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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. You can find information about

 

Why radiotherapy is used

If your cancer is pressing on your spinal cord, it is called metastatic spinal cord compression (MSCC). The pressure on the spinal cord 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 immediately. 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 the more it 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 series of daily treatment sessions called fractions. Each fraction takes a few minutes. Normally you have one a day. But occasionally you may have two fractions a day, for example, just before a weekend.

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 two 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.

Depending on your type of cancer, you may have daily treatment over 1 to 4 weeks. Treatment over a week or 2 is most common.

 

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 pain, weakness in your legs, and any other symptoms such as loss of bladder or bowel control. Radiotherapy controls spinal pain in over 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. You may feel more tired than before the treatment started. Your skin may go a bit red in the treatment area. Your skin is not likely to become sore with this amount of treatment. 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.

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.

 

Research into radiotherapy for MSCC

The SCORAD trial is looking at whether it is better to give one high dose of radiotherapy for spinal cord compression, or several 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 this trial on our clinical trials database. The trial has closed and we are waiting for the results.

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Updated: 3 July 2012