Have you been having back pain for a while? Does this pain sometimes get worse at night? We often think that this kind of pain is normal due to fatigue and bad posture. But sometimes, there can be a more serious reason behind it. Today we are going to talk about a topic that is a bit serious, but we should all be aware of. That is, tumors that develop in the spine, or spinal cord, or 'Spinal Tumors'.
Simply put, what is a spinal tumor?
A spinal tumor is an abnormal growth of cells that forms in or around your spinal column or spinal cord. Just like tumors can form in other parts of our bodies.
To understand this a little more, let's take a look at our spine.
- Spine/Backbone: This is the tower-like structure made up of interconnected bones (vertebrae) that runs from our skull to our buttocks. It is what gives our body the strength to stand upright.
- Spinal Cord: This is a cord-like part of our brain that runs down from our brain and is made up of a large number of nerve fibers. It is protected by the spinal cord that we mentioned earlier. It is through this spinal cord that messages are carried from the brain to the rest of the body, and messages are carried from the body to the brain.
Now you understand how important these two parts are, right? So if a tumor develops in such an important place, it's something to be concerned about.
These tumors can be benign or malignant . However, it is not good to just assume that they are not cancerous. Because, even some non-cancerous tumors can grow large and press on the spinal cord or nerves, causing serious problems.
There are two ways these tumors form.
There are two main ways that spinal tumors form. Understanding this is also very important for treatment.
1. Primary Spinal Tumors: These are tumors that first develop in the spine. This means that the tumor begins in the spine. These are relatively rare.
2. Metastatic or Secondary Spinal Tumors: This is the most common type. What happens here is that cancer cells that have started elsewhere in the body (for example, the lung, breast, prostate) travel through the bloodstream and settle in the spinal cord, where they grow into a tumor.
Simply put, many tumors found on the spine are not actually those that started in the spine, but rather are cancer that has spread from elsewhere in the body.
How do you classify spinal tumors?
Doctors divide these tumors into several types. This makes it easier to accurately understand the disease and determine the best treatment.
Depending on the location in the spine
Our spine is divided into several sections. They are also classified according to where the tumor is located.
| Spinal area | Simply put, |
|---|---|
| Cervical vertebrae | Neck area |
| Thoracic | At chest level, mid-back |
| Lumbar vertebrae (Lumbar) | Lower back |
| Sacrum | The lowest part of the spine, between the hip bones |
These tumors are most often seen in the thoracic and lumbar regions.
Depending on the location along the spinal cord
This is a little deep, but it's important to understand.
- Intramedullary: These tumors develop inside the spinal cord itself. These are somewhat rare.
- Intradural-extramedullary: There is a thin membrane-like covering (dura) around the spinal cord . These tumors develop inside that covering, but outside the spinal cord.
- Extradural: These arise outside the spinal cord. That is, in the bones of the spine (vertebrae). The majority of spinal tumors belong to this type.
Back pain is the main symptom!
The symptoms of spinal tumors depend on many factors. The location, size, and type of tumor can affect this. Some small tumors may not show any symptoms at all. However, symptoms may appear when the tumor grows larger and begins to press on nearby nerves.
Pay special attention to these symptoms:
| Symptom | A description about it |
|---|---|
| Back pain | This is the most common symptom . This pain is different from a normal backache. If the pain increases, especially at night , it is something to be concerned about. The pain may increase when sneezing, coughing, or exercising. This pain may not be relieved by ordinary painkillers. |
| Radicular pain | You may feel a sharp pain that travels from your back to your hips, legs, and arms. It may feel like someone is stabbing you with a knife. |
| Numbness and loss of sensation | Numbness in areas such as the hands, feet, and chest, or loss of sensation to touch, heat, or cold in those areas. |
| Muscle weakness | You lose strength in your limbs. You have difficulty walking, you can't lift things, and you may fall frequently while walking. |
| Loss of bowel and bladder control | You may experience incontinence, which is a more serious symptom. |
| Change in the shape of the spine | Some large tumors can cause conditions such as scoliosis. |
The most important thing is that if you have persistent back pain that doesn't improve with regular treatment, especially at night, you should definitely see a doctor . This is especially important if you have had cancer in the past.
How to diagnose the disease? (Diagnosis)
When you go to see a doctor, he will listen carefully to your symptoms. Then he will examine you. He will do a neurological examination, which will check your muscle strength, sensation, and reflexes.
In addition, the following tests may be performed to confirm the diagnosis:
- Imaging Tests (scans):
- MRI scan: This is the best and most accurate way to find a spinal tumor. An MRI can produce very clear images of the spinal cord, nerves, and surrounding tissues.
- CT scan: This can provide a better understanding of the condition of the bones of the spine.
- X-ray: Sometimes an X-ray may be done as a preliminary test.
- Biopsy: This involves taking a very small piece of tissue from the tumor and examining it under a microscope. This is what determines exactly whether the tumor is cancerous or not, and what type it is.
- Bone Scan: This test may be done if there is a suspicion that cancer has spread to the bones from elsewhere in the body.
- Blood Tests: Some types of cancer can cause changes in the levels of certain substances in the blood (e.g. calcium). Blood tests can also help check for this.
What are the treatments?
The treatment plan will vary from person to person. It depends on the type, size, location of the tumor, and your overall health. The main goals of treatment are to:
- Pain reduction.
- Protecting or improving the function of the spinal cord and nerves.
- Increasing quality of life and lifespan.
A team of doctors from various specialists usually comes together for treatment.
There are several main treatment methods:
1. Surgery: Whenever possible, especially if the tumor is pressing on nerves, surgery is performed to remove all or part of the tumor. Some noncancerous tumors can be cured if completely removed. However, some tumors located within the spinal cord are difficult to completely remove without damaging the nerves.
2. Radiation Therapy: This uses high-energy rays (like X-rays) to destroy cancer cells or shrink the tumor. When the tumor shrinks, pain and other symptoms are reduced.
3. Chemotherapy: This involves giving the body drugs that kill cancer cells. These can be given as pills or injections.
4. Stereotactic Radiosurgery: This is not surgery. It is a technique that delivers a very precise, targeted, high-dose beam of radiation only to the tumor. This causes very little damage to the surrounding healthy tissue.
5. Monitoring: If you have some non-cancerous, asymptomatic, small tumors, your doctor may decide not to treat them at all, but to just watch the tumor for growth with regular MRI scans.
Situations where you need to go to the hospital urgently
If you are being treated for a spinal tumor and develop new symptoms or if existing symptoms worsen, go to the nearest Emergency Department (ETU) immediately.
Whatever the treatment method, it will be decided by your doctor and your medical team. So, don't decide on your own treatment based on what you read on the internet or what others say. Discuss all your questions with your doctor.
Take-Home Message
- If you have back pain that is different from a normal backache, especially at night , and does not respond to regular painkillers, don't ignore it.
- If back pain is accompanied by numbness, weakness, or difficulty controlling urine/feces , it is an emergency. Seek immediate medical attention.
- Not all tumors that form on the spine are cancerous. There are also benign tumors. But they can also cause damage by pressing on nerves.
- If someone who has had cancer elsewhere in the body develops new back pain, it is very important to notify their doctor immediately , as it may be a sign of cancer spreading.
- Early detection and proper treatment can often yield good results. So don't be afraid of the symptoms, and if you have any doubts, see a doctor for a checkup.
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