Symptoms of Spinal Cancer: Early Warning Signs, Diagnosis and Treatment
Mr Karpe
Sharing expertise on spine care, treatment advancements, and patient experiences.
Spinal cancer is uncommon, and the vast majority of people with back or neck pain do not have cancer. Most spinal pain is caused by common conditions affecting the muscles, joints, discs or nerves, Spinal cancer is uncommon, and the vast majority of people with back or neck pain do not have cancer.
Many cases of back pain are caused by common conditions such as muscle strain, disc problems, or arthritis. However, persistent or unexplained back pain—particularly when accompanied by other concerning symptoms may require further medical assessment.
Tumours can affect the bones of the spine, the spinal cord, or the tissues surrounding it. Tumours may originate in the spine (primary spinal tumours) or spread from cancers elsewhere in the body (secondary or metastatic spinal tumours).
This guide explains the symptoms of spinal cancer, possible causes, how it is diagnosed, available treatment options, and when to seek urgent medical advice.
What Is Spinal Cancer?
Spinal cancer refers to abnormal growths (tumours) that develop in or around the spine. These tumours may be:
- Primary spinal tumours, which begin in the spine or spinal cord (rare)
- Secondary (metastatic) spinal tumours, which spread to the spine from another part of the body, such as the breast, lung, prostate, kidney, or thyroid
Not all spinal tumours are cancerous. Some are benign (non-cancerous), but even benign tumours may cause symptoms if they press on the spinal cord or nearby nerves.
What Are the Symptoms of Spinal Cancer?
Symptoms vary depending on the size and location of the tumour and whether it affects the spinal cord or nerves.
Common symptoms include:
- Persistent back or neck pain
- Pain that is worse at night
- Pain that does not improve with rest
- Pain spreading into the arms or legs
- Numbness or tingling
- Muscle weakness
- Difficulty walking or maintaining balance
- Loss of bladder or bowel control (in severe cases)
- Unexplained weight loss
- Fatigue or reduced appetite
Importantly, none of these symptoms on their own necessarily means that someone has spinal cancer. Many are much more commonly caused by non-cancerous spinal conditions.
The overall pattern of symptoms, examination findings and medical history helps determine whether further investigation is necessary.
Persistent Back Pain
Back pain is the most common symptom of spinal cancer.
Unlike mechanical back pain, it may:
- Gradually worsen over time
- Continue despite rest
- Be more severe at night
- Wake you from sleep
- Not improve with usual pain relief
If you have ongoing back pain, our guide on 5 Causes of Lower Back Pain explains some of the more common conditions that may also cause these symptoms.
Pain That Spreads to the Arms or Legs
As a tumour grows, it may compress nearby nerves.
This can cause:
- Pain travelling into the arms
- Sciatica-like pain in the legs
- Burning or shooting pain
- Electric shock-like sensations
The location depends on which part of the spine is affected.
Numbness, Tingling and Weakness
Pressure on the spinal cord or nerve roots may lead to neurological symptoms such as:
- Tingling in the hands or feet
- Reduced sensation
- Muscle weakness
- Difficulty gripping objects
- Trouble climbing stairs
- Problems lifting the foot
Progressive weakness should never be ignored.
Difficulty Walking and Balance Problems
Spinal cord compression can affect coordination.
Some people notice:
- An unsteady gait
- Frequent trips or falls
- Difficulty walking long distances
- Poor balance
These symptoms require prompt medical assessment.
Bladder and Bowel Changes
Advanced spinal cord compression may interfere with bladder or bowel function.
Symptoms include:
- Difficulty passing urine
- Urinary retention
- Loss of bladder control
- Loss of bowel control
These are emergency symptoms requiring immediate medical attention.
Other General Symptoms
Depending on the underlying cancer, you may also experience:
- Unexplained weight loss
- Loss of appetite
- Persistent fatigue
- Night sweats (less commonly)
These symptoms are not specific to spinal cancer but should be discussed with your GP if they persist.
What Causes Spinal Cancer?
Primary spinal cancers are uncommon.
More often, cancer spreads to the spine from another part of the body.
Common cancers that may spread to the spine include:
- Breast cancer
- Lung cancer
- Prostate cancer
- Kidney cancer
- Thyroid cancer
Haematological cancers such as multiple myeloma can also affect the vertebrae.
Risk Factors
Factors that may increase the likelihood of spinal tumours include:
- A previous diagnosis of cancer
- Increasing age
- Certain inherited genetic conditions (rare)
- Exposure to previous radiotherapy in some circumstances
A previous history of cancer does not mean that new back pain is necessarily caused by cancer. However, it is important information for the clinician assessing the symptoms
When Should You Seek Urgent Medical Attention?
