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When cancer spreads to the spine, it can put pressure on the spinal cord that carries nerve signals between our bodies and our brains. Left untreated, it can eventually cause permanent damage to the spinal cord leaving people paralysed. 

Metastatic spinal cord compression (MSCC) – the medical term used when the cancer is putting so much pressure on the spinal cord that it could cause this damage – is a serious medical emergency and usually needs to be diagnosed and treated within 24 hours.

The Clatterbridge Cancer Centre has the UK's only specialist service of its kind offering emergency diagnosis and treatment seven days a week.

Our dedicated MSCC team of different health professionals work in partnership with hospitals, primary care and community health teams across Cheshire and Merseyside.

The recommendations in the new NICE guidelines on setting up MSCC services are based on the model we developed for MSCC patients across Cheshire and Merseyside. [NICE – the National Institute for Health and Care Excellence – advises healthcare professionals on clinical evidence so patients can receive the best care.]

When to seek help

MSCC is a serious medical emergency. Diagnosis and treatment is usually needed within 24 hours. Contact your hospital team immediately if you have cancer and you develop any of the following symptoms:

  • Back or neck pain that becomes severe
  • Pain that feels like a band around the chest or tummy (abdomen)
  • Pain that spreads into your lower back, buttocks or legs
  • Pain in the spine that gets worse when you move, lift something heavy, cough or sneeze
  • Any pain mentioned above that keeps you awake at night
  • Numbness, a burning feeling or pins and needles in the toes, fingers or over the buttocks
  • Feeling unsteady on your feet, having difficulty walking, weakness or your legs giving way
  • Problems controlling your bladder (incontinence) or passing little or no urine
  • Problems controlling your bowels (incontinence) or increasing constipation
Download a pocket-sized MSCC alert card you can keep

BBC News: Coverage of the MSCC service (August 2023)

What we do 

We assess, diagnose and treat metastatic spinal cord compression (MSCC) and secondary (metastatic) spinal cancers with the potential to lead to MSCC for people across Cheshire and Merseyside and the Isle of Man:

  • People with suspected MSCC can be referred to us by their GP, A&E doctor or another health professional. 
  • Health professionals can contact the MSCC for urgent advice if they think a patient might have MSCC.
  • We assess patients referred to us and arrange treatment if they have MSCC. 
  • We provide emergency care and treatment for patients with confirmed MSCC.

If you develop symptoms of MSCC, your cancer team or another healthcare professional can refer you to us for assessment, diagnosis and treatment. 

The service runs seven days a week, from 7:30am to 8:00pm (07:30-20:00).   

Some people with MSCC already know they have cancer and have contacted their medical team because they developed symptoms on the MSCC alert card. 

Other people are diagnosed after going to their GP, A&E or another health professional because of their symptoms. Sometimes they do not know they had cancer until they are diagnosed with MSCC.

If you have suspected MSCC, you will usually need a scan to take images of your spine and the area around it – this is so your healthcare team can see if anything is pressing on the spinal cord. 

The healthcare professional caring for you can contact our MSCC team for advice. 

They will refer you to our MSCC team for further assessment, diagnosis and treatment if your scan shows you might have MSCC. 

If you are at home or in another care setting, you will usually then be transferred to your nearest A&E or Clatterbridge Cancer Centre – Liverpool (CCC-Liverpool) for assessment. The MSCC team will work very closely with your care team and keep them updated every step of the way.

When you arrive at CCC-Liverpool, you will have further scans and tests to confirm if you have MSCC and to help plan your treatment. 

Your treatment will depend on which area of your spine is compressed. We work closely with specialists in other hospitals including The Walton Centre and to make sure you get the treatment that is likely to work best for you. 

We discuss this with them at a multidisciplinary team meeting (MDT) led by consultants. 

The team caring for you will also discuss your treatment options with you so you can decide what is right for you. 

