Hi,
The evaluation of back pain generally focuses on which particular area is involved. Part of this would be the
physical and neurologic examination to establish which areas are suspect. Then images are taken, depending on
what would be the region of interest.
The MRI and the ultrasound may help define extent of involved area, and a presumptive diagnosis of cancer may
also be made. Presumptive means, that there is enough suspicion to warrant sampling of the mass to ascertain
its behavior. While the MRI may be able to say if the mass appears to be invading surrounding structures, this
is a characteristic of cancer but it is not a characteristic unique to cancers. Non-malignant growths may grow
and destroy surrounding areas but do not migrate (or metastasize). Planning definitive treatment would require
information obtained from the sampling (biopsy). Aside from finding out if it is cancer, the biopsy will also
determine what treatment options are available, as well as the known outcomes for each option.
Occasionally, the case scenario may warrant some treatment even before performing the biopsy. If for example,
the mass enters the spine and renders her unable to walk, delivering radiation may be based on the presumptive
diagnosis of cancer through an MRI, as delaying treatment to await the results of the biopsy will likely lower
her chances of walking again.
Keep your hopes up and discuss the course of diagnosis and treatment. The waiting may cause some anxiety, but
as most therapies for cancer have narrow safety margins, the certainty is paramount. Some conditions in this
area even if they are cancer may have curative potential.
Stay positive.
