidney, bowel, or prostate. These tumors can cause severe back pain, neurological deficits, and, in severe cases, spinal cord compression, leading to numbness, weakness, or paralysis.

Diagnosis typically involves imaging studies like MRI, CT scans, and/or PET scans. The vast majority of diagnoses can be made with abdominal and chest imaging, bloodwork, and a careful history taken by Dr. Colman. However, in many cases a biopsy is performed either of the primary or the spinal site of tumor to confirm the diagnosis. Treatment focuses on preserving neurologic function, spinal stability, relieving symptoms, and enhancing quality of life. Each patient is different and there is no one standard approach. This is why Dr. Colman utilizes a multidisciplinary approach involving colleagues in medical oncology, radiation oncology, radiology, pathology, and other disciplines. The multidisciplinary tumor team may combine systemic therapies such as chemotherapy, targeted therapy, immunotherapy, radiation therapy, and/or surgery in your care.

Breast cancer metastasis to the spine occurs when cancer cells spread from the breast to the spinal column, commonly affecting the vertebrae. This is one of the most common tumors to spread to the spine and often carries an excellent prognosis. Key drivers of patient outcomes include hormone receptor status (Estrogen receptor, progesterone receptor, and HER2-neu), extent of disease, and functional status of the patient when beginning treatment. Treatment may include systemic therapies such as chemotherapy, hormone therapy, and targeted therapy, along with radiation therapy and/or surgical interventions to stabilize the spine and alleviate symptoms.

Lung cancer metastasis to the spine occurs when cancer cells spread from the lungs to the spinal column, commonly affecting the vertebrae. This tumor comes in many different varieties, including small cell and non-small cell. The non-small cell variant is by far the most common (85%) and may carry an excellent prognosis depending on the genetics of the tumor. Key drivers of patient outcomes include genetic mutation status (EGFR, ALK, ROS1 are the most common mutations which are generally favorable), extent of disease, and functional status of the patient when beginning treatment. Treatment includes systemic therapies such as chemotherapy, targeted therapy, and immunotherapy, along with radiation therapy and surgical interventions to stabilize the spine and relieve symptoms. The primary aim is to manage pain, maintain neurological function, and improve the patient’s quality of life.

Multiple myeloma, a type of systemic blood cancer originating in plasma cells, commonly metastasizes to the spine. This may lead to the formation of osteolytic lesions (holes in the bone) or tumor cells compressing the nerves, which can in turn result in back pain, fractures, or spinal cord compression. A unique feature of myeloma is that it is extremely sensitive to radiation and chemotherapy, and in many cases surgery is not necessary. Treatment typically includes chemotherapy, targeted therapy, immunotherapy, and bone-strengthening agents such as bisphosphonates or denosumab. Radiation therapy and rarely surgical interventions may also be necessary to stabilize the spine, alleviate pain, and manage neurological complications, aiming to improve the patient’s quality of life.

Lymphoma metastasis to the spine occurs when cancerous lymphocytes spread to the spinal column, leading to symptoms such as back pain, neurological deficits such as numbness and weakness, and potentially even spinal cord compression. A unique feature of lymphoma is that it is extremely sensitive to radiation and chemotherapy, and in many cases surgery is not necessary. Treatment often includes systemic therapies such as chemotherapy and immunotherapy, radiation therapy to target spinal lesions, and rarely surgical interventions to stabilize the spine and relieve symptoms. The primary goals are to manage pain, preserve neurological function, and improve the patient’s quality of life.

Prostate carcinoma metastasis to the spine occurs when cancer cells spread from the prostate to the spinal column. Classically, these metastases create a dense or blastic bone response. This tumor often carries an excellent prognosis because it is very responsive to hormonal therapies. Treatment typically includes systemic therapies such as hormone therapy, chemotherapy, or targeted therapy, along with radiation therapy and possibly surgical interventions to stabilize the spine and alleviate symptoms. The main goals are to manage pain, maintain neurological function, and improve the patient’s quality of life.

Colon and gastrointestinal (GI) cancers can metastasize to the spine. When these cancers spread to the spinal column, they can cause significant back pain, neurological symptoms such as numbness, weakness, or paralysis, and potentially spinal cord compression. These are difficult tumors to treat because they are not very responsive to radiation or chemotherapy, and thus thorough and complete surgery is often critical to control them and prevent damage to the spinal column or nerves. Nevertheless, treatment focuses on systemic therapies such as chemotherapy and targeted therapy, radiation therapy to alleviate pain and control tumor growth, and surgical interventions to stabilize the spine and prevent fractures. The primary goals are to manage pain, maintain neurological function, and improve the patient’s quality of life.

Renal cell carcinoma (RCC), a type of kidney cancer, often metastasizes to the spine, leading to significant clinical challenges. When RCC spreads to the spinal column, it can cause severe back pain, neurological deficits such as numbness, weakness, or paralysis, and potentially spinal cord compression, which is a medical emergency. These are difficult tumors to treat because they are not very responsive to radiation or traditional chemotherapy, and thus thorough and complete surgery is often critical to control them and prevent damage to the spinal column or nerves. RCC is a very hypervascular tumor and typically requires a procedure called embolization prior to surgery, which essentially eliminates the blood supply to the tumor prior to surgery. Treatment includes systemic therapies with a strong emphasis on immunotherapy, possibly along with radiation therapy to reduce pain and control tumor growth. Surgical interventions may be required to protect the nerves, stabilize the spine, reduce tumor burden, and alleviate symptoms. The primary goals are to manage pain, preserve neurological function, and improve the patient’s quality of life.

Thyroid carcinoma can metastasize to the spine, causing significant complications. When thyroid cancer spreads to the spinal column, it may result in severe back pain, neurological symptoms such as numbness, weakness, or paralysis, and potentially spinal cord compression. Fortunately, thyroid cancer typically responds well to radioactive iodine treatment or hormonal therapy targeting thyroid hormone. Other options include systemic chemotherapy, radiation therapy, or even surgery to stabilize the spine, protect the nerves, reduce tumor burden, and alleviate symptoms. The primary goals are to manage pain, preserve neurological function, and improve the patient’s quality of life.

Dr. Matthew Colman at Northwestern Medicine in Chicago, Illinois specializes in spine oncology. His patients find him to be a kind, caring, and thorough surgeon, who has a wonderful bedside manner, and is knowledgeable and trustworthy. They note that he takes time to listen to his patients, explains conditions well and answers their questions. Contact Dr. Colman to schedule a consultation.

At a Glance

Dr. Matthew Colman

  • Internationally recognized expertise and thought leadership for a diverse range of spinal problems
  • Patient-specific and humanistic approach which uses the latest technology and techniques
  • Team centered approach prioritizes availability, communication, and support
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