Paraspinal Sarcoma

What is paraspinal sarcoma?

Sarcomas are cancerous tumors that invade the body’s soft tissues such as muscle, nerves and fat.

Paraspinal sarcoma originates in the area on either side of the spine (paraspinal region). It can also involve the space within the vertebra known as the spinal canal (vertebrae and epidural region).

Paraspinal sarcoma is rare but usually very serious. It is serious because of its location near delicate parts of the nervous system. Symptoms sometimes do not appear until the cancer is in an advanced stage or a person assumes that the back pain is caused by another reason.

There are two types of paraspinal sarcoma:

• Primary, which begins in the paraspinal area
• Metastatic, which has spread from another part of the body  

Treatment and survival rates are somewhat different for the two types of paraspinal sarcoma.

How common is paraspinal sarcoma?

Paraspinal sarcoma is so rare that it is hard to find reliable data on how often it occurs. Sarcomas themselves are rare. They represent about 1% of all cancers or about 15,000 new cases each year in the U.S.

What are the signs and symptoms of paraspinal sarcoma?

Paraspinal sarcoma can go unnoticed for a while. Symptoms can start gradually or suddenly. Many people receive a delayed diagnosis because they do not think the back pain is serious enough to seek treatment. 

When signs and symptoms of paraspinal sarcoma do appear, they may include the following:

• A lump or mass near any the four areas of the spine (cervical, thoracic, lumbar or sacral)
• Stomach problems, if the paraspinal tumor is in the abdomen or digestive tract
• Pain or numbness anywhere in the body if the paraspinal tumor is pressing on nerves

How is paraspinal sarcoma treated?

The goal of treatment for paraspinal sarcoma is to relieve pain and preserve function of the nervous system. The best treatment is usually surgery because it is the fastest way to reach these goals. Even a noncancerous (benign) tumor can press on the spinal cord and other nearby delicate structures.

During surgery, a surgeon will remove as many cancer cells as possible as well as some of the noncancerous cells in that area. If paraspinal sarcoma has spread from other parts of the body, there may be many tumors.

A cancer specialist (oncologist) might suggest other treatments along with surgery:

• Chemotherapy (“chemo”)—uses cancer-killing drugs that are delivered either by mouth or by vein. For paraspinal sarcoma, chemo is often used to destroy any tumor cells remaining after surgery, including those that were not reached during surgery.

Chemo affects all living cells including healthy ones because it is a body-wide treatment. It can be useful when treating paraspinal sarcoma that has spread to other parts of the body.

Side effects of chemo can be severe and include hair loss, appetite loss, nausea, vomiting and mouth sores. These side effects tend to go away after treatment ends. Because of the side effects, doctors usually space the treatments apart to give the body time to recover between each one.

• Radiation Therapy—uses high-energy light particles, such as X-rays or gamma rays, to destroy the cancer. Radiation therapy is more targeted than chemo, so it doesn’t usually affect the whole body. Side effects may include skin problems, nausea, vomiting, fatigue, swelling and weakness.

Other types of treatment are in various stages of clinical trials.

What are the survival rates for paraspinal sarcoma?

The survival rate for paraspinal sarcoma depends on several factors, including a person’s overall health before treatment and the stage of the cancer. Staging determines how advanced the cancer is—the higher the stage, the more the tumor has grown and spread.

Detailed survival rates of paraspinal sarcoma are not available. However, one study showed that people with primary sarcoma that began in the paraspinal region survived the disease at more than twice the rate of people with metastatic sarcoma, where the disease had spread from other areas of the body. People with primary sarcoma survived an average of 40.2 months, while those with metastatic sarcoma survived about 17.3 months. 

Why choose St. Jude for your child’s paraspinal sarcoma treatment?

• St. Jude is the only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children.
• St. Jude has created more clinical trials for cancer than any other children’s hospital in the United States.
• The nurse-to-patient ratio at St. Jude is unmatched— averaging 1:3 in hematology and oncology, and 1:1 in the Intensive Care Unit.
• Your child will have access to a close-knit team of specialists that includes: surgeons; doctors and nurses who treat this cancer; doctors who specialize in radiation therapy, in hormones (endocrinologists), and in diagnosis (pathologists); experts in diagnostic imaging and nuclear medicine; dietitians; speech therapists; rehabilitation specialists (physical therapists, occupational therapists); child life specialists; psychologists; Quality of Life team members; experts who help manage and minimize the long-term or late effects of treatment; researchers; scientists; and many others.
• The medical team works closely with laboratory researchers to bring new treatments from the laboratory to the clinic.