Semmes-Murphey Neurologic & Spine Institute

The National Cancer Institute estimates that there are currently 10.8 million cancer survivors living in the United States, which is an astounding 3.7 percent of the population. Fourteen percent of these long-term survivors were diagnosed over twenty years ago. That’s great news and speaks to better awareness and prevention, earlier detection, and of course, the availability of better treatments.

As patients diagnosed with cancer are living longer, the prevalence of tumors involving the spine has also increased. For example, it is also estimated that 70 percent of cancer patients have evidence of metastatic disease (tumor spreading to other parts of the body) at time of death. When present, the spine is the most commonly affected part of the skeleton. The most common tumors that affect the spine are those most common in the population: lung, breast, prostate, colorectal, and hematopoietic malignancies. Essentially, any cancer can spread to the spine.

What does this mean and why is it so important? When tumors invade the spine, the spinal cord is at risk. Not only can the tumor cause pain from weakening or fracturing of the bone, but the tumor can push against the spinal cord and cause numbness, bowel and bladder dysfunction, weakness, or even complete paralysis. Our goal is to catch the tumor early and intervene quickly to prevent decline or to restore function. Once weakness or incontinence begins it is often difficult to regain function. Our goal is to educate patients and the treating physician to have a heightened level of suspicion that results in early detection.

Early detection leads to earlier intervention which allows us to employ a more diverse and tailored treatment program. Not every spine tumor requires surgery. Chemotherapy, radiation, and surgery are all tools employed in combination with each other or alone to offer each patient the best chance at long-term disease control, or in some circumstances, the possibility of cure.

A shift in the management of spine tumors began in the 1990s with the arrival of complex spinal instrumentation. Prior to this time, spine tumors were widely sent to radiation because we did not have good techniques to resect all the disease and stabilize the remaining spine. There are now several reports in the medical literature that show that surgery, oftentimes followed by radiation, offers better pain control, longer functional status, and even better restoration of function. In other words, with better surgery, we are keeping our patients walking longer, keeping their pain under control more successfully, and allowing them to accomplish their goals.

Semmes-Murphey Neurologic and Spine Institute offers the resources to treat spine tumors in a comprehensive and multi-disciplinary approach. An emphasis is placed on communicating with the oncologists and radiation oncologists, communicating with our patients, and all together selecting a comprehensive treatment strategy designed to give our patient the best possible quality of life.

By Jason Weaver, M.D. – Upon completing his training in neurological surgery at the University of Tennessee College of Medicine, Dr. Jason Weaver completed an additional comprehensive neuro-oncology fellowship training program with the M.D. Anderson Cancer Research Institute.