Types & Stages

Spinal Cancer: Types & Stages

1. Vertebral Column Tumors

Primary tumors: These tumors occur in the vertebral column, and grow either from the bone or disc elements of the spine. They typically occur in younger adults. Osteogenic sarcoma (osteosarcoma) is the most common malignant bone tumor. Most primary spinal tumors are quite rare and usually grow slowly.

Metastatic tumors: Most often, spinal tumors metastasize (spread) from cancer in another area of the body. These tumors usually produce pain that does not get better with rest, may be worse at night, and is often accompanied by other signs of serious illness (such as weight loss, fever/chills/shakes, nausea or vomiting).

  • In women, spinal tumors most frequently spread from cancer that originates in the breast or lung.
  • In men, spinal tumors most frequently spread from cancer that originates in the prostate or lung.

2. Intradural­Extramedullary Tumors

Intradural­Extramedullary (inside the dura) tumors grow within the spinal canal (under the membrane that covers the spinal cord) but outside of the nerves. Usually these tumors are benign and slow growing. However, they can cause symptoms of pain and weakness.

Most of these spinal tumors are:

  • Meningiomasthat occur in the membranes surrounding the spinal cord and are usually benign but may be malignant. These tumors are more common in middle age and elderly women.
  • Nerve sheath tumors (schwannomas and neurofibromas)that arise from the nerve roots that come off the spinal cord. Again, this type of tumor is usually benign and slow growing, and it may be years before any neurological problems occur.

3. Intramedullary Tumors

Intramedullary tumors grow from inside the spinal cord or inside the individual nerves and often arise from the cells that provide physical support and insulation for the nervous system (glial cells). These tumors occur most often in the cervical spine (neck). They tend to be benign, but surgery to remove the tumor may be difficult.

The two most common types of intramedullary tumors are astrocytomas and ependymomas.

Stages

The stage of a cancer is a measure of how far it has spread. A staging system is a standard way for the cancer care team to describe the extent of this spread. For most types of cancer, the stage is one of the most important factors in selecting treatment options and in determining the outlook (prognosis).

But tumors of the brain and spinal cord differ in some important ways from cancers in other parts of the body. One of the main reasons other cancers are dangerous is that they can spread throughout the body. Tumors starting in the brain or spinal cord can spread to other parts of the central nervous system, but they almost never spread to other organs. These tumors are dangerous because they can interfere with essential functions of the brain.

Because tumors in the brain or spinal cord almost never spread to other parts of the body, there is no formal staging system for them. Some of the important factors that help determine a person’s outlook include:

  • The person’s age
  • The person’s functional level (whether the tumor is affecting normal brain functions and everyday activity)
  • The type of tumor (such as astrocytoma, ependymoma, etc.)
  • The grade of the tumor (how quickly the tumor is likely to grow, based on how the cells look under a microscope)
  • The size and location of the tumor
  • How much of the tumor can be removed by surgery (if it can be done)
  • Whether or not the tumor has spread through the cerebrospinal fluid (CSF) to other parts of the brain or spinal cord
  • Whether or not tumor cells have spread beyond the central nervous system