Information for patients with suspected metastatic spinal cord compression
Some of the words used in this leaflet may be unfamiliar to you. We have included an explanation of these terms at the end of the leaflet.
What is metastatic spinal cord compression?
Metastatic spinal cord compression (MSCC) occurs when there is pressure on the spinal cord from a cancerous tumour. For some people spinal cord compression is the first sign that they may have a tumour. However, for most people affected it occurs later in the course of their disease.
How does it happen?
The spinal cord is protected by the backbone. The backbone is a fairly common place for secondary bone cancer to occur. Sometimes these bone secondaries swell and squash the spinal cord or sometimes they can weaken the bone.
What symptoms will I have?
The spinal cord acts as a messenger for the brain, telling your arms and legs to move and sending messages back to the brain. In most people the symptoms occur in the lower half of the body, but some people may also be affected in parts of the upper body including the neck and arms.
Symptoms vary but may include:
What treatment will I have?
If your doctor suspects that you have cord compression you will probably be asked to stay in bed, lying as flat as possible. This is very important because this is the safest and most supportive position for your spine. You may also be asked to wear a supportive collar or brace. If your doctor considers your spine to be stable you will be able to sit up. If this causes pain please tell a doctor or nurse immediately.
You may be given tablets to take called steroids. These will reduce swelling in the area of your spine that is affected.
You may be sent for a special scan called an MRI scan. This allows your doctor to have a clear picture of your spine and shows where the problem is. If the scan confirms cord compression it will help to plan your treatment, which may include radiotherapy.
What will happen if I need radiotherapy?
Radiotherapy is high energy x-rays which will be carefully planned to the area that needs treatment. To be able to plan your treatment you will be asked to go for a planning CT scan.
During the CT scan you will lie on your back on a hard couch. The CT scan will take about 20 minutes. It is important to stay very still, so you may need to take some painkillers to make sure you are comfortable.
The radiotherapy can be given in 1 treatment to up to 10. Your doctor will tell you how many treatments you will need. When you have your treatment you will lie in the same position as you were for your CT scan so you might need to take some painkillers beforehand. Treatment is painless, and will take about 10 minutes per day.
During your course of radiotherapy you will see your doctor and physiotherapist on the ward. They will decide when you can start to sit up.
Will I need surgery?
Surgery may be considered for some people as part of their treatment, for instance when this is the first sign of cancer. In this case you will need to be transferred to another hospital under the care of a specialist surgeon.
What help is available whilst I’m at Velindre?
Whilst you are on the ward nurses will be available to help you with:
You will also see a physiotherapist who will look at your mobility and set goals with you to help you become as independent as possible.
You may see a Social Worker and Occupational Therapist who will talk to you and your family about plans for your discharge. This may include advice on any benefits you may be entitled to.
You may also be referred to an Oncology Support nurse or Palliative Care Clinical Nurse Specialist who can provide information, advice and support to help you and your family.
What can I expect after my treatment has finished?
MSCC affects each person differently. Following treatment, some people with weak legs need to use a stick, walking frame or wheelchair to keep their independence. Other people are able to walk without any assistance. The physiotherapist and nurses will work with you to help you become as independent as possible.
Could MSCC happen again?
Yes, unfortunately in some people MSCC can happen again. Sometimes a different part of the spine can be affected. If the symptoms mentioned above come back or suddenly get worse you will need to contact you GP immediately.
Catheter – A small thin flexible tube which drains urine away from the bladder into a plastic collection bag which can be emptied as required.
Metastasis – This is when the cancer has spread from one part of the body to another. Cancer that has spread is sometimes called metastatic disease or secondaries.
MRI scan (Magnetic resonance imaging) – This is a special type of scan that uses magnetism to build up a detailed picture of areas of the body.
Paralysis – Loss of power or sensation in any part of the body.
Radiotherapy – This is a treatment for cancer using high-energy x-rays.
Secondaries – If cancer has spread to another part of the body then it is described as secondaries. See metastasis.
Contact telephone numbers
Further information and advice is available from:
Physiotherapy department - 029 2061 5888 ext 6340
Macmillan - 0808 808 0000
Tenovus - 0808 808 1010
This information leaflet has been written by health professionals. The leaflet has been approved by doctors, nurses, physiotherapists and patients. It is reviewed and updated annually.