If your prostate cancer is no longer responding to treatment and your doctor has explained that you are approaching the end of your life, you might feel anxious, sad, angry, or frustrated. Some men also feel frightened for themselves and those they care about. And your feelings might change over time. There is no right or wrong way to feel. 

It can be helpful to read about thoughts and feelings you might have, and about what can help. You might find that you can relate to some of these, but it’s okay if you don’t. Everyone’s experience is different.

Coming to terms with things

It’s difficult to hear that your treatment isn’t working and you may be nearing the end of your life. Even if you’ve been living with prostate cancer for years, it can still be a shock.

It might be hard for you and your family to accept that you’re dying. Some men find they think about their life more and try to find meaning in it. These can be difficult thoughts to deal with.

Your prostate cancer or treatment may also be causing physical problems. This might make you feel dependent on other people and that you're not in control.

Read about what can help.

Feeling upset or alone

It’s normal to feel upset if you're approaching the end of your life. Some men feel like no one understands what they’re going through and feel very alone. And some men feel low, feel bad about themselves, or don’t want to do things they normally enjoy. 

You may feel anxious about not seeing the doctors and nurses you are used to in the hospital if your care is passed on to new doctors and nurses in the community team.

It can be especially difficult to deal with these feelings if you live on your own or don’t have family or friends nearby.

Read about what can help.

Feeling angry

Some men feel that their prostate cancer could have been diagnosed earlier. Some men regret decisions they made about their treatment. This can make them feel angry, frustrated, or regretful. 

Advanced prostate cancer and the side effects of treatment can cause physical problems. These can be difficult to manage. You might feel angry or frustrated about how your cancer and treatment has affected your life. 

Some men find that they feel more angry in general and get annoyed easily. 

Read about what can help.

What can help?

Give yourself time – it can take a while to process the news that you’re approaching the end of your life.

Reading more about prostate cancer symptoms and diagnosis could help. Most men don’t have any symptoms until their prostate cancer has spread around their body (advanced prostate cancer). And some men with advanced prostate cancer don’t have symptoms before they are diagnosed.

Managing your side effects can also help. You might be able to manage some side effects yourself. And your doctor or nurse may be able to help you as well. Read more about treatment side effects and how to manage them.

It can help to think about what is happening and how you’re feeling about it. Some men want time by themselves or with a family member or close friend.

If you feel sad, low or angry a lot of the time or are getting annoyed easily, you could be depressed. It’s important to tell your doctor or nurse how you are feeling. They can make sure you get the support or treatment you need.

You may have questions for your doctor or nurse about your situation and what to expect. It can help to write your questions down before you meet with them. Some men find it helps to take a family member or friend with them. Your doctor or nurse can suggest things you can do to help yourself or put you in touch with people who can help.

Talking to family and friends about how you’re feeling can help you feel more supported. You could talk to a family member or friend. Or you could talk to someone who understands what you’re going through in a support group, on our online community or through our one-to-one support service. It can also help to talk to someone who’s trained to listen, like a counsellor or your GP or nurse. You can speak to our Specialist Nurses about how you are feeling. If you need to speak to someone immediately, you could contact the Samaritans any time of day or night. The Samaritans are there for anyone who needs to talk – you don’t have to feel suicidal to get in touch.

It can be helpful to keep a diary – some people use a diary to express their feelings, while others find it a good way to keep track of their symptoms.

Setting small goals for the future can help you feel more positive and keep some independence. If you are well enough, you could plan and go on a holiday. Or you could set goals such as dressing yourself each day or going for a walk. 

Worries about your family

You might worry about your family and friends and how they are feeling. Some men may feel that they are letting loved ones down and that they are a burden.

You may also worry about how they’ll manage in your final weeks and days. And you may be concerned about what will happen to them after you die.

What can help?

It can help to talk to your family and friends about what is happening. Sharing your worries together can help you all cope better. 

It can be difficult if you don’t think your doctor or nurse has considered the impact of what is happening on your family and friends. Tell your doctor or nurse if you’d like them to involve your family and friends in your care. 

Read more about support available for your family and friends.

Talking about dying

Talking about approaching the end of your life and dying can help you process what is happening and feel less alone. It can also help your family and friends prepare themselves.

But knowing how to tell people that your treatment isn’t working or that you’re dying can be difficult. You might worry about how they’ll react and if you’ll upset them.  

Some men feel that they can cope on their own and don’t want to talk. Your family and friends might find this hard to accept. Read about support available for your family and friends.

What can help?

There’s no right or wrong way to talk about dying. How you talk about it will depend on your situation and your relationship with the person you’re talking to. Take time to think about the best way to talk to your family and friends.

Think about the time and place where you want to talk. It can help to be in a calm environment. If you’re able to walk around, some people find that talking while you’re going for a walk can make the conversation less confrontational.

Try to make sure you both have enough time to say the things you want to say and listen to each other.

Remember that the person you are talking to may have similar questions and worries to you. They may find it a relief to be able to talk about their thoughts and feelings. It’s important to listen to them too – understanding what they are thinking can help.

How to start a conversation

You could prepare the other person for the conversation by letting them know you want to talk about something serious. For example you could say, “I want to talk to you about something that might be difficult” or “Can we talk about my prostate cancer?”.

You might want to share what you’ve been thinking and see how the other person responds. For example you could say, “I’m worried about what will happen in the future”, “I’ve been thinking about what might happen if I get seriously ill” or “I’m worried about how long I have left to live”.

If you’re not sure whether the other person wants to talk about something, you could ask them. For example you could say, “I’ve been thinking about where I’d like to be cared for if I become really unwell. Can I talk about it with you?”

