How to care for advanced prostate cancer patients?

Question

Hello doctor,

My father, who is 68 years old, is struggling with advanced prostate cancer that has become increasingly aggressive. He was once a vibrant farmer but is now confined to bed most days. The rapid progression of his condition has left our family feeling overwhelmed.

We are seeking comprehensive guidance on managing his pain, exploring potential treatment options, and providing him with the best possible support during this challenging time. The emotional and physical toll on our family is immense, and we are in need of practical and compassionate advice. Any advice would be greatly appreciated.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

Prostate cancer occurs when abnormal cells develop and grow in the prostate gland. These abnormal cells can disrupt the body's normal functions. Not all abnormal growths, referred to as tumors, are cancerous. Some are benign (non-cancerous), while others are malignant (cancerous).

Benign growths: Conditions like benign prostatic hyperplasia (BPH) are not life-threatening. These growths do not spread to nearby tissues or other parts of the body. They may grow back slowly or not at all after being removed.
Cancerous growths: Prostate cancer can spread (metastasize) to nearby organs, such as the bladder or rectum, and other parts of the body. Even if removed, cancerous growths can recur. Prostate cancer can be life-threatening, particularly if it spreads beyond the prostate (metastatic disease).

Treatment options involve:

Active surveillance: This approach is suitable for men with small, slow-growing prostate cancer. Doctors monitor the cancer using regular tests, such as:

PSA (prostate-specific antigen) blood tests.
Biopsies.
MRI (magnetic resonance imaging) scans.

Active surveillance allows men to maintain their quality of life and avoid urinary, sexual, and bowel side effects for as long as possible. If the cancer shows signs of growth, additional treatments like surgery or radiation therapy (definitive therapy) may be required.

Watchful waiting: Watchful waiting involves tracking the cancer without active intervention. This approach is often used for:

Older men with early-stage prostate cancer are likely to die of other causes.
Men with other health issues that make surgery or radiation challenging.
Unlike active surveillance, watchful waiting does not include regular PSA tests or biopsies, and there is a risk the cancer could grow or spread between visits.

Definitive treatments: Surgery and radiation therapy

The primary goal of surgery or radiation therapy is to eliminate cancer. Both options have similar success rates.

Surgery (radical prostatectomy): Involves removing the prostate, seminal vesicles, nearby tissue, and sometimes pelvic lymph nodes. It requires anesthesia and a short hospital stay.
Radiation therapy: Targets and destroys cancer cells, often used as an alternative to surgery or in combination with other treatments.

Both surgical and radiation treatments have potential complications:

Surgical complications: These may include intraoperative, early postoperative, and late postoperative issues.
Radiation therapy complications: These may involve side effects affecting urinary, bowel, or sexual function.

Pain management options involve:

Pain-relieving medications.
Pain-relieving radiotherapy.
Bisphosphonates (for bone health).
Surgery to support damaged bones.
Transcutaneous electrical nerve stimulation or TENS (a therapy that uses low-voltage electrical currents to relieve pain).
Nerve blocks.

I strongly recommend following your doctor's treatment plan and undergoing regular follow-up tests. Your medical team will intervene promptly if the tumor shows progression. Please rest assured that they are closely monitoring the situation.

I hope this helps.

Please revert so I can assist you further.

Thank you.