Spinal cancer grades

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 educated decision on how to treat spinal cancer begins with determining the grade of the disease. Our cancer doctors use a variety of diagnostic tests to evaluate spinal cancer. If you have been recently diagnosed, we will confirm you have received the correct diagnosis and grading information.

Once your care team knows the location, type, size and grade of the spinal tumor, we can plan your individualized treatment. If you have a recurrence, we will perform comprehensive testing and identify a treatment approach that is suited to your needs.

The staging process assesses the spread of cancer beyond the origin site. Since it is rare for spinal tumors to spread outside the central nervous system (CNS), spinal cancer is usually graded rather than staged.

Grading spinal cancer helps our doctors match treatments to individual needs. For example, it can help us determine the risk for vertebrae collapse (fracture) and the need for surgical intervention.

Spinal cancer is graded in the following ways:

Grade 1 spinal cancer: The tumor grows slowly and rarely spreads into nearby tissues. It may be possible to completely remove the tumor with surgery.

Grade 2 spinal cancer: The tumor grows slowly but may spread into nearby tissue or recur.

Grade 3 spinal cancer: The tumor grows quickly, is likely to spread into nearby tissue, and the tumor cells look very different from normal cells.

Grade 4 spinal cancer: The tumor grows and spreads very quickly, and the spinal tumor cells do not look like normal cells. Metastatic brain disease is almost always grade 4.

Metastatic spinal tumors

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. Some cancers that commonly spread to the spine are lung, breast, prostate and colon.

Rather than using the spinal cancer grading system, metastatic spinal cancers are generally assessed through the Tumor, Node, Metastasized (spread) staging system (TNM). Sometimes, individuals are diagnosed with metastatic brain or spinal cancer before they realize they have another primary cancer.

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