Cancer is a dangerous one wherever it is on the body, but even more in an area as sensitive as the nervous system. The spine and skull base are susceptible to certain cancers. Here we can have a brief discussion about one rare type – chordoma.
Chordoma is a rare tumor, affecting around one in a 10-lakh people per year. Happening in the spine and skull base, they will develop from cells left over from the notochord – a structure found in developing embryos that aids the development of the spine, which disappears as the bones of the spine grow. A small amount of notochord cells are left behind in the spine, which in rare cases, turn cancerous, resulting in a chordoma.
Maximum chordoma cases are diagnosed in patients aged 50 and over, but they have been recognized to affect people of all ages. Chordomas can grow anywhere along the spine, but most commonly found in the sacrum.
What causes chordomas?
It is not known why chordomas develop. It is extremely rare for it to run in families, with only a handful of cases where multiple members of the same family have had a chordoma. Similarly, no environmental or lifestyle factors have been identified.
Symptoms of chordoma:
Chordoma symptoms depend on the location of the tumor. If it is in the spine, symptoms can include:
- Pain and/or numbness
- Back pain which radiates to other body parts
- Loss of balance, feeling unsteady
- Difficulty walking
- Changes or problems in bladder and bowel movements
- Pain that gets worse at night
If the tumor is in the skull, symptoms can include:
- Pain, tingling, or numbness in the face
- Double vision
- Changes in hearing
Chordoma can be easily mistaken for other tumors, such as schwannomas. After analyzing the symptoms and medical history, the doctor will order an MRI scan, which is the best way to diagnose a chordoma, showing the tumor and how it is affecting the surrounding tissue. A CT scan may also be carried out if further details are needed.
Chordoma treatment can vary depending on the size and position of the tumor and on the age and general health of the patient. If the chordoma is small or slow-growing and isn’t causing pressure or damage to the surrounding tissue, the doctor may recommend simply watching and waiting, with regular scans and reviews to monitor the tumor.
Surgery to remove the chordoma can be the most effective way of treating the cancer; however, due to its position in the central nervous system, surgery can be risky. Depending on the location, the tumor may be inoperable, or only part of it may be able to be removed as removing the whole thing would be more dangerous than leaving part of it. In such cases, radiotherapy and chemotherapy are options that kill cancer cells using beams of radiation and powerful drugs respectively. Both can have significant side-effects.
All treatment options have their benefits and risks of complications, so it is imperative that the everything is fully explained to the patient so that they can make an informed decision and understand what is happening and why every step of the way.