Simple prognosis scales available to assist the clinician are reviewed. For poor prognosis patients, a single fraction of 8 Gy is just as effective as multiple fractions, however, are much more convenient. For good prognosis patients, surgery and radiation should be considered. For patients not getting surgery, enrollment in clinical trials of single vs. multiple fractions of radiation should be a priority. For high-risk patients, screening strategies are being developed and hold promise for maintaining ambulation throughout the patients' lifetime.