Castration-resistant Prostate Cancer


Support for Castration-resistant Prostate Cancer

Getting diagnosed with castration-resistance prostate cancer can make you feel powerless. It can cause feelings of anxiety, anger, fear, or even depression.

To find support, approach your doctor or nurse in the hospital, or ask your family doctor. They will be able to give you contact information about patient organizations or others who can help you with psychological support, or practical matters such as financial and legal advice.

Support during hormonal therapy

The most common side effects of hormonal therapy are gynecomastia and hot flushes. To manage this, your doctor will advise you to monitor your weight and avoid alcoholic drinks. If you experience hot flushes, you can:

  • Dress in layers
  • Wear natural fabrics like cotton or linen, which let the body breathe
  • Sleep under layers of light blankets so that you can remove some if you need to
  • Avoid hot baths, saunas or whirlpools
  • Avoid hot or spicy food
  • Drink plenty of water, and carry a bottle with you all day

Dealing with the side effects of immunotherapy and chemotherapy

If you need treatment for cancer, you will experience unpleasant side effects. The side effects are common and management includes therapies to relieve them. It is important that you tell the doctor about the side effects you have.

Write down your symptoms every day and try to describe them as precisely as possible. Note how often they occur and how much they affect your daily life. In some cases temporary treatment interruption, dose modification, or stopping the treatment can be considered.

It is common that you experience fatigue. This means you feel more tired than usual, you are out of energy, have trouble concentrating, and it doesn’t get better after you sleep.

If you experience fatigue, it may help to:

  • Write down things that give you energy, and give them priority during the day or week
  • Get help with household tasks like washing, cleaning, or gardening
  • Take short naps several times during the day
  • Try to be as active as you can. A short walk every day is better than a long walk once a week
  • When planning social activities like a trip or a visit, keep in mind you may need time to rest during the day. Discuss this with your family, friends, or caregiver so that you can plan ahead. It is important to tell them when you are feeling tired
  • Discuss with your doctor if you plan to travel outside of your country. The doctor can give you advice about vaccinations or possible restrictions on certain medicines. Make sure to also check your travel insurance

Other common side effects include nausea, diarrhoea, high blood pressure, and taste alterations. Some things you can do to cope are listed below.

During treatment, you may experience nausea caused by the therapy, tumour growth, or anxiety about your prognosis. The doctor can prescribe medicine to reduce the nausea.

It may also help if you:

  • Eat smaller meals but eat more often throughout the day to make sure you still get enough nutrition
  • Eat snacks
  • Drink smaller amounts but drink more often to stay hydrated
  • Try cold dishes if hot meals make you nauseous
  • Ask someone to cook for you, if possible

Another common side effect of the treatment is diarrhoea. Diarrhoea can lead to dehydration and it is important to:

  • Drink more than usual
  • Avoid food that you think makes the diarrhoea worse
  • Keep the anal area clean to prevent irritation
  • Use moisturizer if you have anal irritation
  • Ask the doctor to prescribe medicine to prevent diarrhoea

You may also experience a mild to moderate raise in your blood pressure, especially early on in your treatment. This is normal and can be managed with standard therapy. Your doctor will advise you if you need to monitor your blood pressure, and how often. If you feel dizzy or have a headache, let your doctor know as soon as possible.

Chemotherapy may also cause changes in how food tastes to you. You may even begin to dislike certain foods you liked before. The best way to figure out what food you like is to try different things:

  • Drink water before you eat to neutralize your taste
  • If red meat tastes strange try white meat or fish, or the other way around
  • If hot food tastes strange try it cold, or the other way around
  • Try using more spices, or try using less
  • Use a plastic fork and knife if the food tastes of metal

Support during radiation therapy

During the course of radiation therapy you can generally carry on with your daily activities. The treatment may cause fatigue from the daily trips to the hospital, and can affect your lower urinary tract and bowel.