Cancer affecting the spine can occasionally cause metastatic spinal cord compression (MSCC). This occurs when cancer presses on the spinal cord or the nerves at the lower end of the spinal canal.
Seek urgent medical assessment if you have a current or previous diagnosis of cancer and develop symptoms such as:
- New or rapidly worsening weakness in the arms or legs
- Increasing difficulty walking
- New bladder or bowel dysfunction
- Numbness or altered sensation that is progressing
- Severe or rapidly worsening spinal pain associated with neurological symptoms
Sudden bladder or bowel dysfunction, numbness around the genitals or buttocks, or rapidly progressive weakness can also occur with other spinal emergencies, including cauda equina syndrome, and requires urgent assessment.
How Is Spinal Cancer Diagnosed?
Your clinician will begin with a detailed medical history and physical examination.
Further investigations may include:
MRI Scan
MRI is the most useful imaging test for assessing the spinal cord, nerves, and soft tissues.
CT Scan
CT scans provide detailed images of the bones and may help identify tumour involvement.
Blood Tests
Blood tests may help identify signs of inflammation or underlying conditions and can support the diagnostic process.
However, blood tests alone cannot rule spinal cancer in or out.
Biopsy
If imaging suggests a tumour, a biopsy may be needed to confirm the diagnosis and determine the tumour type.
Treatment Options
Treatment depends on:
- The type of tumour
- Its location
- Whether it is primary or secondary
- The patient’s overall health
- If the spinal nerves or cord is compressed
- Stability of the spine
Management often involves a multidisciplinary team, including spinal surgeons, oncologists, radiologists, and specialist nurses.
Surgery
Surgery may be recommended to:
- Relieve pressure on the spinal cord or nerves
- Remove part or all of a tumour where appropriate
- Stabilise the spine if weakened by cancer
- Obtain tissue for diagnosis
Not every spinal tumour requires surgery.
Radiotherapy
Radiotherapy is commonly used to:
- Treat certain spinal tumours
- Relieve pain
- Reduce pressure on the spinal cord
- Help control cord compression
Chemotherapy and Other Cancer Treatments
Depending on the cancer type, treatment may include:
- Chemotherapy
- Targeted therapy
- Immunotherapy
- Hormone therapy
These treatments are directed by an oncology team.
Rehabilitation
Following treatment, rehabilitation may involve:
- Physiotherapy
- Occupational therapy
- Pain management
- Psychological support
- Pain management
- Nursing care
The rehabilitation plan depends on each person’s symptoms and functional needs.
Recovery and Outlook
The outlook depends on:
- The type of cancer
- Its response to treatment
- Whether cancer is present elsewhere
- The extent of spinal involvement
- The degree of neurological impairment
- The person’s general health
When spinal cord compression occurs, prompt recognition and treatment are particularly important because neurological function can deteriorate if compression progresses.
Can Spinal Cancer Be Prevented?
There is no guaranteed way to prevent spinal cancer.
However, early investigation of persistent or unexplained back pain—particularly when accompanied by neurological symptoms or a previous history of cancer—can help identify serious conditions sooner.
When Should You See a Specialist?
Arrange an appointment with your GP promptly if you have:
- Persistent back pain lasting several weeks without improvement
- Pain that is worse at night
- Unexplained weight loss
- Progressive weakness
- Persistent numbness
- A previous history of cancer with new spinal pain
Early referral for imaging and specialist assessment may be appropriate if red flag symptoms are present.
Conclusion
Spinal cancer is uncommon, but recognising its symptoms is important because early diagnosis can make a significant difference to treatment and outcomes. Persistent back pain that worsens over time, particularly when accompanied by weakness, numbness, balance problems, or bladder and bowel changes, should always be assessed promptly.
No individual symptom reliably diagnoses spinal cancer. A careful history, examination and appropriate investigations are needed to establish the cause.
Early recognition of spinal cord compression is especially important because prompt treatment may help preserve neurological function and mobility.
If you have persistent back or neck pain, concerning neurological symptoms, or a history of cancer with new spinal symptoms, appropriate medical assessment can help determine whether further investigation is required.
Mr Prasad Karpe, Consultant Spinal Surgeon, provides specialist assessment of spinal conditions and works within a multidisciplinary framework to support appropriate investigation and management.
Disclaimer
This article provides general information and should not be used as a substitute for individual medical advice, diagnosis or treatment. If you develop rapidly progressive weakness, new bladder or bowel dysfunction, or other concerning neurological symptoms, seek urgent medical attention.