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Life Support Issues/What to expect with stage IV prostate cancer when treatments have failed


Ann N. RN wrote at 2007-11-01 22:39:02
Leg weakness is common in later stage prostate cancer.  Pain increases as the cancer spreads to bone and other organs (metastasis).  Pain control should not be an issue.  Make sure to monitor his pain levels because there is no excuse for a person to suffer with pain given the medications available today.  Ask your doctor about hospice care.  He and your mother will undoubtedly need more help as the disease progresses.  Your mother will be trying to reconcile the emotional roller coaster of watching a loved one deteriorate.  Constipation is usually a big issue at this state.  Use of narcotic pain relievers, coupled with the fact that calcium is building up in the body can cause severe constipation.  Senna and colace are good meds to help alleviate this problem.  You may find your father beginning to become angry and withdrawn.  This is normal behavior, as the patient goes through the emotional turmoil of end of life issues.  If your father should develop numbness or tingling in his feet and increased lower body strength, get him to his doctor right away as this might possibly be caused by spinal cord compression . . . a life-threatening complication.  Above all, just be there for your parents during this  difficult time.  Knowing you are loved helps more than you can ever know.  

I hope this info helped even a little.

Alias wrote at 2011-08-25 18:49:30
Margot, your answer has helped me to better prepare for the end of a family member who is scared of the final moment himself.


you are the angel I was looking for .....for the past 6 months

elke1 wrote at 2011-09-01 10:48:20
Having just lost a relative, I found reading this was exactly the way it is.  I wish I had read this beforehand.  

lily wrote at 2012-03-09 02:02:55

my grandfather passed away last month, and like most readers here I was frantically searching for symptoms to know whether it was the final days or not.

I'll start from the beginning, my grandfather was 85 years old, he was healthy and suddenly experienced back pain and constipation as well as urine problems. on christmas day he could no longer get out of bed and was rushed to hospital, 5 days later he was diagnosed with prostate cancer in its final stages. We were informed that it had spread to his bones hence the back pain and up his spine. He was sent for radiotherapy to free up the pain in his back and placed on heavy morphine medication for the pain and hormone therapy to slow down the cancer.

The doctors had informed us that his PSA levels were too high, he was not strong enough for chemotherapy basically telling us we no longer had much time left. They gave us an estimation of upto 6 months. We spent the best part of 6 weeks in the hospital witnessing his condition worsen. He became completely bed bound since his diagnosis

at some points he would brighten up and one day he sat up and asked for a macDonalds meal, after eating about two spoonfuls of food a day. My advice would be to not force feed or emotionally blackmail them, it only makes them feel uncomfortable, always request from the hospital energy suplement drinks if the patient can no longer eat much. Also yoghurts, bananas and soft cool food should be fed to them. my grandfather who used to be quite chubby became skin and bone, the weight loss was incredibly fast.

in the last few weeks my grandfather had a few memory problems, e.g not remembering that certain people were no longer alive, thinking that he had to get out of bed to go to work. However he rememebered the identity of people. He became restless and agitated pulling on the sheets and attempting to get out of bed, however the pain in his back restricted him from doing much else.

My grandfather spent his final week at home, we were told that he could come home and become an outpatient for the hospital, we thought he had improved but a few days later he would sleep for most of the day and only waking up for 10 minutes before sleeping again. In his final days he no longer woke up, he was no longer eating or drinking at all, his breathing became irregular and blood pressure went high, he also had a chest infection which made his breathing rattle and sound uncomfortable. His skin especially his hands became cool almost cold. The nurses who came over for the night informed us of his final breaths and then he was no longer with us.

looking back at this experience my advice would be to speak to them even if you think they can't hear you, because they can, my grandfather squeezed hands when he could hear but he appeared to be in a deep sleep.

