Treatment

Ideally, the goal of spinal tumor treatment is to eliminate the tumor completely, but this goal may be complicated by the risk of permanent damage to the spinal cord and surrounding nerves. Doctors also must take into account your age and overall health. The type of tumor and whether it arises from the structures of the spine or spinal canal or has spread to your spine from elsewhere in your body also must be considered in determining a treatment plan.

Treatment options for most spinal tumors include:

• Monitoring. Some spinal tumors may be discovered before they cause symptoms — often when you're being evaluated for another condition. If small tumors aren't growing or pressing on surrounding tissues, watching them carefully may be all that's needed.

  During observation, your doctor will likely recommend periodic CT or MRI scans at an appropriate interval to monitor the tumor.

• Surgery.This is often the treatment of choice for tumors that can be removed with an acceptable risk of spinal cord or nerve injury damage.

  Newer techniques and instruments allow neurosurgeons to reach tumors that were once considered inaccessible. The high-powered microscopes used in microsurgery make it easier to distinguish tumor from healthy tissue.

  Doctors also can monitor the function of the spinal cord and other important nerves during surgery, thus minimizing the chance of injuring them. In some instances, very high-frequency sound waves might be used during surgery to break up tumors and remove the fragments.

  But even with the latest technological advances in surgery, not all tumors can be totally removed. When the tumor can't be removed completely, surgery may be followed by radiation therapy or chemotherapy or both.

  Recovery from spinal surgery may take weeks or longer, depending on the procedure. You may experience a temporary loss of sensation or other complications, including bleeding and damage to nerve tissue.

• Radiation therapy. This may be used to eliminate the remnants of tumors that remain after surgery, to treat inoperable tumors or to treat those tumors where surgery is too risky.

  Medications may help ease some of the side effects of radiation, such as nausea and vomiting.

  Sometimes, your radiation therapy regimen may be adjusted to help minimize the amount of healthy tissue that's damaged and to make the treatment more effective. Modifications may range from simply changing the dosage of radiation to using sophisticated techniques such as 3-D conformal radiation therapy.

• Chemotherapy. A standard treatment for many types of cancer, chemotherapy uses medications to destroy cancer cells or stop them from growing. Your doctor can determine whether chemotherapy might be beneficial for you, either alone or in combination with radiation therapy.

  Side effects may include fatigue, nausea, vomiting, increased risk of infection and hair loss.

• Other drugs. Because surgery and radiation therapy as well as tumors themselves can cause inflammation inside the spinal cord, doctors sometimes prescribe corticosteroids to reduce the swelling, either after surgery or during radiation treatments.

  Although corticosteroids reduce inflammation, they are usually used only for short periods to avoid serious side effects such as muscle weakness, osteoporosis, high blood pressure, diabetes and an increased susceptibility to infection.