More Options, Better Outcomes
Early detection and treatment can help avoid spinal cord compression and irreversible neurologic effects. Malignant spinal tumors can be treated successfully with surgery, radiation therapy, or both.
Most patients with spinal tumors require multi-modality treatment, typically surgery plus radiation. Our experts in both of these treatments are already on your care team, from the start.
The location and extent of the spinal tumor will determine your best treatment option, but surgery may be necessary. Sometimes metastatic tumors destroy bones in the spine, leading to back pain and function loss of the spinal cord, muscles, or nerves. In other cases, malignancies can push tumor or bone fragments into the spinal canal or against nerve roots entering the spine. Before your treatment team recommends surgery, they’ll consider every nonsurgical option. Your team may recommend a surgical procedure to:
- Biopsy your tumor for a definitive diagnosis
- Relieve pressure on the spinal cord or nerve roots
- Restore spinal strength and mobility
- Treat a tumor that has resisted radiation therapy
Radiation therapy, or radiotherapy, in which a machine directs high intensity radiation at a tumor site to kill cancer cells, is an important part of spinal tumor cancer care. Radiotherapy is frequently used after surgery in the treatment of spinal tumors to eliminate any remaining cancer cells.
The Right Tools
Roswell Park is equipped with the latest and most precise technology in radiation medicine. These innovative computer-assisted devices can deliver radiation more than 60 percent faster than conventional radiation therapy equipment:
- Varian TrueBeam Technology System: The TrueBeam machine with a beam accuracy of 0.7 mm is used for radiosurgery treatments on the spine.
- Trilogy Image-Guided Radiation Therapy Systems: The Trilogy is precise enough to pinpoint an area as small as one millimeter — about the width of a coarse grain of sand.
Roswell Park’s Radiation Medicine Department provides a full range of radiation treatments for spinal tumors, which include:
- Conformal 3-Dimensional Radiation Therapy (XRT): Three-dimensional (3D) conformal radiation therapy allows a precise radiation dose to be delivered to the tumor while minimizing the exposure to normal tissues. 3-D conformal therapy has become the new standard in radiation therapy, combining modern imaging technology, such as computed tomography (CT) and magnetic resonance imaging (MRI) with state-of-the-art computer planning systems.
- Spinal Radiosurgery (SRS): A highly precise single- to 5-session treatment designed for the most challenging cases where surgery or other radiation treatments have failed. Borrowing its name from the surgery-like precision it offers, it treats tumors within the spinal cord, while protecting normal function. Because SRS offers exceptional precision with fewer side effects, and treatment can be completed in fewer sessions over a shorter time period, the treatment is a good option for:
- Radiation-resistant tumors
- Patients who cannot tolerate surgery due to other medical conditions
- Image Guided Radiation Therapy (IGRT): This treatment delivers sharply focused radiation, guided by up-to-the-moment images that capture the tumor’s exact shape and location. IGRT is used on metastatic tumors of the spine and tumors that are in contact with the spinal cord.
- Intensity Modulated Radiation Therapy (IMRT): This advanced form of conformal radiation therapy links treatment planning software to the actual treatment machine using 3-dimensional imaging and different intensities of radiation according to the tumor’s size and shape. For difficult tumors, such as those very close to critical structure, like the spinal cord, IMRT allows the varying, or modulating, of the beam providing a safer treatment delivery. This device enables the treatment team to sculpt the radiation beams to the shape of the tumor and to treat it from several different angles.
- Intra-Operative Radiation Therapy (IORT): Roswell Park is the only facility in the state outside of New York City with the capabilities to deliver radiation therapy internally during surgery, that’s to a specially-equipped surgical suite. IORT delivers high dose radiation from a shielded, computer-controlled device and programmed so that the radiation source can be delivered into the patient by remote control. The radiation source enters the patient through a special pencil thin flexible catheter that conforms to most anatomical shapes.
Spine Fracture First-Aid
Some cancer patients develop fractures in their vertebrae, either from their disease or a resulting side effect of radiation therapy or steroid treatments. Such fractures can be very painful, and if a vertebra collapses, the spine may also begin to curve forward, causing spinal deformity and neurologic disability.
Roswell Park’s Neuroradiology Department offers two types of minimally invasive treatments to treat these conditions:
- Vertebroplasty involves filling spinal fractures with bone cement
- Balloon Kyphoplasty is a modified version of vertebroplasty that can also correct spinal curvature caused by a spinal compression fracture.
Performed on an outpatient basis, both procedures can provide significant pain relief from the spinal fractures. In many cases, mobility improves dramatically and pain medications are no longer needed.