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Cancer and Spinal Fracture

If you’re living with cancer, the health of your spine may be the furthest thing from your mind, but it’s important to understand that cancer can increase your risk for spinal fracture.

How Can Cancer Cause Spinal Fracture?

When cancer spreads to the spine, the normal balance between bone breakdown and repair is disrupted, causing disproportionate destruction of bone in some areas (osteolytic lesions) or overgrowth of bone in others (osteoblastic lesions). As a result, the bones are weakened and more prone to vertebra compression fracture.

Cancer can originate in the bone or spread (metastasize) from the primary site, which is referred to as metastatic bone disease. Bone metastases most commonly affect bones in the spinal column, ribs, or pelvis. 

Does Cancer Treatment Increase My Risk for Spinal Fracture?

Various cancer treatments, such as hormone therapy for breast and prostate cancer, can also cause bone loss. If you’ve been diagnosed with cancer or received cancer treatment in the past, it’s important to understand that you may be at increased risk for spinal fractures. Talk with your doctor about your risk factors and be sure to report any new or unusual back pain.

Are Certain Cancers More Prone to Spread to the Spine?

Certain cancers are more likely to spread to the spine. Below are the types of cancer that more frequently spread to the spine and increase your risk for spinal fracture:

» Lung Cancer and Spinal Fracture
» Breast Cancer and Spinal Fracture
» Prostate Cancer and Spinal Fracture
» Myeloma and Spinal Fracture

Why Does Cancer Often Spread to the Spine?

Cancer cells have special characteristics that enable them to grow uncontrollably and form tumors. In addition, cancer cells don’t stick together like normal cells, and are not inhibited by crowded conditions.

The spine is particularly vulnerable to the development of bony lesions, but the reason for this is still unclear. It may be because the spine is rich in bone marrow and provides an environment that fosters tumor growth.

Unlike soft tissue, bone has an abundance of growth factors. Growth factors direct cells to divide, grow, and mature. As the cancer attacks the bone and these growth factors are released, the cancer cells are further stimulated to multiply. This exacerbates an already pathologic condition, resulting in a cancer growth cycle that is self-generating.

Cancer and Spinal Fracture

References:

  • Cooper C, Atkinson EJ, O’Fallon WM, Melton LJ III 1992 Incidence of clinically diagnosed vertebral fractures: A population-based study in Rochester, Minnesota, 1985-1989. J Bone Miner Res 7:221-227.