Many of these patients will not be referred to a surgeon. In children, this is because the malignant tumors of the spine respond well to medical treatment. Leukemia is treated with multi-drug chemotherapy and neuroblastoma responds well to radiation and chemotherapy. In adults, breast, lung, and prostate cancer frequently spread to the spine. Breast and prostate tumors often respond well to radiation and hormone manipulation.
Spinal tumors caused by lung cancer are more aggressive.
They appear late in the course of the illness and are often multiple. These tumors may involve the brain and other organs as well. Adenocarcinoma of the lung, however, is more likely to cause a solitary mass in the spine and therefore be more amenable to surgery. Generally, surgery is indicated when there is a neurologic deficit referable to the spinal tumor, evidence of spinal instability because of bone destruction by the tumor, failure of radiation therapy to control tumor growth, or lack of a tissue diagnosis. Obtaining a piece of the tumor to identify what kind of tumor it is allows doctors to focus their treatment.