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- Asymptomatic coronary artery disease
- Bone problems
- Cancer-related fatigue
- Central precocious puberty – CPP
- Chronic pain
- Craniofacial growth problems
- Dental and oral problems
- Dyslipidemia
- Eye problems
- Gastro-intestinal problems
- Hair loss
- Health promotion
- Hearing problems
- Heart problems
- Higher risk groups
- HP axis problems
- Hypertension
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- Male fertility problems, testosterone deficiency and sexual dysfunction
- Mental health problems
- Neurocognitive problems
- Obstetric problems
- Overweight and obesity
- Peripheral neuropathy
- Premature ovarian insufficiency
- Psychosocial problems
- Spine scoliosis and kyphosis
- Spleen problems
- Stroke
- Subsequent neoplasms:
- Thyroid problems
SPINE SCOLIOSIS AND KYPHOSIS
This page is part of the PanCare PLAIN summaries about late effects and recommendations for long-term follow-up care for survivors of childhood, adolescent, and young adult cancer. Click here, for more information on the PLAIN summaries.
On this page you can find:
- Spine scoliosis and kyphosis
- Am I at higher risk of spine scoliosis and kyphosis?
- What are the symptoms and signs of spine scoliosis and kyphosis?
- I am at higher risk of spine scoliosis and kyphosis. What tests should I have and when?
- What happens if I have spine scoliosis and kyphosis?
- What else can I do?
- Where can I find more information?
- Please note
This PLAIN summary is based on the PanCareFollowUp guideline about “Spine scoliosis and kyphosis” [1], which is based on the consensus of different national guidelines.
PLAIN version 2.1: 27/05/2024
Spine scoliosis and kyphosis
The spine runs from the top of the neck to the tailbone. The spine contains 24 vertebrae (backbones) each separated by a disc of soft tissue (cartilage) which prevents the vertebrae from rubbing against each other.
Like the other bones in our body, the spine provides our body with support and allows us to stay upright and move. In addition, the spine protects the spinal cord which is a bundle of nerves that connects the brain with the rest of the body.
Sometimes problems can occur with the spinal column. For example, during a growth spurt in childhood and adolescence, the spine may not develop into a normal shape but into a sideway curve. This is called scoliosis. Another problem which can occur with the spine is kyphosis, which is when the upper part of the spine curves forward more than usual. Kyphosis can develop at any age.
Spine scoliosis and kyphosis can be mild and barely noticeable, but in severe cases it can cause problems.
Scoliosis and kyphosis compared to a healthy spine
Created with BioRender.com
Hover over the letters/numbers in the figure for more information.
Am I at higher risk of spine scoliosis and kyphosis?
Anyone, including people who have never had cancer treatment, may develop spine scoliosis or kyphosis. However, there are some medical conditions and treatments that may increase the risk of having spine scoliosis or kyphosis later in life.
The following medical conditions can increase the risk of scoliosis or kyphosis:
- A tumour near or within the spine
The following treatments can increase the risk of spine scoliosis or kyphosis:
- Surgery of the spine
- Surgery of the chest
- Any dose of radiotherapy to the spine or an area that includes the spine
You can find out if you had any of these medical conditions or treatments by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.
If you experience spine scoliosis or kyphosis, it does not always mean that this is caused by cancer or its treatment. Spine scoliosis and kyphosis may have other causes.
Radiotherapy
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, do contact your treating hospital.
Radiotherapy is a treatment for cancer which uses high-energy radiation to destroy cancer cells and to shrink tumours. The radiation comes from a machine outside the body (external beam radiotherapy) or occasionally from radioactive material that is placed in the body near cancer cells (intracavitary or interstitial radiotherapy). The aim of radiotherapy is to treat only one area of the body, around and near the cancer or where the cancer was before it was removed by surgery and as far as possible to protect unaffected areas. For example, if you have cancer in your lung, you will have radiation only to your chest, not to your whole body.
External beam radiotherapy is painless and takes only a few minutes. It is given once or occasionally twice a day often for several weeks. A radiation beam is like an invisible light beam. The machines which produce the radiation beam can be moved so that the beam enters the body from different directions, ‘spotlighting’ on the area to be treated. This means that the tumour is given a high dose whilst normal areas get either a lower or no dose at all.