for those people are going through this, the only thing i can say is to stay strong and keep the person comfortable, pray for them, make neccessary arrangements,spend some time getting used to the situation and most of all support each other in times like this. Losing someone, no words can describe it and nor can any words make anyone feel any better but think about it in a sense that the suffering and pain is over and your loved one is falling asleep being released from the pain.


britany52 wrote at 2012-04-02 15:14:02
I too found this very informative and wish I had found it before my father passed away at 89.  He had been diagnozed with prostate cancer about 9 years ago.  He was put on hormone treatment and had 3-monthly PSA checks "watchful waiting".  In December 2010 he had a fall which seemed to trigger a sequence of events which started with pain in his leg.  Due to an old war injury Dad was already living with back pain, however this started to get gradually worse.  Despite a series of X-rays and CT scans, then finally an MRI in Dec 2011, at no point were doctors able to diagnoze metastatis to the bone, although that was listed as his cause of death.  They say it's possible that prior damage to his spine, along with 3 compression fractures made it hard to detect.  The back and leg pain kept getting worse and all the doctor did was try different painkillers.  Finally in August he was given one shot of radio therapy as an outpatient.  It seemed to bring some temporary relief which meant only that he could just about manage to function with huge doses of painkillers. Dad was strong as an ox and although he lost quite a bit of weight he still maintained upper body strength. After a fall in Dec 2011 he was admitted to hospital where they did another scan, then an MRI and then he was given 4 days of radio therapy treatment coupled with aggressive doses of steroids, tapering off over 8 weeks. He was also taking huge doses of pain killers, morphine and paracetamol (tylenol) as well as a cocktail of other drugs. Towards the end of the  8 weeks he contracted a urinary tract infection which made him disoriented and resulted in another fall.  He was again admitted to hospital, given intravenous antibiotics and sent  home.  However it returned so he went back to hospital for more antibiotics; the whole process left him weakened.  This time we booked him into a care home for repite treatment hoping to get him strong enough to go back home.  However his legs were weakening and movement was hard, although otherwise his body and mind remained strong.  The local palliative nurse readmitted him to hospital for more radio therapy.  He went back again to the nursing home and we still hoped to get him well enough to return home, but by now he was on huge levels of morphine which kept having to be increased to control break-through pain; a few days later morphine was replaced by diamorphine (heroin).  Until this time he'd been eating normally, enjoying food, wine and conversation.  However now he started eating less and speaking became difficult.  However it seemed to me that this was more a side effect of the drugs than the actual cancer.  Then he started having trouble swallowing and went to soft foods then liquids only.  Then as swallowing got more difficult the nurses said it was time to withhold fluids.  From that point the sequence of "dying" events described in the above answer started.  

However I can't help thinking that he died not from the cancer itself but from a combination of heavy painkillers and dehydration... he lasted an agonizing 7 more days from the point they were no longer giving him fluids.  Palliative care controlled a lot but not all of the pain.  In retrospect I feel we should have found a way to do more... I still don't really understand how the cancer killed him.  

PSG1109 wrote at 2013-11-17 19:21:58
I wish I had read this before my partner passed away on Thursday, however, what you have explained is amazingly accurate and by pure chance I did everything you suggested.

Martin said 'Help' right before he died and I was carrying the thought around with me that he was scared, but he wasn't, he was testing if I was ready.....and I was and I let him go peacefully with kisses, cuddles and reassurance.

Thank you so much for the peace of mind x

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Margot RN BScN CGN


I nursed my own Mother and Grandmother at home when they were dying so I have personal experience with the emotions involved. I have also spent the last 20 years as a Registered Nurse caring for The Elderly and Terminally Ill and it has brought me great satisfaction. I am willing to answer any questions I can.


27 years Geriatric Nursing and working with palliative care clients and their families both in facilities and the community.

Registered Nurse, Bachelor of Science in Nursing and Certified Gerontological Nurse

Past/Present Clients
Hundreds of Long Term Care Residents as well as hundreds of Clients and families in the community (including my Mother and Grandmother).

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