Information
Malignant Spinal Cord Compression (MSCC) can affect any patient with cancer. Early diagnosis whilst the patient is still ambulant is crucial. Rapid referral and treatment lead to better outcomes.
Most common symptoms are vertebral pain (especially radicular thoracic), new spinal nerve root pain (burning, numb, shooting), any new difficulty walking, reduced power/altered sensation in limbs and or bowel/bladder disturbance.
Who to refer:
Patients with a cancer diagnosis (strongly suspected or cancer with high risk for metastatic disease for example Lung, Prostate or Breast cancer) and symptoms suggestive of MSCC.
Who not to refer:
If in doubt please do not hesitate to call the on call oncology team. You may be advised to refer via medical team if patient does not have confirmed cancer pathology or does not meet clinical pathway for investigation via oncology.
How to refer:
Contact the Acute Oncology team at the Edinburgh Cancer Centre on 07798774842 or 0131 537 1000 and ask to speak to Acute Oncology team for oncology
You may be advised that assessment will be arranged for the following day in a dedicated MRI slot with primary care prescribing dexamethasone 8 or 16mg with PPI cover as first line treatment. The Acute Oncology team may speak to the patient to relay advice and where to attend etc however if not appropriate will provide you with the details to relay to the patient.
Scottish Referral Guidelines for Suspected Cancer (Malignant Spinal Cord Compression):
https://www.cancerreferral.scot.nhs.uk/malignant-spinal-cord-compression/
Link to Acute Oncology Initial Management Guidelines: UKONS | Acute Oncology Initial Management Guidelines (sundownsolutions.co.uk)
