Cancer Emergencies: Spinal Cord Compression & Warning Signs You Can’t Ignore

0:00Hello and welcome to Everyone Dives. Relax and settle in for our podcast about serious illness, dying, death and bereavement. Because even though everyone dies, no one was facing unprepared. When we think about cancer, we may not realize that the cancer itself can suddenly become a medical emergency. Some cancer-related emergencies develop slowly over weeks or months. This has happened quickly and can lead to paralysis, coma, organ failure or death if they are not treated immediately. Today we are starting a spin-off of the cancer series focusing on cancer emergencies. Our first emergency is spinal cord compression, which if untreated can lead to paralysis, organ dysfunction or death. I'm Mary Ann Bato, a nurse practitioner and I use my experience from working as a nurse for 48 years to help answer your questions about what happens at the end of life. And I'm Charlie Navaret, an actor in New York City, and here to offer an every person

1:04viewpoint to our podcast. We're both here because we believe that the more you know, the better prepared you are to make difficult decisions. And remember, this podcast does not provide medical, nor legal advice. Please listen to the complete disclosure at the end of the recording. In the first half, Charlie has a story about the 1928 hurricane in Palm Beach County and our recipe of the week. In the second half, I'll be talking about spinal cord compression. And in our third half, Charlie has a reading about grief. Charlie, have you seen the Martin Short documentary? No. I don't have that channel or whatever it's called nowadays. I've heard about it. I've heard it's just wonderful. It's really good. I think it's called like Marty is short life. And it goes back all the way to, you know, when he was born, I think he was the youngest,

2:09which would explain a lot in terms of his personality that we say. And his brother, I think, died when he was nine or 13 and then both his parents before age 20. And then, you know, I'm sorry, I was spoiler alert if you should say that, but everybody, well, people who know his story and then his wife died of a bearing cancer. And then just recently his daughter committed suicide. Yeah. Just. So he's had when it comes to grief and loss, certainly his share or more than his share. But the story, but the documentary was just he, they had a lake house and the family movies are totally unlike any of my family movies. You know, the top, the Tom Hanks family is there all the time.

3:10And it's just Spielberg's. You know, all these famous, you know, people that he came up with in, in his acting career. And that he made friends with Steve Martin. I just, all these people, you know, hanging out at the lake and it just, it looks like a movie that really was his life. It's really incredible. Yeah, what would I mean, yeah, I mean, people know him, you know, very funny man. But yeah, in the background is like you said, it's long history of grief throughout his life. Yeah. Yeah. So if I don't know what channel it's on, but yeah, I don't, I don't need it. I think it's called Martin, like I said, Marty is a short life. You know, because the name's Martin.

4:12I also like that we refer to this as the channel. Well, I know what, what do they call them now? Streams. You know, the Marty short documentary streams on. Oh, I said just that. I think, I think it's what it, that. I, in our first half, our recipe for this week is for Zesty Hurricane Chicken Wings, where Caribbean inspired flavors dance across crispy golden brown poultry. Each bite delivers a symphony of sweet citrus notes, subtle spice and aromatic herbs that will transport your palate to sun-wrench shores. The second deadliest hurricane in US history killed as many as 3,000 people in Palm Beach County in 1928, as it brought 150 mile per hour wind gusts and waves as high as 20 feet from

5:15Lake Oki Choby over surrounding towns in the glades. The storm made landfall in Palm Beach County with catastrophic force on September 16, 1928. Mountains had only hours to prepare and entire communities were wiped out. The damage and loss of life was devastating. Fatalities could only be estimated because of the overwhelming number of deaths in the glades. Those who died on the coast were identified and buried in West Palm Beach's cemetery, Woodlawn. In the glades, especially for fear of disease in the glades, people who died, mostly black people were put into mass graves, some at Woodlawn and others at Port Mayaca near Canal Point or cremated in huge funeral pires. 75% of the total deaths were migrant workers and many of their bodies were washed deep into the Everglades and never recovered.

6:19Grace Doyle was 24 years old and 9 months pregnant on September 16, 1928, when the Oki Choby hurricane hit Florida. Her husband Sean was 26. They had been married five years and had a three year old. Sean worked on the dyke. He told the Army Corps for months it's too low, it'll break. They ignored him. On September 16, it broke. 2,000 people drowned. Sean got his crew out then went back for an old man. The water took him. His body was found three days later. Grace went into labor at his funeral on September 19. She gave birth to a son of September 20 at 4 a.m. and a Red Cross tent. At 10 a.m., the Army Corps held an inquest in the next tent. Grace walked in. She was six hours postpartum, bleeding, holding her newborn.

7:23She sat Sean's muddy boots on the table. She said, My husband told you the dyke would break. You call him a dumb Irishman. He died in your dyke. I give birth in your flood. This is his son. Tell me your dyke was enough. The Colonel said, We could have known. Grace said he knew. He died knowing. Now I know and now you know. The inquest ruled the Corps's negligent. It was the first time the federal government was blamed for a hurricane death. The Hoover Dyke was built after. That night, Grace lay in the tent with her three-year-old and her newborn. She put Sean's boots at the front of the cotton, said, Your daddy's home. She never remarried. Grace died in 1998 at 94. Her son, the baby she held in court, became an army engineer.

8:27At her funeral, he said, My mother was 24 and six hours postpartum when she faced the Corps. She was a widow with two kids and she won. She gave me his boots and his name. Let's go to our webpage for this week's recipe and additional resources for this program. This is the part where we ask for your financial support. Your tax deductible gift will go directly to supporting our nonprofit journalism so that we can remain accessible to everyone. You can donate at www.everyonedies.org. That's every the number one dies.org. Or at our site on Patreon, under everyone dies. Mariant? Thanks, Charlie. We might think that the challenges associated with receiving a diagnosis of cancer are related

9:28to the surgeries, chemotherapy, and fear. Unfortunately, there is also the possibility of cancer-related emergencies. These emergencies are potentially life-threatening, appear quickly, and without warning. They may indicate that the cancer is progressing. It's important that we know they exist, what the symptoms are, and what to do about. As much as we may not want to acknowledge them, ignoring them will only make matters worse. Ecology emergencies will be different depending on the person living with cancer, the type of cancer, and the stage of treatment. During the information to recognize the signs and symptoms can be key in preventing serious problems. Without early recognition and effective treatment, cancer-related emergencies may be life-threatening. Most cancer-related emergencies can be classified as metabolic, structural, or treatment-related

10:28emergencies. Emergencies may develop over the course of months, whereas others progress over hours, leading to harmful outcomes such as paralysis, coma, or death. In some cases, cancers diagnose because of the symptoms of the oncology emergency. Structural emergencies result from the progression of a known cancer or the sign of an undiagnosed cancer. Today, I'm going to tell you about spinal cord compression, which happens when the bone fragments in the spine or the tumor itself invades the spinal cord, causing pain and neurological damage. Spinal cord metastag lesions affect 5 to 10% of people living with cancer in the United States, and the most frequent sites are the thoracic spine, which is your upper back and includes 12 vertebrae. About 70% are in that area, followed by the lumbus sacral spine and the cervical spine. People with cancers that metastasize to bone are at greater risk for spinal cord compression.

11:34The primary sources of spinal metastasis are lung cancer, 31%, breast cancer, 24%, gastrointestinal tract, 9%, prostate, 8%, melanoma, 4%, lymphoma, 6%, kidney, 1%, and they don't know the origin about 2%. Spinal cord compression can be life threatening if the compression is in the upper spinal cord. Spinal flight symptoms are trouble breathing, numbness and or loss of sensation, severe pain, sexual dysfunction, and loss of bowel or bladder control. Recognizing the meaning of these symptoms and going to the emergency department for treatment can help to avoid paralysis, organ dysfunction, or death. Specific symptoms that people report with spinal cord compression are sudden uncontrolled

12:34backpapes. That's that 10 out of 10 with no relief from pain medications. Not feeling the need to urinate, but find that they have wet themself. Feeling numbness, burning or tingling in the groin, buttocks, genitals, and upper inner thighs. Not be able to get an erection. Week legs, decreased muscle tone, and decreased reflexes. When you get to the hospital, expect to have an MRI to look for spinal cord compression and maybe CT scans and myelograms. If the MRI indicates spinal cord compression, an immediate lumbar laminectomy is required. Steroids will be given to reduce swelling, and the goals of treatment are pain relief, restoring function, relieving pressure on the spinal cord area, and prevention of irreversible neurologic deficits. If you or someone you love is living with cancer and develops new neurological symptoms, contact

13:39your oncology team immediately and go to the nearest emergency department. Ask treatment can make the difference between recovery and permanent disability. Thank you for spending this time with us on the Everyone Dies Podcast and stay tuned for future shows about cancer-related emergency. We hope these conversations help make difficult topics a little less frightening and easier to understand. Charlie? In our third half, ripped from the internet, a Facebook post about grief. For five long years, I dragged myself through life, telling myself my life ended the day she died, and I believe that too. I repeated it so many times that it became the way I lived. I told myself there was a before and an after, and that the after was just something I had to survive for my kids.

14:39I checked out on my own life. My kids lost both parents. I went through the motions, but I wasn't emotionally there. I called that grief. I called that love. I told myself I had to learn to live with it. That it was what I was supposed to do. It wasn't. A chapter ended, but my life didn't. She died, and I didn't. But I lived like I had. I gave up. I surrendered my time, my energy, and years I will never get back. Not because I had to, but because I believed I was supposed to. That belief cost me more than the loss itself ever did. That's the part no one talks about. But I don't live like that anymore. I didn't get my past or future back. I just started living it. The loss didn't change me. The memories didn't change, and the love didn't change.

15:40What changed was me and how I lived my life. The kids and I honor her by living our best lives, carrying love and making new memories. No more pain, no more sadness, no more ruminating on what would have been. Just enjoying what is. That is a price we pay for love. Please stay tuned for the continuing saga of Everyone dies, and thank you for listening. You can find more episodes on Spotify, Apple Podcasts, or your favorite podcast app. Follow and subscribe to the show. It's shared with someone today. This is Charlie Navarrett. And from the now-dead Stephen Colbert show, when asked, do you believe we all die alone? Signed failed actress Julie Louise Dreyfus responded, no. When you strangled someone, you're right there with them. And I'm Mary Ann Matso, and we'll see you next week.

16:41Remember, every day is a gift. This podcast does not provide medical advice. All discussion on this podcast, such as treatments, dosages, outcomes, charts, patient profiles, advice, messages, and any other discussion are for informational purposes only and are not a substitute for professional medical advice or treatment. Anybody seek the advice of your primary care practitioner or other qualified health providers with any questions that you may have regarding your health? Never disregard professional medical advice or delay in seeking it because of something you have heard from this podcast. If you think you may have a medical emergency, call your doctor or 911 immediately. Everyone dies, does not recommend or endorse any specific tests, practitioners, products, procedures, opinions, or other information that may be mentioned in this podcast. Reliance on any information provided in this podcast by a person appearing on this podcast at the invitation of everyone dies or by other members is solely at your own risk.