Observation of Spinal Cord Tumors

Being diagnosed with a spinal cord tumor can be a challenging and overwhelming experience. It is common to have many questions and concerns about testing, treatment options, and the long-term prognosis. Spinal cord tumors can vary in their presentations, symptoms, and potential complications, making each case unique.

In some instances, spinal cord tumors do not require immediate aggressive treatment. Instead, a course of observation might be recommended by your doctor and health care team to monitor the tumor to ensure that it does not pose a significant risk to your health.

The decision to undergo observation is based on various factors, including the type, size, location, and growth rate of the tumor, as well as your overall health condition.

During the observation period, your medical team will closely monitor the tumor through regular imaging tests, such as magnetic resonance imaging (MRI). They will assess the tumor's growth, any changes in your symptoms, and potential signs of progression. This monitoring enables them to make an informed decision about the need for intervention or further treatment.

Observation provides an opportunity to carefully evaluate the tumor's behavior and determine the most appropriate management strategy. It is essential to maintain open communication with your health care team, sharing any changes in symptoms or concerns you might have. They will guide you through the observation process, address your questions, and provide ongoing support.

This article provides detailed information on the circumstances that might warrant observation for a spinal cord tumor and what the observation process involves. By understanding this aspect of tumor management, you can be better prepared and informed about your treatment journey.

Spinal cord tumors develop on or near an essential structure that enables us to interact with the external world. The spinal cord, a lengthy bundle of nerve fibers approximately 45 cm long, serves as a communication pathway between the brain and the body. This intricate network allows us to perceive sensations, control our movements, and maintain proper bowel and bladder function, among other vital processes.

Any disruption in this neural pathway can significantly affect everyday functioning. Pain, weakness, sensory changes, and incontinence or urinary retention are several of many possible symptoms that a spinal cord tumor can produce. Such tumors can be classified into different types based on their location, aggressiveness, and site of origin.

• Intramedullary—originate from within the spinal cord itself
• Extramedullary—develop outside of the spinal cord

Treatment options for both types of tumors are similar, but intramedullary spinal cord tumors can pose greater surgical risks because of their proximity to the delicate spinal cord.

Not all spinal cord tumors are cancerous, but any of them can be “harmful” in the sense that they could cause symptoms by compressing the spinal cord and its surrounding structures. If a large tumor causes significant symptoms for a long period of time, it can lead to permanent nerve damage. Although physical rehabilitation could help you regain some function after treatment, it might not fully restore normal functionality.

When a spinal cord tumor is benign and does not cause symptoms, immediate treatment might not be necessary. Benign tumors typically grow slowly and monitoring this type of tumor over time might be a favorable option over pursuing interventional treatments, particularly for older patients or those with one or more underlying medical conditions.

Spinal cord treatment options typically include surgery and radiation therapy. Chemotherapy is used rarely but might be suggested after all standard treatment options are exhausted. An alternative approach to active intervention is observation of the tumor over time, which might be considered when

• There are no symptoms associated with the tumor
• The tumor is benign and slow-growing
• Surgery is considered too risky because of various factors
• Additional time is needed to make an informed decision regarding the most appropriate treatment option

By closely monitoring the tumor and regularly evaluating its behavior, health care professionals can assess the need for active treatment and intervene if necessary. However, this observation-based approach can be stressful and produce feelings of uncertainty because it might seem like no direct treatment is being used to address the tumor.

In addition, there is a risk that the tumor could grow between imaging tests. Thus, it is crucial to stay vigilant and promptly report any new symptoms that arise, because timely reporting can lead to earlier imaging and intervention when required.

Spinal tumors are regularly monitored using imaging tests such as MRI. This type of testing offers detailed visualization of soft tissues, including the spinal cord and its surrounding structures. Through periodic imaging, your treatment team can accurately determine how fast the tumor is growing.

The specific timing of these imaging tests will depend on the characteristics of your tumor. They might be scheduled every 6 months, every year, or at even longer intervals, such as every few years. The frequency of imaging could also be lengthened over time if no tumor growth has been observed for an extended period.

At any point in time, you can also choose to pursue treatment. Regular follow-up visits will provide you with the opportunity to discuss any changes in treatment preferences and new concerns.

The best treatment plan for a spinal cord tumor is one that is tailored to your individual goals and preferences. While an observation approach might not directly target the tumor itself, it offers certain advantages.

Unlike surgery or radiation therapy, observation does not carry the inherent risks associated with invasive interventions. It can also save on costs, transportation, and time associated with the recovery process.

Ultimately, the decision to pursue observation as a treatment option should be made in consultation with your health care team, taking into consideration the specific characteristics of the tumor and your overall health status.

• Not all spinal cord tumors require immediate treatment
• Monitoring the tumor over time can be a reasonable option, especially for tumors that are benign and do not cause symptoms
• Observation entails regular imaging tests and check-ups to monitor tumor growth

• American Association of Neurological Surgeons (AANS): Spinal tumors
• National Cancer Institute: Related organizations
• Cancer Support Community: Brain and spinal cord tumors
• Glioma Foundation Center
• Collaborative Ependymoma Research Network (CERN) Foundation