Metastases in the spinal column are secondary cancerous foci. The primary tumor is predominantly located in other organs. And only in 10% of cases the cancer focus is localized in the spinal cord. Spinal metastases are found in the thoracic and upper lumbar vertebrae. Mostly secondary lesions belong to sarcomas and lymphomas. From this article you will learn about methods for diagnosing secondary cancerous lesions, symptoms, methods of diagnosis and treatment, and methods of pain relief. The information will be useful to everyone who is diagnosed for the first time, wants to understand the nature of metastasis and believes in a positive outcome of therapy.
What cancers metastasize to the spine?
Blood circulation determines the spread of cancer cells. They are constantly migrating. From any organ in the body, blood goes to the liver, then flows to the heart and lungs. The return path is directed to the original organs. During the blood circulation, the affected cells enter numerous vascular branches (collaterals), and from there into the spongy structure of the vertebrae. There they settle, beginning to form a tumor. Metastases in the spine in 87% of cases appear due to primary cancerous foci in the following organs:
- mammary glands and lungs;
- gastrointestinal tract;
- kidneys and prostate gland;
- trachea, tongue, larynx;
- uterus, ovaries, bladder;
- multiple myeloma.
Symptoms of metastases in the spine in stage 4 cancer
The statistics are inexorable; half of the diagnoses in our country are made at stage 4 of cancer. There may be no symptoms until this critical point. The first warning sign is pain. It is deep and intrusive in nature, can radiate into the radicular plexuses and increase at night. Symptoms of metastases in the spine include the following:
- radicular disorders (lumbosacral or cervicobrachial radiculitis);
- microfractures, hemorrhages;
- vertebral compression fractures;
- erectile dysfunction, defecation and urination;
- paresis and paralysis;
- redness of the distal extremities;
- hyperhidrosis (increased sweating), etc.
Features of pain syndrome
The mechanisms of metastasis are different, so the nature and manifestation of the pain syndrome may differ. The growth of a tumor in the spinal column provokes an inflammatory process. Tension of the soft tissues occurs, under the influence of which pain occurs. Metastases in the spine show symptoms of varying intensity. They are especially troublesome at night. Often the symptoms are correlated with osteochondrosis, so the diagnosis requires careful verification. If the nerve roots are compressed, a sharp and shooting pain occurs. Muscle weakness, tingling and numbness may occur. With sharp and severe pain, vertebral destruction or pathological fracture is usually diagnosed. It is typical for this case that the symptom manifests itself in a sitting position.
Nature of pain
Pain in a specific vertebra may indicate displacement and entrapment of a nerve root.
Pain in a vertebra under pressure is not an isolated manifestation. It has varying intensity and character, which makes it possible to assume the type of pathological changes. When describing discomfort, be sure to pay attention to several characteristics:
- Intensity – the severity of pain is assessed by subjective sensations. The person is asked to rate their discomfort on a scale from 1 to 10, which corresponds to a range from barely noticeable to unbearable pain. Very severe discomfort, which is almost impossible to tolerate, occurs with oncological pathology, as well as after spinal injuries.
- Character - when pressing on the spine, a sick person may feel tingling, shooting or dull pain, less often there is a burning sensation. Sharp, shooting discomfort indicates involvement of the nerve fibers of the spinal roots in the pathological process, which is an unfavorable sign.
- Localization - by the location of pain, which is most severe, one can judge where the pathological process develops: in the neck, lower back or thoracic spine.
The cause of the pain may be a bruised vertebra.
At the same time, pay attention to the presence of accompanying symptoms and features, which will help to find out the cause of changes in the spine:
- The time when discomfort appears or intensifies after pressing is that in the morning the pain intensifies with the development of an autoimmune process, and in the evening it occurs with degenerative-dystrophic pathology.
- The presence of pain of varying nature and intensity in other places of the body is an unfavorable sign, indicating the possible development of cancer pathology with metastases.
- Decreased spinal mobility - limited movement usually indicates the development of an autoimmune process.
- Severe deformation of the spinal column is a sign of damage to various structures due to trauma or pathological fracture of the bone bases against the background of a decrease in their strength.
