Tumor treating fields (TTFields) for spinal metastasis—The case for bone removal and spinal implants as waveguides to enhance field strength at the target

It is estimated that 5%–14% of cancer patients will develop symptomatic metastatic epidural spinal cord compression (ie, spinal metastasis) during the course of their disease, which can lead to devastating complications such as vertebral body fractures, intractable pain, loss of bowel and bladder function, and paralysis.¹ Treatment of spinal metastases is complex. Here, we describe a novel approach employing tumor treating fields (TTFields), the “fourth modality” of cancer treatment.²