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  • Patients
  • Exploring cancer care
  • Conditions we treat
  • Spinal cancer

Introduction

Spinal cancer

Cancer that starts in the spine is known as primary spine cancer. It is a rare disease caused by cancerous cells that form tumours in the spinal column (backbone) or spinal cord (nerve tissue inside the spine). 

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Spinal cancer

Chapter 01

What is spinal cancer?

Cancer that starts in the spine is known as primary spine cancer. It is a rare disease caused by cancerous cells that form tumours in the spinal column (backbone) or spinal cord (nerve tissue inside the spine).

Cancer can also start in other parts of your body and spread to your spine. This is known as secondary (metastatic) cancer and is more common than primary spine cancer1. If you or a loved one have secondary spine cancer, you may benefit from reading this information together with information about your primary cancer.

 

Types of primary spine cancer

Spinal cancer is an umbrella term for many different types of cancer that can form in the bones, tissue, fluid or nerves of the spine. These are examples of cancer types that may affect the spine:

  • Osteosarcoma – this type of cancer can start in any kind of bone, including the spine
  • Multiple myeloma – this is a blood cancer that may affect the bone marrow of the spine
  • Lymphoma – this is a type of cancer that affects the immune system. Although it may start in the spine, it’s more likely to start elsewhere in the body and spread to the spine
  • Chordoma – this bone cancer can arise anywhere along the spine but is most common in the sacrum at the base of the spine
  • Ewing sarcoma – this is a type of cancer that can start in the bone or soft tissue of the spine
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Symptoms of spine cancer

The symptoms vary according to the type and location of the cancer. They may include:

  • back or neck pain, including pain caused by pinched nerves
  • unexplained change in bowel or bladder function
  • muscle weakness or numbness and tingling
  • difficulty walking or moving

Experiencing any of these symptoms doesn’t mean you have spine cancer, but you should see your doctor for a check-up.

What causes spine cancer?

The different types of spine cancer have various risk factors. These include:

  • inherited genetic conditions, like Li-Fraumeni syndrome and hereditary retinoblastoma2
  • Paget’s disease2
  • Spinal radiation therapy or chemotherapy during childhood
  • exposure to benzene and ionizing radiation3

 

Diagnosis

Chapter 02

Diagnosing spinal cancer

Your GP will probably refer you to a specialist if they are concerned about your symptoms and risk factors for spinal cancer. Tests to diagnose spinal cancer may include:

  • Blood tests – a full blood count can’t diagnose cancer on its own, but it is often the first step in telling doctors what is going on in your body
  • Biopsy – this involves the removal of a small sample of bone or tissue for examination in a laboratory to determine if cancer is present and, if so, what type of cancer it is. A biopsy may require surgery but can be done with a needle in some cases
  • Imaging tests – these might include X-rays, a bone scan, a CT scan, a myelogram, an MRI or a PET scan to check for abnormalities or if cancer has spread to other parts of your body
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Treatments

Chapter 03

Treatment for spinal cancer

Treatment for spinal cancer

Treatment for spine cancer will depend on the type of cancer, how advanced it is and your individual circumstances and preferences. Treatments may include one or a combination of:

  • chemotherapy
  • immunotherapy
  • radiation therapy
  • surgery
  • steroids
  • targeted therapy
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Chemotherapy is used to destroy or damage cancer cells. Chemotherapy may be used in combination with surgery to either shrink the tumour before surgery or to kill any cancer cells left behind after surgery.

Immunotherapy helps your body’s immune system kill cancer cells. Immunotherapy may be used alone or in conjunction with chemotherapy. 

Radiation therapy uses X-rays to damage or kill cancer cells. In spine cancer, it may be given before surgery to shrink a tumour and make it easier to remove, or it may be given after surgery to reduce the chance of cancer cells returning.

Surgery for spinal cancer is often combined with other treatments. It may involve complete or partial removal of a tumour.

Steroids may be used alone or in combination with radiation therapy. They may help reduce swelling in the spine, which can help reduce pain and improve nerve function.

Targeted drug treatments attack specific features of cancer cells. Targeted drug treatments may be used alone or in conjunction with chemotherapy. 

Your treatment with GenesisCare

Chapter 04

Your treatment with GenesisCare

A cancer diagnosis is life changing. Even before your initial encounter with us you will experience a wave of emotions. It’s natural to feel disbelief, anxiety, sadness, anger and loneliness. At GenesisCare we understand these emotions and strive to strengthen your confidence, settle your emotions, and create care experiences for the best possible outcomes.

