[Medullary compression in men with prostatic cancer. A retrospective study of medical records]

The aim of the study was to describe symptomatology and prognosis in patients with spinal cord compression and prostate cancer.

The material was retrospective and included patients from 1.1.1996 to 31.12.2000 with compression of the medulla, dura or intraspinal roots. Data collection was concluded on 30.6.2001.

Seven patients had the cancer diagnosis at the time of the intraspinal compression. The most frequent debut-symptom was acceleration of pain, two thirds had neuropathic pain, and three patients were free of pain. Paresis was present in 23 patients and 18 had sensory symptoms. External irradiation was given to 29 patients, three had a neurosurgical procedure and irradiation and two patients had just endocrine manipulation. The treatment result was good or moderately good on pain in three fourths of the patients, and on the neurological symptoms in two thirds. Eight patients had recurrence. Median survival was three months for patients with hormone resistant progression and two years for those patients, who got their cancer diagnosis in connection with the intraspinal compression.

Rapid acceleration of pain is an early symptom of intraspinal compression. Morphine-resistant pain or neuropathic pain and neurologic symptoms are typical findings, but none of the symptoms are obligatory. Early acute treatment may give good recovery and the survival is comparable with the survival of patients whose illnesses are in the same stadium but who do not suffer from intraspinal compression.