Although patients with metastatic spinal cord compression (MSCC) have a median survival time of 3 to 6 months, few data are available concerning the presence of advance directives and do-not-resuscitate (DNR) orders in this population. There are varying levels of depression. Management of Pain and Spinal Cord Compression in Patients with Advanced Cancer Janet L. Abrahm, MD, FACP Pain and spinal cord compression are two of the most distressing problems faced by patients with advanced cancer. This advice actually applies to spinal cord stimulator and vagus nerve stimulator battery replacement. *This response is based on the best information available as of 12/19/19. Any type of cancer can spread to the bones of the spine (vertebrae), which may lead to spinal cord compression. About 3 to 5 in 100 people with cancer (3 to 5%) develop MSCC. Life after spinal cord injury can require a lot of change, and many people struggle to adjust. In this situation it is appropriate to begin discussions related to end of life desires, hospice care, and terminal pain/symptom management. Click through to become a member and gain access to support, information and real time replies. Objectives: Communication about end-of-life decisions is crucial. Spinal cord compression happens when pressure on the spinal cord stops the nerves working normally. The purpose of this study was to review the morbidity and mortality suffered by these patients. For some, it’s mild and for others, it’s overwhelming and can significantly interfere with quality of life. Management of Pain and Spinal Cord Compression in Patients with Advanced Cancer Janet L. Abrahm, MD, for the ACP–ASIM End-of-Life Care Consensus Panel General internists often care for patients with advanced cancer. Background: Few studies have focused on the outcomes of nonambulatory patients diagnosed with spinal cord compression from metastatic cancer. End of life issues: The patient with spinal cord compression from metastases is usually in the late stages of his/her disease process. Spinal cord compression and cancer. The spinal cord is surrounded by the bones of the spine, which protect it. Find out more about what it is, the symptoms, what causes it … These patients have substantial morbidity caused by moderate to severe pain and by spinal cord compres-sion. As a result, they may develop depression. FIVE Components of Quality End-of-Life Care 1) Adequate pain and symptom management 2) Avoiding inappropriate prolongation of dying 3) Achieving a sense of control 4) Relieving burden 5) Strengthening relationships with loved ones Singer P.A., Martin D.K., Kelner M., Quality End-of-Life Care: Patient’s Perspectives, JAMA 1999 281(2) 163-168 Spinal cord compression is localized mainly to the dorsal and lumbosacral regions (42% each) and is the initial manifestation of the disease in 25% to 67% of patients who develop spinal cord compression. The primary diagnosis is the patient’s condition that warranted the neurostimulator. Prostate Cancer UK Online Community » Living with prostate cancer » End-of-life issues » Spinal cord compression and paralysis Join the online community now. Spinal cord compression is, as it suggests, compression of the spinal cord that causes progressive and irreversible neurological damage (Watson, 2006) and is therefore a true emergency. 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