The brain is an elaborately designed organ that has well organized tissues and nerves. It is the brain that runs the entire body, controls its vital functions and determines our personality. It is encased in by the hard skull bones and the layers (meninges), to protect it from damage. The spinal cord contains long nerve bundles which connect the brain to the rest of the body. It carries vital messages between the brain and the body, on how the body should function. These messages instruct muscles to move, transmit information picked up by our special senses, and coordinate internal organ function like the bladder and bowels. Spinal cord is enclosed in by the bones (vertebrae) of the spinal or vertebral column. There is also a cerebrospinal fluid that surrounds, protects and bathes the brain and spinal cord. The brain stem connects the brain to the spinal cord.
What are spinal cord tumours ?
Spinal Cord Cancers are basically tumours of the Spinal Cord.
How is a spinal cord cancer caused ?
- Radiation Exposure : The most known external risk factor for brain and spinal cord tumours is exposure to radiation, mostly from therapy for other diseases.
- Family History : Most cases are sporadic. Rarely, brain and spinal cord cancers run in families and in these cases, brain tumours occur when the individuals are young. These familial syndromes are-
a) Neurofibromatosis type 1 (NF1)
b) Neurofibromatosis type 2 (NF2)
c) Von Hippel-Lindau disease
d) Li-Fraumeni syndrome - Immune System Disorders : Weakened immune systems can predispose to a higher risk of brain or spinal cord lymphomas.
What are the types of spinal cord cancers ?
There are several types of cancer that can initiate in the Spinal Cord.
- Gliomas : Glioma is a broad term for tumours that initiate in the glial cells. These include glioblastomas, astrocytomas, oligodendrogliomas, and ependymomas.
- Meningiomas : Meningiomas are the tumours that initiate in the meninges, the layers of tissue enclosing the brain and spinal cord.
- Medulloblastomas : Medulloblastomas arise in the neuroectodermal cells (which are nothing but primitive embryonic nerve cells) in the cerebellum.
- Gangliogliomas : Gangliogliomas are tumours containing both neurons and glial cells.
- Schwannomas (neurilemmomas) : Schwannomas develop from Schwann cells, which insulate and protect cranial nerves and other nerves, as well. Schwannomas are mostly benign tumours which can arise in almost any nerve.
- Craniopharyngiomas : These slow-growing benign tumours start on top of the pituitary gland but below the brain itself. They may press on the pituitary gland and the hypothalamus, causing pressure effects and endocrine regulation problems.
- Other tumours that initiate in or near the brain : These include Chordomas, Non Hodgkin’s Lymphoma and Pituitary Adenomas.
What are the clinical features of spinal cord tumours ?
The symptoms vary based on the tumour’s location in the Spinal Cord. Spinal cord tumours may result in weakness, paralysis, or numbness of varying parts of the body. Most of the times, spinal cord tumours cause symptoms on both the sides of the body (such as weakness or numbness in both of the legs). This differs from most of the brain tumours, which mostly affect only a single side of the human body. The nerves that supply arms begin in the spinal cord at the neck level (cervical spine). Nerves that supply the legs, bowels, and bladder originate in the back (thoracic and lumbar spine). Most of the spinal cord tumours initiate in the neck (cervical spine) and cause symptoms in either or both the arms and legs, and can affect bowel and bladder function.
How are spinal cord cancers diagnosed ?
- A complete physical examination of the body is mandatory.
- Imaging Tests: Important diagnostic tests include the following such as X- rays, CT Scan, MRI Scan or PET Scans. Magnetic Resonance Imaging (MRI) & Computed Tomography (CT) Scans are the imaging tests used most often for diagnosis of Spinal Cord Tumours. These scans can detect tumours, and based on location can give an idea as to what the tumour is. To determine the exact extent of disease, these tests may need to be performed so doctors can view, assess and judge the cancer and determine how far it has progressed or spread. Magnetic resonance angiography (MRA): This specialized MRI is done to analyze the blood vessels in the brain. This is extremely useful before surgery to help the surgeon plan operations.
- Lumbar Puncture (spinal tap) : This test looks for cancer cells in the cerebrospinal fluid (CSF), the fluid that surrounds the brain and spinal cord.
- Biopsy : Removed tissue examined under a microscope by a pathologist is the only sure-shot way to make a definitive cancer diagnosis. Brain or spinal cord tumour biopsy may be done either as a stand-alone procedure, or it may be part of the main surgery to remove tumour. It could be either a stereotactic (needle) biopsy or surgical and open biopsy.
How are spinal cord cancers staged & graded ?
Grade and Stage describe the spinal cord tumour, helping to provide guidance for the oncologist in choosing the best treatment option(s). Staging is a careful attempt to find out the exact extent and spread of the cancer. The higher the stage the further the cancer has grown away from its original site in the spinal cord.
As tumours in the brain or spinal cord almost never extend and affect other parts of the body, there is no exact specialized staging system developed for them.
How are spinal cord tumours treated ?
Brain and Spinal Cord Cancers are considerably harder to treat. Treatment options depend on the type of cancer, staging of the cancer, and its location. A neurosurgeon will have to be consulted, and either a single therapy or a combination of treatments will be decided for you by a panel of oncosurgeons, radiologists and your general physician. The treatments for Spinal Cord Tumours include ;
- Surgery : Surgical treatments for spinal cord cancer include debulking the tumour, as much as possible, while preserving maximum function of the spinal cord.
- Radiation Therapy : A cancer treatment that utilizes high-energy x-rays or basically radiation to eradicate cancer cells. Radiation can be used on select patients if surgery is not a good option. Radiation therapy can also be used post surgery to kill any remaining cancer cells.
- Chemotherapy : Another kind of cancer treatment that uses either drugs or chemical substances (hence the name chemotherapy) to kill cancer cells and prevent them from dividing.
- Targeted Therapy : Immunotherapy works by utilizing your own body’s immune system to fight cancer cells. These work differently from standard chemotherapy.
What is the care to be taken after the treatment of spinal cord tumour ?
Metastatic diagnostic workup and monitoring post-treatment has to include imaging and scanning of the brain, spinal cord and rest of the body with radiography, MRI or CT scans because of the risk of possible recurrences.
Adjuvant chemotherapy or radiotherapy may be required in cases wherein excision cannot be done completely.
How to find and reach neurosurgeons for spinal cord tumour surgery ?
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Find, reach and choose a neurosurgeon for spinal cord tumour surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