With the help of clinical symptoms, it is possible to suggest the origin and nature of the pathological process that led to pain. This is necessary for targeted subsequent diagnosis and rapid initiation of appropriate therapeutic measures.
Methods for diagnosing metastases in the spine
Making an accurate diagnosis depends on careful diagnosis. In medical practice, there is a rule that is based on the need to conduct an MRI or CT scan of the spine when any type of cancer is detected in the body. Metastases can develop slowly or quickly, so testing for their presence is a mandatory measure. The main diagnostic methods are also contrast myelography and biopsy (cytological and histological analysis of a tumor fragment). Additional methods include ultrasound, radiography, mammography, and scintigraphy. Patients are sent for angiography to clarify information about the blood supply to a cancerous tumor.
How to Diagnose the Problem
If discomfort occurs, you need to go to the doctor and have an examination, which will make it possible to choose the optimal treatment. The specialist prescribes imaging of the spine using radiography, computed tomography or magnetic resonance imaging.
If diseases of the internal organs are suspected, an electrocardiogram, ultrasound of the abdominal cavity and retroperitoneal space, and fibrogastroduodenoscopy are additionally prescribed. With the help of laboratory tests, which include a clinical analysis of urine, blood, biochemical kidney and liver tests, the functional state of the patient’s body is assessed.
Treatment methods for metastases
Metastases in the spine require treatment depending on the type, location of the primary tumor, the general condition of the patient and the number of focal formations. With stage 4 cancer, the task of doctors is to make you feel better and improve your quality of life. It is not always possible to completely get rid of pain, but to reduce it immediately is possible. Treatment of metastatic tumor formations in the spine is necessary due to the risk of paralysis. The list of methods that oncologists practice is as follows:
- radiation therapy;
- surgical removal of tumors;
- chemotherapy;
- radionuclide treatment;
- hormone therapy;
- radiofrequency ablation.
Causes of pain when pressing on a vertebra
One wrong move can knock you out of normal life for weeks, or maybe even months. Sometimes a person may not remember when and under what circumstances he received a bruise, and may not know about the pathologies and anomalies occurring in his spine. These may be benign or malignant tumors in the tissues surrounding the spine, depletion of bone tissue, leading to fragility. Women's diseases of the ovaries or uterus can also lead to unpleasant pain when touching the back. The list can be continued as it is quite extensive. By looking at just one symptom, it is impossible to identify the cause.
Types of pain
As you know, pain can be of different types. Pulling, cutting, aching, short-term, sharp. Bruise-like pain (in the absence of a visual bruise) may occur when bending or squatting, during a long walk, or when standing up after prolonged sitting.
If a person experiences headaches, dizziness, or feels muscle weakness, these may be symptoms of protrusion, hernia, or osteochondrosis of the spine
. If a tumor is suspected, a person's muscles weaken, he loses weight, the functioning of the urinary system and intestines is disrupted, he has pain and dizziness, and loss of appetite. Arthritis and arthrosis are accompanied by limited mobility, swelling, pain in the heart area and redness of the skin in areas of inflammation. With spondylosis, the lumbar spine hurts, radiating to the legs, and there is a tingling and burning sensation. vertebral instability leads to hamstring pain after walking.
Self-diagnosis
This is not the best way to eliminate the cause of pain and diagnose yourself. With the help of doctors and modern scientific approaches, the cause can be identified with the greatest accuracy. And only after making the correct diagnosis can we talk about treatment.
Diseases that cause pain in the spine upon palpation include pathologies such as:
- osteochondrosis of the cervical spine;
- unstable position of the vertebrae;
- arthritis and arthrosis;
- intervertebral disc herniation;
- gout and ankylosing spondylitis;
- tumors and infections, for example, staphylococcus or tubercle bacilli.
Such pathologies cannot be identified without a specialist.
Treatment methods for spinal pain
Depending on the diagnosis, the doctor prescribes treatment for the spine
. Either conservative (drug or non-drug) or operative (surgical) intervention.
Drug treatment includes nonsteroidal drugs, vitamins, analgesics, antibiotics, vasodilators, warming, and relaxants. Non-drug treatments include warming up, magnetic therapy, manual therapy, massages, exercise therapy. If symptoms do not subside within 6-8 weeks and relief does not occur, then surgical intervention is used.