Your skin may be affected by the radiation. To care for your skin you can:

  • Avoid scratching or rubbing the affected area
  • Ask your doctor or nurse which type of skin lotion you should use to deal with skin irritation
  • Avoid sun exposure
  • Use a high-factor sunscreen
  • Wear loose-fitting clothes in natural fabrics such as cotton or linen
  • Wash yourself daily with mild soap and lukewarm water
  • Gently pat your skin dry after washing
  • Avoid the sauna

Lifestyle advice

It is important to maintain a healthy lifestyle during treatment. Try to get physical exercise regularly. Find an activity that you enjoy doing. If you have doubts about what you can do, ask your doctor to refer you to a physiotherapist.

Try to eat a balanced diet with a mix of vegetables, fruit and dairy. Also include starchy food like bread and potatoes, rice or pasta, and protein-rich food like meat, fish, eggs, or legumes. Try to eat less sugar, salt, and fatty food. If you have any questions, ask your doctor to refer you to a dietician.

Psychological support

During treatment you may worry about your prognosis, the impact of cancer on your social or financial situation, or other issues.

If you feel the need to have someone to talk to, you can ask your doctor for a referral to a psychologist. A patient organization can also offer support.

Discuss with your health care team the possible financial consequences of your treatment. They might be able to direct you to people or places where you can get advice about your economic situation or even financial help. They can also help you find legal advice about your will and related matters.

Treatment can affect your sexuality. Feelings of depression and fatigue can also have a negative effect on your sexual life. It is important that you talk to your partner about your feelings. There are many ways in which you can be intimate. If you do not want to be sexually active, be near each other, touch each other, give and take hugs, and just sit or lay down close to each other.

A cancer diagnosis can make you look at life in a different way and you may realize you now have different priorities. This will affect your work or relationships and can make you feel disoriented and uncertain. Talk to family, friends, or your spiritual advisor about your feelings and wishes. If you don’t feel comfortable addressing these issues with those close to you, you can ask your health care team for a referral to a psychologist. The psychologist can give you the tools to deal with these feelings.

Support for family and friends

A cancer diagnosis not only affects the patient, but also the people around them. As a loved one, you can offer support in many different ways. Sometimes you can help with practical things like laundry, gardening, or grocery shopping.

It may also be helpful to go to the doctor together. You could offer to drive to the visit or help formulate questions to ask during consultation. Being there for the consult can also be good. You may remember different things or focus on other details, which you can later discuss together. You could also ask the doctor how the treatment may impact your lives in terms of caregiving and psychological effects.

The diagnosis and treatment can be very emotional for everybody involved. Cancer treatment is intense and your life may change suddenly. Questions about prognosis, effects of the treatment, and death will come up. As a friend or a loved one you can be there and listen. You don’t need to have the answers.

If you feel you need somebody to talk to, approach your family doctor or the medical team to get support. Patient organizations also offer support for family members or friends of people who have been diagnosed with cancer.

Support for partners

A cancer diagnosis can put pressure on your relationship. Often talking to each other becomes more difficult because of the time and energy spent on treatment. You could decide to discuss any difficulties with a therapist.

You may experience a similar degree of stress, anger, and depression as your partner. You could feel exhausted, both physically and emotionally. This can be a result of the responsibilities of caring for your partner, and taking on extra tasks around the house. Be sure to make time for yourself and think about your own wishes and needs.

Cancer treatment can affect your sex life. Try to talk to your partner about your feelings. There are many ways in which you can be intimate. Be near each other, touch each other, give and take hugs, and just sit or lay down close to each other.

It is normal to worry about being left alone. If you feel you need somebody to talk to, approach your family doctor or your spiritual advisor. Patient organizations also offer support for partners. They can also help you find people or organizations who can help you with practical things like legal and financial issues.

How to find a patient organization nearby

Patient organizations can be very helpful. To find one close to you, ask your family doctor, nurse, or doctor at the hospital. You can also search the Internet for a patient group.