Coping emotionally
Contents
Advanced prostate cancer

Living with advanced prostate cancer

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

Download or order fact sheet

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. Or sometimes it can make relationships feel more difficult, and some days may feel harder than others.

The cancer and your treatment might mean that your partner or family need to do more for you, such as helping you get up, get dressed, wash and eat. Or they might take on tasks that you can’t do any more, such as managing finances or doing jobs around the house. These changing roles can sometimes be difficult for both you and your family to deal with. You might not feel comfortable becoming more dependent, and you might have problems coping or feel very tired.

Some people may be unsure how to act around you and might find it difficult to talk about your cancer. They could be worried about upsetting you, or about becoming upset themselves. Sometimes it can help if you let them know whether you want to talk about it or not.

What can help?

Talking to those close to you can help everyone deal with tensions. But sometimes talking is not that easy. If you’d like help with relationship problems, 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. 

Supporting someone with advanced prostate cancer

If someone close to you has advanced prostate cancer you might be able to offer them a great deal of support. But looking after someone with advanced prostate cancer can be difficult. It’s important to look after yourself and get support if you need it.

  • Talk to someone. Sharing your worries and fears can make you feel less alone. You could talk to a family member or a close friend, or someone trained to listen, like your GP or a counsellor.
  • Connect with other carers. You might find it helpful to talk to other people in similar situations. You can search for local carers groups on the Carers UK website.
  • Take time for yourself. Take time to relax and rest so that you don’t get too tired and can cope in the long run.
  • Accept help from friends and family. Don’t feel that you have to cope with everything on your own. Try to accept help from other people.
  • Look after your health. If you feel unwell, tired or low, talk to your GP.
  • Ask for help. Practical, financial and emotional support is available from social services and charities. Talk to your GP about what support is available in your area, or speak to our Specialist Nurses.

Macmillan Cancer Support have more information about caring for someone with advanced cancer. You can also read our booklet, When you’re close to someone with prostate cancer: A guide for partners and family.

Talking to children

It can be difficult and upsetting to talk to children or grandchildren about your cancer, whatever their age. Not everyone chooses to talk about their prostate cancer. Everyone is different and it’s okay to keep things private. But if you do decide to tell your family it usually helps to be honest with them. Keeping things from them might only make them worry more.

Children can often sense that something is wrong even if they don’t understand it. They may also notice that things at home have changed, such as their day-to-day routine. This can be confusing, especially for younger children. Charities such as Macmillan Cancer Support and Winston’s Wish have more information about how to talk to children when a parent or grandparent has cancer. Fruit Fly Collective also has information, and activity kits to order for children of all ages. You could also ask your GP or specialist nurse for advice, or call our Specialist Nurses.

If you’re worried about talking to teenagers or adult children about cancer, find a time and place that feels right for everyone to talk. Everyone reacts differently when they’re told that someone they love has cancer, but they may be shocked, upset or even angry. They may also have questions, which you might not always know the answers to. It’s okay to be honest and say if you don’t know something. Some people find it helps talking to a counsellor, either together as a family or individually. Your doctor or nurse can tell you more about counselling services for yourself, and for your family. Your hospital and local hospice will also have support and information for partners and family members.

Daily life with advanced prostate cancer

Advanced prostate cancer can affect whether you’re able to work or carry out everyday tasks. But there is advice and support available.

Work and money

Advanced prostate cancer and the side effects of treatments can make it more difficult for you to work. You might decide to work part-time, or stop working altogether. If your partner is caring for you, they might not be able to work as much.

A lot of men and their partners worry about how they will cope financially. It’s a good idea to get advice about your own situation. You may be entitled to sick pay if you are employed, or to retire early and start receiving your pension. You may also be entitled to claim certain benefits. In the UK, there’s a law to say that cancer is a disability. So, even if you feel well or don’t have symptoms that are bothering you, remember that the law protects your rights, including at work. 

You can find out more about benefits and other types of financial help from other organisations, including:

At home

You might find everyday tasks more difficult. If you need help, speak to your GP or your local council. The council’s social services department may provide a range of support services, such as practical and financial advice and access to emotional support. Social services can assess your needs and those of your carer, if you have one. They can work out what services can help, and provide information about support available in your area. Some services may be free. Or you may need to pay towards them.

Equipment and changes to your home

An occupational therapist may be able to advise you about practical things to make it easier to live at home. For example, they may suggest making some changes to your home, or special equipment to help with everyday tasks. Your social services department or your GP can refer you to an occupational therapist.

Help at home

You may be able to get help from a home care worker. Home care workers include care assistants, for help with housework and shopping, and personal care assistants, for help with tasks like getting washed and dressed.

Respite care

If you need ongoing care from your partner, family member or a friend, respite care allows them to have a break. A professional will take over your care for a short time.  Examples of respite care include:

  • a sitting service, where someone stays with you in your home for a few hours
  • a short stay in a residential home or hospice
  • a carer who comes into your home for a few days.

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 help 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. Find details of your nearest support group or ask your doctor or nurse.

