A spinal cord cancer diagnosis can change nearly every aspect of a person’s life. Beyond the fear and uncertainty that come with cancer, tumors affecting the spinal cord can threaten mobility, independence, sensation, bladder and bowel function, and the ability to participate in everyday activities. They may also affect sexual function, intimacy, relationships, emotional well-being, and a person’s vision for the future.
Because the spinal cord carries messages between the brain and much of the body, a tumor in or around it can cause symptoms that extend far beyond the back. The effects depend on the tumor’s type, location, size, and growth rate, as well as the treatments required.
Understanding spinal cord cancer, its warning signs, treatment options, and potential long-term effects can help patients and their loved ones prepare for the journey ahead.
What Is Spinal Cord Cancer?
The spinal cord is part of the central nervous system. It runs through a protective canal in the backbone and carries signals that help control movement, sensation, and many automatic body functions.
The term spinal cord cancer is sometimes used broadly to describe tumors affecting the spinal cord or nearby structures. However, there are important differences between these conditions.
- Primary spinal cord tumors begin in the spinal cord or nearby tissues.
- Secondary or metastatic tumors develop when cancer that began elsewhere in the body spreads to the spine or, less commonly, directly to the spinal cord.
- Spinal tumors involving the vertebrae affect the bones of the backbone and may compress the spinal cord, even though they did not originate in the cord itself.
Most tumors found in the bones of the spine are metastases from cancers elsewhere in the body, while tumors that actually begin in the spinal cord are much less common. Some spinal cord tumors are cancerous, while others are noncancerous but can still cause serious problems because of their location.
The distinction matters because the tumor’s origin and exact diagnosis help determine the most appropriate treatment.
Types of Spinal Cord Tumors
Spinal cord tumors are classified according to the cells involved and where the tumor develops.
Ependymomas
Ependymomas arise from cells associated with the fluid-filled spaces of the central nervous system. Some develop within the spinal cord. Their behavior varies, and treatment depends on the tumor’s grade, location, and whether it can be safely removed.
Astrocytomas
Astrocytomas develop from astrocytes, cells that support the nervous system. They can grow within the spinal cord and vary from relatively slow-growing tumors to more aggressive cancers. Their location can make complete surgical removal difficult.
Meningiomas
Meningiomas develop in the membranes surrounding the spinal cord. Many are noncancerous and grow slowly, but they may press against the cord and interfere with nerve function as they enlarge.
Nerve sheath tumors
Tumors such as schwannomas develop from the protective coverings of nerves. Many are benign, but they can cause pain, tingling, numbness, or weakness by pressing on nearby nerve structures.
Metastatic tumors
Cancer from another part of the body, including the breast, lung, or prostate, may spread to the vertebrae or structures surrounding the spinal cord. These tumors can cause pain, weaken the spine, and compress the spinal cord or nerve roots. Treatment usually addresses both the pressure on the nervous system and the original cancer.
These examples represent different conditions rather than a single disease. A specialist may use MRI, other imaging tests, and sometimes a biopsy or surgical tissue sample to establish the diagnosis.
Symptoms of Spinal Cord Cancer
Symptoms vary according to where a tumor develops and which nerves or structures it affects. Some symptoms progress gradually over weeks or months, while others can worsen rapidly.
Back or neck pain
Persistent back pain is a common symptom. Pain may be localized to the spine or radiate into the shoulders, arms, chest, hips, or legs. It may become worse at night, while lying down, or with coughing or straining.
Pain alone does not mean someone has a spinal tumor, but persistent, unexplained, worsening pain deserves medical evaluation, particularly in someone with a history of cancer.
Numbness, tingling, or changes in sensation
A person may experience pins and needles, burning sensations, unusual sensitivity, or reduced feeling in the arms, hands, legs, or feet. Some people experience pain in an area where sensation has changed.
Muscle weakness and mobility problems
Tumors can interfere with nerve signals controlling muscles. Symptoms may include:
- Weakness in the arms or legs.
- Difficulty climbing stairs or standing from a chair.
- Problems with balance and coordination.
- Frequent stumbling or falls.
- Muscle stiffness, spasms, or involuntary contractions.
