University Teaching Trust

Spinal cord compression What to look out for

Clinical Sciences Building Acute Oncology 0161 206 2312

© G20020302W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2020. Document for issue as handout. Unique Identifier: NOE06(20). Review date: May 2022. If you have a type of cancer that has spread to a bone, you need to know What are the warning signs? about compression and the warning signs. This depends on which part l Stiffness and heaviness in If you can recognise these early warning signs and get treated quickly, of the spine is affected. Pain your legs affecting your permanent damage may be avoided. The aim of this booklet explains what may be present for some balance and walking to look out for, and what you should do if you have any warning signs. time before other symptoms l Numbness or changed develop. The warning signs can sensation in your legs - this What is spinal cord compression? be any of the following: can also affect your lower The spinal cord is a bundle of l Pain in one area of your spine body, chest or arms nerves that runs from the brain that is severe, distressing or l Weakness in your legs, or down the back. different from your usual arms and legs pain The bones of the spine l Bladder / bowel problems - l surround it. Pain down your leg or arm loss of control (incontinence) The spinal cord provides nerves l Tingling - like electric shocks or not being able to empty to the body including the - down your spine into your your bladder bladder, arms and legs. legs, or arms and legs If you have a tumour in the l Severe pain in your spine bones of the spine (vertebrae) which changes when you or in the tissues around the lie down or stand up, lift or Tumour spinal cord, it can cause strain, wakes you at night, or pressure (compression) on the Spinal Cord stops you getting to sleep Spine spinal cord. l Pain which starts in the spine This can cause pain, altered and goes around the chest or sensation and weakness. abdomen Spinal cord compression is not l New pain which gets worse common and the risk of cord and does not respond to compression is small even if you painkillers have a secondary cancer in the spine.

© G20020302W. Design Services, Salford Royal NHS Foundation Trust, 1 All Rights Reserved 2020. Document for issue as handout. 2 Unique Identifier: NOE06(20). Review date: May 2022. What should I do if I develop any warning signs? l The doctor will prescribe l If you have cord compression Remember to get help if you Get advice immediately: contact steroids () for you will probably be develop any warning signs. the hospital team where you you before or after the scan. admitted to your local Seek immediate help if you usually go for your cancer Steroids reduce pressure and hospital. You may need to have unexplained tingling, follow-up clinics, your GP or swelling around nerve tissue. be transferred to The Christie numbness or weakness in your Macmillan nurse. Describe your If you are diabetic, or have (Withington, Manchester arms and legs. symptoms and explain that had problems with steroids in or Christie@Salford) for you are worried that you may the past, you should tell your radiotherapy or Salford Royal doctor if you need . You will have spinal cord compression So remember: and that you need to be seen l Radiotherapy, surgery or have to stay flat in bed until If you have any of the above urgently. chemotherapy are all options the doctors are satisfied that symptoms: for treatment. Your oncology your spine is stable and it is Don’t delay team will discuss the best safe to start walking again. l Speak with a health Ring someone today even treatment for you with the You will get help with this professional, for example, if it is at a weekend or a specialist surgeons. This from the physiotherapist. your GP, Oncologist, Specialist holiday period. treatment option depends on If your neck or top of the Nurse or a Physiotherapist as the type of cancer, which part (cervical) spine is affected, soon as is practical (preferably of the spine is affected and you will also need to wear a within 24 to 48 hours) What happens next? your general health. In any collar to prevent damage to the spinal cord l Tell them that you are l A doctor needs to examine case, treatment should start worried about your spine and you. If the doctor suspects as soon as possible after the would like to be examined as that you may have spinal scan Spinal cord compression, if soon as possible untreated or if there is a delay cord compression he will l Bring this booklet with you advise you to stay flat in bed in treatment, can lead to and a scan of your spine will permanent damage and even l Try to avoid bending your back be arranged urgently. This is . Early diagnosis and usually an MRI scan, but you treatment gives the best chance may have a different scan if of preventing paralysis. this is not suitable for you

© G20020302W. Design Services, Salford Royal NHS Foundation Trust, 3 All Rights Reserved 2020. Document for issue as handout. 4 Unique Identifier: NOE06(20). Review date: May 2022. Useful contact numbers? Notes

GP

Macmillan Nurse

Oncology Clinic

The Christie Hotline 0161 446 3658 Specialist Nurse (Key Worker)

For the Doctor or Healthcare Professional: l This patient has cancer and is therefore at risk of metastatic spinal cord compression (MSCC) l If they have any of the symptoms described in this booklet, then please consider MSCC as a possible diagnosis and discuss further management with the Network MSCC Co-ordinator through The Christie Acute Oncology Management Service (incorporating the Hotline - 0161 446 3658)

© G20020302W. Design Services, Salford Royal NHS Foundation Trust, 5 All Rights Reserved 2020. Document for issue as handout. 6 Unique Identifier: NOE06(20). Review date: May 2022. © G20020302W. Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2020 This document MUST NOT be photocopied University Teaching Trust Information Leaflet Control Policy: Unique Identifier: NOE06(20) Review Date: May 2022

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