Metastatic Spinal Cord Compression (MSCC) happens when cancer spreads to the spine and puts pressure on the spinal cord. When this happens, people may experience symptoms such as back pain, weakness, numbness, or problems controlling their bladder or bowels. MSCC usually develops in the later stages of cancer and needs urgent treatment to prevent permanent nerve damage.

One of the main ways to treat MSCC is radiotherapy, which can reduce pressure on the spinal cord and help ease symptoms. Treatment works best when it is given as quickly as possible, ideally within 24 hours of the decision to start radiotherapy. However, current treatment can sometimes be delayed because patients need several appointments for scans and planning. This can be difficult for people who are already in pain or struggling to move comfortably.

To make treatment faster and easier, we are introducing a new approach using a machine called an MR Linac. This machine combines an MRI scanner and a radiotherapy machine in one. This means that instead of coming to the hospital several times, patients can have their scan, treatment plan, and radiotherapy all in one visit. This reduces waiting times, avoids multiple hospital trips, and helps minimise movement that could cause more discomfort.

We are also training specialist radiographers to lead this process, helping to deliver treatment quickly and safely. This work will support a new and improved way of caring for patients who need urgent radiotherapy—not only those with MSCC, but also people with other cancers who may benefit from quicker treatment in the future.

By using the latest technology and developing specialist roles, our aim is to provide faster, more comfortable, and more effective care for patients when they need it most.

Patient enrolling on this study will be able to decide whether they receive treatment on an MR-Linac or a conventional radiotherapy linac.