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Spinal tumours
A guide for patients and carers
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Tests and investigations
After the onset of symptoms, most people would usually see their GP who then refers them to a local hospital, or directly to a neuroscience centre, for tests and investigations.
If your symptoms have developed very gradually, you are likely to have an outpatient’s appointment in the first instance, rather than be admitted to hospital. If you are being treated for cancer in another part of your body and your doctors suspect that your symptoms are caused by the cancer spreading to your spine, they will arrange the tests and investigations.
X-rays of your spine will provide important information. However, spinal tumours are usually confirmed with the results of an MRI scan or a CT scan (see below) and possibly a biopsy (see below).
If your symptoms have developed very gradually, you are likely to have an outpatient’s appointment in the first instance, rather than be admitted to hospital. If you are being treated for cancer in another part of your body and your doctors suspect that your symptoms are caused by the cancer spreading to your spine, they will arrange the tests and investigations.
X-rays of your spine will provide important information. However, spinal tumours are usually confirmed with the results of an MRI scan or a CT scan (see below) and possibly a biopsy (see below).
MRI scan
An MRI (Magnetic Resonance Imaging) scan produces pictures of the spine using strong magnetic fields and radio waves. It differs from a standard X-ray as it produces very detailed pictures.
During the scan you will lie in a long tube. The scan is painless but, unfortunately, the scanner is very noisy. Earplugs or headphones will be provided.
If you think you will feel anxious or uncomfortable in the confined space of the scanner tunnel you should tell the staff before the scan. You should also tell them if you unexpectedly feel anxious just before you are due to enter the scanner tunnel.
Sometimes a dye (MRI contrast agent) is injected into a vein in your arm to help show the tumour more clearly in the pictures.
CT scan
A CT (Computerised Tomography) scan is a special type of X-ray which takes pictures of your spine from different angles.
During the scan you will be asked to lie on a scanner table while the scanner rotates around your body. It is a quick and painless examination.
Sometimes a dye (CT contrast agent) is injected into a vein in your arm to help show the tumour more clearly in the pictures.
(You might be interested in reading our fact sheet on brain and spine scans for further information.)
Isotope bone scan
An isotope bone scan is a test to show if there is a problem with your bone tissue. It involves a very small amount of a radioactive chemical being injected into a vein. After a delay to allow the chemical to move around your body, pictures are taken using special equipment (a gamma camera). The chemical concentrates in abnormal bone so any problems with the bone tissue can be detected in the pictures. Only a very small amount of radiation is used and the test is safe.
Biopsy
A biopsy is an operation to remove a small sample of a tumour to be sent for examination by a pathologist (a doctor who specialises in the causes, effects and behaviour of diseases). You might have a biopsy if your doctors are not sure from the results of your scans what type of tumour you have.
Sometimes the biopsy can be performed under a local anaesthetic using a large needle. This will depend on the size and location of the tumour. Scanning equipment is used to guide the needle. A sample of the tumour is taken via the needle. Usually, you will need to lie face down. Some people find the procedure uncomfortable.
Otherwise, open surgery will be performed under a general anaesthetic. A small incision (cut) is made, usually over the back of the spine, to expose the area where the tumour is located. A small amount of the tumour is removed and sent for analysis.A preliminary diagnosis is often made during the biopsy operation but it might not be confirmed for several days.
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