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Metastatic spinal cord compression (MSCC)

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People with cancer are at risk of it spreading to other parts of the body.

This includes the spine and is known as Spinal Metastases.

Spinal Metastases can be painful and if not treated can lead to Metastatic Spinal Cord Compression (MSCC).

This is when the spinal metastases press on the spinal cord and nerves in the spine.

Metastatic Spinal Cord Compression (MSCC) is rare, but it can cause damage to the spinal cord and can lead to permanent paralysis.

This leaflet is not intended to scare you but to help you recognise the important symptoms of Spinal Metastases and Metastatic Spinal Cord Compression (MSCC).

It is important to report your symptoms quickly as the earlier treatments are started the better the result usually is.


    What are the symptoms?


    Symptoms can include the following:

    • Pain or tenderness in the middle or top of your back or neck.
    • Severe pain in your lower back that is getting worse or does not go away.
    • Pain in your back that is worse when you cough, sneeze or go to the toilet.
    • Back pain that stops you from sleeping.
    • A narrow band of pain down the arm or leg or around the body.
    • Numbness, pins and needles, weakness or difficulty using your arms or legs.

    If you have any of these symptoms


    If you have any of these symptoms listed please speak to your:

    • Key Worker.
    • GP.
    • Consultant Team.
    • Clinical Nurse Specialist.
    • Treatment Radiographer.
    • Paramedic

    Please speak to one of the people above as soon as is practical and certainly within 24 hours.

    Tell them you have cancer and that you are worried about your spine and would like to see a doctor.

    Please show the doctor this fact sheet.

    ADVICE

    • Try to bend your back as little as possible.

    How is it diagnosed?


    Before your doctor can be sure whether these symptoms may be caused by Metastatic Spinal Cord Compression (MSCC), a number of tests will need to be done and these may include:

    MRI (Magnetic resonance imaging) scan

    •  This test uses magnetism to build up a detailed picture of areas of your body.

    CT (Computerised tomography) scan

    • A CT takes a series of x-rays to build up a three-dimensional picture of the inside of your body.

    Bone scan

    • This scan does not diagnose Metastatic Spinal Cord Compression (MSCC) but may be done to check any abnormal areas inside the bone itself.


    How is it treated?


    The aim of the treatment is to shrink the tumour and to relieve pressure on the nerves.

    Treatment usually involves a combination of the following:

    Bedrest 

    • Your doctor will usually advise complete bed rest.
    • At first you may need to lie flat on your back.

    Steroids

    • High doses of a steroid called Dexamethasone are usually started immediately if Metastatic Spinal Cord Compression (MSCC) is suspected.
    • The steroids help to reduce pressure and swelling around the spinal cord and can quickly relieve symptoms such as pain.

    Radiotherapy

    • Radiotherapy is the use of high-energy x-rays to destroy the cancer cells and is the commonest way to treat Metastatic Spinal Cord Compression (MSCC)
    • It is usually used on its own or occasionally alongside other treatments such as surgery.
    • It is given by directing the x-ray beam at the tumour from outside the body.

    Chemotherapy

    • Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells.
    • It is occasionally used to treat Metastatic Spinal Cord Compression (MSCC).

    What happens when the treatment has finished?


    Some people who have lost the ability to walk or have lost movement before treatment may not get this back.

    In this situation treatment would usually be followed by a period of rehabilitation and further care from the health professional team.

    They will work closely with you and your family to organise a plan of care and rehabilitation to suit your needs.

    Your further care may be at your cancer centre or your local hospital.

    The rehabilitation team will monitor your progress and help you to become as independent as possible.

    Before you leave hospital, the staff should organise any care you will need while at home.

    This may include nursing care and physiotherapy.

    Adaptions to your home to make things easier for you such as ramps or wider door frames to allow wheelchair access can also be arranged.

    Any equipment you may need such as wheelchairs, special mattresses or lifting aids will also be supplied.


    Information for the doctor or health care professional


    This patient has cancer and is therefore at risk of Metastatic Spinal Cord Compression (MSCC).

    If they have any symptoms discussed on this leaflet please consider Metastatic Spinal Cord Compression (MSCC) as a possible diagnosis and discuss further management with the local Metastatic Spinal Cord Compression (MSCC) coordinator.

    To do this please call the:

    ROYAL SUSSEX COUNTY HOSPITAL

    • Telephone Number: 01273 696955
    • Ask the person you are speaking to please bleep the on-call Oncology Registrar.

    Useful contact numbers


    ROYAL SUSSEX COUNTY HOSPITAL

    THE SUSSEX CANCER CENTRE

    Reception

    Radiotherapy

    ONCOLOGY WARD

    Courtyard: Level 8

    UROLOGY MACMILLAN TEAM

    Disclaimer
    The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

    Publication Date: November 2019

    Review Date: November 2022

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