Palliative Care for Metastatic Prostate Cancer: How to Find Symptom Relief and Support

If you or a loved one has metastatic prostate cancer, slowing the cancer progression isn’t the only concern. Dealing with the pain, nausea, fatigue, and other side effects of this cancer and its treatments must also be considered.

That’s where palliative care can help. It’s supportive care, given alongside treatments like hormone therapy and chemotherapy, that helps with symptom relief in metastatic prostate cancer. "It’s a mix of medications and other treatment approaches to try to reduce pain and other symptoms, including things like nausea and vomiting, constipation, anxiety, and stress," says Alicia Morgans, MD, MPH, a genitourinary medical oncologist and the director of the survivorship program at Dana-Farber Cancer Institute in Boston.

This supportive program isn’t just for prostate cancer patients, either. Their caregivers can also benefit from palliative care. It can connect them with the resources they need to take better care of their loved one — and themselves.

Palliative vs. Hospice Care

Martin Gugino, who was diagnosed with metastatic prostate cancer in 2015, has never officially been in a palliative care program, but he has taken anti-nausea drugs and other medications to lessen the side effects of his treatments. He has a theory about why more men don't take advantage of this program. "I think a lot of people confuse it with hospice, and they won't try it for that reason," he says.

Although palliative care and hospice care are both focused on improving quality of life for people with cancer, these two programs are not the same. Hospice care is used at the end of life — generally when someone has six months or less to live, and they have stopped receiving treatments to slow their cancer. Palliative care happens during prostate cancer treatment.

Palliative Treatments for Metastatic Prostate Cancer

These are a few of the palliative treatments that doctors recommend for managing symptoms of advanced prostate cancer.

Anti-Nausea Medications

If those measures don't work, your doctor can prescribe an antiemetic medication like ondansetron (Zofran). It works by blocking the chemical serotonin, which triggers nausea.

Exercise

Fatigue can be one of the most debilitating symptoms of advanced prostate cancer because it prevents you from doing the things you want to do. "I think graded exercise is probably the most effective treatment for fatigue," Esch says. With this therapy, you start exercising slowly and gradually increase your effort over time.

"Try walking to the mailbox and do that a few days in a row," he suggests. "Then see if you can walk to the mailbox twice. Then see if you can walk three or four houses down." Keep a log to track your progress.

Pain Medications

Radiation

Another option is to take a radioactive drug like radium-223 (Xofigo) that works inside your body to shrink cancer in your bones. Dr. Morgans says radiation helps 70 to 80 percent of her patients and allows some of them to cut down on or avoid narcotic pain medications.

Relaxation Techniques

Surgery

Talk Therapy

Therapy can be a powerful tool for managing the stress of advanced prostate cancer. A social worker, therapist, or counselor from your palliative care team can offer advice and help you work through any issues you're having. They can also help you deal with sexual health and intimacy issues that arise during prostate cancer treatment.

How to Get Palliative Care

You don't have to wait until your symptoms become unbearable to ask for palliative care. You can start at any time, from the day you're diagnosed, says Esch.

If your oncologist or cancer hospital doesn't suggest palliative care, ask about it. Not every cancer hospital offers this program, but resources may be available in your community. "If you can't find anything and you speak to your local hospice, they may be able to point you in the direction of a palliative care group," Morgans says. You can also search for a program in your area through the Get Palliative Care Provider Directory.

It's worth asking for palliative care when you're diagnosed with advanced prostate cancer. This program can give you relief from pain, stress, and other symptoms, and let you focus on controlling your cancer.