Living with advanced prostate cancer can be hard to deal with emotionally as well as physically and may affect your life, work and relationships but there are ways to deal with these changes.

 

Coping emotionally

Living with advanced prostate cancer can be hard to deal with emotionally. Symptoms and treatments can be draining and make you feel unwell. And some treatments, including hormone therapy, can make you feel more emotional and cause low moods. 

You may feel a wide range of emotions. Your emotions might change very quickly. All these are very normal ways to feel. But if you are feeling very down or worried, do speak to your GP or nurse, there are things that can help. Or you can call our Specialist Nurses.

There is no 'right way' to deal with your feelings. Give yourself time. Don’t put yourself under pressure to be positive if that’s not how you feel. There will be good days and bad days, make the most of the days you feel well, and find ways to get through the bad days.

Some men want to find their own way to cope and don’t want any outside help. But there is support available if you need it.

Relationships

Having cancer can often bring you closer to your partner, family or friends. But the pressure of advanced cancer can also put a strain on relationships. 

The cancer and your treatment might mean that your partner or family need to do more for you, such as running the home or caring for you. These changing roles can sometimes be difficult for you and your family to deal with

Talking to those close to you can help everyone deal with tensions. But sometimes talking is not that easy. Your nurse or GP can put you in touch with a counsellor and your local hospice may have a family support team.

You could also try contacting organisations such as Relate or the College of Sexual and Relationship Therapists

Are you supporting someone with prostate cancer?
If someone close to you has advanced prostate cancer you might be able to offer him a great deal of support, but it is likely that you will need help and support as well.

Don’t be afraid to ask for help if you need it. Friends or family might be able to help out, and support is also available from social services and voluntary organisations. For more helpful tips read our booklet, When you’re close to a man with prostate cancer: A guide for partners and family.

If you live alone

Dealing with advanced prostate cancer can be hard at times, particularly if you live on your own. Don’t be afraid to ask for support if you need it. 

  • You could speak to your GP or nurse.
  • If you have friends or neighbours nearby, they may be able to help, both practically and emotionally.
  • Joining a local support group can also be a good way of meeting people with similar experiences.
  • Our One-to-one support service offers a chance to speak to someone who’s been there and understands what you’re going through.

Daily life with advanced prostate cancer

Advanced prostate cancer can affect your ability to work or carry out everyday tasks. Whatever your situation, there is advice and support available. 

Diet and physical activity
A healthy diet and being physically active might help you feel more in control of your health. A healthy lifestyle can also help with some of the side effects of treatment. 

Work and money
The symptoms of advanced prostate cancer and the side effects of treatments can make it more difficult for you to work. You might decide to reduce your working hours, or stop working altogether. If your partner is caring for you, they might not be able to work as much. Read more about work and prostate cancer.

A lot of men with cancer and their partners worry about how they will cope financially. It is a good idea to get some advice about your individual circumstances. Read more about money issues

At home
You might find everyday tasks more difficult. If you need extra help, speak to your GP or get in touch with your local social services department for advice. There is support available to help you at home

Respite care
If your cancer means that you need ongoing care from your partner or family, respite care allows them to have a break. A professional will take over your care for a short time. There are different types of respite care:

  • a sitting service, where someone stays with you for a few hours
  • a short stay in a residential home to give you a change of scenery and help you rest
  • a carer who comes in for a few days to allow your partner or family to take a short break away. 

Speak to your GP, nurse or local social services about what respite care is available for you.

Thinking about the future

It’s natural to find it difficult or upsetting to think about the future. But you might find that making plans helps you feel more prepared for what the future may hold. It can also reassure you about the future for your family. Although it might be very hard, it is a good idea to talk about your wishes to those close to you, and write them down, so that they can understand what is important to you. It also means that, if you are ever in a situation where you can’t make decisions or speak for yourself, your healthcare team should know what you want.

Find out more about planning for the future from Dying Matters and Compassion in Dying. Macmillan Cancer Support and Marie Curie also provide information about what will happen in the last few weeks and days of life. 

Thinking about your future care
Think about what care you would like to receive in the future. This is called advance care planning. Planning your care can help to make sure you get the care you want. But not everyone wants to think about what care they want in the future, and it’s not something you have to do.

