Why Cant My Doctor Tell Me How Long Ive Got To Live
Its hard for your doctor to be sure how long you will live and they may be reluctant to give you an exact timescale. They may be able to give you an estimate but you may live longer or, unfortunately, you may live for less time than this. Although the future is uncertain, for many people its important to plan ahead and make the most of the days when you feel well.
Physical And Occupational Therapy
A physical or occupational therapist can work with your family members. Your therapist can teach your family how to:
- Position and turn you in your bed and chairs.
- Adjust your position to make you comfortable.
- Help you transfer safely from bed to chair or from bed to commode.
- Do passive exercises for your arms and legs. These can help you maintain some strength.
- Move their bodies properly so they dont harm themselves.
What Is Prostate Cancer
The prostate is a small gland located underneath the bladder in men and is part of the reproductive system. Some men develop prostate cancer, usually later in life. If cancer develops on your prostate gland, it will likely grow slowly. In rare cases, the cancer cells may be more aggressive, grow quickly, and spread to other areas of your body. The earlier your doctor finds and treats the tumor, the higher the chances are of finding curative treatment.
According to the Urology Care Foundation, prostate cancer is the second most common cause of all cancer-related deaths among American men. About 1 in 7 men will be diagnosed with the disease in their lifetime. Approximately 1 in 39 men will die from it. Most of these deaths occur among older men.
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The Final Days To Weeks Of Life
Providing excellent care toward the end of life requires an ability to anticipate when to focus mainly on palliation of symptoms and quality of life instead of disease treatment. Prognostic information plays an important role for making treatment decisions and planning for the EOL. However, the available literature suggests that medical providers inaccurately predict how long patients will live and tend to overestimate survival times. This appears to hold true even for providers who are experienced in treating patients who are terminally ill. In a multicenter cohort study of 230 hospitalized patients with advanced cancer, palliative care providers correctly predicted time to death for only 41% of patients. Survival time was overestimated in 85% of patients for whom medical providers gave inaccurate predictions, and providers were particularly likely to overestimate survival for Black and Latino patients.
Providers attempting to make prognostic determinations may attend to symptoms that may herald the EOL , or they may observe trends in patients functional status.
The investigators assigned patients to one of four states:
- Stable .
- Transitional .
- EOL .
Where Can I Get Support
You might find it helps to talk openly to your family about your cancer, and your death. This can be very hard especially if you feel that youre the one having to start difficult conversations. But it can help both you and them deal with difficult feelings.If you dont want to talk to those close to you, you might find it easier to talk to someone else. Talking to your medical team can help. Your local hospice may have services to help you deal with difficult feelings. They can also support your family.There are quite a few specialist organisations and websites that offer advice, information and support during this time, including: Macmillan Cancer Support, Hospice UK, , Carers UK, Compassion in Dying, Citizens Advice Bureau, Age UK and Disabled Living Foundation.You can also speak to our Specialist Nurses who have the time to listen and talk through any problems youre having either physically or emotionally.
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What Do Your Symptoms Mean Should You Worry
The condition causes decreased appetite, which in turn has your body looking at itself for nutrition. Kathryn E. Fruits and vegetables contain many vitamins and nutrients that can contribute to your health. Medically reviewed by Gerhard Whitworth, R. Disregarding any of these symptoms can also affect your finances as treating prostate cancer with severe symptoms can be expensive.
Eat a variety of fruits, vegetables and whole grains. Read this next. By continuing to use our site or clicking “Accept”, you consent to the use of ALL the cookies. For some, the pain experienced when they attempt to pee is one of the reasons why they would choose to hold their bladders for longer periods.
Thompson RH, et al. Journal of Urology. Warner KJ. This category only includes cookies that ensures basic functionalities and security features of the website. Many men could confuse an enlarged prostate with one of the symptoms of prostate cancer.
Trouble urinating is one of the most common symptoms. This kind of weight loss in cancer patients, if it is a significant amount, is also called cachexia. Stage 3 Prostate Cancer: What to Expect. The seeds emit a permanent low dose or temporary high dose of radiation. Manage consent.
My Tips For Family And Friends
- It was very difficult to get the care we needed so that Mick could die at home. But Im really glad we did I know I did everything I could to help him have the death that he wanted.
- Death can be peaceful. I was so worried about Mick being in pain or that I wouldnt know what to do. But in the end, Micks death was very peaceful. Talking to the doctors and nurses and knowing what to expect was essential.
- Have a close family member or friend on-call. I didnt know whether Id want to be alone with Mick in his final hours or whether Id want someone with me. Knowing there was someone who I could call day or night and who would be round in half an hour was really reassuring.
The nurses would sit and talk to me and see how I was.
