Weill Medical College of Cornell University

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Spinal Tumor Program (Spinal Oncology)

The Spinal Tumor Program is an innovative subspecialty dedicated to patients with tumors of the spine and spinal cord. The goal of the service is to improve patient care with new treatments that improve quality of life and prevent paralysis and disabling pain for patients with cancer.

About Spine Tumors

Spine tumors are classified as either primary (benign or malignant) or secondary (metastatic) tumors. The spine is one of the most common places in the body for the spread (metastasis) of cancer. Each year, an estimated 18,000 people in the U.S. are diagnosed with metastatic spine disease. More than 40% of all patients who have cancer elsewhere in the body, including breast, lung, prostate, thyroid, renal, and colon, will experience the spread of their cancer to their spine in their lifetime.

Spinal tumors can occur inside the spinal cord itself (intradural, intramedullary) or inside the dura (the tough covering over the spinal cord) but outside of the spinal cord (intradural, extramedullary). Tumor growth can lead to a pathological fracture or to spinal cord or nerve root compression. The goal of treatment is to remove the tumor, preserve or improve neurological function, and to provide pain relief and structural stability.

Diagnosis

The most common symptom of a spine tumor is pain. The pain tends to be progressive. Symptoms may result from bone and soft tissue invasion, spinal instability, or pressure on the spinal cord and/or nerves. Signs include numbness or abnormal sensations in the arms or legs, weakness of the arms or legs and/or loss of bowel or bladder control. Imaging studies are used to determine the presence and extent of spinal lesions. These studies may include X-rays; CT, MRI, and PET scans; and myelograms.

Interdisciplinary Team Approach to Spine Tumor Treatment

Drs. John Boockvar, Roger Härtl, and Eric Elowitz treat patients with spinal tumors in the Department of Neurosurgery at Weill Cornell. The interdisciplinary team includes neurosurgeons, neuro-oncologists, radiation oncologists, neuroradiologists, neuropathologists, nurses, nurse practitioners, physician assistants, neuropsychologists, physical therapists, social workers, pharmacists, and case managers.

A weekly tumor conference provides an opportunity to discuss every patient under our care. After evaluation of clinical reports, radiology studies, and pathology materials, recommendations are made for therapeutic options for each patient. These may include surgery, radiation therapy, and standard or investigational chemotherapies. This interdisciplinary approach leads to highly coordinated and expert quality patient care as well as superior patient satisfaction.

We offer our patients state-of-the-art spinal stabilization for metastatic spine tumors to preserve neural function and improve quality of life. We emphasize minimally invasive techniques, such as retropleural thoracotomies, short segment fusions, and the use of cages to enhance fusion. For tumors of the spinal cord, we emphasize intraoperative monitoring and stimulation of the spinal cord to maximize the safety of the resection.

Procedures such as kyphoplasty and vertebroplasty are available to reconstruct compressed vertebral bone, restore alignment, or remove pressure on a nerve. Technically, the main concerns in the treatment of a spinal metastasis are to preserve mechanical and neurologic function. The early diagnosis and treatment of spinal cord tumors are essential in reducing pain, preserving or improving neurological function, and improving quality of life.

Treating the Person, Not Just the Disease

Our multidisciplinary spine cancer team is dedicated to exploring all options with patients and their family members, providing the most advanced treatments possible based on each patient's unique needs and desires.

As new, more powerful, and targeted treatments become available, more and more people are living with cancer. Our goal is to provide patients with the full range of cancer management strategies, so that they can continue to live as normally and actively as possible. In cases where cancer cannot be cured, palliative treatments (or symptom relief) can improve a patient's quality of life by increasing or restoring mobility, relieving pain, numbness and other symptoms, and allowing the return to normal daily activities.

Opportunities to participate in research protocols and clinical trials are available. Please contact Erma Bell for details. elb2014@med.cornell.edu

For more information, visit the Health Library entry on spinal tumors.