MSCC clinical guidance

• MSCC clinical guidance - Group 1: (Urgent referral to GP)

  • No history of cancer, red flags suggestive of malignancy which warrant further investigation:
  • Age > 60
  • Persistent non-mechanical pain
  • Mechanical symptoms non-responsive to appropriate management over a reasonable time scale
  • Recent unexplained weight loss
  • Unwell/fever/night sweats
• MSCC clinical guidance - Group 2:

  • History of cancer, suspect metastatic disease
  • History of cancer is the most prominent symptom in cancer
• MSCC clinical guidance - Group 3:

  • Hx of Ca, suspect MSCC:
  • cauda equina syndrome
  • New onset/progressive worsening less than grade 4 OS, associated with 1 or more myotome
  • New onset/progressively worsening loss of sensation one or more dermatome
  • Altered reflex at one of more level
• MSCC clinical guidance - Group 4:

  • Hx of Ca, low suspicion of metastatic disease