Malignant spinal cord compression (MSCC) is a rare condition and occurs when cancer has spread to your spinal cord causing compression around your spine.
- When cancer spreads to your spinal bones, it can exert pressure around your spinal cord and the nerves around it. This damages the nerves and causes symptoms such as pain, numbness or weakness.
- Although the condition is rare, see your doctor, call an ambulance or go straight to the hospital immediately as it can cause permanent irreversible damage to your nerves. The earlier malignant SCC is diagnosed, the more effective the treatment is.
- Any cancers can spread to your spinal bones. However, those most likely to include breast cancer, lung cancer, prostate cancer, lymphoma and myeloma.
- Warning signs and symptoms of malignant SCC are important to look out for when you have cancer. These include severe or gradual back pain, back pain that spreads down your legs or arms and back pain that disturbs your sleep.
- Treatment aims to reduce pressure and swelling around your spinal cord.
What is malignant SCC?
Your spinal cord is a bundle of nerves that carry messages from your brain to your arms, body and legs. Malignant SCC occurs when cancers spread to your spinal bones and exert pressure on your spinal cord and the nerves around it. The pressure can cause damage to your nerves and can cause symptoms such as pain, numbness or weakness. This is an emergency and you need to seek urgent medical attention as it can cause permanent irreversible damage to your nerves.
What are the causes of malignant SCC?
There are several cancers that can spread to your spinal cord. The more common cancers include:
What are the symptoms and warning signs of malignant SCC?
Look out for the warning signs and symptoms of malignant SCC if you have cancer or a tumour. You may experience one of the following symptoms:
- severe back pain not responding to pain killers, and changes in pain when you stand or lie down, cough or sneeze
- back pain spreading down your legs or arms
- back pain troubling you to sleep at night
- mild and gradual back pain that is different from your normal back pain
- weakness in both legs or arms
- altered sensation in both legs or arms such as tingling, numbness or 'pins and needles'
- feeling unsteady on your feet or legs giving way
- bowel problems such as constipation
- problems with urination (peeing) such as urinary leakage or unable to pee at all.
If you notice any of the symptoms above, contact your doctor immediately. The earlier malignant SCC is diagnosed, the more effective the treatment will be.
How is malignant SCC diagnosed?
Your doctor will take a history, do a physical examination and request some tests based on your symptoms. This usually involves urgent scanning of your spine such as an MRI or CT scan, which is usually done in hospital.
How is malignant SCC treated?
If you have malignant SCC, your doctor will discuss with you the best treatment options. These usually depend on the cause of the spinal cord compression, the type of cancer you have and your general health. Before treatment is started, your doctor may ask you about your wishes or whether you have any advance care plan. You may also be admitted to a hospital to receive treatment and be referred to a palliative care specialist.
Treatment aims to reduce swelling and pressure around your spinal cord. Your doctor will consider giving you steroids such as dexamethasone or prednisone to help reduce swelling and pressure on your nerves. If you have diabetes or any past problems with steroids, let your doctor know. You may also need radiotherapy or radiation treatment to destroy cancer cells around the area of compression.
What support is available with malignant SCC?
It can be scary to experience sudden weakness or altered sensation in malignant SCC. Talk through your feelings with your family members, whānau or health professionals taking care of you. Read more about how to talk about your feelings.
Below are some support services and information for people affected by cancer and their family/whānau:
Emotions and cancer Cancer Society of NZ
How we can help Cancer Society of NZ
NZ cancer services – find a hospital/service near you Healthpoint, NZ
More cancer support groups
The following links provide further information about malignant SCC. Be aware that websites from other countries may have information that differs from New Zealand recommendations.
Spinal cord compression Cancer Research, UK
Malignant spinal cord compression Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, UK
Metastatic spinal cord compression (MSCC) University College Hospital, UK
- Malignant spinal cord compression Auckland HealthPathways, NZ
- Spinal cord compression management in the palliative patient Starship Clinical Guidelines, NZ