The spinal cord is a long column of nerve fibers. Its purpose is to carry messages to and from the brain that control our body's movements. The spine also supports our body's stability and structure. Three protective membranes (meninges) wrap around the spinal cord.

Spine tumors and spine cancers develop in the bones, nerves, and other tissues of the spine.

Cancerous spinal tumors and benign spinal tumors can compress the spinal cord and nerves. Permanent nerve damage often results from this compression. Aggressive therapy can potentially limit the loss of nerve functioning or help restore nerve functioning.

Types of Spinal Tumors:

• Epidural tumors: Epidural tumors grow in the bones that make up the spine. The risk is that they can compress your spinal cord, nerves, and spinal fluid.
• Intradural tumors:  These tumors are spine tumors that form in the dura mater. The dura mater is the outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord.
• Extramedullary tumors: These tumors develop outside the spinal cord, such as in the surrounding dura mater (meningiomas) or in the nerve roots that extend out from the spinal cord (schwannomas and neurofibromas). These tumors are noncancerous in most cases.
• Intramedullary tumors: Tumors that start in the supporting cells within the spinal cord. Most are either astrocytomas or ependymomas.

Tests

Magnetic Resonance Imaging (MRI) 
A magnet, radio waves, and a computer create detailed pictures of the brain and spinal cord. Gadolinium, injected into a vein, collects around cancer cells and makes them shine brightly in the images. Nuclear magnetic resonance imaging (NMRI) is another name for an MRI. Magnetic resonance spectroscopy (MRS) also can be done during an MRI scan. MRS diagnoses tumors, based on their chemical make-up.

Computed Tomography (CT or CAT Scan) 
This procedure makes a series of detailed pictures of areas inside the body from different angles. A colored dye may be injected into a vein or given as a liquid. The dye makes tissue or organ abnormalities show up clearly. Computed tomography, computerized axial tomography, and computerized tomography are other names for this test.

X-rays
An X-ray can identify the specific vertebra (bones) compressing your spinal cord. It can also help us evaluate your spine’s alignment. X-rays may be performed during treatment, too. For instance, to help a surgeon accurately place rods and pedicle screws to stabilize the spine following surgical removal of the tumor.

• Myelography: X-rays are taken after dye is injected into your spinal fluid cavity. The outline of a tumor can be seen. Myelography is mostly used to plan a treatment before using a high-dose, high-precision radiation therapy called stereotactic radiosurgery.

Positron Emission Tomography (PET) Scan 
You will lie down on the PET scan machine, as the PET scanner rotates around your body. A small amount of radioactive glucose gets injected into a vein. The PET scanner makes a picture of where the glucose is in your brain. Malignant tumor cells will show up brighter in the picture. Cancer cells ingest more glucose than normal cells because the cancer cells are very active. This test can help us see if a cancer is a primary tumor or if cells have spread from other places in the body.

Biopsies
If imaging tests show us that there may be a spine tumor, a biopsy is performed. The surgeon guides a needle into the tumor and removes a small amount of fluid or tissue. This is then examined by our pathologists (cellular experts) under a microscope.

Treatments

Active Surveillance
Also called watchful waiting or monitoring, if small tumors are noncancerous and aren't growing or pressing on surrounding tissues, your doctor may recommend not treating the tumor yet. You will receive regular check-ups and tests to keep monitoring the condition.

Surgery
Few patients receive surgery for spinal tumors due to the risk and nearby location of nerves. However, newer techniques are making it an option for some patients. Surgery may be followed by radiation therapy, chemotherapy, or both, to ensure removal or destroying of all cancerous cells. Types of surgery include:

• Posterolateral Resection: The spine tumor is removed through an incision in the back, and the spine and bones are then reinforced. This operation can reduce complications and shorten recovery time.
• En Bloc Resection: This technique is for tumors that can be removed in a single piece. It can be used for giant cell tumors, low-grade chondrosarcomas, and chordomas located in the bones of your spine or next to your spine.
• Metastatic Spine Tumor Surgery: Techniques such as spinal cord decompression can relieve pressure on the spinal cord and nerve roots. It also frees up room in the spine to then proceed to high-dose radiation therapy.
• Spinal Angiography: Spinal angiography can reduce blood loss in surgery. Your surgeon will inject a contrast dye and take an X-ray to see where the blood vessels are. An interventional radiologist then injects small beads into these vessels to prevent bleeding.

Radiation Therapy
High energy X-rays, gamma rays or proton beams are aimed at a tumor to kill cancer cells or shrink a tumor. Radiation therapy can be the main treatment if surgery is not an option. It can also help relieve symptoms caused by a tumor. There are two main types of standard radiation therapy:

• Internal Radiation Therapy: A small amount of a radioactive substance delivers radiation right to the inside of the cancer cells using a needle, wire or catheter. Or it might be delivered using tiny seeds (brachytherapy) that your surgeon would implant near the tumor. Your radiation specialist will discuss the best therapy for you.
• External Beam Radiation Therapy: With external beam radiation therapy, you will rest comfortably, lying flat. The radiation machine will slowly rotate around your body. It will deliver a carefully pointed radiation beam toward the tumor or cancerous growth. Sylvester Cancer Center technology ensures minimal or no radiation exposure to your healthy body tissue. Types of external beam radiation therapy include:
• 3-Dimensional Conformal Radiation Therapy (3-D CRT): A computer creates a 3-D picture of the brain or spinal cord tumor. This allows us to give the highest possible dose of radiation to the tumor.
• Intensity-Modulated Radiation Therapy (IMRT): This is also a type of 3-D radiation therapy. Thin radiation beams of different intensities (strengths) hit the tumor from many angles.
• Stereotactic Radiosurgery: A single dose of radiation is aimed directly at a brain tumor. Stereotaxic radiosurgery and radiosurgery are other names for this technique. It is not a surgical procedure.
• Gamma Knife® Radiosurgery: Focuses one large dose of radiation to small tumors (less than 3 centimeters) with pinpoint accuracy.

Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells. The drugs either kill the cells or stop them from growing and spreading. Adjuvant chemotherapy is chemotherapy after surgery or a biopsy. Chemotherapy may be given as a liquid into a vein or muscle using an IV (short for intravenous); taken orally by mouth, as pills; or delivered right into the fluid-filled space around the brain.

Why Choose Sylvester Comprehensive Cancer Center?

Sylvester is an NCI-designated cancer center. The National Cancer Institute has reaffirmed us as South Florida’s only NCI-designated cancer center. We have been recognized for our scientific leadership, our commitment to training the next generation of cancer researchers and providers, as well as our engagement with the communities that we serve. For patients, this designation translates into greater access to leading-edge treatment options, including clinical trials that prioritize your specific cancer.

Intrathecal chemotherapy for appropriate brain and neurological cancer. This advanced treatment provides greater accuracy and safety than traditional chemotherapy for select tumors. For this therapy, medicine is delivered directly into the tumor site through a dissolving wafer.

Leaders in gene therapy research. You’ll be cared for by a team including experts in the world’s newest molecular and genetic treatments.

Gamma Knife® Radiosurgery for inoperable brain tumors. Small tumors can be destroyed using innovative technology if surgery is not recommended.

One of only six designated Cancer Centers of Excellence in Florida.. You can rest easy knowing you are in the best possible place to treat your cancer. We provide a 17 percent higher likelihood of surviving cancer after five years than at other hospitals.

Multidisciplinary care teams with nationally recognized expertise. Your care team is made up of experts in all aspects of your exact type of cancer. All of your physicians, nurses, and more collaborate to save lives.