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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, and loss of bladder or bowel control. This situation is very serious because if the pressure on the spinal cord continues, it permanently damages the spinal cord nerves.

Radiotherapy treatment shrinks the tumour and quickly relieves the pressure on the spinal cord. So if you have any of the symptoms of spinal cord compression, tell your doctor or nurse straight away. They will arrange for you to have urgent radiotherapy treatment and will prescribe painkillers if you need them. You will also have steroids because they take away swelling and help to relieve the pressure. Surgery is sometimes used to treat spinal cord compression but generally radiotherapy is quicker.

The radiotherapy usually shrinks the tumour pressing on your spine very quickly. The quicker it does, the sooner your symptoms will go. And 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.

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. But 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 from the treatment.

First, you have a specialised CT planning scan so the treatment team can plan exactly where to give the radiotherapy. You may 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 will help you to get into the right position.

A photo of a linear accelerator, which gives radiotherapy

Once you are in the right position the staff leave you alone in 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 either through a window or on a closed circuit television screen.

You can't feel the radiotherapy. It doesn’t hurt but you may 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.

 There is information about how you have external radiotherapy on the page about having external radiotherapy treatment.

 

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 and may last for a week or 2 after the treatment has finished.

You may feel more tired than before the treatment started. 

Your skin may go a bit red in the treatment area but is not likely to become sore with this amount of treatment. 

You may 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 may 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.

There is information about the SCORAD 3 trial on our clinical trials database.

 

More information about radiotherapy

We have detailed information about external radiotherapy in this section. There is also detailed information about the side effects of radiotherapy.

You can phone the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday. They will be happy to answer any questions that you have.

Our general organisations page gives details of people who can provide information about radiotherapy. Some organisations can put you in touch with a cancer support group. Our cancer and treatments reading list has information about books, leaflets and other resources about radiotherapy treatment.

If you want to find people to share experiences with online, you could use Cancer Chat, our online forum.

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Updated: 30 April 2014