Coping with Late-Stage Prostate Cancer
Reviewed by: HU Medical Review Board | Last reviewed: October 2017 | Last updated: March 2022
Although prostate cancer prognosis is often good, especially when found in early stages, it is possible to diagnose prostate cancer later on, or have an aggressive cancer that progresses to late-stages or spreads to other parts of the body. In these instances, an individual with prostate cancer may have a poor prognosis and need to begin planning for the end of their battle. These conversations can be incredibly hard to have, especially with loved ones, however, communicating your needs, feelings, and opinions on end-of-life care or planning is critical. Your healthcare team may be able to help facilitate these kinds of conversations, as well has provide you with resources to help make the process easier. Although difficult, outlining your wishes during this time will help you end your battle with dignity, and reduce stress on yourself and your loved ones.
Hospice care is non-curative care, designed to provide assistance with pain management, emotional and spiritual support, and comfort to an individual battling a life-threatening injury or illness. This approach can help these individuals maintain the highest possible quality of life during their remaining days. Hospice care is generally utilized when cancer treatments can no longer control or impact a man’s cancer. Hospice care is covered by many private insurers, as well as by Medicare or Medicaid when your doctor provides documentation that your current life expectancy is 6 months or less. Hospice care is available 7 days a week, and a healthcare team member is on call 24 hours a day, for whatever needs may arise. Hospice often occurs in a patient’s home, where he can be most comfortable, but centers are available for those who do not wish for in-home hospice care.
Beginning hospice care does not mean that an individual or their family has given up, but rather, that the individual and their family want to focus on maintaining the highest possible quality of life during this difficult time. The focus of hospice care is to make an individual and their family feel as comfortable and supported as possible, across all aspects of their life and care. Medical care continues while on hospice, although curative treatments, such as chemotherapy, are usually stopped.
Hospice care utilizes a team approach, involving doctors, nurses, physical therapists, spiritual workers, occupational therapists, counselors, trained volunteers, and home-health aides, among others. This allows an individual to address any and all needs they have, even ones that are not being addressed by their current treatment plan. They can also pursue and address their most important priorities during their remaining time. Members of an individual’s hospice team may also work with their family, to help them cope with grief or loss. Research has indicated that this approach reduces the risk of family members experiencing persistent major depression after their loved one passes. Also, some research has indicated that individuals with certain kinds of late-stage cancer who are utilizing hospice care live just as long, if not longer, than their non-hospice counterparts with similar prognoses.1-4
Hospice is often confused with palliative care, although there are differences. Palliative care focuses on keeping a patient comfortable at any stage of an illness, even if it can be cured. Patients on hospice care can receive palliative care to keep them comfortable, but the focus is no longer on cure.
End-of-life planning can be difficult and confusing for an individual with late-stage cancer and their family or friends. End-of-life planning may include deciding to utilize hospice care, and defining their goals and priorities for their remaining time. End of-life-planning may also include financial planning, deciding what resuscitation measures can be used if needed (if any at all), memorial service or funeral planning, estate-related decisions, final treatment considerations, among other topics. What issues you’d like to address when planning the end of your life is completely up to you, however, the more you are able to plan for or outline while you are stronger or of sound mind, the less stress you or your family may be under later on.
Legal considerations, such as advanced directives or determining a power of attorney, may also be considered during this process. An advanced directive is legally binding, and is also referred to as a living will. It outlines your preferences for your care, in the event that you are unable to communicate these wishes, or are unable to make your own decisions. This may include information on life supportive measures or organ donation, among other things. A power of attorney allows you to appoint another individual as your healthcare representative. This individual will be able to make decisions for you in the event that you are unable to. Whatever legal options you decide to pursue as you are end-of-life planning is up to you, however, not everyone will pursue these options.4
At times, caregivers, as well as friends and family, may need support just as much as the individual battling the late-stage cancer. Feelings of fear, depression, frustration, grief, and more are often experienced by those supporting a loved one through this time. As hospice care recognizes, it is important for family and friends to receive counseling and medical support to manage these emotions. If you feel as though you are in emotional distress or your mental, emotional, or physical health is declining as a result of supporting someone during their battle with late-stage cancer, it is important, and encouraged, to seek the support you need. Although you may not be the one battling a life-threatening illness, reaching out for additional support or medical attention may make a big difference in your own overall wellbeing.