Cancers That Metastasize to the Spine

Most Common Primary Cancers

More than 50% of spinal metastases originate from breast, lung, or prostate carcinomas, with renal cell carcinoma also being a common primary source 1, 2
Breast cancer: Bone metastases occur in 65-75% of patients with advanced disease, with 70% developing bone involvement overall 3, 4
Prostate cancer: Bone metastases occur in 65-85% of patients with advanced disease 3, 4
Lung cancer: Bone metastases occur in 30-40% of patients with advanced disease 3, 4, 5
Renal cell carcinoma: Bone metastases occur in 20-40% of patients with advanced disease 3, 4, 5

Multiple myeloma: Affects the spinal column in 95% of cases, with bone pain being a presenting feature in three-quarters of patients 1, 3, 6
Lymphomas: May also affect the spinal column, though less frequently than multiple myeloma 1, 6

Postmortem examinations demonstrate that spinal metastases are present in approximately 70% of patients with cancer, making the spine the most frequent site of skeletal involvement 1, 2

The axial skeleton (spine) is affected more frequently than the appendicular skeleton 3
Spinal metastases can lead to devastating complications including pathological fractures, spinal cord compression, neurological deficits, and severe pain that profoundly impacts quality of life 1, 2, 6
Despite the osteosclerotic appearance of prostate cancer bone metastases, histomorphometric studies demonstrate increased osteolysis within affected bone, making skeletal-related events very common 3

The American College of Radiology notes that lung cancer accounts for approximately 24% of spinal metastasis episodes and develops bone metastases in 30-40% of patients with advanced disease 7
The American College of Radiology states that breast cancer represents about 21% of spinal metastasis cases, with 65-75% of patients with advanced disease developing bone involvement 7
The American College of Radiology reports that prostate cancer comprises approximately 20% of spinal metastases and affects 65-85% of patients with advanced disease 7

The American College of Radiology found that lymphoma can involve the spine through local encasement or nerve infiltration 8, 9
The American College of Radiology notes that colorectal cancer can directly invade or compress the lumbosacral spine 8, 9
The American College of Radiology states that gynecologic cancers (cervix, ovary, endometrium) commonly affect the lumbar spine through direct extension or lymphatic spread 8, 9
The American College of Radiology reports that bladder and prostate cancers can involve the lumbosacral region through local invasion 8, 9