Our care team know your name and get to know who you are as a person. We don’t want you to feel alone when you’re at GenesisCare. Your nursing team and oncology team are here to support you before, during and after your cancer treatment. We are here to guide you to get the support you need which may include a psychologist, exercise physiologist, physiotherapist and dietitian.

Please contact your local GenesisCare centre for more details on services available. View a list of our centres here.

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Side effects

Chapter 05

Side effects

Side effects of chemotherapy for spinal cancer

Whether you experience side effects, and how severe they are, depends on the type and dose of chemotherapy treatment you are given and your reaction from one treatment cycle to the next. Most side effects are short-term and can be managed. These may include but are not limited to:

  • fatigue
  • nausea or vomiting
  • constipation or diarrhoea
  • potential hair loss in the treated area
  • temporary loss of libido
  • temporary loss of erection
  • lower sperm production

These symptoms tend to improve gradually once treatment stops. Talk to your doctor or nurse if you feel upset or anxious about how long treatment is taking or the impact of side effects.

What can I do to help my chemotherapy treatment go smoothly?

  • Get as much rest as possible
  • Aim for a wholefood, varied diet, but we also encourage you to eat foods that interest you rather than what you think you should eat
  • Appetite changes are common, and you may experience taste changes or nausea. Help manage this by eating small, frequent snacks and avoiding smells that make you nauseated
  • Drink lots of water
  • Reach out to support groups and others who have had chemotherapy
  • Ask your team about topical treatments for your skin if you have irritation or pain
  • Stay out of the sun as much as possible throughout your treatment
  • Record your side effects in a diary or journal
  • Take some gentle exercise, such as walking, if you feel up to it. Light to moderate exercise can reduce treatment-related fatigue and improve your mood. Plan your exercise for times in the day when you know you have more energy
  • It is important to acknowledge when you are fatigued and rest when you need to
  • Ask for and accept help from family, friends and neighbours
  • Be open with employers about your treatment and discuss flexible working options if you need them

Side effects of immunotherapy for spine cancer

General side effects include but are not limited to:

  • fatigue
  • nausea
  • coughing
  • skin rashes or itching
  • diarrhoea
  • low blood pressure
  • high fevers

Talk to your doctor or nurse if you are concerned about your treatment or side effects.

Side effects of radiation therapy for spine cancer

General side effects may include but are not limited to:

  • soreness and swelling around the treatment area
  • tiredness and lethargy after you finish
  • potential hair loss in the treated area
  • nausea
  • diarrhoea

Most of these side effects will ease soon after treatment is finished. However, your team will discuss any long-term considerations with you, depending on the tumour type.

Side effects of surgery for spinal cancer

Your doctor will talk to you about any risks before surgery. General side effects of surgery include pain and swelling.

Side effects of steroid therapy for spine cancer

General side effects include:

  • increased blood sugar
  • swelling of the lower legs or hands
  • infections
  • weakness in the arms and legs
  • stomach upsets, nausea or pain

Talk to your doctor or nurse if you are concerned about your treatment or side effects.

Side effects of targeted therapy for spine cancer

General side effects include but are not limited to:

  • nausea
  • fatigue
  • mouth sores
  • loss of appetite
  • cough
  • changes in your voice

Talk to your doctor or nurse if you are concerned about your treatment or side effects.

Helpful services

Chapter 06

Helpful services

Cancer information, resources and support services are available to assist you during your cancer journey. These include:

 

Cancer Council Australia

13 11 20

cancer.org.au

 

Australian Cancer Research Foundation

02 9223 7833

acrf.com.au

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References

  1. Kumar N et al. An overview of the tumors affecting the spine—inside to out. Neurooncol Pract; 2020.  https://academic.oup.com/nop/article/7/Supplement_1/i10/5987753?
  2. Brown HK et al. Biology of Bone Sarcomas and New Therapeutic Developments. Calcif Tissue Int; 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805807/
  3. Theodoros N et al. Risk Factors for Multiple Myeloma: A Systematic Review of Meta-Analyses. Clinical Lymphoma Myeloma and Leukemia; 2015. https://www.sciencedirect.com/science/article/abs/pii/S2152265015003808

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Radiation therapy may be offered in the early stages of cancer treatment, or after it has started to spread. There are different radiation therapy techniques which may be suitable for different cancer types at different stages.

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