Decorative image

Radiotherapy for spinal cord compression

Radiotherapy treatment uses high energy x-rays to kill cancer cells. Find out about it as a treatment for spinal cord compression.

Spinal cord compression means that cancer is pressing on the spinal cord. It is also called metastatic spinal cord compression or MSCC. The pressure from the cancer can cause symptoms such as:

  • pain
  • weakness or tingling in your legs
  • loss of bladder or bowel control

If the pressure on the spinal cord continues, it permanently damages your spinal cord nerves. So it is very important to treat it quickly.

How radiotherapy can help

Radiotherapy treatment shrinks the cancer and relieves the pressure on the spinal cord. It usually does this very quickly and the symptoms start to lessen. This lowers the chance of long term nerve damage to your spinal cord.

Your doctor will prescribe painkillers if you need them. You also have steroids because they take away swelling and help to relieve the pressure on the spinal cord.

How you have radiotherapy for MSCC

You are usually admitted to hospital urgently for radiotherapy treatment for spinal cord compression. You stay in hospital while you have the treatment. 

You have the radiotherapy as a single treatment or a series of daily treatment sessions called fractions. Each fraction takes a few minutes. Normally you have one a day. But occasionally you may have 2 fractions a day, for example, just before a weekend.

The most common way of having this treatment is 5 treatments over 1 week. But it is possible to have fewer treatments or more treatments.

Exactly how you have the treatment depends on the part of your spine that’s affected. 

Having treatment

First, you have a specialised CT planning scan so the treatment team can plan exactly where to give the radiotherapy. You might also need to have a plastic mould made to keep you completely still during the treatment sessions.

To have the treatment you lie on a radiotherapy couch. The radiographers help you to get into the right position.

External radiotherapy machine
An external radiotherapy machine

The staff then leave the room. This is so they are not exposed to the radiation. You will be alone for a few minutes. The radiographers watch you carefully on a closed circuit television screen.

You can't feel the radiotherapy. It doesn’t hurt but you might find it uncomfortable to lie still during the treatment. The radiotherapy couch can be quite hard. You can ask your doctor or specialist nurse if you can take a painkiller half an hour beforehand if you think it might help.

Treatment results

You should see your symptoms improve within a few days of starting your radiotherapy. How well the treatment works depends on the type of cancer you have and how well it responds to radiotherapy. It also depends on the symptoms you have. 

The treatment usually helps to relieve:

  • pain
  • weakness in your legs
  • loss of bladder or bowel control

Radiotherapy controls spinal pain in more than 7 out of 10 people treated (70%). People with minor problems with walking when they start treatment are likely to recover their walking completely. But if you were completely unable to walk because of the tumour pressing on your spine, it is much less likely that your walking will come back completely.

According to studies, between 1 and 5 out of 10 people in this situation are able to walk again after radiotherapy.

Possible side effects

Side effects of radiotherapy for spinal cord compression are usually mild. The effects tend to come on gradually as you go through your treatment course. They might last for a week or 2 after the treatment has finished. They can include:

  • tiredness
  • reddening or darkening of the skin in the treatment area
  • feeling sick
  • diarrhoea
  • a worsening of pain for 1 to 2 days

Speak to your team about any side effects that you have. There are lots of things they can do to help, such as giving you anti sickness medicines for sickness.

Research into radiotherapy for MSCC

The SCORAD 3 trial is looking at whether it is better to give one high dose of radiotherapy for spinal cord compression, or 5 smaller doses over a number of days. 

At the moment, you might have radiotherapy in either of these ways depending on your condition. But doctors want to find out if one type of treatment would be better for everyone. They also want to learn more about the differences in side effects.

Last reviewed: 
05 Dec 2016
  • Metastatic spinal cord compression in adults: risk assessment, diagnosis and management
    National Institute for Health and Care Excellence, November 2008

  • External Beam Therapy
    Peter Hoskin
    OUP Oxford, 30 Aug 2012

  • De Vita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology (9th edition)
    De Vita, V.T., Lawrence, T.S. and Rosenberg S.A.
    Lippincott, Williams and Wilkins, 2011

  • Symptom management in advanced cancer (4th edition)
    R Twycross, A Wilcock and S Tolle
    Radcliffe Medical Press Ltd, 2009

Information and help

Dangoor sponsorship

About Cancer generously supported by Dangoor Education since 2010.