Chordoma, a rare type of bone cancer, develops in the bones of the skull base or spine. Affecting roughly one in a million people per year, chordoma tumors arise from remnants of the notochord, a structure present in early human development. Unlike many fast-growing cancers, chordomas progress slowly. However, they pose significant health risks due to their location near critical nervous structures. Understanding chordoma’s symptoms and diagnostic processes is essential for anyone experiencing potential signs or those with a genetic predisposition, as early detection can improve outcomes. This blog explores the epidemiology, symptoms, diagnostic techniques, and challenges in treating chordoma to raise awareness and help patients make informed healthcare decisions.
Chordoma originates from notochordal cells, which are embryonic structures that help form the spine. These tumors, classified as rare malignancies, account for approximately 1-4% of all primary bone tumors. Chordomas most commonly appear at the base of the skull (clivus) or in the sacrococcygeal region, which is near the tailbone. Though benign in their growth rate, they are considered malignant due to their local aggressiveness and propensity to recur even after treatment. Chordomas can cause substantial complications by compressing nerves and other critical structures in the head and spine, affecting quality of life and requiring highly specialized care for treatment and management.
Symptoms of chordoma vary depending on the tumor’s location. Skull-based chordomas may cause headaches, blurred vision, facial pain, and problems with swallowing or speaking, due to proximity to cranial nerves. Spine-based chordomas often lead to neck or back pain, which might radiate to the arms or legs. As the tumor grows, it can impinge on surrounding nerves, causing neurological symptoms like numbness, weakness, or difficulty with motor functions. Because these symptoms overlap with other, less serious conditions, chordoma is often misdiagnosed initially, leading to delayed treatment. Recognizing the specific signs is crucial for seeking timely medical evaluation.
Diagnosing chordoma requires a multifaceted approach. Medical imaging is the first step; MRI scans provide detailed images of soft tissues, highlighting tumors, while CT scans offer a clearer view of bony structures. Once a suspicious mass is identified, a biopsy is often conducted to confirm the diagnosis, where tissue samples are examined for characteristic physaliphorous cells unique to chordomas. Molecular testing can further identify certain genetic mutations, such as alterations in the T (brachyury) gene, linked with chordoma development. Early and precise diagnosis is essential, as it informs treatment planning and can improve the long-term outlook for patients.
Chordoma, a rare type of cancer that arises in the bones of the spine and skull base, demands highly specialized care. In India, treatment options are diverse, and hospitals are well-equipped with cutting-edge technology. These treatment options include surgery, radiation therapy, and proton therapy, which precisely targets tumors while minimizing damage to surrounding tissues. Advanced radiotherapy methods, such as stereotactic body radiation therapy (SBRT), are also available to treat difficult-to-reach tumors. Additionally, immunotherapy and targeted therapy have started to gain ground, with hospitals in India staying up-to-date on these advancements, offering patients a range of treatment modalities. With experienced oncologists and neurosurgeons, India has become a hub for chordoma treatment, attracting patients from around the world.
Chordoma is a rare and complex bone tumor that develops along the spine or skull base. Because of its challenging location near vital structures, surgery is often a crucial part of the treatment plan for patients diagnosed with chordoma. This blog will walk you through what to expect from chordoma surgery, including types of procedures, preoperative preparations, recovery, and tips to help patients and their families navigate this journey.
Chordoma surgery is typically the primary treatment option for these tumors, aiming to remove as much of the tumor as possible. Complete resection—removal of all visible tumor tissue—is challenging due to the tumor’s close proximity to critical structures like the brainstem, spinal cord, and nerves.
Depending on the location of the chordoma, surgeons may use different approaches:
The primary goal is maximum tumor resection, which reduces the risk of recurrence and alleviates symptoms. However, complete removal is challenging, and there are risks of recurrence. Additionally, chordoma surgery carries specific risks, such as nerve damage, cerebrospinal fluid leaks, and infection due to the tumor’s complex location. These risks underscore the importance of skilled surgical teams specializing in skull base or spinal tumors.
Preparing for chordoma surgery involves both physical and mental readiness, as well as logistical preparations to support a smooth recovery process.
Facing surgery for a rare tumor like chordoma can be emotionally taxing. Many patients benefit from counseling or joining support groups where they can connect with others who have experienced similar surgeries. Preparing mentally for the road ahead can reduce anxiety and improve recovery outcomes.
Doctors often recommend certain lifestyle adjustments to improve surgical outcomes:
Arrangements should be made for a caregiver to assist with post-surgery tasks, as well as accommodations for hospital stays and transportation needs. It’s essential to have all necessary paperwork, insurance, and medical documents prepared for hospital admission.
Chordoma surgeries are typically long procedures due to the complexity involved in accessing the tumor while avoiding damage to nearby structures.
Patients are administered general anesthesia, and the surgical team will monitor vital signs closely throughout the procedure. Once under anesthesia, the surgical team positions the patient to allow optimal access to the tumor site, depending on its location.
The surgeon carefully dissects the tumor from surrounding tissues. Given the intricate anatomy, surgeons employ advanced imaging techniques like intraoperative MRI or CT to guide their approach in real-time, which improves the accuracy of tumor removal. In some cases, part of the tumor may be left to avoid damaging critical structures, with follow-up radiation planned to address remaining cells.
