Information for the public

Cancer that has spread to the spine or is pressing on the spinal cord: the care you should expect

Cancer that has spread to the spine is known as 'spinal metastases'. Without treatment, spinal metastases can press on the spinal cord, which is made up of nerves that carry messages between the brain and the rest of the body. This is called metastatic spinal cord compression (or MSCC). If it isn't treated quickly, MSCC can lead to serious disability, including permanent paralysis.

MSCC is rare, but very serious. About 3 to 5 in 100 people with cancer develop it. Any type of cancer can lead to spinal cord compression, but it is more common in people with breast cancer, lung cancer, prostate cancer, lymphoma or myeloma.

We want this guideline to make a difference by making sure people:

  • know what symptoms to look out for if they are at risk of spinal metastases or MSCC, and when to contact their healthcare professional
  • have an urgent scan if spinal metastases or MSCC is suspected (within 24 hours for MSCC) and are diagnosed and assessed as soon as possible
  • have a pain management plan and are given medicine that relieves their pain
  • have radiotherapy or surgery as soon as possible to minimise damage to their spinal cord and reduce any symptoms
  • have their needs assessed and get the support, rehabilitation and equipment they need to help them adjust to any disability and have the best possible quality of life.

Making decisions together

Decisions about treatment and care are best when they are made together. Your health and care professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns.

To help you make decisions, think about:

  • What matters most to you – what do you want to get out of any treatment?
  • What are you most worried about – are there risks or downsides to the treatment that worry you more than others?
  • How will the treatment affect your day-to-day life?
  • What happens if you don’t want to have treatment?

If you need more support to understand the information you are given, tell your healthcare professional.

Read more about making decisions about your care.

Where can I find out more?

The NHS website has more information about cancer and lumbar decompression surgery.

The organisations below can give you more advice and support.

NICE is not responsible for the content of these websites.

To share an experience of care you have received, contact your local Healthwatch.

We wrote this guideline with people who have been affected by spinal metastases or spinal cord compression and staff who treat and support them. All the decisions are based on the best research available.

ISBN: 978-1-4731-5306-6

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