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Bone metastases and spinal cord compression

Metastases ossium et compressio medullae spinalis · Kostní metastázy a útlak míchy

What it is

Cancer spread to bone — most often from breast, prostate, lung, kidney and thyroid, and myeloma — causing pain, fractures and high calcium; a deposit in the spine can squeeze the cord, an emergency that decides whether a person walks again.

Symptoms & signs

  • Deep bone pain, worse at night and lying down
  • new back pain in someone with cancer
  • fracture after little force
  • thirst, confusion, constipation (high calcium)
  • leg weakness, numbness, bladder or bowel trouble — cord compression, same-day MRI

🚩 Get help if…

  • call 112 / 911 now Leg weakness, numbness or trouble walking with back pain
  • call 112 / 911 now New loss of bladder or bowel control
  • see a doctor soon Back pain that is worse lying down or at night
  • see a doctor soon Thirst, confusion and constipation (high calcium)

Where it strikes

Medical treatment

  • Whole-spine MRI the same day for suspected cord compression
  • Dexamethasone and urgent radiotherapy or surgery for cord compression — walking at treatment predicts walking after trials support
  • Single-dose radiotherapy for painful deposits — as good for pain as longer courses trials support
  • Bisphosphonates or denosumab — fewer fractures; rare jaw osteonecrosis, low calcium trials support
  • surgical fixation of bones about to break
  • treatment of the cancer itself

Natural & lifestyle

  • Dental check before bone drugs
  • vitamin D and calcium with denosumab
  • staying active as pain allows

Emerging & experimental

  • Radiopharmaceuticals (radium-223, lutetium PSMA) in prostate cancer
  • stereotactic body radiotherapy for few deposits
  • thermal ablation and cementing (vertebroplasty) — pain relief trials mixed

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Acupuncture for cancer pain — small trials, mixed mixed evidence
  • High-dose vitamin C against the cancer — no benefit in trials not confirmed in trials
  • Mistletoe extract — quality-of-life trials disagree; no survival benefit shown early / small studies

ICD codes