What is Chordoma?
Chordoma is a rare type of bone cancer that primarily occurs in the bones of the spine and skull. It most commonly forms at the base of the skull, where it meets the spine, or at the bottom of the spine in the sacrum. Chordomas arise from remnants of the notochord, a structure in the developing embryo that contributes to the formation of spinal discs. While most of these cells disappear after birth, a few may persist and, in rare cases, develop into cancerous growths.
This type of cancer is most frequently diagnosed in adults aged 40 to 60, although it can occur at any age. Chordomas typically grow slowly, making them challenging to treat due to their proximity to critical structures such as the spinal cord, nerves, and major blood vessels.
Diagnosis of Chordoma
The diagnosis of chordoma involves several key steps:
Biopsy: This procedure entails removing a sample of suspicious cells for laboratory examination. The biopsy must be carefully planned to avoid interfering with potential surgical removal of the tumor. It’s essential to consult a medical team with expertise in chordoma management for this procedure.
Imaging Tests: To visualize the chordoma and assess its spread, imaging tests like MRI or CT scans are often employed. These tests help in determining the precise location of the tumor and its relationship to surrounding tissues.
Following a confirmed diagnosis, a tailored treatment plan is developed by a multidisciplinary team, including specialists in oncology, surgery, otolaryngology, and potentially other areas such as endocrinology or rehabilitation.
Treatment Options for Chordoma
Treatment strategies for chordoma depend on factors like tumor size, location, and whether it has invaded nearby nerves or tissues. Common treatment modalities include:
Treatment for Sacral Chordoma
Surgery: The primary goal is to excise the tumor along with a margin of healthy tissue. Given the tumor’s proximity to critical structures, complete removal may not always be possible, but the surgeon will aim to remove as much as feasible.
Radiation Th*rapy: High-energy beams are used to target and destroy cancer cells. Radiation th*rapy may be employed before surgery to shrink the tumor or afterward to eliminate residual cancer cells. Newer techniques, such as proton th*rapy, can deliver higher doses while protecting surrounding healthy tissue.
Radiosurgery: This technique utilizes multiple radiation beams converging on the tumor to deliver a concentrated dose. It can be performed as a standalone treatment or in conjunction with surgery.
Treatment for Skull Base Chordoma
Surgery: Initial treatment often involves surgical resection to remove as much of the tumor as possible while safeguarding nearby critical structures. In some cases, minimally invasive techniques such as endoscopic surgery may be utilized to access the tumor through the nasal cavity.
Radiation Th*rapy: Similar to sacral chordomas, radiation is frequently recommended after surgery to target any remaining cancer cells. Advanced radiation techniques allow for more precise targeting, increasing the effectiveness of treatment.
New Treatments: Ongoing clinical trials are exploring innovative th*rapies targeting specific vulnerabilities in chordoma cells. Patients interested in these options should discuss potential participation with their healthcare providers.