Malignant Spinal Cord Compression (MSCC) is an oncological emergency (Mitera, Loblaw. Radiother Oncol. 2003;69(Suppl 1):Abstr. 141) affecting patients with cancers that have metastasised to the spine. This is most common in breast, lung and prostate cancers and haematological malignancies (National Institute for Health and Care Excellence. Metastatic spinal cord compression: diagnosis and management of patients at risk of or with metastatic spinal cord compression. [CG75.], 2008). The NICE Quality Statement regarding management of Metastatic Spinal Cord Compression requires that ‘Adults at high risk of developing MSCC, and their families or carers (as appropriate), are given information that describes the symptoms of MSCC and what to do if they develop symptoms’ (National Institute for Health and Care Excellence. Metastatic spinal cord compression in adults. [QS56], 2014).
Aims To evaluate the proportion of patients at risk of MSCC given information regarding the risk and red flag signs. If this information was provided, by whom was it provided and at what stage of their illness.
Methods From September 2020 to May 2022, a proforma was used to collect data from 30 hospice patients on the inpatient unit and in the community. A set of inclusion/exclusion criteria were used to ensure appropriate data collection.
Results 30 patients with 9 different malignancies were approached. 63% had known bone metastases. Of those who had received information about MSCC, 20/21 patients were told about MSCC after they had developed symptoms. 1/30 patients was informed by a GP, 18/30 were informed by the hospice team and 4/30 by the hospital oncology team. 3/30 patients were deliberately not informed. 17/21 patients had awareness of red flag signs once they had been informed of the risk MSCC.
Conclusion Information was frequently only given to patients regarding the possibility and red flag signs of MSCC once symptoms had developed. This will potentially lead to patients developing paraplegia and double incontinence which has a profound effect on quality of life. These results will be communicated to teams in the hospice and the Trust to ensure that this is addressed.
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