When is palliative radiotherapy recommended for spinal cord compression?

Spinal cord compression happens when a tumour or cancer-related change narrows the space around the spinal cord or the nerves leaving it. It can cause back pain, weakness, altered sensation, or changes in bladder or bowel control. Radiotherapy aims to shrink or control a radiation-sensitive tumour in the affected area. It may be used after imaging and a specialist assessment, alongside corticosteroids, surgery, or other cancer treatment. The choice depends on the location, stability of the spine, overall health, previous radiation, and whether an operation is needed first.

Treat new or worsening back pain with weakness, numbness, walking difficulty, or bladder or bowel changes as an oncology emergency. Contact the treating cancer team or emergency service immediately and describe the symptoms and cancer history. Do not wait for a routine appointment. The clinical team may arrange urgent scans, start medicines to reduce swelling, and decide between radiotherapy, surgery, or both. Until assessed, follow instructions about movement and medicines, and take a current medication list with you.

Seek emergency care now for rapidly increasing back pain, new leg weakness, inability to walk, spreading numbness, or loss of bladder or bowel control. These symptoms can signal pressure on the spinal cord that may worsen without prompt treatment. Even milder new neurological symptoms need same-day assessment because early treatment can affect the options for preserving function.

Ask which scan confirmed the compression, whether the spine is stable, and whether surgery or radiotherapy should come first. Ask what improvement the team is aiming for, how quickly treatment could begin, which area will be treated, and how side effects such as tiredness, skin changes, or temporary pain flare will be managed.