Spinal Cord & Spinal Tumors, from the CureRays guide library.

Spinal tumors grow in or around the spinal cord and spine; treatment protects nerve function, and precise radiation — including spine SBRT — can control tumors while sparing the delicate spinal cord.

What it is.

Spinal tumors are growths that develop in or around the spinal cord and the bones of the spine. They fall into two broad groups. Primary spinal tumors begin in the spine itself — in the spinal cord, the nerves, the protective coverings, or the bones — and include both noncancerous and cancerous types. Far more common are secondary, or metastatic, spinal tumors, which are cancers that have spread to the spine from elsewhere in the body, such as the breast, lung, or prostate; the spine is one of the most frequent sites for cancer to spread. Because the spinal cord and nerves control movement, sensation, and bladder and bowel function, even a small tumor in this area can cause significant symptoms — back or neck pain (often worse at night or with activity), weakness or numbness in the limbs, trouble walking or with balance, or changes in bladder and bowel control. Some situations, such as a tumor pressing on the spinal cord, are urgent because prompt treatment can preserve or recover function. Treatment depends on the tumor type and location and may involve surgery, radiation, and medication. Radiation is especially important here: modern precise techniques can deliver effective doses to a tumor while protecting the spinal cord, which is highly sensitive to radiation. Care is coordinated by a team that may include radiation oncologists, neurosurgeons, and other specialists.

How radiation treats it.

Radiation uses focused high-energy beams to damage the DNA inside cancer cells so they can no longer grow and divide. Spinal tumors present a special challenge because the spinal cord, which runs right beside the tumor, is one of the most radiation-sensitive structures in the body — too much dose can harm nerve function. The great advance has been precision. Modern techniques, especially spine stereotactic body radiation therapy (SBRT), use image guidance and steeply focused beams to deliver a high, effective dose to the tumor in just one to a few sessions while the dose drops off sharply at the edge of the spinal cord, keeping it within safe limits. This makes it possible to control tumors that are less responsive to standard radiation and to achieve durable, long-lasting tumor control. For many situations — relieving pain or treating pressure on the spinal cord from a metastasis — conventional external-beam radiation given over several sessions is highly effective and widely available. Radiation is often combined with surgery: an operation can relieve pressure on the cord or stabilize the spine, and radiation then controls the remaining tumor. When the spinal cord is being compressed, treatment is urgent, because acting quickly can preserve or recover the ability to walk and to control the bladder and bowel. Your radiation oncologist carefully plans the dose to protect the spinal cord while treating the tumor, choosing the technique that best fits the tumor type, location, and your overall situation.

The ways we can treat it.

Spine stereotactic body radiation therapy (SBRT). Highly focused beams deliver a powerful dose to the tumor in one to a few sessions with steep dose fall-off, controlling the tumor durably while keeping the dose to the spinal cord within safe limits.

Conventional external-beam radiation. Standard radiation over several sessions is effective for relieving pain and treating cord compression from many metastases, and is widely available and well tolerated.

Postoperative radiation. After surgery to remove a tumor or stabilize the spine, radiation targets any remaining tumor cells to reduce the chance of regrowth.

Proton therapy. For selected primary spinal tumors, especially in younger patients or tumors near the cord, proton beams can deliver dose to the tumor while sharply limiting dose to the spinal cord and surrounding tissue.

Questions we hear often.

Are most spinal tumors cancer that started in the spine? No — the most common spinal tumors are metastases, meaning cancer that spread to the spine from elsewhere in the body, such as the breast, lung, or prostate. Tumors that begin in the spine itself, including some noncancerous ones, are less common. The type guides the treatment plan.

How can radiation treat a tumor right next to the spinal cord safely? Modern techniques such as spine SBRT use precise image guidance and steeply focused beams so the high dose is delivered to the tumor while the dose falls off sharply at the spinal cord, keeping it within safe limits. This precision is what allows effective treatment so close to the cord.

Why is a tumor pressing on the spinal cord treated urgently? When a tumor compresses the spinal cord, it can cause weakness, numbness, or loss of bladder and bowel control that may become permanent if not treated quickly. Prompt radiation and/or surgery can relieve the pressure and preserve or recover function, which is why this situation is treated as an emergency.

This guide is informational only. It is not medical advice — please confirm anything here with your care team.