When should I consider referring a patient with suspected MSCC to a specialist, and what information should I include in the referral?

Refer a patient with suspected spinal cord compression due to metastatic cancer to a specialist immediately if they present with symptoms or signs listed in box 1, such as bladder or bowel dysfunction, gait disturbance, limb weakness, neurological signs of spinal cord or cauda equina compression, numbness, paraesthesia, sensory loss, or radicular pain. This should be treated as an oncological emergency and involve contacting the MSCC coordinator within 24 hours ¹.

Seek advice through the MSCC coordinator within 24 hours if a person with a past or current diagnosis of cancer presents with pain characteristics suggesting spinal metastases, such as severe unremitting, progressive, or mechanical pain, pain aggravated by straining, night-time pain disturbing sleep, localised tenderness, or claudication ¹.

Include in the referral: the patient's cancer history, specific symptoms and signs (e.g., neurological deficits, pain characteristics), and any relevant imaging or clinical findings. Clearly state the urgency of the situation, especially if neurological symptoms are present, to facilitate prompt specialist assessment ¹.