Indications for the operation:
- removal of an intervertebral hernia in order to relieve pain and restore the patient’s quality of life, restoring his ability to work.
- In case of a large number of malignant tumors, only the metastasis that directly causes pain is removed. This makes a person’s life easier, but, unfortunately, does not save.
- In a state of instability of the vertebrae, when they pinch the spinal nerve. During the operation, a vertebra is removed, making the spine immobile and relieving pain in the affected area.
If you experience pain when pressing on a vertebra, contact a doctor immediately; with early treatment, the likelihood of a favorable prognosis increases significantly. Modern diagnostic equipment allows you to accurately make the correct diagnosis.
The main diagnostic methods are:
- X-ray – allows you to see how displaced the vertebrae are and determine the presence of bone growths;
- CT - computed tomography, allows you to identify a number of diseases, including tumors, and is also used in preparation for surgery;
- MRI - magnetic resonance imaging, through which the spinal cord and blood vessels and tumors around the spinal column are viewed;
- myelography is a procedure based on the introduction of a contrast agent into the subarachnoid canal of the spine, through which it is possible to examine the infringement of the spinal cord and nerve processes;
- electrospondylography - a method that helps to identify predictive conditions of the spine.
In more severe cases, additional examination requires general clinical tests, blood biochemistry and biopsy to identify pathogenic processes.
How to protect yourself from spinal pain
Pain in the spine can occur regardless of age. Of course, first of all you should contact a medical institution, in a clinic this is a neurologist. But a more specialized specialist in back treatment is a vertebrologist.
To prevent this nuisance and prevent surgical intervention, you need to follow some recommendations. Prevention is simple muscle strengthening. It is necessary to regularly engage in active sports, at least daily gymnastics. Try not to overload yourself physically in order to prevent displacement of the vertebrae, leading to the formation of a hernia. Eat right, adding foods rich in proteins and fiber to the menu, eat fresh vegetables and fruits every day, give up bad habits, try to maintain your posture when walking. When working sedentarily, take a break every two hours to warm up. Use orthopedic bedding for sleep.
By following these simple recommendations, you can prevent spinal diseases.
And if violations have already appeared, then slow them down or even get rid of them completely. Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr
Methods to suppress pain with metastases in the spine
Obsessive and radiating pain sensations physically exhaust the patient. They can appear spontaneously or be permanent. A common way to treat moderate pain is to take non-steroidal anti-inflammatory drugs. For more severe cases, opioid medications are used. According to the doctor's opinion and the patient's condition, glucocorticoids may be prescribed. There is another method from the field of vertibrology for metastases in the spine - injections of medical cement. This procedure has no medicinal properties and does not reduce the size of tumors, but it can relieve pain due to severe destruction of the vertebrae. Such manipulations allow you to maintain the normal functioning of organs, the ability to move and lead a normal life.
What not to do if you have cancer
For any type of cancer and in the presence of metastases, baths, saunas, and massages are prohibited without first consulting a specialist. They stimulate physical activity on the body and organs, which accelerates blood circulation. The consequence of massage is the intensive spread of cancer cells throughout the body. For an existing tumor, the risk of it growing increases. As a result, the cancer patient’s well-being worsens and general intoxication may increase. For this reason, any thermal procedures and massages are prohibited for pain in the back and spine.
Stage 4 cancer and multiple metastases in the spine cannot provide a favorable prognosis for a complete cure for cancer. On average, survival varies from 3 to 10 months when it comes to complex and inoperable cases. The sooner you contact when suspicious symptoms appear, the better the prognosis. Life expectancy after diagnosis can be 10-12 years. The result depends not only on the patient’s condition, but also on the therapy methods used in combination with new technologies.
You can consult and undergo diagnostics at an oncology center with world-class treatment standards. The advantages of the clinic are not only technical equipment and experienced doctors, but also the provision of psychological assistance for cancer patients and their relatives, social adaptation, and rehabilitation. Health is urgent, so we need to pay attention to cancer prevention and find time to undergo follow-up examinations.
