How Should Caregivers Talk To Children About A Family Member’s Advanced Cancer
Children deserve to be told the truth about a family members prognosis so they can be prepared if their loved one dies. Its important to answer all of their questions gently and honestly so they dont imagine things that are worse than reality. They need to be reassured that they will be taken care of no matter what happens.
Caregivers need to be prepared to answer tough questions. To do this, they should know what their own feelings and thoughts are about the situation. They need to be able to show children how to hope for the best while preparing for and accepting that their loved one may die.
Palliative Care For Prostate Cancer Patients
Prostate cancer is a condition where the cells in a mans prostate start to grow and change rapidly, creating a tumor that can spread throughout the body. The prostate is a gland located in the lower abdomen in front of the rectum and just below the bladder. The purpose of the prostate is to manufacture seminal fluid that helps nourish the sperm and carry it from the body in the mans semen.
When Cancer Reaches The End
Since your diagnosis, youâve been tested and treated to control the cancer in your body. When something worked, you stuck with it. If it stopped working, you and your health care team reviewed the options and perhaps tried a different treatment.
When you reach the end-of-life stage of cancer, there may be no more methods available to control your cancer — or you are ready to stop all the testing and treatment.
Your care, however, continues. The focus shifts from trying to stop the cancer to focusing on helping you live as well and as comfortably as possible for the rest of your life.
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What Is Advanced Prostate Cancer
When prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer.
Prostate cancer is often grouped into four stages, with stages III and IV being more advanced prostate cancer.
- Early Stage | Stages I & II: The tumor has not spread beyond the prostate.
- Locally Advanced | Stage III: Cancer has spread outside the prostate but only to nearby tissues.
- Advanced | Stage IV: Cancer has spread outside the prostate to other parts such as the lymph nodes, bones, liver or lungs.
When an early stage prostate cancer is found, it may be treated or placed on surveillance . Advanced prostate cancer is not curable, but there are many ways to treat it. Treatment can help slow advanced prostate cancer progression.
There are several types of advanced prostate cancer, including:
Biochemical Recurrence
With biochemical recurrence, the prostate-specific antigen level has risen after treatment using surgery or radiation, with no other sign of cancer.
Castration-Resistant Prostate Cancer
Non-Metastatic Castration-Resistant Prostate Cancer
Prostate cancer that no longer responds to hormone treatment and is only found in the prostate. This is found by a rise in the PSA level, while the testosterone level stays low. Imaging tests do not show signs the cancer has spread.
Metastatic Prostate Cancer
- Lymph nodes outside the pelvis
- Bones
- Other organs, such as liver or lungs
Metastatic Hormone-Sensitive Prostate Cancer
Supportive And Palliative Care For Adults With Cancer
The guidance on supportive and palliative care for adults with cancer was published by NICE in March 2004. It placed importance on the holistic approach to managing patients, their carers and relatives following a diagnosis of cancer. In particular, the multidisciplinary team was recognized as key in the process of providing continuity of total care. The importance of working as a multidisciplinary team cannot be stressed enough. To believe that the suffering experienced by patients with a terminal diagnosis can be solely managed by one professional body is foolish. Within the context of the Palliative Care Team, members of the MDT should include those who can deal with physical, spiritual, psychological and social needs. Rehabilitative and nutritional needs should also be recognized and addressed along with the provision of access to complementary therapies.
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What Symptoms Might I Get With Advanced Prostate Cancer
Depending on where the cancer has traveled to, the symptoms you may have will vary. If you dont have many symptoms you will have more once the cancer begins to spread again. You may not experience this at all as not everyones cancer creates symptoms that affect you on a day-to-day basis. Here are some symptoms you may experience when you have advanced prostate cancer.
About Prostate Cancer Its Late Stage Symptoms And Diagnosis Procedures
The probability of prostate cancer tends to increase with age. More than 80 percent of men are diagnosed with prostate cancer when they reach 65 years of age or above. Cancer affects the prostate gland surrounding the bladder, the main function of which is to release semen out of the body. Prostate cancer also affects urination as urethra pass through the prostate gland. Henceforth, most surgical or radiation treatment for prostate cancer involves side effects like urinary incontinence characterized by an involuntary loss of urine due to an overactive bladder.
Symptoms and Diagnosis of Prostate Cancer
Symptoms of prostate cancer in men include difficulties in starting urination or dribbling, pain in the back or hip, blood in semen or urine, etc. Symptoms tend to start showing in later stages especially if cancer affects the urethra, in turn, changing the way men urinate. The symptoms will spread by the time cancer takes a toll on the body.
