Spinal cancer involves the growth of malignant tumors within and or around the bony structures of the spinal cord. They can then compress and irritate the surronding neural tissues causing pain, weakness or sensory change.  These tumors are most commonly secondary metastases that spread from primary cancers elsewhere in the body, such as the breasts, lungs and/or prostate. There are also rare primary tumors can also originate directly in the spine (myeloma, osteosarcoma and Giant cell tumors). As these masses expand, they infiltrate healthy tissue, degrade bone stability, and compress critical pathways, which causes localized pain or severe neurological deficits. Management is highly collaborative and often relies on a combination of surgical resection to decompress nerves, targeted radiation therapy, and systemic treatments like chemotherapy or immunotherapy to kill cancer cells. Many different types of physicians will be involved in the care including neurosurgeons, oncologist and radiation oncologist.