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Prostate Cancer Survival Rates Are Favorable Overall
Thinking about survival rates for prostate cancer takes a little mental stretching. Keep in mind that most men are around 70 when diagnosed with prostate cancer. Over, say, five years, many of these men will die from other medical problems unrelated to prostate cancer.
To determine the prostate cancer survival rate, these men are subtracted out of the calculations. Counting only the men who are left provides what’s called the relative survival rate for prostate cancer.
Taking that into consideration, the relative survival rates for most kinds of prostate cancer are actually pretty good. Remember, we’re not counting men with prostate cancer who die of other causes:
- 92% of all prostate cancers are found when they are in the early stage, called local or regional. Almost 100% of men who have local or regional prostate cancer will survive more than five years after diagnosis.
- Fewer men have more advanced prostate cancer at the time of diagnosis. Once prostate cancer has spread beyond the prostate, survival rates fall. For men with distant spread of prostate cancer, about one-third will survive for five years after diagnosis.
Many men with prostate cancer actually will live much longer than five years after diagnosis. What about longer-term survival rates? According to the American Society of Clinical Oncology, for men with local or regional prostate cancer:
- the relative 10-year survival rate is 98%
- the relative 15-year survival rate is 96%
Ontogenesis Of Postural And Sphincter Anticipatory Adjustments
The control of body position in space develops with different intensity during life span . As an example, Zaino and McCoy showed that young healthy children exhibit much higher variability of posture control than older healthy children . It is also reported that the age 79 years is an important period of their life in which children master postural control . Moreover, Schmitz et al. showed that children 34 years old develop APA, although they show coexistence of both adult-like and immature patterns, concluding that this anticipatory activities are being set up and that children are progressively mastering them.
Changes in brain structure are continuous throughout life . By the age 2, the brain has reached 75% of its adult weight and the processes of synaptic pruning and cell death are most active during these early years . During the school-age years, strong signs of brain maturation are appreciable, especially in its connectivity . MRI measures of the structure in fibers tracts correlate with behavioral indices that also change in this period . Later changes involve the associative neocortex, which continues to develop well into the third decade , and the corpus callosum, which connects all major subdivisions of the cerebrum .
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Risk Of Prostate Cancer
About 1 man in 8 will be diagnosed with prostate cancer during his lifetime.
Prostate cancer is more likely to develop in older men and in non-Hispanic Black men. About 6 cases in 10 are diagnosed in men who are 65 or older, and it is rare in men under 40. The average age of men at diagnosis is about 66.
Are There Side Effects Of The Combination Approach
There is a slightly higher chance that patients who receive the combined therapy will have rectal irritation or urinary side effects, both of which are common with any radiation treatment given to the prostate. But at MSK, we routinely use sophisticated planning techniques that help us reduce the dose given to normal tissues such as the rectum, bladder, and urethra, lessening the chances of side effects and complications.
In addition, at MSK, we routinely use a rectal spacer gel, which we inject between the prostate and the rectum while the patient is under mild anesthesia, to create a buffer between these two tissues. By creating this space, we can further reduce the dose of radiation that the rectum is exposed to. This leads to fewer side effects for the patient. The rectal spacer gel is biodegradable and after a few months dissolves on its own within the body, causing no harm or long-term effects.
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Possible Changes In Circulation And Temperature
- Arms and legs may feel cool to the touch as circulation slows down
- Skin on arms, legs, hands, and feet may darken and look blue or mottled
- Other areas of the body may become either darker or paler
- Skin may feel cold and either dry or damp
- Heart rate may become fast, faint, or irregular
- Blood pressure may get lower and become hard to hear
What Will Happen In The Last Weeks Days And Months
Every man will have a different experience at the end of his life.The burden of cancer on the body can cause a number of symptoms. Bone marrow may not be able to make enough red blood cells, which can cause anaemia. Cancer can affect your ability to get energy from food, which can make you feel weak. Sometimes organs, like the kidney and liver may not work so well, which can mean you get a build up of waste products in your blood. In the later stages of the disease you may feel drowsy and drift in and out of consciousness.However, its important to know that you may not experience all or any of these effects. And if you do, there are things your medical team could do to help relieve symptoms and make you comfortable.Macmillan Cancer Support and also provide information about what will happen in the last few weeks and days of life.
Loss Of Bladder And Bowel Control
The dying person might lose control of their bladder and bowel. This happens because the muscles in these areas relax and dont work as they did. This can be distressing to see and you might worry that they may feel embarrassed. The nursing staff will do all they can to protect the bed and keep your relative or friend as clean and comfortable as possible.