Driving and public transport

There are various schemes available to help with transport. These include the Blue Badge scheme for parking, the Motability Scheme for help with leasing a car, and cheap or free travel on public transport. Contact your local council for details.

If you’re having trouble getting around, ask your nurse or GP about local transport services. For example, the British Red Cross offer a door-to-door transport service.

If you drive, you don’t need to tell the Driver and Vehicle Licensing Agency (DVLA) – or the Driver and Vehicle Agency (DVA) in Northern Ireland – that you have prostate cancer. But you should tell them if:

  • your medication causes side effects likely to affect safe driving
  • your doctor is concerned about your fitness to drive
  • you develop any problems with the brain or nervous system
  • you can only drive vehicles with special adaptations or certain types of vehicle.

If you’re unsure, speak to your doctor. You can find out more from the official government website, www.gov.uk. You should also tell your insurance company about your prostate cancer to make sure you’re properly covered.

Travel

Holidays can be a great way to relax. Having advanced prostate cancer shouldn’t stop you going away, but there are things you might want to consider. For example, it can be more difficult to get travel insurance. Read more about things to think about when travelling with prostate cancer.

Planning for the future

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.

Some men find it difficult or upsetting to think about what will happen if their cancer progresses and they come to the end of their life. Although it might be very hard, it’s a good idea to talk about your wishes with those close to you so that they understand what is important to you. It can be helpful to have these conversations and start making plans well ahead of time. It’s important to write your wishes down so that if you become too unwell to make decisions, your healthcare team and family 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. 

Planning your future care

It can help to think about what care you would like to receive in the future. For example, you may need to decide how and where you’d prefer to be cared for and whether there are any treatments you don’t want to have. 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.

People often find the thought of planning for their future treatment and care overwhelming. But the options may be more straightforward than you think, and there’s lots of support available. We’ve listed some of the options below.

Writing down your wishes

An advance statement (or anticipatory care plan in Scotland) is a general statement about anything that is important to you in relation to your future health and wellbeing. It can include:

  • things that are important to you or that you’d like other people to know about your life, including information about your identity and religious or cultural beliefs
  • your wishes about the type of care you want, for example if you have a daily routine you’d like to stick to
  • who you would like to be involved in making decisions about your care, if you’re unable to make them yourself
  • where you would prefer to be cared for – for example, at home, in a hospice or at hospital
  • where you would prefer to die.

Your doctor will take your advance statement into account when making any decisions about your care. But they don’t legally have to follow what your advance statement says, and your doctor might not always be able to follow your wishes. Download an advance statement form for free.

Deciding not to have certain treatments

An advance decision to refuse treatment (ADRT), known in Scotland as an advance directive to refuse treatment, allows you to record any treatments you don’t want to have in certain situations. You might hear it called a living will.

An advance decision or advance directive is 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 are unconscious or very sleepy in your final days.

You can’t use an advance decision or advance directive to ask for a specific treatment or to ask for your life to be ended.

If you wish to make an advance decision or advance directive, you must do this in writing. Make sure your doctor, nurse and family know about it. This means they can follow your wishes.

Download a free advance decision pack, and find lots of free support to help you complete it on the Compassion in Dying website. It’s a good idea to speak to your partner or family about what to include in your advance decision. And ask your doctor or nurse if you’re not sure about something.  

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

Whatever you decide, your doctor or nurse will still try to make sure you are comfortable and not in pain.

Support in making decisions

Thinking about your wishes and making decisions can be difficult. Here are some things that may help, but you don’t have to make any decisions if you don’t want to.

  • Talk to your doctor or nurse so they know your wishes when planning your care. They’ll keep a record of your decisions.
  • Talk to your family about what you want, and help them understand your wishes. Let them know if you change your mind.
  • Read more about making decisions about your care from Compassion in Dying, Age UK, Marie Curie and the NHS website.

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

Appointing someone to make decisions for you

You, your loved ones, and your doctor or nurse will usually make decisions about your care together. But you can choose one or more people to make decisions for you if you’re unable to – for example, if you are unconscious. The people you chose won’t be able to make any final decisions about your care, but they should be involved in conversations with health professionals about you care. They should be someone you trust, like a family member or friend. This person is known as an attorney, and the legal document is known as a lasting power of attorney.

There are two types of lasting power of attorney, and you might choose someone different as each one.

  • A property and financial affairs lasting power of attorney can make decisions about money and property.
  • A health and welfare lasting power of attorney can make 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 on the official government website.

Read more about planning your future care

Practical things

Making a Will

By making a Will you can decide who will get your money, property and possessions after you die. If you die without making a Will, the government can decide who gets these things. You don’t need a solicitor to make a Will, but using one makes sure your Will is made properly and is valid.

Age UK and Macmillan Cancer Support have more information about making a Will. The Law Society can help you find a solicitor.

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.

Worries about dying from advanced prostate cancer

Not all men with advanced prostate cancer will die from prostate cancer, and men often live with advanced prostate cancer for several years. But you might have questions about what will happen if your cancer progresses and you’re approaching the end of your life. It can help to know what to expect and how you can get the support you need. This can also make things easier for your family and friends.