Community health clinics use Prostate-Specific Antigen blood test in order to diagnose prostate cancer in men. Abbreviated PSA, the test aims to diagnose the extent of the antigen in the blood. A rise in the level of PSA can be caused by several health conditions, so PSA test only suggests cancer, but wont diagnose it fully. It may indicate prostate gland pathologies comprising of prostate cancer, and when combined with a higher risk, it can preempt the occurrence of the condition.
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Signs Of Dying From Cancer
Cancer is one of the leading causes of death in the United States. Although mortality rates are dropping, cancer is common enough that most people in the United States know someone who has had cancer in their lifetime.
However, not as much is known about the end-of-life signs of cancer, and what one should expect at the end. Furthermore, many are unaware of the ways in which hospice can help patients in dealing with the stages of death from cancer.
Getting More Information About What To Expect
- National Institute for Health and Care Excellence. Palliative care for adults: strong opioids for pain relief. Clinical guideline 140. 2012.
- National Institute for Health and Care Excellence. Prostate cancer: Diagnosis and treatment. NICE clinical guideline 175. 2014.
- Salvati M, Frati A, Russo N, Brogna C, Piccirilli M, DAndrea G, et al. Brain metastasis from prostate cancer. Report of 13 cases and critical analysis of the literature. J Exp Clin Cancer Res CR. 2005 Jun 24:2037.
- Thompson JC, Wood J, Feuer D. Prostate cancer: palliative care and pain relief. Br Med Bull. 2007 83:34154.
- Vinjamoori AH, Jagannathan JP, Shinagare AB, Taplin M-E, Oh WK, Van den Abbeele AD, et al. Atypical Metastases From Prostate Cancer: 10-Year Experience at a Single Institution. Am J Roentgenol. 2012 Aug 199:36772.
- Kate Bullen, Head of School for Applied Social Science, University of Brighton, Brighton
- Jackie Dawson, Community Palliative Care Clinical Nurse Specialist, Guys and St Thomas NHS Foundation Trust
- Hazel Parsons, Palliative Care Nurse Specialists, Dorothy House Hospice, Winsley, Bradford on Avon
- Elizabeth Rees, Lead Nurse for end of life care, Leeds Teaching Hospitals
- Our Specialist Nurses
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Eating And Drinking Less
Wanting to eat or drink less is natural as the body uses less energy. Tastes can change and people wont always need to eat at the same times every day. Some people have difficulty swallowing, a sore or dry mouth, or feel sick.
The people around the person can help them to eat and drink if they want to and feel able to. Smaller portions may help. If the person feels thirsty and has problems swallowing, taking small sips, trying different cups, sucking on ice chips or swabbing their mouth might help. People who have problems chewing might prefer to eat soft, high-calorie foods such as ice cream and yoghurt.
Some people dont want to eat or drink or arent able to at the end of their life. This is normal and they shouldnt be forced.
People sometimes ask about having food or drink through a tube if someone is unable to swallow. If someone is expected to die within hours or days, this is unlikely to help them live longer or make them feel better, and it can cause other problems. Their doctor or nurse can look at whether extra nutrition or fluids are needed and talk about the advantages and disadvantages of giving these.
Difficulty Swallowing Or Not Wanting To Eat Or Drink At All
There will come a time when the dying person wonât 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.
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Knowing What To Expect In The Final Days Or Hours Helps Comfort The Family
Most people don’t know the signs that show death is near. Knowing what to expect can help them get ready for the death of their loved one and make this time less stressful and confusing. Healthcare providers can give family members information about the changes they may see in their loved one in the final hours and how they may help their loved one through this.
Late Stages Of Prostate Cancer
Can somebody tell me what the last few weeks of the life of someone with prostate cancer is like?
My dad is suffering so much that every moment of my life I am wishing he dies. I can’t stand seeing so much pain and misery. A few months ago I thought he can’t get any worse but he is actually getting worse everyday. I can’t function, can’t do anything in my life just thinking when will this be over??
In my country there is no hospices and they won’t admit him into a hospital , so he’s going through all this at home. No opioids work and he’s constantly throwing up. He can’t sleep because of the pain. He needs help bathing and changing clothes because he’s too weak to do those things. The cancer is all over his bones but it seems like it hasn’t spread to any organs. Does it have to spread to viral organs to kill?
I really appreciate any help.
