Spinal metastases are lesions of the spine that have spread from a cancer originating in another organ.
What causes them?
Spinal metastases arise when a cancer cell breaks away from the original tumour, settles and grows in the bony part of the spine or in the spinal cord. Why cancer cells are able to take these steps in some patients remains unknown, and the question is being actively researched at universities around the world. This is an advanced cancer that is difficult to treat. Long-term remission is often out of reach, but treatment remains important, as it can relieve your symptoms and potentially help you live longer.
How are spinal metastases treated?
Spinal metastases are a complex situation in the context of a malignant systemic underlying disease, so treatment planning is always interdisciplinary, involving the treating oncologists and radiation oncologists as well as neurosurgeons.
The aim of treatment is to relieve symptoms and improve quality of life by shrinking or removing existing spinal tumours and slowing or stopping the growth of new ones.
As with other cancers, doctors often treat spinal metastases with a combination of methods such as radiotherapy, surgery and chemotherapy. Technological advances and other improvements in cancer care 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?
As the prognosis for cancer patients improves, spinal metastases are being diagnosed more and more often. They currently occur in 10% of all cancer patients. Men are affected slightly more often than women. The diagnosis is most often made in middle-aged patients (40 to 65 years). Metastases are very rare in children.
After the liver and lungs, bone is the third most common site of metastasis, and 2/3 of these bone metastases affect the spine. Spread to the spine usually occurs via the bloodstream. The vertebral bodies are usually affected first. As the metastases continue to grow, from transpedicular to epidural, the spinal cord comes under increasing pressure. The vast majority of spinal metastases stay outside the dura mater, so intradural spread occurs in only 2–4% of cases and intramedullary spread in only 1–2% of cases.
In principle, any type of malignant tumour can lead to spinal metastases. Lung, breast, gastrointestinal and prostate cancer, renal cell carcinoma and lymphoma are, however, particularly common, accounting for about 80% of patients.
Choosing the treatment
The choice of treatment depends on the type of primary carcinoma, its location, the stability of the spine, the duration and severity of symptoms and the patient’s general condition. Various classification systems help decide whether surgery is needed and, if so, what type. These classifications are not universally applicable, however, and so do not always help in decision-making. Rather, they serve as guides in what is essentially an interdisciplinary decision-making process.
The main aim of treatment is to shrink the tumour or remove it completely, relieving pressure on the spinal cord and affected nerve roots and easing pain.
