Treatment for spinal cord tumours

Some types of brain tumour may start in the spinal cord but this is very rare. The treatment for a spinal cord tumour will depend on

• The type of tumour you have
• Its position in the spinal cord
• Your age - the treatment may be different for children with a spinal cord tumour

You may have steroids to take straight away, to bring down any swelling around the tumour. This will relieve symptoms and help to stop damage to your spinal cord from becoming permanent. Your doctor will want you to carry on taking the steroids for a while after you have had surgery to remove the tumour, or radiotherapy to shrink it.

For primary spinal cord tumours in adults and children, surgery is the most likely treatment. It is possible to remove some spinal tumours completely. This is most likely if the tumour is in the outer part of the spinal cord.

Even if the surgeon can't completely remove your tumour, it is usually possible to remove some of it. This will help in 3 ways. Firstly, it will immediately help to relieve the pressure on your spinal cord. Secondly, it will slow down the progress of the tumour. With some slow growing tumours, this may keep it under control for years. Thirdly, a smaller tumour will be more likely to respond well to treatment with radiotherapy or cancer drugs.

You may have radiotherapy if you have a spinal tumour that can't be completely removed with surgery. Or a tumour that has come back after it was first treated.

In children spinal cord tumours are often gliomas (including spinal ependymoma). It is also possible for children to get spinal cord neuroblastomas or Ewing's sarcomas. All these are very rare.

As with adults, the main treatment is usually surgery. If the tumour is a slow growing type (low grade) this may be all the treatment your child needs.

If the surgeon can't completely remove the tumour, or if it is a fast growing (high grade) type, then your child's doctor may suggest radiotherapy after surgery. If your child is very young, the doctor may suggest chemotherapy instead. Radiotherapy is then delayed until your child is over 3 years old. This is because radiotherapy can be particularly damaging to the nerves in very young children and may cause permanent side effects.

If the tumour comes back, the treatment will depend on the treatment your child had when their cancer was first diagnosed. It may be possible to operate again to remove more of the tumour. If your child didn't have radiotherapy at first, the specialist may suggest it now. If your child did have radiotherapy first time round, it isn't usually possible to have it again because it would cause too much damage to healthy tissue. Your child's specialist may suggest chemotherapy instead.

Unfortunately, you may have permanent effects from your tumour and treatment. This will depend on

• The size of the tumour when it was diagnosed
• How much surgery you needed
• How long you had symptoms before you were treated

You may have numbness in some parts of your body. Exactly where depends on the position of the tumour along your spine. The nerves that control different parts of your body come out of different parts of the spine. A tumour higher up in the spine may affect your arms for example. A tumour lower down may affect your legs, your bladder or bowel control, or your sexual function. Your doctor will be able to give you more specific information about the likelihood of side effects and exactly what they are likely to involve if you have them.

Children can also have long term side effects after treatment for a spinal tumour. The more severe the symptoms of paralysis or weakness before treatment, the more likely that some problems will carry on after treatment. Your surgeon will not be able to tell you beforehand how the tumour and treatment will affect your child. You won't have a clear idea until the child has begun to recover from treatment.

Curvature of the spine can develop soon after treatment or several years later. This is more likely if one of the bones of the spine (vertebrae) had to be removed during surgery.