The clinical guideline recommends that all cancer networks in England and Wales have an MSCC coordinator to provide 24-hour cover to guide the care of these patients.
A rare complication of cancer, MSCC occurs when cancer spreads to the bones and the metastases press on the spinal cord. If not treated quickly, it can lead to permanent paralysis and early death. Patients with cancer of the lung, breast and prostate are most commonly affected.
The guidelines recommend that any patient suspected of having MSCC should be referred to the MSCC coordinator within 24 hours, who will act as a rostered point of contact to coordinate the care of individual patients.
The coordinator will perform an initial assessment, advise on immediate care of the spinal cord and spine, and oversee investigations and any hospital admissions.
Christine Ward, nurse consultant for adult palliative care at North Yorkshire and York PCT, and a member of the NICE guideline development group, said that having a designated MSCC coordinator would help improve outcomes by making sure that patients received the right treatment as quickly as possible.
However, Maria Guerin, lung cancer nurse specialist at Aintree University Hospitals NHS Foundation Trust in Liverpool and chairperson of the National Lung Cancer Forum for Nurses, said: ‘Serious consideration needs to be given as to who will take on this important role if it is to be carried out effectively.
‘Lung cancer nurse specialists are working over their hours and lung, along with urology cancer nurse specialists, have higher caseloads per incidence than other tumour site nurses.’
NICE has recommended erlotinib as an alternative to docetaxel in the treatment of non-small-cell lung cancer.