Spinal Tumor Treatment
Our Treatment Approach
We know that you have the highest chance for successful treatment when your spinal tumor care is designed especially for your specific situation. That¡¯s why we customize your therapy to include the most advanced treatments with the least impact on your body.
Spinal tumor care often requires complex and delicate surgery. The goal is to remove as much of the tumor as possible, while not disturbing important parts of the spine and surrounding structures. This requires a high degree of skill.
Surgical Skill is Key
Like all surgeries, spinal cancer surgery is most successful when performed by a specialist with a great deal of experience in the particular procedure. MD Anderson spine surgeons are among the most skilled and recognized in the world. They perform a large number of surgeries for spinal tumors each year, using the least-invasive and most advanced techniques. If surgery is not possible or cannot remove the entire spinal tumor, we often are able to treat the tumor using other leading-edge treatments.
And we¡¯re constantly researching newer, safer, more-effective spinal tumor treatments. This means we are able to offer a range of clinical trials of new therapies for spinal tumors.
Our Spinal Tumor Treatments
If you are diagnosed with spine cancer, your doctor will discuss the best options to treat it. This depends on several factors, including the type and location of the tumor and your general health.
One or more of the following therapies may be recommended to treat the tumor or help relieve symptoms.
Corticosteroids: These drugs (such as dexamethasone) may be given to reduce swelling if a spinal tumor is pressing against the spinal cord. These tumors are treated as soon as possible, often with surgery.
Surgery: Some spinal tumors can be removed by surgery. If the entire tumor cannot be removed, radiation therapy may be given after surgery to relieve pressure on the spinal cord.
Radiation therapy: may be given alone or after surgery to relieve pressure on the spinal cord. Stereotactic radiosurgery is an advanced form of radiation treatment that focuses radiation precisely on the spinal tumor, causing less impact to healthy tissue.
Chemotherapy: MD Anderson offers the most up-to-date and advanced chemotherapy options for spinal tumors. These drugs may be taken orally or by injection. They may be given alone or with other treatments.
Targeted therapies: These newer agents are used to help fight some types of spinal tumors. Targeted therapies attack cancer cells by using small molecules to block pathways that cells use to survive and multiply.
Proton therapy: The Proton Therapy Center at MD Anderson is one of the largest and most advanced centers in the world. It¡¯s the only proton therapy facility in the country located within a comprehensive cancer center. This means this cutting-edge therapy is backed by all the expertise and compassionate care for which MD Anderson is famous.
Proton therapy delivers high radiation doses directly to the tumor site, with no damage to nearby healthy tissue. For some patients, this therapy results in better cancer control with less impact on the body.
Our Spinal Tumor Clinical Trials
Because of its status as one of the world¡¯s premier cancer centers, MD Anderson participates in many clinical trials (research studies) for spinal tumors. Sometimes they are your best option for treatment. Other times, they help researchers learn how to treat cancer and improve the future of cancer treatment.
Learn more about spinal tumors:
Metastatic breast and spine cancer survivor: ¡®I¡¯m living into the cure¡¯
¡°I have an illness, not a terminal diagnosis,¡± says Lisa Ordmandy. Despite her metastatic breast cancer diagnosis, Lisa remains optimistic. Her motto is ¡°Live into the cure.¡±
Lisa, now 66, was first diagnosed with breast cancer in 2007. Following treatment at another hospital, her doctors said she wouldn¡¯t have a recurrence.
But a few years later, Lisa tripped on her stationary bicycle and fell. ¡°I call it my bicycle accident ¨C it¡¯s so much cooler than what happened,¡± she laughs. ¡°As I was falling, I caught myself, but I heard a ¡®crunch¡¯ sound. I later found out that my C2 vertebra had fractured.¡±
Lisa sat down to compose herself. ¡°The pain started, but I could still feel everything,¡± she recalls. She later learned that most people who fracture that spinal bone do not survive; of those who do, most become paralyzed. ¡°I am forever grateful to be in that tiny percentage that could walk away with no damage,¡± she says.
Her husband drove her to the ER. Still, even though she could walk, she was in severe pain. At a local hospital, doctors identified the fracture and believed it was caused by a recurrence of her breast cancer. This time, the cancer had settled in her vertebra. ¡°That¡¯s when my metastatic journey began,¡± says Lisa.
MD Anderson was the only choice for metastatic breast and spine cancer treatment
When Lisa found out the cancer had returned, she was determined to go to MD Anderson. ¡°Once I had a recurrence, and it was metastatic, I wanted to be at MD Anderson for sure,¡± she emphasizes. Why? ¡°Because they¡¯re the top-rated cancer facility in the United States. They say it matters where you go first; I went there first.¡±
Lisa met with , a neurosurgeon who specializes in spinal procedures. He suggested waiting on surgery. Lisa began taking palbociclib, a targeted therapy used to treat breast cancer. Under the care of breast medical oncologist , Lisa remained stable for five years and lived a normal life.