Coming to terms with things

If you’re approaching the end of your life, this might be hard for you and your family to accept. Even if you’ve been living with prostate cancer for years, it can still be a shock. Some men feel upset, alone, or angry. Some men worry about their family and friends. It can be difficult to talk to your family about what’s happening.

Give yourself time – it can take a while to process what’s happening. Some men want time by themselves or with a family member or close friend. There are things you can do to help yourself and people who can support you.

What to expect

Some men find that they get more symptoms in their last months and weeks. Others find that existing problems get worse. Read more information about what to expect.

Getting access to care

Towards the end of your life, your doctor or nurse will try to manage any pain and other symptoms. They will try to give you emotional, physical, practical and spiritual support. And provide support for your family and for people looking after you. This is sometimes called palliative or supportive care.

You might be looked after in a hospice, hospital, care home, or your own home. Where you’re looked after will depend on what you need, what you prefer, and the services in your local area.

Your GP can refer you for palliative care and end of life care. Even if your doctor or nurse doesn’t bring this up, you can still ask them about it. They can explain the services in your area and what support might be suitable.

Read more about dying from prostate cancer, or speak to our Specialist Nurses. They are here to support you and your family.

References

Updated: November 2021 | Due for Review: November 2023

  • Mottet N, Van den Bergh RCN, Briers E, Cornford P, De Santis M, Fanti S, et al. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer. European Association of Urology; 2019.
  • National Institute for Health and Care Excellence. Prostate cancer: diagnosis and management. NICE guideline 131. 2019.
  • Drudge-Coates L, Oh WK, Tombal B, Delacruz A, Tomlinson B, Ripley AV, et al. Recognizing Symptom Burden in Advanced Prostate Cancer: A Global Patient and Caregiver Survey. Clin Genitourin Cancer. 2018 Apr;16(2):e411–9.
  • Cancer Research UK. Prostate cancer 5 year survival by stage. 2014.
  • James ND, Spears MR, Clarke NW, Dearnaley DP, De Bono JS, Gale J, et al. Survival with Newly Diagnosed Metastatic Prostate Cancer in the “Docetaxel Era”: Data from 917 Patients in the Control Arm of the STAMPEDE Trial (MRC PR08, CRUK/06/019). Eur Urol. 2015 Jun;67(6):1028–38.
  • Koornstra RHT, Peters M, Donofrio S, van den Borne B, de Jong FA. Management of fatigue in patients with cancer – A practical overview. Cancer Treat Rev. 2014 Jul;40(6):791–9.
  • Pachman DR, Price KA, Carey EC. Nonpharmacologic approach to fatigue in patients with cancer. Cancer J. 2014;20(5):313–318.
  • Bower JE, Bak K, Berger A, Breitbart W, Escalante CP, Ganz PA, et al. Screening, Assessment, and Management of Fatigue in Adult Survivors of Cancer: An American Society of Clinical Oncology Clinical Practice Guideline Adaptation. J Clin Oncol. 2014 Jun 10;32(17):1840–50.
  • 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. 2013 Jun;21(6):1761–71.
  • Horneber M, Fischer I, Dimeo F, Ruffer JU, Weis J. Cancer-Related Fatigue. Dtsch Arztebl Int. 2012 Mar;109(9):161–71.
  • Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR. Cancer-Related Fatigue: The Scale of the Problem. The Oncologist. 2007 May 1;12(suppl_1):4–10.
  • Morrow GR. Cancer-Related Fatigue: Causes, Consequences, and Management. The Oncologist. 2007 May 1;12(suppl_1):1–3.
  • Storey DJ, McLaren DB, Atkinson MA, Butcher I, Frew LC, Smyth JF, et al. Clinically relevant fatigue in men with hormone-sensitive prostate cancer on long-term androgen deprivation therapy. Ann Oncol. 2012;23(6):1542–9.
  • Storey DJ, McLaren DB, Atkinson MA, Butcher I, Liggatt S, O’Dea R, et al. Clinically relevant fatigue in recurrence-free prostate cancer survivors. Ann Oncol. 2012 Jan 1;23(1):65–72.
  • Merriman JD, Dodd M, Lee K, Paul SM, Cooper BA, Aouizerat BE, et al. Differences in Self-reported Attentional Fatigue Between Patients With Breast and Prostate Cancer at the Initiation of Radiation Therapy: Cancer Nurs. 2011 Sep;34(5):345–53.
  • Larkin D, Lopez V, Aromataris E. Managing cancer-related fatigue in men with prostate cancer: A systematic review of non-pharmacological interventions. Int J Nurs Pract. 2014 Oct;20(5):549–60.