Once the tumor is removed, the surgeon may perform additional procedures to stabilize the area. If spinal structures have been compromised, spinal fusion may be necessary. For skull-base tumors, reconstructive techniques help close any openings to protect the brain.
Recovering from chordoma surgery involves several stages, starting with hospital recovery and extending into rehabilitation and follow-up care.
Patients typically spend time in intensive care to monitor for complications such as cerebrospinal fluid leaks, infection, or neurological issues. Depending on the surgery type, initial hospital stays may last between 5 to 10 days.
Pain management is crucial, with medications provided to reduce discomfort and address specific symptoms like nausea. Patients may experience headaches, back pain, or temporary neurological deficits depending on the surgery’s extent and location.
Rehabilitation, including physical and occupational therapy, begins soon after surgery. Therapy focuses on improving mobility, strength, and coordination, particularly for patients who have undergone spinal chordoma surgery. Customized therapy programs are vital for restoring function and minimizing long-term limitations.
Regular follow-up appointments are crucial to monitor for recurrence. These visits may include imaging scans to assess for any regrowth. If residual tumor cells remain, radiation therapy or targeted therapies may be recommended.
For patients and their families, proactive planning and self-care are essential to ensure a comfortable recovery period.
Creating a supportive environment at home is vital. Consider rearranging furniture to allow easy access and ensure essentials are within reach. Patients recovering from spinal surgeries may need special equipment, like adjustable beds or shower chairs, to aid in daily activities.
Recovery from chordoma surgery can be lengthy. Setting realistic expectations can help patients and caregivers stay patient and motivated. Daily progress may seem slow, but small improvements accumulate over time, leading to a return to normalcy.
Maintaining connections with friends, family, or support groups can provide emotional support and reduce isolation during the recovery period. Many chordoma patients find it helpful to connect with others who have undergone similar treatments.
A balanced diet rich in proteins, vitamins, and minerals aids the body in healing and rebuilding tissue. Staying hydrated is also essential, as it can help reduce swelling and promote cellular recovery.
Chordoma surgery is a complex, life-altering procedure that requires careful planning, a skilled surgical team, and a supportive recovery environment. By understanding what to expect before, during, and after surgery, patients and caregivers can take proactive steps to ensure the best possible outcomes. From preoperative preparation to setting up a home recovery environment, each stage is integral to regaining strength and adapting to life post-surgery. With the right information, support, and resources, patients can navigate their chordoma surgery journey with greater confidence and resilience.
Chordoma treatment comes with unique challenges due to its complex location, resistance to traditional therapies, and high recurrence rate. Prognosis largely depends on early diagnosis, the tumor’s size and location, and whether it has spread to other parts of the body. The likelihood of a complete surgical resection, known as en bloc resection, is a key factor in determining outcomes. Despite India’s advancements in treating chordoma, challenges remain, especially in cases with skull base tumors or recurrent chordoma. The prognosis also varies with patient age, overall health, and the genetic characteristics of the tumor. Indian hospitals are employing new techniques and studies to mitigate recurrence, striving to improve survival rates and quality of life for patients.
One of the key advantages for international patients is the comparatively lower cost of chordoma treatment in India. While treatment costs vary, they are generally 60-80% lower than in Western countries, making India an affordable option for specialized surgeries and therapies. A comprehensive chordoma treatment plan, including surgery and post-operative care, might cost around $10,000 to $20,000 in India, compared to upwards of $60,000 in the U.S. or Europe. These savings do not compromise on quality; many Indian hospitals are internationally accredited, ensuring care standards comparable to those in the West. With such economic advantages, India has become an increasingly popular choice for chordoma patients.
India boasts several top-tier hospitals for chordoma treatment, including Fortis Memorial Research Institute (Gurgaon), Apollo Hospitals (Chennai, Delhi), and Tata Memorial Hospital (Mumbai). These hospitals are known for their experienced teams, modern facilities, and comprehensive cancer care programs. Many hospitals offer proton therapy, stereotactic radiosurgery, and robotic-assisted surgery, enhancing the precision of treatments. Fortis and Apollo Hospitals, in particular, have departments dedicated to neuro-oncology and spinal oncology, which play a crucial role in managing chordoma cases. With specialized multidisciplinary teams, India’s leading hospitals are prepared to manage complex chordoma cases with expertise and high success rates.
India’s future in chordoma treatment looks promising, with ongoing research into gene-targeted therapies, improved surgical techniques, and advanced radiation options like proton therapy. With a growing number of hospitals adopting international healthcare standards, India is poised to be a leader in cancer treatment, including rare tumors like chordoma. Hospitals are also increasingly participating in global research collaborations, enabling them to stay updated on the latest advancements in chordoma care. The country’s emphasis on affordable, high-quality care will continue to attract international patients, giving them access to life-saving treatments that may otherwise be financially prohibitive elsewhere.
Chordoma surgery is a complex, life-altering procedure that requires careful planning, a skilled surgical team, and a supportive recovery environment. By understanding what to expect before, during, and after surgery, patients and caregivers can take proactive steps to ensure the best possible outcomes. From preoperative preparation to setting up a home recovery environment, each stage is integral to regaining strength and adapting to life post-surgery. With the right information, support, and resources, patients can navigate their chordoma surgery journey with greater confidence and resilience.
Written By
Shafiq Ahmad Khan
Founder & CEO
Author
Faster Smarter Medical Tourism in India