In 2020, Lisa was hiking when she tripped and fell. ¡°I noticed after that I had a little hip problem,¡± she recalls. An MRI revealed a collapsed L3 vertebra. ¡°Dr. Tatsui said it was stable, and we continued to watch it.¡±
But after another fall in late 2023, things got worse. ¡°My leg collapsed, and I landed splat on the sidewalk. So I thought, ¡®Something is really wrong here,¡¯¡± she recalls. An X-ray at MD Anderson revealed a hairline fracture; doctors thought it would heal on its own.
But the pain kept increasing. ¡°It got to the point where I was crawling to the toilet, weeping. This was amazing pain,¡± remembers Lisa.
She knew something wasn¡¯t right, so she reached out to Tatsui and Abouharb. They advised her to come to MD Anderson¡¯s Acute Cancer Care Center immediately, where doctors found that her spine was fractured at the L3 vertebra.
Surgery preserves ability to walk
¡°Dr. Tatsui immediately put me in the hospital. He was very cautious and protective, which I really appreciate,¡± recalls Lisa. Tatsui operated on her spine in November 2023.
He explained exactly what condition her spine was in to ensure she understood the complex process. ¡°He takes the time to show me pictures,¡± she says, alluding to the 3D imaging MD Anderson¡¯s spine specialists use to visualize spine tumors and plan surgeries. These technologies help our surgeons plan and execute surgeries more precisely. Tatsui kept Lisa informed at every step about her condition and surgical treatments. ¡°He showed me pictures that indicated my spinal cord was quite dented, like a V shape,¡± Lisa says. ¡°He fixed me up! I¡¯ve got 2 titanium rods in my back and 8 screws, but I can walk.¡±
It took about 10 weeks for the pain to ease up. Lisa used a walker for several weeks, then a cane. Today, thanks to the care she received from Tatsui and his advanced practice nurse, Queena Gonzalez, she can walk unassisted. ¡°I¡¯m careful, but I would attribute my ability to walk to Dr. Tatsui and Queena. I can tell they care about me,¡± says Lisa, who recently started physical therapy. ¡°Once that nerve finally relaxed, I was normal again.¡±
Finding comfort in MD Anderson
Once again, Lisa is moving ¨C this time, closer to MD Anderson. ¡°A large part of the decision was because Dr. Abouharb is looking for clinical trials for me,¡± she says. Her doctors will need to monitor her condition closely if she participates in a clinical trial, which means more frequent appointments.
Lisa also continues to see Abouharb regularly. ¡°She moved to MD Anderson League City, and I followed her there,¡± says Lisa. ¡°I have all my scans at MD Anderson¡¯s Texas Medical Center Campus, but it¡¯s worth it to have the relationship. She¡¯s been with me for nine years, and it¡¯s comforting to be in such good hands.¡±
A positive outlook
Lisa attributes her recovery to her faith and her outlook. ¡°Positive outlook is a whole lot of?it,¡± she says. ¡°You have to have a lot of faith. I live on prayer, and I¡¯m not reluctant to ask people to pray for me.¡±
Lisa also has faith in the scientists and researchers working on new cancer treatments. ¡°If they treat me long enough, I¡¯ll be here when the cure comes,¡± she says.
For now, she¡¯s living her life to the fullest. ¡°Metastatic cancer is more like a chronic illness now,¡± she says. ¡°It¡¯s like whack-a-mole: when something comes up, you whack it down. Dr Tatsui whack-a-moled that spot on my spine down.¡±
What would she tell someone else with metastatic cancer? ¡°Go to MD Anderson first. It matters where you go first; that¡¯s what the billboard says.¡±
or call 1-877-632-6789.
Multiple myeloma and spine cancer survivor: ¡®Always think about a second opinion¡¯
In 2022, Emily Shults, then 47, had recently moved to Magnolia, Texas, from California, to be closer to family. During the move, she remembers dealing with bad back pain. Emily wasn¡¯t too concerned. ¡°I thought I¡¯d tweaked something in the move,¡± she says.
But she went to a local doctor north of Houston to get checked out.
Back pain leads to cancer diagnosis
Blood work showed she was borderline anemic. She was referred to physical therapy. Emily recalls telling the physical therapist, ¡°You¡¯ll think I¡¯m insane, but the pain is no longer in my shoulder; it¡¯s in my lower back and radiating down into my leg.¡±
Throughout the autumn of 2022, her pain got worse. On a trip, the pain was so bad she had trouble sitting in a car. ¡°I thought I was going to keel over!¡± she says. Emily¡¯s legs felt numb as she stood up a few days later. As she started to fall, she put her arm out and then heard her arm snap. A call to 911 led her to the emergency room at a local hospital.