- Difficulty walking or, in severe cases, paralysis.
The location of the tumor helps determine which parts of the body are affected.
Bladder and bowel changes
Pressure or damage involving spinal pathways may affect the ability to empty the bladder, recognize the need to urinate, or control urination and bowel movements.
Symptoms can include urinary retention, incontinence, constipation, or loss of bowel control. These changes may be difficult to discuss, but they are medically important and should not be ignored.
Sexual and reproductive changes
Because spinal pathways contribute to sexual arousal, genital sensation, erections, lubrication, orgasm, and ejaculation, a tumor may affect sexual function. Changes can occur alongside pain, weakness, altered sensation, or bladder and bowel symptoms.
Other symptoms
Depending on the tumor and its location, a person may also experience reduced stamina, difficulty performing physical tasks, or symptoms related to the cancer’s original site if the tumor is metastatic.
Important warning: New or rapidly worsening weakness, difficulty walking, loss of bladder or bowel control, inability to urinate, or numbness around the groin or buttocks can indicate spinal cord or nerve compression. These symptoms require emergency medical assessment. Rapid treatment may be essential to prevent permanent nerve damage.
How Is Spinal Cord Cancer Treated?
Treatment is individualized. Doctors consider the tumor’s type, grade, location, size, growth rate, whether it has spread, and the patient’s overall health and goals.
The main approaches include surgery, radiation therapy, medication-based treatments, and supportive rehabilitation. Some patients need a combination of treatments, while others may be candidates for close monitoring.
Surgery
Surgery may be recommended to remove as much of a tumor as safely possible, obtain tissue for diagnosis, or relieve pressure on the spinal cord.
The goal is to control the tumor while protecting the delicate nerves responsible for movement, sensation, and bodily functions. Some tumors can be removed completely; others are too closely connected to important nerve tissue for complete removal to be safe.
Possible complications include pain, infection, bleeding, spinal instability, and changes in neurological function. Recovery varies considerably depending on the procedure and the condition of the spinal cord before surgery.
Radiation therapy
Radiation therapy uses focused energy to damage cancer cells and control tumor growth. It may be used after surgery, instead of surgery in certain circumstances, or to treat tumors that have spread to the spine.
Techniques may include conventional external-beam radiation or highly focused approaches such as stereotactic radiation, when appropriate for the tumor’s location and clinical situation.
Potential side effects include fatigue, skin irritation in the treatment area, and inflammation of nearby tissues. Depending on the location, dose, and treatment method, there may also be risks to the spinal cord and surrounding nerves. The radiation oncology team explains the expected risks and precautions for each treatment plan.
Chemotherapy and other medicines
Chemotherapy is used for certain tumor types but is not effective against every primary spinal cord tumor. Other medicines may include targeted therapies for cancers with particular molecular features, or treatments aimed at the original cancer when a tumor has spread from elsewhere.
Corticosteroids may sometimes be prescribed to reduce swelling around the spinal cord, especially when compression is present. They do not eliminate the tumor itself and must be used under medical supervision.
Active surveillance
Some small, slow-growing tumors may be monitored with periodic MRI scans and neurological assessments rather than treated immediately. This approach may be appropriate when a tumor is not causing significant symptoms and the risks of treatment outweigh the benefits of immediate intervention.
Monitoring does not mean ignoring the tumor. New symptoms or changes in imaging may lead the care team to recommend treatment.
Rehabilitation and supportive care
Physical therapy, occupational therapy, pain management, and rehabilitation can help people maintain or regain strength, mobility, and independence.
Depending on a person’s needs, care may also involve specialists in bladder and bowel management, sexual health, rehabilitation medicine, mental health, and palliative care. Palliative care can help manage symptoms and improve quality of life at any stage of a serious illness; it does not automatically mean someone is nearing the end of life.
Clinical trials may offer additional options for selected tumor types.
Treatment plans should be developed with a multidisciplinary team that may include a neurosurgeon, neuro-oncologist or medical oncologist, radiation oncologist, rehabilitation specialists, nurses, and other professionals.
Citations.
Cancer.org
NIH
Mayo Clinic
City of Hope
Empowering Intimacy