Spinal cord tumours

Symptoms depend on the position of the tumour in the spinal cord. Spinal cord tumours often cause symptoms by pressing on the spinal cord or nerves. This can cause:

• weakness and numbness in the arms and legs
• clumsiness or difficulty walking
• back or neck pain
• aching in the spinal area, arms or legs
• tingling or pins and needles in the hands or feet
• loss of bladder and bowel control (incontinence)
• problems with sex, such as erectile dysfunction.

Your doctors need to find out as much as possible about the type, position and size of the tumour, so they can plan your treatment.

You will have:

• an MRI scan or a CT scan to find out the exact position and size of the tumour
• do a physical examination of parts of your nervous system, such as, tests on your reflexes and the power and feeling in your arms and legs
• blood tests to check your general health.

The main treatments used for spinal cord tumours are surgery, radiotherapy and steroids.

Your treatment depends on:

• your general health
• the size, position and type of the tumour
• your symptoms.

A team of specialists will plan your treatment. Your specialist doctor and nurse will explain the aims of your treatment and what it involves. They will talk to you about the benefits and risks of different treatment types. They will also explain the side effects.

You may be given a choice of treatment options. You will have time to talk about this with your hospital team before you make any treatment decisions.

You will need to give permission (consent) for the hospital staff to give you the treatment. Ask any questions about anything you do not understand or feel worried about. Tell your specialist doctor if you need more information or more time to decide on a treatment.

Surgery is the main treatment for many types of spinal tumours. If your surgeon cannot remove the tumour completely, they may be able to remove part of it. This is called debulking surgery. It can improve your symptoms by relieving the pressure on the spinal cord and nerves.

During surgery, the surgeon will take a sample of cells from the tumour (biopsy). This will be examined to find out what type of tumour you have. It can help your doctors plan further treatment, if needed.

After surgery, you may be looked after in a high dependency unit or on the ward for a few days. Your surgeon will give you more information about what to expect.

Sometimes it is not possible to remove the tumour. In this situation, the surgeon may only take a biopsy. Or it may be possible to diagnose the type of tumour you have from how it looks on the MRI scan.

Radiotherapy uses high-energy rays to destroy tumour cells and control the tumour. You may have radiotherapy:

• as the main treatment when surgery is not possible
• if the doctor thinks the tumour is likely to respond very well to radiotherapy (radiosensitive)
• after surgery if the tumour cannot be completely removed
• to reduce the risk of the tumour coming back
• if a tumour comes back.

Doctors may sometimes prescribe steroid drugs to help reduce the swelling around spinal cord tumours. They can reduce the symptoms caused by increased pressure and make you feel better. They may be given before or after surgery, and during or after radiotherapy. The most commonly used steroid is called dexamethasone, but other types can also be used.

It is important to take them exactly as your doctor has explained. Do not stop taking steroids suddenly without talking to your doctor or specialist nurse first. Tell them if you are worried about any side effects of steroids. These will go away gradually as your doctor reduces your steroid dose.

Active monitoring  means regularly checking the tumour to find out if it is growing.

If the scans of your spine suggest that the tumour is slow growing (low-grade), and it is not causing you problems, your doctor may suggest active monitoring instead of starting treatment straight away. This is also called active surveillance or watch and wait.

Active monitoring means regularly checking the tumour with MRI scans to find out if it is growing or changing. You may see your specialist doctor regularly to discuss the results of your scans. This can help your doctor know if and when to recommend treatment. They may suggest a biopsy (an operation to remove a small piece of the tumour) to confirm the diagnosis.

Low-grade spinal tumours may grow only very slowly. Treatment can cause side effects and some of these may be permanent. Active surveillance may be suggested if the side effects of treatment might outweigh the benefits.

Talk to your specialist doctor or nurse if you are worried about any symptoms.

Chemotherapy uses anti-cancer drugs to destroy tumour cells. It is rarely used for spinal tumours. Side effects of chemotherapy depend on the drugs you have. Your doctor will talk to you about chemotherapy treatment, if it is suitable for you.

Clinical trials are a type of medical research involving people. They are important because they show which treatments are most effective and safe. This helps healthcare teams plan the best treatment for the people they care for.

Trials may test how effective a new treatment is compared to the current treatment used. Or they may get information about the safety and side effects of treatments.

They will give you information about the clinical trial so that you understand what it means to take part. If you decide not to take part in a trial, your specialist doctor and nurse will respect your decision. You do not have to give a reason for not taking part. Your decision will not change your care. Your doctor will give you the standard treatment for the type of tumour you have.

Clinical trials also research other areas. These include diagnosis and managing side effects or symptoms. As these tumours are rare, there may not always be a relevant clinical trial happening. If there is, your doctor or nurse may ask you to think about taking part.

We have more information about clinical trials.

Your specialist doctor or nurse will explain your treatment and possible side effects. Most side effects are short-term and will improve gradually when the treatment is over. Some treatments can cause side effects that can continue and may not get better. These are called long-term effects. You may also get side effects that start months or years later. These are called late effects. We have more information about coping:

• before and after surgery
• with side effects of radiotherapy
• with side effects of chemotherapy.