Being diagnosed with MSCC can be a lot to cope with. We want to make sure you have all the support you need, during and after your treatment. 

To help us do this, we will ask you to complete a holistic needs assessment (HNA). You will be able to talk through your needs and concerns and then agree on a plan for your care and support needs.

It is called ‘holistic’ because you can discuss any needs or concerns you have about any area of your life. 

One of our MSCC cancer support workers will also be with you every step of the way while you are under our MSCC team’s care. They will make sure you have all the information you need.   

Radiotherapy is a treatment that uses radiation to destroy cancer cells. If you are having radiotherapy for MSCC, you will have this in Clatterbridge Cancer Centre –Liverpool (CCC-Liverpool). 

Find out more about radiotherapy more widely at The Clatterbridge Cancer Centre.

Get a virtual tour of the Radiotherapy department at CCC-Liverpool

 

Sometimes surgery is an option for treating MSCC. We work closely with the spinal surgery team at The Walton Centre so we can make sure you get the care that is best for you. If you are having surgery for MSCC, you will have this at The Walton Centre. 

Find out more about spinal surgery at The Walton Centre.

Drugs that are used to treat cancer are known as systemic anti-cancer therapies (SACT). Sometimes they are an option for treating MSCC.

There are many different types including chemotherapy, immunotherapy, hormone therapy and targeted therapy.  

They can be given as an injection, infusion or oral medication. 

If you are having this form of treatment for MSCC, you will usually have this at CCC-Liverpool or one of our other cancer centres.

Find out more about chemotherapy and SACT at The Clatterbridge Cancer Centre. 

Find out more about immunotherapy at The Clatterbridge Cancer Centre.

If you are under the care of another hospital, the Acute Oncology team provides support and expert advice on all aspects of cancer to the team that are caring for you there.  

They make sure that you have the right tests, treatment, emotional support, information and advice while you are in hospital. They also make sure you have the follow-up care you need after you are discharged.

Our MSCC team works closely with the Acute Oncology team so they are kept up to date every step of the way.

Find out more about our acute oncology service. 

Enhanced supportive care (ESC) helps people with cancer to cope with the impact of their condition and the treatment they are having. 

Find out more about our enhanced supportive care service.

Our team

Our MSCC team includes a wide range of healthcare professionals and supporting staff with different expertise and skills. 

MSCC Service Lead

Kate Lacey leads the MSCC service. Kate is a therapeutic radiographer by background and has been instrumental in developing our MSCC service. 

MSCC Clinical Lead

Dr Clare Hart – Consultant Clinical Oncologist

CORD Consultant

Each week, a consultant clinical oncologist oversees the care of patients with suspected or confirmed MSCC that week. The role rotates between different consultants. 

MSCC Coordinator

The MSCC coordinator arranges the care of every patient referred to the service with suspected or confirmed MSCC. They make sure that we have all the information we need for the multidisciplinary team meeting to provide the right care plan for each patient. 

MSCC Cancer Support Worker

The cancer support workers are there to help patients every step of the way, making sure their care plan is right for them. They look after holistic needs assessments (HNA) with the patient and their family members or carers.

They also arrange patient transfers to and from CCC-Liverpool.  

MSCC Support Coordinator

The support coordinator helps with administration, data, audit and governance processes and supports the MSCC coordinators in their work.

MSCC Physiotherapy Rehab

Our physiotherapy colleagues advise on assessment, mobilisation, rehabilitation and brace guidance for patients.

MSCC Clinical Analyst

The clinical analyst develops and introduces new digital solutions to streamline our processes and improve efficiency in the MSCC pathway.

Further information

Our Cancer Information and Support Centres  can provide individualised help and support for patients and families affected by cancer. The team’s main base is in Clatterbridge Cancer Centre – Liverpool but they also work at our Aintree and Wirral hospitals.

There are also local Macmillan services in other hospitals across our region.

External sites that offer extra support and information about MSCC include: