Metastatic cancer of the spinal column.

In an effort to determine the potential of radiotherapy or surgery in alleviating the symptoms and signs of metastic cancer to the spinal neuraxis, 77 cases with documented malignant disease in this area were studied retrospectively over a 2 year period. Emphasis must be placed on early diagnosis, and recognition of intractable day and night pain as a hallmark of cancer of the spine. This symptom was found to be present for many months before the diagnosis could be made on plain X-rays. Bone-scanning, tomography, and myelography were consistently found to be useful adjuncts to early diagnosis. This study points out that operative intervention is ineffective in relieving the signs and symptoms of cord compromise, and adds significantly to the general morbidity of the patient. This was a consistent finding in cases with metastases to the thoracic spine who had developed neurological dysfunction secondary to their tumors. Radiation therapy should be considered a useful form of palliation for the pain associated with metastatic cancer.