Treatment of metastases to the vertebrae
Many types of cancer metastasize to bone tissue. Is no exception the spine. Moreover, among all neoplastic processes affecting the spine, more than 90% are metastatic. Most often metastasizes to the spine lung cancer, cancer of the prostate and mammary glands, as well as myeloma and lymphoma. These and other tumors can affect any metastases of the spine.
What happens to the spine?
In case of metastatic lesions of the spine the tumor penetrates into the body of the vertebrae, shattering the bone substance. Cancer process tumor factors that activate osteoclasts, that destroy bone. Formed foci of osteoporosis. This is a dangerous process, as the weakened bone becomes poor support for the body. Significantly increases the risk of fractures and spinal cord compression. In addition, the metastatic lesions compress the spinal canal, which is also reflected in the status and functions of the spine.
The symptoms of metastases in the spine
Pain metastases to the spine are the main symptom. At first they may be barely perceptible, but gradually the strength of the pain increases. Man feels them all the time. The pain occurs in the projection of the affected vertebra, and is often credited with degenerative disc disease. Special attention is needed to treat pain in the spine in the presence of a primary tumor. Persistent pain in the back of an alarming symptom and sign of metastasis in the spine. Thus, the level of pain is directly linked with the degree of destruction of bone tissue.
Back pain metastases to the vertebrae can be mixed with pain in other organs. These pains may be due to the spread of metastases, but may be only sensations that occur due to lesions of certain parts of the spine. For example, metastases in the cervical spine are often accompanied by headaches, chest pains in the heart area, the stomach. Metastases in the lumbar spine often cause irregularities in bowel habits, incontinence.
Other symptoms of metastases in the spine:
- Disorders of stool and urination,
- Sensitivity disorders
- Motor disorders: muscle weakness, muscle twitching.
These manifestations are called radicular syndrome. They develop due to the irritation of the nerve roots located in the spinal canal. This is due to compression of the spinal cord or effects of the products of destruction of the vertebral bodies.
Diagnosis and treatment
For the decision how to treat metastases in the spine the correct diagnosis.
Methods of diagnosis:
- Magnetic resonance imaging,
- Skeletal scintigraphy,
The first two methods are basic. They allow to determine the location of metastases, their size, extent of bone lesions and the volume of the lesion.
Methods of treatment:
- Hormonal treatment
- Treatment with bisphosphonates, depressing the function of osteoclasts,
- Palliative treatment.
The leading method is often chemotherapy, as it has a systemic effect on the body. The development of metastases in the spine is already talking about the spread of cancer cells throughout the body. Hormonal therapy is indicated in cases where the primary lesion is hormonally active tumors, e.g., ovarian tumor. Bisphosphonates, inhibiting function of osteoclasts, slows bone resorption. Drugs of this class are recognizedthe "gold standard" in the treatment of bone tissue.
When is surgery indicated:
- Fracture of a vertebra,
- Compression of the spinal cord
- Instability of the spine, accompanied by radicular syndrome,
- The inability to stop pain in other ways.
Treatment of metastases to the vertebrae or in several often is palliative. In fact, it's a relief the condition of the patient, providing him the opportunity to spend the last months with a higher quality of life. However, the survival from the primary cancer it is, unfortunately, no effect.