Treatment advances are helping people live longer with advanced prostate cancer. But like other ongoing illnesses, the disease can affect your relationships and quality of life. Don’t be embarrassed to ask your cancer care team for support.
But your doctor isn’t the only person who can help you feel better. You’ve got an active role to play.
Focus on Your Mental Health
Christine McMinn, a licensed clinical professional counselor with the LivingWell Cancer Resource Center in Geneva, IL, says it’s common for people with advanced prostate cancer to have anxiety or depression. And she thinks that’s exactly why we should talk more about it.
“We don’t always acknowledge that [mental health issues] can be a real part of the experience, just as much as the diagnosis is,” she says.
Here are some of her tips on how to manage your mental health:
Talk to someone. Make a connection at least once a week. Maybe that’s with a friend, counselor, doctor, or someone in your faith community. What’s important is that you find some kind of outlet.
“When we stuff it in and bottle it up, it just gets bigger and badder,” McMinn says.
Do mental check-ins. Take stock of how you feel every day or at least a couple times a week. Jot down your thoughts in a notebook. And keep your doctor in the loop.
“We want to be proactive, not reactive, if symptoms like depression are building,” McMinn says.
Join a cancer community. You might feel better if you talk to people who know what you’re going through. Ask your doctor or social worker if they know of support groups you can go to online or in person. McMinn also suggests the website for Us Too, a prostate cancer resource group.
Educate yourself. Maybe you’re dealing with depression, end-of-life issues, or sexual health.
“Reading about what you’re experiencing -- from credible sources -- can really go a long way,” McMinn says. “It can help put what you’re experiencing fully into context.”
Michael Kahn, MD, a medical oncologist who specializes in prostate cancer at Northwestern Medicine, says sustained hormone suppression can leave you feeling “blah.” To get more specific, he says you might lose muscle mass, gain weight, or just feel worn down. But physical activity can help.
“The one thing that’s been shown to be effective at reducing these symptoms is vigorous exercise,” he says.
Before you start a new routine, talk to your doctor. They might want you work with a trainer at a cancer support center who’ll help you work out safely. (There are certain exercises you might want to avoid. For example, situps might cause urine leaks. And if you have prostate cancer in your bones, you might need to skip high-impact exercises like running.)
Here are some activities you might want to try:
- Fast walking
- Weight training
Or just get out in your garden or do some stretches. You don’t have to exercise really hard to get a boost.
“Simple movement can really be a game changer for people,” McMinn says.
It’s important to carve out some space to relax. Elizabeth Prsic, MD, director of adult palliative care at Smilow Cancer Hospital and Yale Cancer Center, says you should do what brings you happiness and peace, whatever that looks like.
Prsic says for one person, that was teaching his spouse how to use a snow blower before winter.
“That was bringing him more peace of mind than any spa treatment or yoga class or hour of counseling ever would,” she says.
But Prsic says people find their calm in lots of ways, including:
- Going to a baseball game
- Grilling out at a friend’s house
- Reading a book
- Cooking a big family meal
- Getting end-of-life affairs in order
- Picking out your funeral outfit
For more standard relaxation techniques, you might want to give some of the following a try:
- Deep breathing
- Mindfulness meditation
- Guided imagery (visualizing peaceful, positive things)
- Tai chi
- Muscle relaxation
Medications, such as antidepressants, can also help. Ask your doctor if they’re right for you.
Manage Side Effects
Michael Leapman, MD, a urologic oncologist with Smilow Cancer Hospital and Yale Cancer Center, says hot flashes are a common side effect of advanced prostate cancer treatment. More than half of men on hormone suppression have them. If you have mild hot flashes, he suggests using cold compresses.
Fatigue is another big one. Remember that it’s OK if you need more breaks than you used to.
“Don’t compare how you’re feeling or functioning now to what it was before,” McMinn says. “Give yourself permission to rest when you need to.”
And don’t forget about your palliative care team. Whether you need help with pain, pee problems, or sexual health, they’ll connect you with the right resource.
“Especially with prostate cancer, there are urologists, radiologists, radiation oncologists, oncologists -- there are so many different specialists involved,” Prsic says. “It can be tough to know who’s going to give you what answers and what their individual roles are.”
For more bothersome symptoms, talk to your doctor. Medication or other treatment changes may help.
Meet With a Dietitian
A healthy diet is a key part of any cancer treatment. But it can be hard to get the right nutrition when you don’t feel well. Plus, you might not know how to come up with a cancer-friendly meal plan. A dietitian who specializes in oncology can help. Your doctor can help you find one.
“They’re not just going to tell you to eat your vegetables,” Prsic says. “They have a lot more detailed information about how diets may or may not affect your cancer and your treatment.”
Kim Culver, a registered dietitian certified in oncology nutrition at Smilow Cancer Hospital and Yale Cancer Center, says everyone’s nutrition needs are different. But if you’re dealing with constipation -- a side effect of some cancer treatment -- make sure you get fiber from plant-based foods. And stay hydrated.
That being said, Culver says timing when you have your fluids can help. For example, don’t drink a lot before bed. You might wake up at night to pee. Instead, she says to hydrate in the morning or early in the day.
Talk to Your Doctor
There’s a lot to get used to when you have advanced prostate cancer. But you should always let your doctor know what’s going on. Your symptoms might not be from your illness. “It could be a side effect of treatment,” McMinn says. “Maybe it’s a medication that needs to be adjusted.”