  • Bower JE. Cancer-related fatigue—mechanisms, risk factors, and treatments. Nat Rev Clin Oncol. 2014 Aug 12;11(10):597–609.
  • Ryan J, Carroll J, Ryan E, Mustian K, Fiscella K, Morrow G. Mechanisms of Cancer-Related Fatigue. The Oncologist. 2007 May;12:22–34.
  • Wang XS. Pathophysiology of Cancer-Related Fatigue. Clin J Oncol Nurs. 2008 Jan 1;12(0):11–20.
  • Kyrdalen AE, Dahl AA, Hernes E, Cvancarova M, Foss\aa SD. Fatigue in hormone-naive prostate cancer patients treated with radical prostatectomy or definitive radiotherapy. Prostate Cancer Prostatic Dis. 2010;13(2):144–150.
  • Minton O, Jo F, Jane M. The role of behavioural modification and exercise in the management of cancer-related fatigue to reduce its impact during and after cancer treatment. Acta Oncol. 2015 May;54(5):581–6.
  • Garrett K, Dhruva A, Koetters T, West C, Paul SM, Dunn LB, et al. Differences in Sleep Disturbance and Fatigue Between Patients with Breast and Prostate Cancer at the Initiation of Radiation Therapy. J Pain Symptom Manage. 2011 Aug;42(2):239–50.
  • Gardner JR, Livingston PM, Fraser SF. Effects of Exercise on Treatment-Related Adverse Effects for Patients With Prostate Cancer Receiving Androgen-Deprivation Therapy: A Systematic Review. J Clin Oncol. 2014 Feb 1;32(4):335–46.
  • Keogh JWL, MacLeod RD. Body Composition, Physical Fitness, Functional Performance, Quality of Life, and Fatigue Benefits of Exercise for Prostate Cancer Patients: A Systematic Review. J Pain Symptom Manage. 2012 Jan;43(1):96–110.
  • Bourke L, Smith D, Steed L, Hooper R, Carter A, Catto J, et al. Exercise for Men with Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol. 2016 Apr;69(4):693–703.
  • Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev [Internet]. 2012 Nov 14; Available from: http://doi.wiley.com/10.1002/14651858.CD006145.pub3
  • Teleni L, Chan RJ, Chan A, Isenring EA, Vela I, Inder WJ, et al. Exercise improves quality of life in androgen deprivation therapy-treated prostate cancer: systematic review of randomised controlled trials. Endocr Relat Cancer. 2016 Jan 2;23(2):101–12.
  • Menichetti J, Villa S, Magnani T, Avuzzi B, Bosetti D, Marenghi C, et al. Lifestyle interventions to improve the quality of life of men with prostate cancer: A systematic review of randomized controlled trials. Crit Rev Oncol Hematol. 2016 Dec;108:13–22.
  • Nguyen PL, Alibhai SMH, Basaria S, D’Amico AV, Kantoff PW, Keating NL, et al. Adverse Effects of Androgen Deprivation Therapy and Strategies to Mitigate Them. Eur Urol. 2015 May;67(5):825–36.
  • Thompson JC, Wood J, Feuer D. Prostate cancer: palliative care and pain relief. Br Med Bull. 2007;83:341–54.
  • Kane C, Hoskin P, Bennett M. Cancer induced bone pain (clinical review). BMJ. 2015;350(h315).
  • National Institute for Health and Care Excellence. Neuropathic pain in adults: pharmacological management in non-specialist settings. NICE Clinical Guideline 173. (updated April 2018); 2013.
  • Parsons BA, Evans S, Wright MP. Prostate cancer and urinary incontinence. Maturitas. 2009;63(4):323–8.
  • Yoon PD, Chalasani V, Woo HH. Systematic review and meta-analysis on management of acute urinary retention. Prostate Cancer Prostatic Dis. 2015 Dec;18(4):297–302.
  • Gravas S, Cornu JN, Gacci M, Gratzke C, Herrmann TRW, Mamoulakis C, et al. EAU Guidelines on Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO). European Association of Urology; 2019.
  • National Institute for Health and Care Excellence. Lower urinary tract symptoms in men: assessment and management. NICE Clinical Guideline 97 [Internet]. (modified June 2015); 2010. Available from: https://www.nice.org.uk/guidance/cg97
  • Alsadius D, Olsson C, Pettersson N, Tucker SL, Wilderäng U, Steineck G. Patient-reported gastrointestinal symptoms among long-term survivors after radiation therapy for prostate cancer. Radiother Oncol. 2014 Aug;112(2):237–43.
  • Schaake W, Wiegman EM, de Groot M, van der Laan HP, van der Schans CP, van den Bergh ACM, et al. The impact of gastrointestinal and genitourinary toxicity on health related quality of life among irradiated prostate cancer patients. Radiother Oncol J Eur Soc Ther Radiol Oncol. 2014 Feb;110(2):284–90.
  • Shadad AK, Sullivan FJ, Martin JD, Egan LJ. Gastrointestinal radiation injury: Symptoms, risk factors and mechanisms. World J Gastroenterol WJG. 2013 Jan 14;19(2):185–98.
  • Michalski JM, Moughan J, Purdy J, Bosch W, Bruner DW, Bahary J-P, et al. Effect of Standard vs Dose-Escalated Radiation Therapy for Patients With Intermediate-Risk Prostate Cancer: The NRG Oncology RTOG 0126 Randomized Clinical Trial. JAMA Oncol. 2018 Jun 1;4(6):e180039–e180039.
