Treatment of spine tumors at
City of Hope
is individualized to the patient. Important factors in developing a treatment strategy include the tumor type, location and the patient’s overall health. These determine which options – surgery, radiation, chemotherapy and other experimental therapeutic agents – would be the most beneficial.
Minimally Invasive Surgery
Surgery is commonly used to treat patients with spine tumors. When applicable, our specialists utilize minimally invasive surgery with advanced technologies such as laparoscopy and the da Vinci S Surgical System with robotic capabilities that allows for greater precision. These surgeries feature small incisions. The result is less discomfort and blood loss with faster recovery and fewer complications.
One of the following surgical procedures may be used:
Endoscopic surgery: Certain brain and spine surgeries may be performed through an endoscope — a thin, lighted tube that requires a small opening and accommodates tiny surgical tools. Smaller openings minimize post-operative discomfort and risk of infection. City of Hope researchers are working to develop a miniaturized surgical system that will allow these surgeries to be even less invasive, with an even lower risk of complications.
Spinal cord monitoring: Used when performing surgery for tumors within the spinal cord, nerve transmission monitoring provides important data that helps doctors preserve important nerve function and sensation.
Advanced spine instrumentation: Spine instrumentation is a method of straightening and stabilizing the spine after spinal fusion surgery by attaching structural elements so that stresses on the bones can be better distributed, keeping them in proper alignment. City of Hope is advancing the field of spine instrumentation by grafting bone matrix materials infused with stems cells topromote natural bone regrowth.
Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells. OurDivision of Radiation Oncologywas the first in the western United States to offer theHelical TomoTherapy Hi-Art System, one of the first radiation therapy systems of its kind to integrate radiation therapy and tumor imaging capabilities comparable to a diagnostic computed tomography (CT) scan.
The TomoTherapy system integrates two types of technology – spiral
ning and intensity modulated radiation therapy, or IMRT, that produces hundreds of pencil beams of radiation (each varying in intensity) that rotate spirally around a tumor. The high-dose region of radiation can be shaped or sculpted to fit the exact shape of each patient’s tumor, resulting in more effective and potentially curative doses to the cancer. This, in turn, reduces damage to normal tissues and offers fewer complications.
TomoTherapy is particularly useful in treating children with certain spine tumors. Because it operates with absolute precision, normal tissue is protected, reducing the risk of long-term cognitive problems.
Chemotherapy – the use of anticancer medicines – is another strategy used to combat spine tumors. Drugs may be given alone or in combination with surgery and radiation therapy.
Chemotherapy is often given in situations where cancers in other areas of the body have metastasized to the spine. In these cases of secondary cancer, the kind of drugs given are the same that are used to treat the original (primary) tumor.
Generally, tumors of the central nervous system are more difficult to treat with drugs than other cancers. This is because they cannot cross the blood-brain barrier, a natural barrier that prevents toxic chemicals from reaching nerve cells. However, new drugs are being developed that can either cross the barrier or be delivered directly to the spinal cord.