Fred Astaire and Ginger Rogers face the music and dance
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Perhaps best known for his role in The Band Wagon, what some may not know is that the star suffered from spinal arthritis, an inflammatory condition that affects the joints between the spine and pelvis. Despite the painful condition, Buchanan kept on performing, featuring in numerous dance numbers with Astaire and other Hollywood films such as Monte Carlo in 1930 and Goodnight Vienna in 1932. Unbeknown to him at the time, the actor’s spinal troubles were far from over, as in his later life he developed cancer, and passed away in London.
Spinal cancer is a “relatively rare condition” with only about one in 180 women and one in 140 men developing the disease during their lifetime.
There are many different types of spinal tumours, with not all of them cancerous. The most common include primary tumours and secondary tumours.
The first, primary tumours, originate in the spinal column. Typically they are benign, but for those that are malignant, there is a chance that they will spread elsewhere in the body.
Secondary tumours, also known as metastatic spinal tumours are those that have already spread to the spine from other areas of the body. Johns Hopkins Medicine explains that if a tumour is able to spread, it is a good indicator that it is malignant.
Between 30 and 70 percent of cancer patients develop metastatic spine cancer during the course of their disease. The most common cancers that tend to spread to the spine include: Lung, prostate, and breast.
As the spine is so long and made of different types of tissues, tumours can also grow in several different places along the back and into the neck and pelvis. Based on the location of the tumour, they are categorised into three different groups.
- Extradural tumours – form inside the spinal column and may involve the vertebrae, but typically don’t affect the spinal cord. They are often located in the epidural space, which is the area surrounding the outer – dura – membrane that protects the spinal cord
- Intradural tumours form inside the dura and may or may not involve the spinal cord
- Intramedullary tumours are intradural tumours that grow inside the spinal cord.
The location and position of the tumour also means that individuals will suffer from slightly different symptoms. Often tumours in the spine can press on certain nerves. This can cause the following:
- Weakness and numbness in the arms and legs
- Clumsiness or difficulty walking
- Back or neck pain
- Aching in the spinal area or arms or legs
- Tingling or pins and needles in the hands or feet
- Loss of bladder and bowel control (incontinence), if the tumour is in the lower part of the spinal cord.
If the tumour is large enough, it may also cause scoliosis, a condition that causes the spine to curve often appearing like an S or C. This is a physical deformity and often, individuals with scoliosis appear as if they are leaning to one side.
If you or someone you know is concerned that they might have spinal cancer, or they are experiencing any of the above symptoms it is advised they seek medical advice as soon as possible. In order to determine whether someone has spine cancer or not, a biopsy may need to be done.
This involves a needle being inserted to extract a sample of the tumour in order to test whether it is cancerous. Other tests that may be done include an MRI scan or X-ray.
Once diagnosed, treatment for spinal cancer will depend on the aggressiveness of the tumour and its location. The main treatment options used include:
- Radiation therapy
- Full or partial surgical removal of the tumour
- Steroids to help with swelling and back pain.
In order to help determine which treatment is best suited to the individual, tumours are given a grade, which describes how abnormal cells look underneath the microscope.
Macmillan Cancer Support explains that most spinal cord tumours are low-grade, meaning they grow slowly. Low-grade spinal cord tumours do not usually spread to other parts of the brain or spine. But they may cause problems by continuing to grow and pressing on nearby nerves or the bones of the spine. Whereas, high-grade spinal cord tumours grow more quickly and may need urgent treatment.
For some low-grade cancers, doctors may suggest “active monitoring” instead of other treatment options. This means individuals will go for regular check-ups to monitor the size and any changes to the tumour.
As Buchanan also had spinal arthritis, which might have caused similar symptoms to his cancer, it can be tricky to know when aches and pains are a sign of something more serious.
In light of this, NHS Choices said: “The pain can sometimes be wrongly mistaken for arthritis in adults and growing pains in children and teenagers.”
Due to this, it is important to know the differences between spinal arthritis and cancer. Johns Hopkins Medicine explains that arthritis of the spine can result from wear and tear. Symptoms usually experienced include the following:
- Back and neck pain, especially in the lower back
- Stiffness and loss of flexibility in the spine, such as being unable to straighten your back or turn your neck
- Swelling and tenderness over the affected vertebrae
- Feeling of grinding when moving the spine
- Pain, swelling and stiffness in other areas of the body (especially in inflammatory arthritis)
- Whole-body weakness and fatigue (more common in inflammatory arthritis)
- Pain and numbness in your arms or legs if the nerves are affected
- Headaches (in case of arthritis in the neck).
Commonly, arthritis of the spine is a form of osteoarthritis, which affects the facet joints between the vertebrae. As discs between the vertebrae become thinner, more pressure is transferred to the facet joints. This leads to more friction and more damage to the cartilage.
Arthritis cannot currently be cured, but further damage can be limited due to treatment options. These mainly involve taking anti-inflammatory drugs, physical therapy and lifestyle changes such as quitting smoking and changing your posture.
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