  • Clarke NW. Management of the Spectrum of Hormone Refractory Prostate Cancer. Eur Urol. 2006 Sep;50(3):428–39.
  • Andreyev HJN. GI Consequences of Cancer Treatment: A Clinical Perspective. Radiat Res. 2016 Mar 28;185(4):341–8.
  • Aluwini S, Pos F, Schimmel E, Krol S, van der Toorn PP, de Jager H, et al. Hypofractionated versus conventionally fractionated radiotherapy for patients with prostate cancer (HYPRO): late toxicity results from a randomised, non-inferiority, phase 3 trial. Lancet Oncol. 2016;17(4):464–74.
  • Berkey FJ. Managing the adverse effects of radiation therapy. Am Fam Physician. 2010 Aug 15;82(4):381–8, 394.
  • Bubendorf L, Schöpfer A, Wagner U, Sauter G, Moch H, Willi N, et al. Metastatic patterns of prostate cancer: An autopsy study of 1,589 patients. Hum Pathol. 2000 May;31(5):578–83.
  • Pettersson A, Johansson B, Persson C, Berglund A, Turesson I. Effects of a dietary intervention on acute gastrointestinal side effects and other aspects of health-related quality of life: A randomized controlled trial in prostate cancer patients undergoing radiotherapy. Radiother Oncol. 2012 Jun;103(3):333–40.
  • Henson CC, Burden S, Davidson SE, Lal S. Nutritional interventions for reducing gastrointestinal toxicity in adults undergoing radical pelvic radiotherapy. Cochrane Database Syst Rev [Internet]. 2013 [cited 2014 Nov 18];(11). Available from: http://doi.wiley.com/10.1002/14651858.CD009896.pub2
  • Wedlake LJ, Shaw C, Whelan K, Andreyev HJN. Systematic review: the efficacy of nutritional interventions to counteract acute gastrointestinal toxicity during therapeutic pelvic radiotherapy. Aliment Pharmacol Ther. 2013 Jun;37(11):1046–56.
  • Eastham JA. Bone health in men receiving androgen deprivation therapy for prostate cancer. J Urol. 2007 Jan;177(1):17–24.
  • Serpa Neto A, Tobias-Machado M, Esteves MAP, Senra MD, Wroclawski ML, Fonseca FLA, et al. Bisphosphonate therapy in patients under androgen deprivation therapy for prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2012;15(1):36–44.
  • Patrick DL, Cleeland CS, von Moos R, Fallowfield L, Wei R, Öhrling K, et al. Pain outcomes in patients with bone metastases from advanced cancer: assessment and management with bone-targeting agents. Support Care Cancer [Internet]. 2014 Dec 23 [cited 2015 Feb 18]; Available from: http://link.springer.com/10.1007/s00520-014-2525-4
  • Macherey S, Monsef I, Jahn F, Jordan K, Yuen KK, Heidenreich A, et al. Bisphosphonates for advanced prostate cancer. Cochrane Database Syst Rev [Internet]. 2017 Dec 26 [cited 2018 Jan 5]; Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006250.pub2/abstract
  • Attar S, Steffner RJ, Avedian R, Hussain WM. Surgical intervention of nonvertebral osseous metastasis. Cancer Control. 2012;19(2):113–121.
  • National Institute for Health and Care Excellence. Percutaneous cementoplasty for palliative treatment of bony malignancies. IPG179. 2006;
  • Bancroft J, Janssen E, Strong D, Carnes L, Vukadinovic Z, Long JS. The Relation Between Mood and Sexuality in Heterosexual Men. Arch Sex Behav. 2003 Jun 1;32(3):217–30.
  • Schover LR, Canada AL, Yuan Y, Sui D, Neese L, Jenkins R, et al. A randomized trial of internet-based versus traditional sexual counseling for couples after localized prostate cancer treatment. Cancer. 2012 Jan 15;118(2):500–9.
  • Magnan S, Zarychanski R, Pilote L, Bernier L, Shemilt M, Vigneault E, et al. Intermittent vs Continuous Androgen Deprivation Therapy for Prostate Cancer: A Systematic Review and Meta-analysis. JAMA Oncol. 2015 Sep 17;1–10.
  • Botrel TEA, Clark O, dos Reis RB, Pompeo ACL, Ferreira U, Sadi MV, et al. Intermittent versus continuous androgen deprivation for locally advanced, recurrent or metastatic prostate cancer: a systematic review and meta-analysis. BMC Urol. 2014;14:9.
  • Todd M. Understanding lymphoedema in advanced disease in a palliative care setting. Int J Palliat Nurs. 2009;15(10):474.
  • Wanchai A, Beck M, Stewart BR, Armer JM. Management of Lymphedema for Cancer Patients With Complex Needs. Semin Oncol Nurs. 2013 Feb;29(1):61–5.
  • Shaitelman SF, Cromwell KD, Rasmussen JC, Stout NL, Armer JM, Lasinski BB, et al. Recent progress in the treatment and prevention of cancer-related lymphedema. CA Cancer J Clin. 2015 Jan;65(1):55–81.
  • Sharifi N, Gulley JL, Dahut WL. An Update on Androgen Deprivation Therapy for Prostate Cancer. Endocr Relat Cancer. 2010 Dec;17(4):R305–15.
