Metastases in the spine
Metastases in the spine are lesions in the spine that have spread from cancer originating in another organ.
What causes this?
Metastases in the spine occur because cancer cells from the primary tumor exit, deposit, and grow in the bony part of the spine or spinal cord. The reason why cancer cells can perform these steps in some patients is unknown. This issue is actively being researched at universities around the world. It is an advanced stage of cancer that is difficult to treat. Long-term remission is often not possible, but treatment remains important as it can help alleviate your symptoms and potentially help you live longer.
What is the treatment for spinal metastases?
.Spinal metastases present a complex situation in the context of malignant systemic primary disease, so treatment planning always involves interdisciplinary collaboration with oncologists radiation oncologists, and neurosurgeons.
The goal of treatment is to relieve symptoms and improve the quality of life by reducing or removing existing spine tumors and slowing or halting the growth of new ones.
As with other types of cancer, doctors often treat spinal metastases using a combination of treatment methods such as radiation therapy, surgery, and chemotherapy. However, advancements in cancer treatment technology and other improvements have made the treatment of spinal metastases more precise and effective, further improving patient outcomes.
Treatment in Switzerland offers advanced world-class medical care, including radiosurgery, for patients with spinal metastases.
How common are spinal metastases?
Due to improved prognosis for cancer patients, spinal metastases are being diagnosed more frequently. Currently, they are found in 10% of all cancer patients. Men are slightly more affected than women. The diagnosis is most often made in middle-aged patients (between 40 and 65 years old). Spinal metastases are very rare in children.
After the liver and lungs, bones are the third most common site of metastasis, with two-thirds of these bone metastases affecting the spine. Spinal metastasis usually occurs through the bloodstream. Initially, vertebral bodies are most commonly affected. However, as metastases continue to grow from transpedicular to epidural, the spinal cord is subjected to increasing pressure. The vast majority of spinal metastases do not invade the dura mater, so intradural spread occurs in only 2-4% of cases, and intramedullary spread occurs in only 1-2% of cases.
In principle, any type of malignancy can lead to spinal metastases. However, lung cancer, breast cancer, gastrointestinal tract cancer, prostate cancer, renal cell carcinoma, or lymphoma are particularly common, occurring in about 80% of patients.
Choice of therapy
The choice of therapy depends on the type of the primary carcinoma, the location, stability of the spine, duration and severity of symptoms, and the patient's overall condition. Various classification systems help determine if surgery is necessary and, if so, what type of surgery. However, these classifications are not universally applicable and therefore do not always assist in decision-making. Instead, they serve as guidelines for what is essentially an interdisciplinary decision-making process.
The main goal of therapy is to reduce or completely excise the tumor to relieve pressure on the spinal cord and affected nerve roots and achieve pain relief.