Since the early 1980’s computers and other technical advances have improved radiotherapy. Before this there were not many ways to protect normal tissues which were in the path of a radiation beam. Even now, whilst modern techniques allow doctors to target the cancer cells more precisely than older techniques, healthy cells may still get damaged. This can result in some of the late effects covered in the PLAIN summaries. It will help you and your follow up specialist to know what long term effects there might be after your radiotherapy if you and they have your treatment summary.
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, please contact your treating hospital.
What are symptoms and signs of spine scoliosis and kyphosis?
There are symptoms and signs that can tell you if you or your child might have spine scoliosis or kyphosis. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.
These symptoms and signs may suggest that you or your child have scoliosis:
- Uneven shoulders, hips or waist
- Leaning to one side
- Back pain (more common in adults)
Symptoms and signs of kyphosis are:
- Abnormally curved or hunched upper back
- Back pain or stiffness
- Breathing problems (in severe cases)
If you recognise any of these symptoms or signs in yourself or your child, please contact your general practitioner or follow-up care specialist.
Symptoms and signs
Pain
From a physical point of view, pain is a life-sustaining biological reaction to damaging influences – even if tissue damage has not yet occurred. Due to its function as a damage indicator or warning, pain is usually associated with negative feelings so that we pay sufficient attention to it and learn as quickly as possible when it is dangerous for us. How intensely we feel a pain stimulus, whether it causes us to feel fear and panic, depends not only on the pure nerve signal, but is an interplay of biological, psychological and social factors.
All pain whose duration exceeds the extent of an acute (recent) cause and lasts for an incomprehensibly long time is called chronic pain. Strong and prolonged pain stimuli can make the transmitting nerve cells of the spinal cord and brain more sensitive to subsequent pain stimuli. This means that even mild stimuli can be perceived as severe pain. Under certain circumstances, these nerve cells, which have become hypersensitive
I am at higher risk of spine scoliosis and kyphosis. What tests should I have and when?
If you or your child are at higher risk of spine scoliosis and kyphosis, it is advised to:
- Have a physical exam of the spine done every year until you or your child are fully grown. The physician may advise to have the physical exam done more often during puberty and growth spurt.
If you or your child might have spine scoliosis or kyphosis, it may be necessary to confirm the diagnosis by taking an X-ray of the spine.
X-ray
In addition, there is also the option of CT (computer tomography) and MRI that are giving a more detailed look. The choice of imaging depends on what exactly needs to be looked at or examined. These images are used by healthcare professionals to make diagnoses or create treatment plans.
What happens if I have spine scoliosis and kyphosis?
If you have spine scoliosis or kyphosis, your general practitioner or follow-up care specialist will probably refer you to a specialist. Depending on the symptoms and/or signs you experience, you may be referred to an:
- Orthopaedic surgeon (surgeon specialised in bones and joints)
- Physiotherapist (healthcare professional specialised in exercise)
The specialist may discuss different treatment options with you.
What else can I do?
Knowing that you may be at increased risk of spine scoliosis or kyphosis can be difficult. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.
Although it may not lower your risk of spine scoliosis or kyphosis, it is still important to live a healthy lifestyle. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.
It is also important for your wellbeing and health to keep physically active. Being at risk of developing or having scoliosis or kyphosis should not prevent you from taking part in physical activity. Please find out together with your doctor or physiotherapist what activities you or your child can do
It is important that you are aware of the possibility of developing spine scoliosis or kyphosis and that you know the symptoms and signs. If you have any further questions or if the information in this brochure concerns you, please contact your general practitioner or follow-up care specialist.
Healthy lifestyle
- Having a healthy diet
- Drinking less (or no) alcohol
- Exercising regularly
- Quitting smoking (if you smoke)
Your follow-up care specialist or general practitioner may give you additional advice tailored to your individual situation for maintaining a healthy lifestyle. For more information on taking up a healthier lifestyle, please read: Health promotion.
Where can I find more information?
You may find more information about spine scoliosis and kyphosis online. However, it is important to be aware that this information is not always up to date or accurate.
Some sources of further information are:
- NHS: Here you can find more information about scoliosis and its treatment
- NHS: Here you can find more information about kyphosis in general
- Mayo Clinic: Here you can find more information about scoliosis in general
- Mayo Clinic: Here you can find more information about kyphosis in general
On this website, you can also find more information related to this topic:
Please note
This PLAIN summary is based on the PanCareFollowUp guideline about “Spine scoliosis and kyphosis” [1], which is based on the consensus of different national guidelines.
While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.
Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.
No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.
The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.
[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext