25th February 2025

An 81-year-old woman is found at home on the floor by her daughter. She was last seen well 3 days earlier

An 81-year-old woman is found at home on the floor by her daughter. She was last seen well 3 days earlier. She has a previous history of breast cancer, for which she was originally treated several decades ago with oxaliplatin chemotherapy. She has recently been diagnosed with a recurrence with liver and bony metastases for which she was deemed too unfit for systemic treatment, as she has since been diagnosed with ischaemic heart disease, chronic kidney disease and frailty.

An MRI of the whole spine reveals multiple bony deposits, with compression of her spinal cord at the level of L2. She is started on high-dose steroids and is urgently referred urgently to the oncology team and neurosurgical spinal MDT. Her daughter has been told that she has a poor prospect of neurological recovery.

Which of the following factors is least likely to be considered when assessing her suitability for surgical intervention?

Select the SINGLE most appropriate option from the list below. Select ONE option only.