Cancer is complex — there is no routine spine tumor or routine way to treat it.
The first treatments for spine tumors often represent the best opportunity to put the cancer into remission or effectively treat it with the least amount of side effects.
For patients with primary tumors (originating in the spine), the treatment goal is to cure them by removing the tumor intact without spillage into the surrounding tissue to contain it and to avoid compromising the surrounding tissue.
For patients with metastatic spine tumors (originating elsewhere in the body and spreading to the spine), treatment is palliative, or designed to alleviate symptoms to make patients more comfortable and improve their quality of life.
OSUCCC – James spine cancer specialists and subspecialists are internationally renowned for researching and treating their one particular cancer. Our spine cancer treatment team includes medical oncologists, neurosurgeons, radiation oncologists, pathologists, hematologists, geneticists, spine cancer researchers and more. Working together and across medical disciplines, this subspecialized team develops personalized treatment plans that target the molecular and genetic makeup of your individual spine cancer.
This science-based treatment approach is available at only a few cancer centers in the country. In fact, OSUCCC – James physicians help write the national clinical guidelines for treating specific cancers.
As one of only four cancer centers in the country funded by the National Cancer Institute (NCI) to conduct both phase I and phase II clinical trials on novel anticancer agents sponsored by the NCI, the OSUCCC – James offers patient access to more clinical trials than nearly any other cancer hospital in the region, and more of the latest and most effective treatments.
Technological Treatment Advances
OSUCCC – James spine cancer experts are working with specially trained engineers to build personalized spine models for each spine tumor patient. By using something called biodynamics, these subspecialized neurosurgeons will be able to see each patient’s cancer in 3-D and determine what the surgery will look like before it occurs. This will lead to greater precision, faster response times and fewer side effects for patients.
Other technological advances include spinal radiosurgery for patients with spine tumors. This procedure is being studied for use in combination with minimally surgical procedures, including vertebroplasty and kyphoplasty. These procedures, which treat vertebral compression fractures of the spine that may be caused by tumors, osteoporosis or other maladies, may also enable neurosurgeons to inject chemotherapy directly into the affected vertebrae of patients with spine tumors. OSUCCC – James neurosurgeons are experts in vertebroplasty and kyphoplasty, performing more of these procedures for cancer patients than neurosurgeons at any other hospital in the region.
Spine Tumor Treatment Factors
Spine tumor treatment is based on:
- The type of tumor
- Where the tumor originated
- The amount of cancer left after surgery
- The tumor grade (usually a rating of 1-4 based on the amount of abnormality, with grade 1 tumors being the most normal)
- The molecular makeup of the tumor
One or more of the following treatments may be recommended (patients may also benefit from new therapies available in clinical trials):
Surgery may be one of the initial treatment options for spine tumors. This is important because it allows OSUCCC – James experts to examine tissue under a microscope and make the most accurate diagnosis. Surgery may consist of a biopsy to remove a small piece of tumor, or a tumor resection to remove a larger portion of the tumor.
Types of Surgery
The type of surgery your OSUCCC – James doctor recommends will depend on the type of tumor, its location and the symptoms you are experiencing. If you have weakness, numbness or paralysis of arms and legs, or a change in bladder or bowel function, an open surgical procedure may be necessary.
Minimally invasive procedure (vertebroplasty) – Using a needle, the surgeon injects special cement into the vertebral body damaged by the tumor.
Minimally invasive procedure (kyphoplasty): Surgeons inflate a balloon in the vertebral body to create a cavity into which they inject special cement under lower pressure.
Open procedures – These procedures may be done with a surgical incision on the front or back.
- Decompression: to remove bone that has the tumor and to increase the space around the spinal cord and nerves.
- Stabilization: application of screws, rods or cement to stabilize the spinal column
- Combination: both of the above procedures, which may be staged one or more days apart.
Radiation therapy uses high-energy X-rays to destroy cancer cells or keep them from growing. A patient with spine cancer may receive radiation therapy before or after surgical removal of a tumor. Radiation can shrink a tumor to make surgery more successful. It is delivered only to the tumor to prevent damage to surrounding healthy tissue.
OSUCCC – James radiation experts are leaders in innovative treatments, and The James is one of the few hospitals in Ohio to offer radiation treatments to patients in the prone position (lying face down).
The OSUCCC – James also offers other leading-edge radiation treatments, including imaging-based radiation therapy, intensity-modulated radiation therapy (IMRT), stereotactic radiosurgery and using a Varian TrueBeam Linear Accelerator.
Chemotherapy drugs stop cancer cell growth by either destroying the cells or by preventing them from dividing and making new cells.
How chemotherapy is given to patients with spine tumors depends on the type of tumor being treated. Chemotherapy drugs can be taken by mouth or injected into a vein or muscle, and they may be given over a period of months.
When the drugs enter the bloodstream, they can reach cancer cells throughout the body (called systemic chemotherapy). Combination chemotherapy uses more than one anticancer drug.
Targeted therapies are drugs designed to attack cancer cells without destroying healthy surrounding cells. When targeted drugs are delivered in combination with chemotherapy, they interrupt certain proteins and receptors to stop cancer cells from growing.
These drugs tend to have less-severe side effects and are usually tolerated better than traditional chemotherapy drugs.
(Source: National Institute of Neurological Disorders and Stroke)
Spine Tumor Research & Clinical Trials
For cancer patients, clinical trials mean hope for finding more-targeted ways to prevent, detect, treat and cure individual cancers. Patients can enter clinical trials before, during or after their cancer treatment.
The OSUCCC – James has hundreds of open clinical trials at any given time, making some of the world’s latest science-based treatments available to clinical trial patients from central Ohio and beyond. Patients not only have access to more cancer clinical trials here than at nearly any other hospital in the region, but they also have access to some of the most advanced, targeted treatments and drugs available anywhere. These include several novel spine tumor trials, such as new vaccines against spine tumors, viruses that divide in spine tumor cells and kill them, ways to overcome resistance to currently used treatments, and antibodies that link to specific proteins and block tumor growth.
The OSUCCC – James is one of only four U.S. cancer centers funded by the National Cancer Institute (NCI) to conduct both phase I and phase II clinical trials on novel anticancer agents sponsored by the NCI. These trials go only to centers that demonstrate an exemplary capacity for research and clinical care, the expertise to deliver the latest in treatments, and the infrastructure to interpret and track treatment results.
Additionally, Ohio State has nearly 300 cancer researchers dedicated to understanding what makes each patient’s cancer grow, move, spread or recur. Because of the OSUCCC – James’ NCI phase I and phase II approvals, these experts can move research discoveries into clinical trials and make them available to patients sooner.
Who Should Participate in a Clinical Trial
For some patients, taking part in a clinical trial may be the best treatment choice. Patients can enter clinical trials before, during or after their cancer treatment.
If you’ve been diagnosed with a spine tumor, would like a second opinion or would like to speak with a spine cancer specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.