Radiotherapy for spinal cord compression | Cancer Research UK
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Radiotherapy for spinal cord compression

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This page is about radiotherapy treatment for cancer that is pressing on the spinal cord. Cancer pressing on the spinal cord is called metastatic spinal cord compression or MSCC. You can find information about

 

How radiotherapy can help

Cancer pressing on your spinal cord (metastatic spinal cord compression or MSCC) can cause symptoms such as

  • Pain
  • Weakness or tingling in your legs
  • Loss of bladder or bowel control

If you have any of the symptoms of spinal cord compression, tell your doctor or nurse straight away.

If the pressure on the spinal cord continues, it permanently damages your spinal cord nerves. 

Radiotherapy treatment shrinks the tumour and quickly relieves the pressure on the spinal cord. 

Your doctor arranges for you to have urgent radiotherapy treatment and prescribes painkillers if you need them. You also have steroids because they take away swelling and help to relieve the pressure. Surgery is sometimes used to treat spinal cord compression but radiotherapy is used more often.

The radiotherapy usually shrinks the tumour pressing on your spine very quickly. The quicker it does, the sooner your symptoms will go. This lowers the chance of long term nerve damage to your 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.

Having treatment

Exactly how you have the treatment depends on the part of your spine that’s affected. You will probably just have the beams aimed at your back. 

If your neck is affected, you may have 2 lots of treatment for each fraction, one aimed from each side. This gives a high dose of treatment to the spinal cord but a lower dose to healthy body tissues in your head. So it reduces the chance of side effects.

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 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.

A photo of a linear accelerator, which gives radiotherapy

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 in position 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 start to see results within a few days of starting your radiotherapy. How well the treatment works depends mainly on two things – the type of cancer you have and how well it responds to radiotherapy. But it can also depend on the symptoms you have at the time you are treated.

The treatment usually helps to relieve symptoms such as 

  • 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 side 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.

You might feel more tired than before the treatment started. 

Your skin may go a bit red in the treatment area. 

You might have a flare up of pain for 1 to 2 days and your treatment team will advise you on adjusting your painkillers.

You may feel sick if your stomach is in the treatment area. To help control sickness, your doctor can give you anti sickness drugs (anti emetics). You might find that taking an anti sickness tablet an hour before your treatment helps. 

If your bowel is in the treatment area, you may have some diarrhoea. Your doctor or nurse can give you some medicines to help control diarrhoea.

 

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.

 

More information about radiotherapy

We have detailed information about external radiotherapy

Spinal cord compression

Painkillers

Steroids

Radiotherapy moulds and masks

Anti sickness medicines

The SCORAD 3 trial

For general information and support 

Contact the Cancer Research UK nurses on freephone 0808 800 4040 (Open 9am to 5pm, Monday to Friday)

Share experiences on our online forum – Cancer Chat

 

conformal radiotherapy

 

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Updated: 14 March 2016