Sorry to read that your Dad is going through this without an adequate level of pain relief and know this must be very difficult for him and the family to deal with.
I see that you are not in the UK but sincerely hope that chatting here will give you a feeling that you are not alone during this very difficult time. Hope too that your Dad’s pain relief can be adjusted as ths would I think help to make things just that little easier to bear.
Sending virtual hugs. Jules54
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End Stage Prostate Cancer Or Stage 4 Prostate Cancer: A Major Fork In The Road
End stage prostate cancer also known as stage 4 prostate cancer or prostate bone cancer is defined by the medical industry as the most severe form of prostate cancer because it has spread outside the prostate capsule.
Once that happens, according to them, only radical treatments can delay the inevitable end. These interventions seek to radiate the body, treat with chemo drugs, remove the prostate gland with a radical prostatectomy, and often combine these treatments.
Unfortunately, there is no evidence to support added life expectancy with these treatments. My opinion is simply that the treatments weaken the body further and can hasten the end. Of course, there is no way to prove this opinion, but this is where I define the fork in the road.
The choice to me is clear: do everything you can to change the conditions that caused the stage 4 prostate cancer to become so extreme.
On this site and in my book, Healthy Prostate, you can read much, much more about the causes of prostate cancer and how to heal it naturally.
What You Can Do
Its important that you learn all you can about advanced prostate cancer so you can make informed decisions. Be open with your doctors and others on your healthcare team. Express your concerns and feel free to advocate for yourself and your quality of life. Get another medical opinion if you feel its necessary.
Some complementary therapies may prove helpful in coping with advanced cancer. For example:
- tai chi, yoga, or other movement therapy
- music therapy
- meditation, breathing exercises, or other relaxation techniques
- massage
A variety of services can help you with everything from lodging while youre getting treatment to getting some help around the house. Communicating with online or in-person groups are a good way to share information and lend mutual support.
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How We Treat Prostate Cancer
The prognosis for metastatic prostate cancer can be discouraging, but some treatment centerslike the Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancerspecialize in innovative, individualized therapy with the potential to improve outcomes.
What Can You Do About Fatigue
The first step in helping to manage fatigue is recognizing and controlling any symptoms that make it worse, like pain, nausea, neuropathy, or constipation. Another step is to try to prevent more fatigue by carefully balancing rest and activity. If you feel tired, stop and rest. Your health care team and your caregivers can help you find ways to manage the things that can make you feel more fatigued. Tell them how you feel, and try different things to see if they help you feel less tired.
Some medicines can make you feel tired, too. They may be needed, but you may want to talk with your health care team to find out if switching to new ones or taking them at different times may help. You might even be able to stop taking certain medicines that arent helping or arent needed any more.
Keep safe when youre active. If youre unsteady on your feet, make sure you have help when walking. You may feel safer if you have a walker or wheelchair. Your doctor or hospice team can help you get the equipment you need to be comfortable and safe. If you’re shaky, don’t use sharp utensils or other things that might cause injury. If you’re able to drive, be careful to not drive when you are feeling fatigue.
Plan activities around the times you feel the best and have the most energy. Sit outside, listen to music, go for a ride in the car, spend time watching a meal being prepared distractions and stimulation of your senses may help ease fatigue.
You can learn more in Cancer-related Fatigue.
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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
What Are Prostate Cancer Survival Rates By Stage
Staging evaluation is essential for the planning of treatment for prostate cancer.
- A basic staging evaluation includes the patient examination, blood tests, and the prostate biopsy including ultrasound images of the prostate.
- Further testing and calculations may be performed to best estimate a patient’s prognosis and help the doctor and patient decide upon treatment options.
Prognosis refers to the likelihood that cancer can be cured by treatment, and what the patient’s life expectancy is likely to be as a consequence of having had a prostate cancer diagnosis.
If cancer is cured, your life expectancy is what it would have been had you never been diagnosed with prostate cancer. If cancer cannot be cured due to it recurring in distant locations as metastases, or recurs either locally or in an area no longer able to be treated in a curative manner, then estimates can be made of what is likely to be your survival-based again on group statistics for people who have been in the same situation.
Nomograms are charts or computer-based tools that use complex math from the analysis of many patients’ treatment results.
The prognosis for prostate cancer varies widely and depends on many factors, including the age and health of the patient, the stage of the tumor when it was diagnosed, the aggressiveness of the tumor, and cancer’s responsiveness to treatment, among other factors.
The 5 and 10-year survival rate of prostate cancer chart
| Stage and 5-Year Survival |
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