  • Hicks BM, Klil-Drori AJ, Yin H, Campeau L, Azoulay L. Androgen Deprivation Therapy and the Risk of Anemia in Men with Prostate Cancer: Epidemiology. 2017 Sep;28(5):712–8.
  • Curtis KK, Adam TJ, Chen S-C, Pruthi RK, Gornet MK. Anaemia following initiation of androgen deprivation therapy for metastatic prostate cancer: A retrospective chart review. Aging Male. 2008 Jan;11(4):157–61.
  • Nalesnik JG, Mysliwiec AG, Canby-Hagino E. Anemia in men with advanced prostate cancer: incidence, etiology, and treatment. Rev Urol. 2004;6(1):1.
  • National Institute for Health and Care Excellence. Metastatic spinal cord compression: Diagnosis and management of adults at risk of and with metastatic spinal cord compression. NICE clinical guideline 75 [Internet]. 2008. Available from: https://www.nice.org.uk/guidance/cg75
  • Loblaw DA, Mitera G, Ford M, Laperriere NJ. A 2011 updated systematic review and clinical practice guideline for the management of malignant extradural spinal cord compression. Int J Radiat Oncol. 2012;84(2):312–7.
  • Samphao S, Eremin JM, Eremin O. Oncological emergencies: clinical importance and principles of management. Eur J Cancer Care (Engl). 2010;19(6):707–13.
  • Al-Qurainy R, Collis E. Metastatic spinal cord compression: diagnosis and management. BMJ. 2016 May 19;353:i2539.
  • Mundy GR, Roodman GD, Smith MR. New Opportunities for the Management of Cancer-Related Bone Complications. 2009 [cited 2013 Nov 4]; Available from: http://www.curatio-cme.com/newsletters/CAHO_New_Opp_May2009.pdf
  • Gastanaga VM, Schwartzberg LS, Jain RK, Pirolli M, Quach D, Quigley JM, et al. Prevalence of hypercalcemia among cancer patients in the United States. Cancer Med. 2016 Aug;5(8):2091–100.
  • National Institute for Health and Care Excellence. Hypercalcaemia: Clinical Knowledge Summary [Internet]. 2014 [cited 2016 Oct 6]. Available from: http://cks.nice.org.uk/hypercalcaemia
  • Walji N, Chan AK, Peake DR. Common acute oncological emergencies: diagnosis, investigation and management. Postgrad Med J. 2008 Aug 1;84(994):418–27.
  • Dorff TB, Crawford ED. Management and challenges of corticosteroid therapy in men with metastatic castrate-resistant prostate cancer. Ann Oncol. 2013 Jan 1;24(1):31–8.
  • NHS England. Clinical Commissioning Policy Statement: Docetaxel in combination with androgen deprivation therapy for the treatment of hormone naive metastatic prostate cancer. 2016.
  • James ND, Sydes MR, Clarke NW, Mason MD, Dearnaley DP, Spears MR, et al. Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial. The Lancet. 2016 Mar;387(10024):1163–77.
  • Vale CL, Burdett S, Rydzewska LH, Albiges L, Clarke NW, Fisher D, et al. Addition of docetaxel or bisphosphonates to standard of care in men with localised or metastatic, hormone-sensitive prostate cancer: a systematic review and meta-analyses of aggregate data. Lancet Oncol. 2015;
  • Tucci M, Bertaglia V, Vignani F, Buttigliero C, Fiori C, Porpiglia F, et al. Addition of Docetaxel to Androgen Deprivation Therapy for Patients with Hormone-sensitive Metastatic Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol. 2015 Sep;
  • National Institute for Health and Care Excellence. Docetaxel for the treatment of hormone-refractory metastatic prostate cancer. NICE technology appraisal guidance 101. 2006.
  • Bahl A, Oudard S, Tombal B, Ozguroglu M, Hansen S, Kocak I, et al. Impact of cabazitaxel on 2-year survival and palliation of tumour-related pain in men with metastatic castration-resistant prostate cancer treated in the TROPIC trial. Ann Oncol. 2013 May 30;24(9):2402–8.
  • Collins R, Trowman R, Norman G, Light K, Birtle A, Fenwick E, et al. A systematic review of the effectiveness of docetaxel and mitoxantrone for the treatment of metastatic hormone-refractory prostate cancer. Br J Cancer. 2006 Aug 1;95(4):457–62.
  • Serpa Neto A, Tobias-Machado M, Kaliks R, Wroclawski ML, Pompeo ACL, Del Giglio A. Ten Years of Docetaxel-Based Therapies in Prostate Adenocarcinoma: A Systematic Review and Meta-Analysis of 2244 Patients in 12 Randomized Clinical Trials. Clin Genitourin Cancer. 2011 Dec;9(2):115–23.
  • Singer EA, Srinivasan R. Intravenous therapies for castration-resistant prostate cancer: Toxicities and adverse events. Urol Oncol Semin Orig Investig. 2012 Jul;30(4):S15–9.
  • de Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels J-P, Kocak I, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Lancet. 2010 Oct 2;376(9747):1147–54.
