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.² These are examples of cancer types that may affect the spine:²

• Osteosarcoma - this type of cancer usually starts in the cells that form bones
  
• Multiple myeloma - this is a type of cancer that starts in a plasma cell (a type of white blood cell), and then builds in the bone marrow
• Lymphoma - is a type of blood cancer that occurs when abnormal white blood cells (lymphocytes) in the lymphatic system grow in an uncontrolled way. It can form in any part of the body that has lymph tissue
• Chordoma - is regarded as being a rare and slow growing type of bone cancer that usually occurs in the bones of the spine or the skull
• Ewing sarcoma - generally regarded as being a rare type of cancer which forms in any kind of bone or in the soft tissue around the bones

The symptoms of spinal cancer can vary according to the type and location of the cancer. Symptoms may include:^1,3

• Back or neck pain which may be felt in other parts of the body as well, and including pain caused by pinched nerves
• Unexplained change in bowel or bladder function
• Muscle weakness or numbness and tingling
• Difficulty walking or moving
• Back pain that may be more painful during the night

If you are experiencing any of the above symptoms, it doesn't necessarily mean that you have spinal cancer. If you are concerned or would like further information, please speak with your GP or specialist.

There is no clear reason for what causes spinal cancer. There are a number of risk factors however, including:^3,4

• Inherited syndromes, that may include neurofibromatosis 2 and Von Hippel-Lindau disease
  
• Radiation therapy during childhood
• A weakened immune system
• Exposure to certain chemicals that may include ionising radiation

If you meet with your GP and they are concerned about any of your symptoms or risk factors, they may refer you to a specialist. Tests to diagnose spinal cancer may include:³

• Physical examination
• Blood tests – A blood test can help test for abnormal levels of substances in your blood, which may include calcium and alkaline phosphatase. This may be the first step in helping you understand more about any potential changes in your body.
• Biopsy - This involves the removal of a small sample of bone or tissue for examination in a laboratory to determine if the tumour is benign or malignant, and if it is malignant, then what type of cancer it is, how advanced, and if it's growing and spreading. A biopsy can require surgery, however may be done with a needle in some circumstances.
• Imaging scans - These scans may include an X-ray of the spine, a bone scan, a computed tomography (CT) scan, a myelogram, a magnetic resonance imaging (MRI) or a positron emission tomography (PET) scan. These scans aim to check for any potential abnormalities within the spinal cord, nerves, and surrounding spine (bony and soft tissue), and whether the cancer may have spread to any other parts of the body.

Chemotherapy is an approach to cancer therapy that involves the administration of medicine, usually orally or by injection, which is intended to kill cancer cells or minimise their growth and spread. Chemotherapy can be used in conjunction with other cancer treatments.^1,3

Immunotherapy is a type of treatment that is intended to help your own immune system fight cancer. There are different types of immunotherapy for cancer that work in different ways.³

Radiation therapy uses high-energy X-rays or other particles to treat cancer and can be used at all stages.^1,3

Surgery for spinal cancer may be combined with other treatments. It may involve complete or partial removal of a tumour.^1,3

Steroids may be used alone or in combination with radiation therapy treatment.³

This type of treatment is designed and aims to attack specific cancer cells. Targeted therapy medicines mimic antibodies that our bodies naturally produce that target and attach to proteins on cancer cells, making it easier for our immune system to find and destroy the cancer.³

All cancer treatments may have side effects. The type and severity of side effects will vary between individuals.^3,5,6 You can ask your doctor for detailed information about the side effects that you may experience with any treatment recommended for you.

• Rest when needed – it is important to acknowledge when you are fatigued and rest when you need to^5,6
  
• Aim to maintain a healthy diet,⁵ and we also encourage you to think about eating 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 nauseous⁵
• Drink adequate water⁵
• Reach out to support groups and others who have had cancer treatment⁶
• Record your side effects in a diary or journal⁷
• Speak to your doctor about incorporating some gentle exercise into your weekly routine^5,6
• Ask for and accept help from family, friends and neighbours⁶
• Be open with employers about your treatment and discuss flexible working options if you need them