Causes of Cancer of Spine Pain
Spinal pain from cancer could be from various reasons:
Spinal tumor: An abnormal growth of cells within the spine. They can be either cancerous (malignant) and spread uncontrollably, or noncancerous (benign). There are two general types of spinal tumors:
Primary tumors occur straight from the spinal column.
Metastatic tumors spread to the spine from another part of the body that had a tumor. These are cancerous, and about 90% of spinal tumors are diagnosed as metastatic.
Other cancer-related pain can be from:
Surgery: Surgery to remove a cancerous tumor could have injured a nerve or created painful scars.
Radiation therapy & chemotherapy: These common treatments for cancer can cause widespread nerve pain and muscle pain.
X-ray of a spinal tumor.
Cancer of Spine Pain Symptoms
You may not have any symptoms in the beginning stages of spinal cancer. Over time, when tumors have increased in size, the chance for pain increases. Symptoms of spinal cancer and spinal tumors will vary based on size and location, but can include:
- Back pain & neck pain (most common)
- Nerve problems related to spinal tumors:
- Radiculopathy (pinching of the nerve roots)
- Myelopathy (spinal cord compression)
- Bladder and bowel problems
- Numbing, tingling, muscle weakness
- Rarely, loss of function (paralysis)
If the tumor grows large enough, it can also cause scoliosis, kyphosis, and other deformities of the spine curvature.
Prognosis
The prognosis for spine cancer can depend on numerous factors, including the patient’s overall health, whether the tumor in the spine is primary or metastatic, and age of the patient. It also includes what stage of cancer it is at when it is discovered. In general, survival rates of primary tumors are anywhere from a month to two years.
Impact of Spine Pain from Cancer
When cancer patients experience their back pain, many other things are affected, such as:
- Decreased appetite & weight loss
- Decreased sleep, mood, & energy levels
- Increased dosage of medications
If pain levels are too great for the patient, they often feel discouraged from pursuing treatments for their cancer, and some patients develop depression as a result of the difficulties of dealing with the pain as well.
Diagnosis of Cancer of Spine Pain
Diagnosing cancer of spine pain typically involves:
Full Medical History: Discussion of symptoms, past medical conditions, and any history of cancer/tumors.
Physical Examination: Assessment of spine and overall body for tumor growth.
Neurological Examination: Includes pain and function assessment.
Diagnostic Imaging: X-rays, CT scans, and MRI scans to determine the source of pain and type of tumor (primary vs. metastatic), along with a biopsy. The biopsy may require surgery, but oftentimes involves a needle to reach the tumor and extract a sample. Myelography (contrast dye injection followed by imaging), bone scans, and PET scans may also be required in some cases.
Blood tests: Blood tests are sometimes used to diagnose and screen for cancer, and also to help determine where a metastatic (secondary) tumor in the spine originally came from.
Treatment of Cancer of Spine Pain
Treatment of cancer and spinal tumors will differ depending on their types, aggressiveness, along with various other factors.
Cancer Treatments may include:
Chemotherapy: Drug treatment that uses powerful chemicals to kill the mutant, multiplying tumor cells in your body.
Radiation Therapy: Uses high-energy beams to kill cancer cells.
Full or Partial Removal of Tumors: Targeted surgery to remove the tumors and prevent them from further growing and causing damage to the spine, or from spreading elsewhere in the body.
Steroids: To help with swelling and back pain.
Cancer Pain Management: Several methods could be used to help the patient deal with all the different types of pain associated with spinal cancer and tumors.
Opioids may be prescribed, depending on the severity of the pain.
Spinal Cord Stimulation (SCS) is an innovative technology that can be used for nerve-related pain in the back for patients.
Nerve blocks can also treat many types of pain, including in bone and tissue. A fast-acting local anesthetic can be applied to the affected area, and is done under fluoroscopy (X-ray) or ultrasound guidance for safety and accuracy.
Sympathetic injections can also be used to treat nerve pain that involve sympathetic nerves, which spread from the spine to the body to help control involuntary functions (blood flow, temperature regulation, etc.).
Peripheral Nerve Stimulation (PNS) is used to block pain signals from damaged nerves. A small electrical device is implanted near the damaged nerve to interrupt those signals.
Intrathecal (IT) Pumps are small devices that deliver pain relief medications directly to the spinal cord. This direct delivery ensures quicker and stronger effects than medications taken by mouth. The pump is often a last resort treatment for cancer patients
Acupuncture or Chiropractic Care: Some patients find relief through alternative therapies.