Advance decisions and advance directives
In England and Wales
, an advance decision to refuse treatment allows you to record any treatments you wish to refuse in certain circumstances. It’s used if there’s ever a time when you are unable to make a decision for yourself, or if you can’t communicate what you want. For example, if you were unconscious, or were being given sedatives at the end of your life, you might decide in advance that you wouldn’t want treatment to prolong your life.

An advance decision to refuse treatment is legally binding. This means your doctor or nurse would have to carry out your wishes.

You can’t use an advance decision to ask for specific treatments, or to ask for your life to be ended. If you refuse treatment within an advance decision your doctor or nurse will still make sure you are comfortable and free of pain.

In Scotland, you can make an advance directive to say what treatments you would refuse, if you were unable to decide for yourself or communicate your wishes. An advance directive isn’t legally binding, but your doctor or nurse would need to take it into account when making a decision on your behalf.

In Northern Ireland, advance decisions or directives aren’t legally binding. But it’s still a good idea to record what treatments you would refuse if you couldn’t decide yourself or communicate your wishes. Your doctor or nurse should take this into account when making a decision on your behalf.

It’s a good idea to put your advance decision or advance directive in writing – then it’s clearer to your doctor or nurse, and will be easier for them to follow. If your advance decision contains a refusal of treatment that will keep you alive, it must be in writing.

Speak to your partner, family, doctor and nurse about what to include. Refusing certain treatments may put your life at risk, or cause you discomfort. Your doctor can talk to you about this in more detail, and help you think through the consequences of any decision carefully. Make sure your doctor or nurse knows about it, so that they can follow your wishes.

You can change your advance decision or advance directive at any time. It’s a good idea to review it regularly to make sure it is still what you want.

Advance statement
An advance statement is a general statement about anything that is important to you in relation to your future health and wellbeing. It can include some of the following:

  • your wishes and preferences about the type of care you want
  • who you would like to be asked for a decision about your care, if you are unable to make it yourself
  • where you would like to be cared for – for example, at home, in a hospice or hospital
  • where you would like to die.

An advance statement isn’t legally binding in the same way that an advance decision is. But your doctor does have to take your advance statement into account when making any decision on your behalf – although it might not always be possible for them to follow your wishes.

Even if you say in your advance statement who you would like to make decisions on your behalf if you can’t, your doctor doesn’t legally have to follow what that person says. The only way to give another person the legal power to make health or care decisions on your behalf is by making a Lasting Power of Attorney for Health and Welfare.

Support in making decisions
These can be very difficult decisions to think about. You don’t have to make any decisions if you don’t want to. But if you think about these things early on, it helps your doctor or nurse plan your care according to your wishes. They will discuss these issues with you and keep a record of your decisions. You can also talk to your family about what you want, and help them understand your wishes. If you change your mind at any time, you can change your plans or cancel them.

Age UK and Compassion in Dying have more information about making decisions about your future care.

Making a power of attorney
A lasting power of attorney is a legal document. It lets you appoint someone to make decisions on your behalf if you are unable to, for example, if you are unconscious. You can appoint one or more people to make decisions for you. In the legal paperwork, they are called an attorney. They should be someone you trust, like a family member or friend. 

There are two separate types of lasting power of attorney.

  • A property and financial affairs lasting power of attorney covers issues around money and property.
  • A health and welfare lasting power of attorney covers decisions about your health, personal care and welfare.

Age UK and Compassion in Dying provide information about making a lasting power of attorney. You can find more information and the forms you need to fill in from the GOV.UK website.

Making a Will
By making a Will you can make sure that your property and possessions are passed on according to your wishes. If you die without making a Will, the state decides who inherits your property. You don't need a solicitor to make a Will, but using one makes sure that the correct legal processes are followed and your Will is valid. 

Age UK and Macmillan Cancer Support have more information about making a Will. 

Making a funeral plan
Some people want to be involved in decisions about their own funeral, such as whether they will be buried or cremated, or what music and readings to have. Some people take comfort in making these plans. But others prefer not to think about this. 

