Palliative Care for Metastatic Prostate Cancer: Symptom Relief and Support

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By Staff
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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

Nausea and vomiting are common side effects of chemotherapy. To manage this symptom, you might first try lifestyle changes such as eating smaller meals, drinking more fluids, and avoiding foods that upset your stomach.

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

Not every man with metastatic prostate cancer will have pain. But when pain does occur, it’s often because the cancer has spread to the bones or is pressing on nerves.
Doctors often try to minimize the use of opioid pain relievers because of side effects like drowsiness and the potential for addiction. Instead, for advanced prostate cancer pain management, they may prescribe anti-inflammatory drugs like steroids or nonsteroidal anti-inflammatory drugs (NSAIDs). Bisphosphonates also reduce bone pain by slowing bone breakdown and preventing fractures.

For the type of shooting pain triggered by the tumor pressing on a nerve, drugs for nerve pain like gabapentin (Neurontin) or pregabalin (Lyrica) may be helpful. Muscle relaxants are good for easing muscle spasms. And lidocaine patches and creams or heating pads can be helpful for relaxing the muscles around the bone area.

Radiation

Radiation won’t cure metastatic prostate cancer, but it can shrink tumors enough to relieve bone pain. A type of radiation therapy called stereotactic body radiation therapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), aims a very precise beam of radiation at specific areas of bone that contain cancer.

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

Living with advanced prostate cancer is stressful. Deep breathing, progressive muscle relaxation, and guided imagery are just some of the relaxation methods that can help ease that stress. There’s evidence that these techniques can help ease symptoms and improve coping skills in cancer patients.

Surgery

In early-stage prostate cancer, the goal of surgery is to cure the cancer. In advanced prostate cancer, it’s more about symptom relief. A procedure called transurethral resection of the prostate (TURP) removes cancer that’s blocking the urethra and making it hard to urinate. Surgery is also done to fix a bone that cancer has weakened to the point of fracture.

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.

A review published in 2024 found one type of therapy called cognitive behavioral therapy (CBT) helpful for improving depression, anxiety, and quality of life in prostate cancer survivors. This treatment also improved participants’ sexual function, including their desire and sexual satisfaction.

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