Spinal 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

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.

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

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

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.

• 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

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.

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.

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

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.

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.

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