If you do want to think about your funeral, you could discuss your wishes with your family, or write them down for them. Some people include instructions for their funeral in their Will. You can get more information about planning a funeral from Age UK and GOV.UK

References

Updated: February 2015 | Due for Review: February 2017

  • References used  

    • Abel J, Pring A, Rich A, et al. The impact of advance care planning of place of death, a hospice retrospective cohort study. BMJ Support Palliat Care 2013;3(2):168–73.
    • Age UK. Fact sheet 72. Advance decisions, advance statements and living wills. 2014
    • Alibhai SMH, Gogov S, Allibhai Z. Long-term side effects of androgen deprivation therapy in men with non-metastatic prostate cancer: A systematic literature review. Crit Rev Oncol Hematol 2006;60(3):201–15.
    • Bader P, Echtle D, Fonteyne V, et al. Prostate cancer pain management: EAU guidelines on pain management. World J Urol 2012;30(5):677–86.
    • Bancroft J, Janssen E, Strong D, et al. The relation between mood and sexuality in heterosexual men. Arch Sex Behav 2003;32(3):217–30.
    • Barsevick AM, Whitmer K, Sweeney C, Nail LM. A pilot study examining energy conservation for cancer treatment-related fatigue. Cancer Nurs 2002;25(5):333–41.
    • Beck AM, Robinson JW, Carlson LE. Sexual intimacy in heterosexual couples after prostate cancer treatment: What we know and what we still need to learn. Urol Oncol Semin Orig Investig 2009;27(2):137–43.
    • Borda AP, Charnay-Sonnek F, Fonteyne V, Papaioannou EG. Guidelines on pain management & palliative care. Eur Assoc Urol 2014
    • Caffo O, Gernone A, Ortega C, et al. Central nervous system metastases from castration-resistant prostate cancer in the docetaxel era. J Neuro-Oncol 2012;107(1):191–6.
    • Clarke NW. Management of the spectrum of hormone refractory prostate cancer. Eur Urol 2006;50(3):428–39.
    • Compassion in Dying. AD01 Understanding Advance Decisions - England and Wales. 2014.
    • Compassion in Dying. AD02 Understanding Advance Directives – Scotland. 2014
    • Compassion in Dying. AD05 Talking to your doctor about your Advance Decision]. 2014
    • Compassion in Dying. IN04 Your rights in Northern Ireland. 2014
    • De Bono JS, Oudard S, Ozguroglu M, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet 2010;;376(9747):1147–54.
    • De Sousa A, Sonavane S, Mehta J. Psychological aspects of prostate cancer: a clinical review. Prostate Cancer Prostatic Dis 2012;15(2):120–7.
    • Eastham JA. Bone health in men receiving androgen deprivation therapy for prostate cancer. J Urol 2007;177(1):17–24.
    • Elliott S, Latini DM, Walker LM, Wassersug R, Robinson JW. Androgen Deprivation Therapy for Prostate Cancer: Recommendations to Improve Patient and Partner Quality of Life: Improving Life on ADT. J Sex Med 2010;7(9):2996–3010.
    • Heidenreich A, Aus G, Abbou CC, et al. Guidelines on Prostate Cancer. European Association of Urology. 2013
    • Heidenreich A, Aus G, Abbou CC, et al. Guidelines on Prostate Cancer. European Association of Urology. 2013
    • Help the hospices. What is hospice care? . Hospice UK. 2011
    • Hurlow A, Bennett MI, Robb KA, et al. Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults. Cochrane Database Syst Rev 2012;3:CD006276.
    • Langston B, Armes J, Levy A, Tidey E, Ream E. The prevalence and severity of fatigue in men with prostate cancer: a systematic review of the literature. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 2013;21(6):1761–71.
    • Loblaw DA. Systematic Review of the Diagnosis and Management of Malignant Extradural Spinal Cord Compression: The Cancer Care Ontario Practice Guidelines Initiative’s Neuro-Oncology Disease Site Group. J Clin Oncol 2005;23(9):2028–37.