If you are caring for the person at home, the district nurses and specialist nurses can arrange for you to have protective sheets or pads for the bed. They might also be able to arrange a laundry service for you, if necessary. As people become very close to death and are not eating or drinking, the amount of urine and stools they produce gets less and less.
How Is Advanced Prostate Cancer Treated
Androgen deprivation therapy is usually the choice of treatment of metastatic prostate cancer. Also known as hormone therapy, it is also used for treating patients who are unfit or unwilling to undergo surgery or/and radiation therapy.
Examples of hormone therapies for advanced prostate cancer include
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Advanced Prostate Cancer Symptoms
Men with advanced prostate cancer may experience additional symptoms. Thats because the cancer has spread from the prostate to other parts of the body, such as the bones or lymph nodes.
A wide range of treatment options are available for managing advanced cancer. These treatments kill cancer cells, but they may also help patients manage pain.
Signs of metastatic prostate cancer may include:
- Swelling in legs or pelvic area
- Numbness or pain in the hips, legs or feet
- Bone pain that persists or leads to fractures
Are Older Men Undertreated
Schwartz and colleagues reviewed the treatment decisions and factors influencing them in a cohort of men with localized prostate cancer. Age, comorbidity, and Gleason score were found to be independent predictors of suboptimal treatment. It was concluded that most men older than 70 years with moderately or poorly differentiated tumors and no to mild comorbidity were given suboptimal treatment. Most of these men were undertreated, receiving watchful waiting therapy when potentially curative therapy could have been applied. With optimal treatment, clinical outcomes could have been improved.
Thompson and colleagues investigated otherwise healthy octogenarians diagnosed with prostate cancer who underwent radical prostatectomy. At the last follow-up visit, 10 patients had survived more than a decade after surgery, and 3 patients had died within 10 years of surgery. The remaining 6 patients were alive at less than 10 years of follow-up. Seventy-four percent of patients were continent. No patient had died of prostate cancer, and the 10-year, all-cause survival rate was similar to that observed in healthy patients 60 to 79 years old undergoing radical prostatectomy. These findings indicate that careful selection of patients even older than 80 years can achieve satisfactory oncologic and functional outcomes after surgery. It is important to note, however, that the rate of urinary incontinence after surgery exceeds that of younger counterparts.
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Difficulty Swallowing Or Not Wanting To Eat Or Drink At All
There will come a time when the dying person won’t want to eat or drink anything. It is important not to try and force them to eat or drink. This will make them uncomfortable.
You can give them small pieces of ice to suck or sips of fluid, if they are still awake. This will keep their mouth moist. You can put lip balm on their lips to help stop them getting dry and sore.
Even if they cant take anything into their mouth, you can moisten their lips and mouth every 1 to 2 hours with lemon and glycerine swabs or water. Your GP or district nurse can get you the swabs.
Andrew’s Final Week At Home
It was a very busy and happy house in the final week. Friends and family visited every morning and evening. Andrew and I rested in between.
It was a very busy and happy house in the final week.
Andrew was paralysed from his spinal cord compression, so his needs were quite complicated. We had carers come in four times a day to clean and move Andrew. And every afternoon, the district nurses would come in. They would check on Andrew and see how he was doing. And they would sit and talk to me and see how I was.
The district nurses left a box of drugs in our house. They explained to us that they would give Andrew these drugs if his current drugs werent able to control his pain. It made me realise that he would actually die soon. But it also reassured me that the nurses were prepared and knew what they were doing.
Andrew turned to me one day and said, Im not frightened of dying, I just dont want to leave you.
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What Should I Expect As My Cancer Progresses
How does prostate cancer spread?
Prostate cancer cells can move from the prostate to other parts of the body through the blood stream. Or they can spread to the lymph nodes near the prostate and then travel through the lymph vessels to other parts of your body. Lymph nodes and lymph vessels are part of your lymphatic system and are found throughout your body.
Prostate cancer most commonly spreads to the bones and lymph nodes. It can also spread to, or press on, the tube you urinate through , the bladder, the tubes that carry urine from the kidneys to the bladder and part of the bowel . Prostate cancer may spread to other parts of the body, including the lungs and liver. But this is less common.
If tests and scans show that your cancer is spreading, ask your doctor what will happen next. This can help you and your family prepare for what to expect. Find out more about advanced prostate cancer and treatments.
Watch our video about advanced prostate cancer.
How does prostate cancer cause problems?
Prostate cancer can cause problems if it is pressing on your bones or nerves. It can also cause problems by stopping your normal cells from working properly.
What problems can advanced prostate cancer cause?
The symptoms and problems you have will depend on where the cancer has spread to. Even though your cancer is still growing, you will still be able to have treatment to help manage these problems.
Advanced prostate cancer problems may include:
What should I look out for?