  • Parker CC, James ND, Brawley CD, Clarke NW, Hoyle AP, Ali A, et al. Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial. The Lancet. 2018 Oct;
  • National Institute for Health and Care Excellence. Cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel. Technology appraisal guidance 391. 2016.
  • Scottish Medicines Consortium. Cabazitaxel, 60mg concentrate and solvent for solution for infusion (Jevtana®). SMC No.735/11. 2016.
  • National Institute for Clinical Excellence. Radium-223 dichloride for treating hormone-relapsed prostate cancer with bone metastases. Technology appraisal guidance 376. 2016.
  • Parker C, Nilsson S, Heinrich D, Helle SI, O’Sullivan JM, Fosså SD, et al. Alpha Emitter Radium-223 and Survival in Metastatic Prostate Cancer. N Engl J Med. 2013;369(3):213–23.
  • Parker C, Nilsson S, Heinrich D, Helle SI, O’Sullivan JM, Fosså SD, et al. Alpha Emitter Radium-223 and Survival in Metastatic Prostate Cancer. N Engl J Med. 2013;369(3):213–23.
  • British Pain Society. Cancer pain management: a perspective from the British Pain Society, supported by the Association for Palliative Medicine and the Royal College of General Practitioners. London: British Pain Soc.; 2010.
  • Li KK, Hadi S, Kirou-Mauro A, Chow E. When Should we Define the Response Rates in the Treatment of Bone Metastases by Palliative Radiotherapy? Clin Oncol. 2008 Feb;20(1):83–9.
  • Spencer K, Parrish R, Barton R, Henry A. Palliative radiotherapy. BMJ. 2018 Mar 23;k821.
  • Hospice UK. What is hospice care? 2011.
  • National Institute for Health Research. Better Endings: Right care, right place, right time. [Internet]. 2015. Available from: http://www.dc.nihr.ac.uk/__data/assets/file/0005/157037/Better-endings-FINAL-DH-single-page.pdf
  • NHS National End of Life Care Programme. Deaths from urological cancers in England 2001-2010 [Internet]. 2012 Nov. Available from: http://www.endoflifecare-intelligence.org.uk/resources/publications/deaths_from_urological_cancers
  • Husson O, Mols F, Poll-Franse LV van de. The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol. 2010 Sep 24;mdq413.
  • Saylor PJ, Smith MR. Metabolic Complications of Androgen Deprivation Therapy for Prostate Cancer. J Urol. 2013 Jan;189(1):S34–44.
  • Allott EH, Masko EM, Freedland SJ. Obesity and Prostate Cancer: Weighing the Evidence. Eur Urol. 2013 May;63(5):800–9.
  • Keto CJ, Aronson WJ, Terris MK, Presti JC, Kane CJ, Amling CL, et al. Obesity is associated with castration-resistant disease and metastasis in men treated with androgen deprivation therapy after radical prostatectomy: results from the SEARCH database. BJU Int. 2011;110(4):492–8.
  • De Laet C, Kanis JA, Odén A, Johanson H, Johnell O, Delmas P, et al. Body mass index as a predictor of fracture risk: A meta-analysis. Osteoporos Int. 2005 Nov;16(11):1330–8.
  • Oefelein MG, Ricchuiti V, Conrad W, Seftel A, Bodner D, Goldman H, et al. Skeletal fracture associated with androgen suppression induced osteoporosis: the clinical incidence and risk factors for patients with prostate cancer. J Urol. 2001;166(5):1724–1728.
  • Ryan CW, Huo D, Stallings JW, Davis RL, Beer TM, McWhorter LT. Lifestyle Factors and Duration of Androgen Deprivation Affect Bone Mineral Density of Patients with Prostate Cancer During First Year of Therapy. Urology. 2007 Jul;70(1):122–6.
  • Abrahamsen B, Brask-Lindemann D, Rubin KH, Schwarz P. A review of lifestyle, smoking and other modifiable risk factors for osteoporotic fractures. BoneKEy Rep. 2014 Sep 3;3:574.
  • Hechtman LM. Clinical Naturopathic Medicine [Internet]. Harcourt Publishers Group (Australia); 2014 [cited 2015 Jul 21]. 1610 p. Available from: http://www.bookdepository.com/Clinical-Naturopathic-Medicine-Leah-Hechtman/9780729541923
  • Tillisch K. Complementary and alternative medicine for functional gastrointestinal disorders. Gut. 2006 May 1;55(5):593–6.
  • NHS Choices. The risks of drinking too much [Internet]. 2017 [cited 2017 Jul 4]. Available from: http://www.nhs.uk/Livewell/alcohol/Pages/Effectsofalcohol.aspx
  • Islami F, Moreira DM, Boffetta P, Freedland SJ. A Systematic Review and Meta-analysis of Tobacco Use and Prostate Cancer Mortality and Incidence in Prospective Cohort Studies. Eur Urol. 2014 Dec;66(6):1054–64.
  • Moreira DM, Aronson WJ, Terris MK, Kane CJ, Amling CL, Cooperberg MR, et al. Cigarette smoking is associated with an increased risk of biochemical disease recurrence, metastasis, castration-resistant prostate cancer, and mortality after radical prostatectomy: Results from the SEARCH database. Cancer. 2014 Jan 15;120(2):197–204.
