This occurs in 5–10% of cancer patients, the most common underlying tumours being lung, breast and prostate (40% of all cases).
Early detection has a significant outcome on morbidity and mortality.
1. NICE recommends that in the following instances the Metastatic Spinal Cord Coordinator (e.g. Acute Oncology Nurse Specialist, on call Consultant Oncologist/Spinal Surgeon/Neurosurgeon) is contacted within 24 hours to discuss the care of patients with cancer and any of the following symptoms suggestive of spinal metastases:
2. is contacted immediately to discuss the care of patients with cancer and symptoms suggestive of spinal metastases who have any of the following neurological symptoms or signs suggestive of MSCC, and view them as an oncological emergency:
Oral dexamethasone 16 mg daily.
If a patient with suspected MSCC is considered fit for investigation and treatment an urgent MRI of the whole spine is the investigation of choice.
See also Chapter: Corticosteroids.
This Guide is intended for use by healthcare professionals and the expectation is that they will use clinical judgement, medical, and nursing knowledge in applying the general principles and recommendations contained within. They are not meant to replace the many available texts on the subject of palliative care.
Some of the management strategies describe the use of drugs outside their licensed indications. They are, however, established and accepted good practice. Please refer to the current BNF for further guidance.
While WMPCPS takes every care to compile accurate information , we cannot guarantee its correctness and completeness and it is subject to change. We do not accept responsibility for any loss, damage or expense resulting from the use of this information.