This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science
This page was updated on June 7, 2022.
Making an informed decision on how to treat spinal cancer begins with determining the grade of the disease. The grade of spinal cancer is one of the most important factors in developing a treatment plan.
Cancer staging typically assesses the spread of cancer beyond the origin site. However, since it's rare for spinal tumors to spread outside the central nervous system (CNS), spinal cancer is usually graded rather than staged.
Grading spinal cancer helps the care team match treatments to individual needs. For example, it can help doctors determine the risk for vertebrae collapse (fracture) and the need for surgical intervention.
Spinal cancer is graded using the designations listed below.
The spinal tumor grows slowly and rarely spreads into nearby tissues. It may be possible to completely remove the tumor with surgery.
The tumor grows slowly but may spread into nearby tissue or recur.
The tumor grows quickly, is likely to spread into nearby tissue, and the tumor cells look very different from normal cells.
The tumor grows and spreads very quickly, and the spinal tumor cells do not look like normal cells. Metastatic spinal cancer is almost always grade 4.
Metastatic (or secondary) spinal tumors, which have spread to the spine from another location in the body, are much more common than primary spinal tumors. Spinal metastases represent about 90 percent of masses observed on spinal imaging. Some cancers that commonly spread to the spine are lung, breast, prostate and colon cancer.
Rather than using the spinal cancer grading system, the health care team generally assesses metastatic spinal cancers through the Tumor, Node, Metastasis (spread) staging system (TNM). This system grades cancers based on the characteristics listed below.
T (tumor): This describes the tumor’s size, location and how deep it has grown into the skin.
N (node): This indicates whether or not cancer cells have spread to nearby lymph nodes, or the channels connecting the lymph nodes.
M (metastasis): This refers to whether the cancer cells have spread to distant organs or other parts of the body.
Sometimes, patients are diagnosed with metastatic brain or spinal cancer before they realize they have another primary cancer.
Next topic: How is spinal cancer diagnosed?