    • Nalesnik JG, Mysliwiec AG, Canby-Hagino E. Anaemia in men with advanced prostate cancer: incidence, etiology, and treatment. Rev Urol 2004;6(1):1.
    • National Institute for Health and Care Excellence. Prostate cancer: Diagnosis and treatment. NICE clinical guideline 175. 2014 Available from: http://www.nice.org.uk/guidance/CG175
    • NHS End of Life care programme. Advance care planning: a guide for health and social care staff. 2008 Available from: http://www.ncpc.org.uk/sites/default/files/AdvanceCarePlanning.pdf
    • NICE. Metastatic spinal cord compression: diagnosis and management of adults at risk of and with metastatic spinal cord compression. 2012.
    • NICE. Neuropathic pain – pharmacological management: The pharmacological management of neuropathic pain in adults in non-specialist settings. 2013.
    • Paez Borda A, Charnay-Sonnek F, Fonteyne V, Papaioannou EG. Guidelines on pain management and palliative care. European Association of Urology 2014.
    • Parsons BA, Evans S, Wright MP. Prostate cancer and urinary incontinence. Maturitas 2009;63(4):323–8.
    • Salvati M, Frati A, Russo N, et al. Brain metastasis from prostate cancer. Report of 13 cases and critical analysis of the literature. J Exp Clin Cancer Res CR 2005;24(2):203–7.
    • Samphao S, Eremin JM, Eremin O. Oncological emergencies: clinical importance and principles of management: Oncological emergencies. Eur J Cancer Care (Engl) 2010;19(6):707–13.
    • Segal RJ, Reid RD, Courneya KS, Sigal RJ, et al. Randomized controlled trial of resistance or aerobic exercise in men receiving radiation therapy for prostate cancer. J Clin Oncol Off J Am Soc Clin Oncol 2009;27(3):344–51.
    • Segal RJ. Resistance Exercise in Men Receiving Androgen Deprivation Therapy for Prostate Cancer. J Clin Oncol 2003;21(9):1653–9.
    • Smith Jr JA, Soloway MS, Young MJ. Complications of advanced prostate cancer. Urology 1999;54(6):8–14.
    • Sood A, Barton DL, Bauer BA, Loprinzi CL. A critical review of complementary therapies for cancer-related fatigue. Integr Cancer Ther 2007;6(1):8–13.
    • Stark D. Anxiety Disorders in Cancer Patients: Their Nature, Associations, and Relation to Quality of Life. J Clin Oncol 2002;20(14):3137–48.
    • Statistical Bulletin. Deaths in Northern Ireland 2013. Northern Ireland Statistics and research Agency; 2014. Available from: http://www.nisra.gov.uk/archive/demography/publications/births_deaths/deaths_2013.pdf
    • Team NR of SW. Vital Events Reference Tables 2013. National Records of Scotland. 2013
    • Thompson JC, Wood J, Feuer D. Prostate cancer: palliative care and pain relief. Br Med Bull 2007;83:341–54.
    • Thorsen L, Courneya KS, Stevinson C, Fosså SD. A systematic review of physical activity in prostate cancer survivors: outcomes, prevalence, and determinants. Support Care Cancer 2008;16(9):987–97.
    • Todd M. Understanding lymphoedema in advanced disease in a palliative care setting. Int J Palliat Nurs 2009;15(10):474.
    • Valdimarsdottir U, Helgason ÁR, Fürst CJ, Adolfsson J, Steineck G. The unrecognised cost of cancer patients’ unrelieved symptoms: a nationwide follow-up of their surviving partners. Br J Cancer 2002;86(10):1540–5.
    • Vinjamoori AH, Jagannathan JP, Shinagare AB, et al. Atypical Metastases From Prostate Cancer: 10-Year Experience at a Single Institution. Am J Roentgenol 2012;199(2):367–72.
    • Walji N, Chan AK, Peake DR. Common acute oncological emergencies: diagnosis, investigation and management. Postgrad Med J 2008;84(994):418–27.
    • Watson M, Lucas C, Hoy A, Back I, Armstrong P. Palliative care adult network guidelines. 3rd Edition. 2011.
    • What are the top causes of death by age and gender? Office for National Statistics. 2013 Available from: http://www.ons.gov.uk/ons/rel/vsob1/mortality-statistics--deaths-registered-in-england-and-wales--series-dr-/2012/sty-causes-of-death.html