Primary spinal cord tumours

Body map showing Primary Spinal Cord Tumours

Spinal cord tumour facts and figures

  • Primary spinal cord tumours are very rare, with fewer than 1,000 new cases a year diagnosed in the UK.
  • Children: these tumours are extremely rare and account for about 1-2% of childhood CNS cancers. The majority of them are astrocytomas or ependymomas.
  • Adults: the highest incidence of these is in the 50-70 year age group and are either intramedullary tumours that arise within the nerves of the spinal cord and are usually astrocytomas or ependymomas or intradural extramedullary tumours that occur within the coverings of the spinal cord and are usually meningiomas or nerve sheath tumours. Causes are unknown, although some genetic conditions such as neurofibromatosis increase the risk of developing a primary spinal cord tumour.

Spinal cord tumour symptoms

Depends on the position of the tumour, most common are:

  • Back and/or neck pain.
  • Numbness/tingling/weakness in arms and/or legs.

Diagnosis of spinal cord tumours

Investigations may include:

  • Physical examination (including some degree of neurological examination).
  • CT scan.
  • MRI scan.
  • Biopsy (may be possible if decompressive laminectomy performed).

Spinal cord tumour treatment

Depends on several factors:

  • The type of tumour.
  • The position of the tumour.
  • The size of the tumour.
  • The stage of the cancer.
  • Age and general health.

Surgery

Surgery is likely to be performed to either completely remove the tumour, particularly if it is on the outer part of the spinal cord or partially remove it, which can help to slow down the progression of the tumour.

A decompressive laminectomy may be performed; this involves removing parts of the vertebrae and some of the tumour which relieves the pressure and also enables tissue samples to be taken for analysis.

Radiotherapy

Radiotherapy is usually given post-operatively if it was not possible to completely remove the tumour or if the tumour recurs. It may be the main treatment if surgery is not possible. Radiotherapy needs to be prescribed with great care as the spinal cord is very sensitive to radiation and radiation induced damage to the spinal cord can be progressive and irreversible.

Chemotherapy

Chemotherapy is occasionally used for some spinal cord tumours that progress after surgery and radiotherapy, research is ongoing in this area.

Steroids

Steroids are powerful anti-inflammatory drugs that are usually prescribed very early on to these patients to help reduce any swelling around the tumour and consequently any potential damage to the spinal cord. They will also help to control symptoms and may be prescribed pre or post-surgery and pre or post radiotherapy.

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