  • Davies NJ, Batehup L, Thomas R. The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Cancer. 2011 Nov 8;105:S52–73.
  • Ahmadi H, Daneshmand S. Androgen deprivation therapy: evidence-based management of side effects. BJU Int. 2013 Apr;111(4):543–8.
  • Hamilton K, Chambers SK, Legg M, Oliffe JL, Cormie P. Sexuality and exercise in men undergoing androgen deprivation therapy for prostate cancer. Support Care Cancer. 2015 Jan;23(1):133–42.
  • Cormie P, Newton RU, Taaffe DR, Spry N, Joseph D, Hamid MA, et al. Exercise maintains sexual activity in men undergoing androgen suppression for prostate cancer: a randomized controlled trial. Prostate Cancer Prostatic Dis. 2013;16(2):170–175.
  • Newby TA, Graff JN, Ganzini LK, McDonagh MS. Interventions that may reduce depressive symptoms among prostate cancer patients: a systematic review and meta-analysis. Psychooncology. 2015 Dec;24(12):1686–93.
  • Chipperfield K, Brooker J, Fletcher J, Burney S. The impact of physical activity on psychosocial outcomes in men receiving androgen deprivation therapy for prostate cancer: A systematic review. Health Psychol. 2014;33(11):1288–97.
  • Keilani M, Hasenoehrl T, Baumann L, Ristl R, Schwarz M, Marhold M, et al. Effects of resistance exercise in prostate cancer patients: a meta-analysis. Support Care Cancer. 2017 Jun 10;
  • Macmillan Cancer Support. Your rights at work [Internet]. 2013 [cited 2015 Aug 18]. Available from: http://www.macmillan.org.uk/Documents/Cancerinfo/Livingwithandaftercancer/WorkandcancerPDFs/Yourrightsatwork_2013_2.pdf
  • nidirect. Employment rights and the Disability Discrimination Act. Available from: https://www.nidirect.gov.uk/articles/employment-rights-and-disability-discrimination-act
  • Compassion in Dying. IN04 Your rights in Northern Ireland [Internet]. [cited 2014 Apr 10]. Available from: http://www.compassionindying.org.uk/sites/default/files/IN04%20Your%20rights%20in%20Northern%20Ireland.pdf
  • Abel J, Pring A, Rich A, Malik T, Verne J. The impact of advance care planning of place of death, a hospice retrospective cohort study. BMJ Support Palliat Care. 2013;3(2):168–173.
  • Watson M, Lucas C, Hoy A, Back I, Armstrong P. Palliative care adult network guidelines [Internet]. 4th Edition. 2016. Available from: http://book.pallcare.info/index.php?user_style=1
  • Compassion in Dying. Advance Decisions (Living Wills): an introduction. 2015.
  • National Institute for Health and Care Excellence. Care of dying adults in the last days of life. NICE Quality Standard 144 [Internet]. 2017. Available from: care-of-dying-adults-in-the-last-days-of-life-pdf-75545479508677.pdf
  • Marie Curie Cancer Care. Difficult conversations with dying people and their families [Internet]. 2014. Available from: http://www2.mariecurie.org.uk/ImageVaultFiles/id_1956/cf_100/Difficult-Conversations_report.PDF
  • National End of Life Care Intelligence Network. What we know now 2014 [Internet]. Public Health England; 2015. Available from: www.endoflifecare-intelligence.org.uk/view?rid=872
  • NHS. End of life care: Why plan ahead? [Internet]. 2017 [cited 2018 Jan 24]. Available from: http://www.nhs.uk/Planners/end-of-life-care/Pages/why-plan-ahead.aspx
  • Carter N, Bryant-Lukosius D, DiCenso A, Blythe J, Neville AJ. The supportive care needs of men with advanced prostate cancer. In: Oncology nursing forum [Internet]. Onc Nurs Society; 2011 [cited 2014 Dec 11]. p. 189–198. Available from: http://ons.metapress.com/index/G82215H56920T680.pdf
  • NHS. End of life care: What it involves and when it starts [Internet]. National Health Service. 2015 [cited 2018 Jan 24]. Available from: http://www.nhs.uk/Planners/end-of-life-care/Pages/what-it-involves-and-when-it-starts.aspx

You may also be interested in...

201910 Nurses Staff

Contact Our Specialist Nurses

Ask all the questions you need answers to, or just talk. Our nurses have time for you.
Learn More
2024 Support Man Phone Helpline

One-to-one peer support service

Anyone affected by prostate disease can talk with one of our trained support volunteers.
Learn More

Thinking and planning ahead

Learn about end of life care and support you can get, where you can be cared for, and who might be able to help.
Learn More

Advanced prostate cancer fact sheet

This fact sheet is for people who have been diagnosed with advanced prostate cancer. It explains what advanced prostate cancer is, what your test results mean, and the treatments available.
Learn More