Recognising metastatic spinal cord compression

Metastatic spinal cord compression (MSCC) is a potentially life changing oncological emergency. Neurological function and quality of life can be preserved if patients receive an early diagnosis and rapid access to acute interventions to prevent or reduce nerve damage. Symptoms include developing spinal pain, numbness or weakness in arms or legs, or unexplained changes in bladder and bowel function. Community nurses are well placed to pick up on the 'red flag' symptoms of MSCC and ensure patients access prompt, timely investigations to minimise damage.

Spinal Metastasis in Glioblastoma Multiforme

Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor. Spinal metastasis is rare. However, as local control of the primary tumor improves, metastatic disease is increasingly possible. The neuroscience nurse plays an instrumental role in caring for patients with GBM, developing a plan of care based on each patient's needs and outcomes.

Upper Cervical Spine Chordoma: A Case Study

Cervical chordomas are rare, slow-growing, but locally aggressive tumors. Predominantly found in people 50-69 years old, a chordoma arises from remnants of the primitive notochord. It is most often found in the sacrococcygeal or skull base areas. However, it can be found throughout the spine. Because chordomas are slow growing, they may reach considerable size before the patient becomes symptomatic. Surgical resection with a wide margin is the only curative procedure. Usually, because of tumor location and infiltration, this is not possible. Although this type of tumor is generally considered radioresistant, radiation therapy is often prescribed after surgical resection. The following case study illustrates the clinical presentation, surgical interventions, and neuroscience nursing considerations for a patient undergoing a posterior stabilization as well as a midline mandibulotomy-glossotomy approach for an upper cervical spine chordoma resection.

Cancer: new therapies and new approaches to recurring problems

Caring for patients with cancer presents unique challenges to anesthetists. Chemotherapeutic regimens can cause cardiac, pulmonary, and other complications that will influence the anesthesia provider's care. New surgical techniques, including vertebroplasty, vertebrectomy, radiofrequency ablation of the liver, and sentinel node biopsy, present issues related to the surgical techniques and drugs administered. Recurring problems, including tumors of the airway and cardiac tamponade, continue to present challenges for anesthesia providers. Many patients with cancer who undergo surgery not only have acute pain related to the surgical procedure but also have chronic pain that will influence anesthetic and postoperative pain management. This Journal course discusses new therapies and procedures and approaches to recurring problems in cancer care.

Caring for patients with a diagnosis of cancer and spinal metastatic disease

This article aims to provide a greater understanding of the process involved in diagnosing cancer, particularly that associated with spinal metastasis. The article focuses on the diagnosis of secondary cancer of the spine, however, the information and discussion might also be relevant to other anatomical areas.

Tumors of the spine and spinal cord

OBJECTIVES

To provide an overview of spinal cord neoplasms with a focus on location, histology, pathophysiology, diagnosis, treatment and nursing assessment and management.

DATA SOURCES

Published books and peer-reviewed articles.

CONCLUSIONS

Tumors of the spine and spinal cord are rare, and they can have grave implications for the patient. The key in the management of spinal cord tumors is their timely diagnosis and treatment to preserve function.

IMPLICATIONS FOR NURSING PRACTICE

A thorough nursing assessment and timely intervention can have a positive impact on the outcome of patients with tumors of the spine and spinal cord.

[Visiting nurse support for patients wishing to die at home]

Thirty-two (1994) and 55 (1995) patients in the terminal stage of many kinds of cancer were cared for satisfactorily at home by a visiting team of nurses from Niigata Cancer Center Hospital. A prostate cancer patient with multiple bone metastasis was suffering from morphine-resistant intractable pain, and highly dependent on medical care. We continued to take care of him by frequent visitation and psychological assist until he eventually died at home according to his wishes. It is important to create a suitable support team for the continual difficult home care of each terminal patient.

Palliative nursing care of a man with terminal cancer

Care study

Harry, a 60-year-old man, was diagnosed with a left parotid carcinoma and bone metastases. He had a left parotidectomy and node dissection, and a course of radiotherapy to his spine. He was admitted to the palliative care unit 2 months later with nausea and vomiting and lower back pain. He lived with his wife, Shannon, and his son, David (22 years of age), who was a source of emotional and financial stress for both of his parents. Harry also had a daughter, Linda (26 years of age), who worked as a nurse in Texas and with whom he enjoyed a close, loving relationship.

On learning that the illness was terminal, Harry and his family were extremely anxious and upset by the relatively rapid progression of the disease. Consequently, primary nursing was employed to ensure continuity in nursing care throughout Harry's stay. His nursing care was organized using the model derived by Roper et al (1980) as this allowed Shannon to help to care for him while ensuring that the primary nurse regularly monitored his progress. In addition, care centred around Harry's usual daily routine, which helped to ease the family's distress. Harry's initial aim was to die at home surrounded by his family and close friends.

The second-named author was the primary nurse for Harry and his family during his stay on the palliative care unit.^arry's family granted permission for the publication of this care study which was written to help nursing students and registered nurses with little background in palliative care to learn more about the nature of nursing care provided by an experienced palliative care nurse to a person with terminal cancer and his family.

Caring for cancerous wounds in the community

An account of the management of a fungating sacral tumour

A nursing intervention for early detection of spinal cord compressions in patients with cancer

This article reviews the current literature regarding spinal cord compression including its prevalence and presenting signs and symptoms; increases an awareness of the potentially severe effects of spinal cord compression; and describes a model for patient educational intervention focusing on early warning signs of spinal cord compression. With increased understanding of the nature and effects of spinal cord compression, nurses may effectively intervene to minimize the severity of the neurological deficits.