Your treatment will depend on your age and general health, and the position, size and type of the tumour. Your specialist doctor and nurse will explain the aims of your treatment and what it involves. They will talk to you about treatment benefits and disadvantages. They will also explain the risks and side effects.
You will have time to talk this through with them before you make any treatment decisions. You may be given a choice of treatment options. Let your specialist know if you need more information or time.
The main treatments used for spinal cord tumours are surgery, radiotherapy and steroids.
Surgery
The aim of surgery is to remove the tumour without damaging the spine or spinal cord. If possible, the surgeon will remove the tumour completely. If not, it’s often possible to remove part of it (debulking surgery). This can improve your symptoms by relieving the pressure on the nerves, and can slow down the progress of the tumour. During surgery, a sample of cells from the tumour (biopsy) is taken and examined under a microscope. This allows your doctors to see the type of tumour and to plan further treatment if needed.
Your surgeon will explain exactly what your operation will involve. They will talk to you about the possible complications and risks.
After surgery, you may be looked after in a high dependency unit for a few days. Your surgeon will give you more information about what to expect. You may have some pain after surgery, but this will be controlled with painkillers. There are various ways of giving painkillers. Always let the nurse know if you are still in pain. Before you go home, your pain will be controlled by tablets. You’ll be given a prescription for painkillers you can take at home as needed.
You will be encouraged to get up fairly soon after your operation. The ward staff will help you with this at first. Once you are moving about more freely, you’ll probably be able to manage this for yourself. Some people may need extra support to help with their recovery. This may be from a physiotherapist who can help you to improve your balance, walking or strength. Occupational therapists can provide equipment and help you become more independent.
Your wound will be closed using clips or stitches. Your surgeon or nurse will explain how to look after the wound when you are home. It's important to let your nurse or doctor know straight away if your wound becomes hot, painful, or begins to bleed or leak any fluids, even after you go home.
It can take a while to recover after surgery so it’s important to take good care of yourself. Get plenty of rest, try to eat well and follow the advice given by your surgeon and specialist nurse.
Radiotherapy
Radiotherapy uses high-energy rays to destroy the cancer cells. You may have this after surgery to treat any remaining tumour cells or if the tumour comes back after surgery. Even if all the tumour was removed with surgery, you may have radiotherapy to reduce the risk of it coming back. Sometimes radiotherapy is used as the main treatment when surgery isn’t possible.
You normally have radiotherapy in the hospital radiotherapy department as a series of short, daily sessions over several weeks. Treatment is usually given from Monday to Friday, with a rest at the weekend.
Radiotherapy has to be carefully planned to make sure it’s as effective as possible. On your first visit to the radiotherapy department, you’ll be asked to have a CT scan or lie under a machine called a simulator, which takes x-rays of the area to be treated. Your radiotherapy team use this scan to plan your treatment.
At the beginning of each treatment session, you lie in the same position but under the radiotherapy machine. The treatment itself only takes a few minutes. You’ll be left alone in the room but you can talk to the radiographer who will watch you from the next room. Radiotherapy is not painful, but you have to be very still for a few minutes during the treatment.
Radiotherapy can cause side effects or make your symptoms worse for a time. This can carry on for some weeks after it finishes. Your specialist doctor and nurse will talk to you about the side effects of radiotherapy and how they can help you cope with them. They may give you steroids to improve your symptoms after treatment.
Side effects of radiotherapy may include skin reactions, feeling sick and feeling tired. Some people find the side effects temporarily get worse after their treatment has finished. You may feel low or worry your treatment isn’t working. But it’s usually a reaction to the radiotherapy or because your steroids may have been reduced or stopped. It’s important to let your doctor or nurse know straight away if your side effects get worse.
Steroids
Doctors prescribe steroid drugs to reduce the swelling around spinal cord tumours. They reduce the symptoms caused by increased pressure and make you feel better. They may be given before or after surgery, and during or after radiotherapy.
It’s important to take them exactly as your doctor has explained. Your pharmacist or nurse will give you a steroid card. The card should be carried with you at all times so that in an emergency a doctor will know you are having steroid treatment. A card is not necessary if you are only having a short course of steroids.
Never stop taking your steroids suddenly as this can make you very ill. Your doctor will gradually reduce the dose.
Possible side effects include:
• indigestion – take them with food and tell your doctor if you have stomach problems as they can prescribe a drug to help with this
• increased appetite and weight gain – this is more common when steroids are taken over a longer time and will improve when your steroids are reduced
• difficulty sleeping – avoid taking your steroids after 6pm
• feeling restless or agitated – let your doctor know if this is a problem
• a higher level of sugar in the blood – you will have blood or urine tests for this.
Talk to your doctor or specialist nurse if you’re worried about any side effects. These will go away gradually as your doctor reduces your steroid dose.
Chemotherapy
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy is occasionally used for certain types of spinal tumours.
Chemotherapy can cause different side effects. These vary depending on the drugs you have. Your cancer doctor will tell you more about treatments that may be useful for you.
Some side effects are more common than others but you won’t have them all. They can be reduced and controlled with drugs. Your doctor or nurse can tell you how to manage them. The most frequent ones include:
• increased risk of infection
• anaemia (reduced number of blood cells)
• hair loss or thinning
• feeling sick or vomiting
• mouth ulcers
• tiredness.
Most side effects are short term and will improve gradually when the treatment is over.