The spinal cord is a bundle of nerves that runs from the brain down the back. It plays an important role in many body functions. These include:

• movement
• bowel and bladder function
• the sensations of touch, pain and temperature.

The spinal cord is surrounded by the bones of the spine, which protect it.

Malignant spinal cord compression (MSCC) can happen when cancer grows in the bones of the spine or in the tissues around the spinal cord. The cancer can cause pressure (compression) on the spinal cord.

About 3 to 5 in 100 people with cancer (3 to 5%) develop MSCC. Any type of cancer can spread to the bones of the spine (vertebrae), which may lead to spinal cord compression. But it is more common with certain cancers, including breast, lung and prostate cancer, lymphoma and myeloma.

Depending on which part of the spine is affected, the warning signs could be any one or more of the following:

A new, unexplained back or neck pain, which may:

• be mild to start with but becomes more severe
• feel like a ‘band’ around your chest or tummy (abdomen)
• spread down a leg or arm, or into your lower back and buttocks
• get worse with movement
• get worse when you strain, for example if you lift something heavy, cough or sneeze
• keep you awake at night.

Numbness or pins and needles that is new or quickly getting worse. This may be:

• in your toes
• in your fingers
• over the buttocks.

Feeling unsteady on your feet, including:

• having difficulty walking
• leg weakness
• your legs giving way.

Problems passing urine, including:

• having difficulty controlling your bladder (incontinence)
• only passing small amounts of urine or none at all.

Bowel problems, including:

• having problems controlling your bowels (incontinence)
• being newly constipated, or constipation getting worse.

These symptoms can also be caused by a number of other conditions, but you should always get them checked.

If you develop any of these symptoms, you should get medical advice immediately. Contact someone straight away, even if it is the weekend or a holiday.

You should contact the hospital team where you usually go for cancer treatment and follow-up appointments. If you are unable to get in touch with anyone, go to the nearest Emergency Department (A&E) or contact your GP.

When you speak to a health professional: 

• describe your symptoms
• tell them you have cancer and are worried you may have spinal cord compression
• tell them that you need to be seen straight away.

Do not wait for further symptoms to develop. The sooner MSCC is diagnosed, the sooner treatment can begin. If left untreated, MSCC will cause permanent problems.

The doctor needs to examine you. If they suspect MSCC, they may tell you to lie flat. The doctor will also arrange an urgent scan of your spine. This is usually a magnetic resonance imaging scan (MRI scan), but may be a computerised tomography scan (CT scan) if you can’t have an MRI.

The doctor will usually prescribe some steroids. These help reduce swelling and pressure on the nerves. Tell the doctor if you are diabetic or have had problems with steroids before.

If you have MSCC, the doctor will talk with you about the best treatment options for you. This will depend on:

• the type of cancer you have
• which part of the spine is affected
• your general health.

For the best result, treatment should start as soon as possible.

We have more information on the treatment options for MSCC.