The other person might not know how to respond straight away. So it can help to give them time to think about having a conversation. For example you could say, “At some point, I’d like to go through my Will so that you know what I’d like to happen after I die. Can we talk about it some time?”

You could let the other person know that they can ask you about things in the future, so that you keep communicating about things. For example you could say, “You can talk to me if you have questions or worries about things” or “I know that some things are difficult to talk about, like what will happen if I get more ill or after I die. But it’s okay to talk about these things with me if you want to”.

If you need support to have these conversations, ask your doctor or nurse for advice.

Find out more about talking about dying from Dying Matters.

Talking to children and grandchildren

Children can often sense that something is wrong even if they don’t understand it. It can be difficult to know what to say to them and if they’ll understand.

What can help?

It is usually best to be honest with your children or grandchildren. Keeping things from them might only make them worry more. 

There is information about talking to children about cancer from Macmillan Cancer Support. And there is information about talking to children about dying from Winston's Wish. Or you could ask your doctor or nurse for advice.

Not knowing what to expect

It can be difficult to know what to expect as you approach the end of your life. You might be worried about what will happen, especially if you’re hearing a lot of this information for the first time. 

You may worry about physical problems, such as being sleepy or in pain. And you might be concerned about the effect these problems could have on those around you.

What can help? 

You might find it helpful to find out about what to expect. It can help you prepare for what could happen.

It can also help to write down questions or thoughts you have. You could talk about them with your doctor or nurse, or someone close to you. And it can help to talk to a professional counsellor.

Some men find it helpful to talk to their doctor about things in their life they can have control over. This might include setting small realistic goals for the future and planning things to look forward to. 

Read more about what to expect.

How to know how long I have left to live

Some men want to know how long they have left to live. This can help you prepare and plan your time. There might be things you want to do before you die, or people you want to see.

But some men don’t want to know how long they have left to live. Everyone is different.

What can help?

You can ask your doctor how long you have left to live. They won’t be able to give you an exact answer. This is because everyone’s cancer and everyone's body is different. But your doctor may be able to give you some idea based on where the cancer has spread to, how quickly you are responding to treatment, how quickly the cancer has spread, and what problems it is causing. And they should be able to let you know when you are approaching your final weeks and days.

It can also be helpful to talk with your family about how long you have left to live. You may want to talk about the things you want to do and the people you want to see before you die.

Read more about how to know how long you have left to live.

Planning your care

Some men worry about how they will be looked after towards the end of their life. It may be important to you that you’re not in pain, you’re surrounded by the people you love, and you have privacy and dignity. 

What can help?

Thinking and planning ahead can help you get support in the coming weeks or months. It can help you get control over how and where you will be cared for. It can also help make things easier for your family and friends when you’re nearing the end of your life. 

Read more about planning your care.

Getting support

It can be difficult to cope with the fact that you are approaching the end of your life. Sometimes it can feel overwhelming. 

Here are some ways to get more support.

References and reviewers

Updated: July 2018 | Due for Review: May 2020

  • List of references  

    • Bausewein C, Calanzani N, Daveson BA, Simon ST, Ferreira PL, Higginson IJ, et al. ‘Burden to others’ as a public concern in advanced cancer: a comparative survey in seven European countries. BMC Cancer. 2013;13(1):105. 
    • Buckley J, Herth K. Fostering hope in terminally ill patients. Nurs Stand. 2004;19(10):33–41. 
    • 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. Onc Nurs Society; 2011. p. 189–98.
    • Clayton JM, Butow PN, Arnold RM, Tattersall MHN. Fostering coping and nurturing hope when discussing the future with terminally ill cancer patients and their caregivers. Cancer. 2005 May 1;103(9):1965–75. 
    • Clayton JM, Hancock K, Parker S, Butow PN, Walder S, Carrick S, et al. Sustaining hope when communicating with terminally ill patients and their families: a systematic review. Psychooncology. 2008 Jul;17(7):641–59.
    • Jonsson A, Aus G, Berterö C. Men’s experience of their life situation when diagnosed with advanced prostate cancer. Eur J Oncol Nurs. 2009 Sep;13(4):268–73. 
    • Levy A, Cartwright T. Men’s strategies for preserving emotional well-being in advanced prostate cancer: An interpretative phenomenological analysis. Psychol Health. 2015 May 15;1–19. 
    • Macmillan Cancer Support. The rich picture on people at end of life. 2017.
    • Marie Curie Cancer Care. Difficult conversations with dying people and their families. 2014.  
    • National End of Life Care Intelligence Network. What we know now 2014. Public Health England; 2015. 
    • NHS Choices. End of life care: Why plan ahead? [Internet]. 2014 [cited 2018 Jan 24].
    • Public Health England. Prostate cancer risk management programme (PCRMP): PSA test benefits and risks. 2016.
    • Rethink Mental Illness. Depression Factsheet. Rethink Mental Illness; 2016. 
    • Sue Ryder. A time and a place: What people want at the end of life. 2013. 
    • Thompson JC, Wood J, Feuer D. Prostate cancer: palliative care and pain relief. Br Med Bull. 2007;83(1):341–54.
    • Wilson C, Ormandy P, Vasilica C, Ali S. e-Health Diaries for People at End-of-Life: “A crutch to lean on”. :8. 
  • List of reviewers  

    • Kate Bullen, Head of School for Applied Social Science, University of Brighton, Brighton
    • Jackie Dawson, Community Palliative Care Clinical Nurse Specialist, Guy’s 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
    • Our Volunteers.