Emily had broken her arm. Scans revealed a lesion on her humerus, the large bone of the upper arm. But that wasn¡¯t all: ¡°My spine was caving in on itself because of lesions, and I had a lesion on my left pelvis and left rib,¡± recalls Emily.
She was diagnosed with multiple myeloma, a blood cancer that affects the bone marrow and weakens the bones. ¡°The rug was pulled out from us,¡± Emily says. ¡°I was like, ¡®I have back pain! What do you mean, I have cancer?¡¯¡±
Second opinion at MD Anderson changes treatment plan
Emily started radiation therapy at her local hospital, but she remained concerned that she needed more care. ¡°Everyone said, ¡®You need a myeloma specialist,¡± she recalls. ¡°¡¯ Go to MD Anderson.¡¯¡±
She scheduled an appointment at MD Anderson.
But a week before her MD Anderson appointment, Emily¡¯s legs felt heavy. Her doctor recommended she go to MD Anderson¡¯s Acute Cancer Care Center right away. There, MD Anderson doctors found clots in her legs and a pulmonary embolism.
Emily spent a week in the hospital at MD Anderson while her care team developed a treatment plan. First, she would need chemotherapy. Her doctors recommended a combination medication, carfizomib lenalidomide dexamethasone (KRd), widely used for multiple myeloma. She also would receive daratumumab, a targeted therapy with monoclonal antibodies.
The goal was for Emily to have no minimal residual disease (MRD), meaning no trace of the disease could be found.
She met with , a neurosurgeon who specializes in spine surgery, to explore options for treating the damage on her spine from the cancerous lesions. Tatsui felt she wasn¡¯t stable enough for surgery yet, so she began physical therapy nearby.
Spinal surgery and stem cell transplant help multiple myeloma patient regain independence
A few months later, Emily had no minimal residual disease after successful chemotherapy. Her doctors felt she was ready for spinal stabilization surgery to help her walk and independently carry out daily activities again.
¡°It was very scary, but I think Dr. Tatsui and his team did everything they could to make me feel comfortable,¡± says Emily of the June 2023 surgery. ¡°He was very thoughtful and careful.¡± Tatsui and his team explained every detail of the surgery as well as potential side effects. ¡°They did everything they could to make sure I understood,¡± Emily says.
The surgery was a success. In addition, her MD Anderson doctors recommended a stem cell transplant, which replaces diseased bone marrow with healthy bone marrow cells.
Two months after her spine surgery, Emily had a stem cell transplant under the care of stem cell transplant specialist ¡°I went in the hospital using a walker, had surgery, and in July of 2023, I did my stem cell and went in with a rollator,¡± reflects Emily on her progress.
Today, Emily remains MRD-negative. Effectively, she is in remission. While she continues maintenance chemotherapy, she is back to walking and doing everything on her own. Her broken arm bone has also fully healed.
How does Emily feel about her time at MD Anderson? ¡°Everyone has been really good about listening to me,¡± she says. ¡°Every time I¡¯ve had a challenge, they listen and connect me with specialists and rule things out.¡± For instance, a few months after her stem cell transplant, Emily had fluid buildup in her lower legs and feet. It was edema. This condition can occur in multiple myeloma patients after a stem cell transplant due to the cumulative effects of chemotherapy, white blood cell growth factors, and nutrition changes. ¡°My legs felt like cement blocks,¡± Emily recalls.
Her care team responded immediately, putting her on a medication called furosemide twice a day and giving her a referral for therapy near her home. ¡°Patients with severe edema can benefit by getting care at a lymphedema clinic or center,¡± says Qazilbash. ¡°It is fully reversible in almost all cases.¡±
Emily¡¯s team also ordered compression stockings for her. Today, the swelling is much more manageable.
Staying positive and engaged in care
Reflecting on her diagnosis and surgery, Emily says, ¡°I allowed myself those days to cry, but focusing on the positive was a big driver for me.¡± Even on her worst days, she¡¯d look for the positive. ¡°As we¡¯d see the doctors and nurses, they said, ¡®You have a bright light,¡¯¡± she recalls.
Being an active participant in her treatment and recovery helped Emily cope and heal. ¡°Stay focused on the prize, partner with your team and figure out how to get through the setbacks,¡± she tells other patients.
Asking questions helped Emily feel empowered during her treatment, and she encourages other patients to do the same: ¡°Make sure you are your own advocate; ask questions because that gives you peace of mind,¡± says Emily, who uses MyChart for questions between appointments. ¡°If I can¡¯t talk to the doctor on the phone, someone on their team is responding.¡±
Staying connected to loved ones also helped Emily and her family throughout her treatment. Her husband used social media to keep friends and family updated. ¡°It¡¯s hard on your caregivers; he needed an outlet,¡± she says.
Reflecting on her journey, Emily offers one last suggestion for other patients. ¡°Always think about a second opinion. And don¡¯t be afraid to say you need help or support.¡±
or call 1-877-632-6789.