Is prostate cancer painful at the end?

Pain. Many people worry about being in pain when they are dying. Some people do get pain if their prostate cancer presses on their nerves or makes their bones weak. But not everyone dying from prostate cancer has pain.

prostatecanceruk.org - What to expect | Prostate Cancer UK

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What will happen in the last few days?

It can help to know what is normal in the last few days of life so that you know what to expect. You might not be aware of these changes when they happen because you may be drowsy or unconscious. If you're supporting someone who is dying, read about what you can do to help and how you can get support.

Pain

Many people worry about being in pain when they are dying. Some people do get pain if their prostate cancer presses on their nerves or makes their bones weak. But not everyone dying from prostate cancer has pain. And if you are in pain, there are things that can help to reduce and manage pain. You should tell your doctor or nurse if you’re in pain or if your pain gets worse. They can talk with you about how best to manage your pain and can help keep it under control. You may find sitting or lying in some positions more comfortable than others, so ask if you need help getting into a different position. Your doctor can give you medicines to help manage pain. The type of medicines they give you will depend on what is causing the pain and which medicines are suitable. Your doctor will monitor how the pain medicines are working and may change the type of medicine or the dose. If you’re still in pain or get pain in between taking medicines, it’s important to tell your doctor or nurse. Your doctor may also prescribe medicines for you to take if your pain gets worse or you get new symptoms like feeling sick. This means these medicines are available if you need them quickly or during the night. You might hear this called “anticipatory drugs”, “anticipatory prescribing” or “just in case medicines”. If you find it hard to swallow tablets or liquids, your doctor or nurse can give you medicines in other ways, such as with a skin patch or an injection. They may also suggest using a syringe driver. A syringe driver is a small, battery-operated pump that will give you a continuous dose of pain-relieving medicine. Your medicines are put in a syringe, and the syringe driver pushes the medicines into your body through a needle, which is inserted under the skin on your arm, leg or tummy. Read more about ways to manage pain.

Sleeping and feeling drowsy

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Most people will sleep for long periods of time when they are dying. Some people may feel drowsy when they’re awake and others may become completely unconscious. This may only last a few hours, or it may continue for days. Even if you aren’t able to respond to people around you, you may be able to hear them talking. It can be reassuring to hear people talking calmly to you or to have someone holding your hand.

Not recognising people

Some people become confused and don’t recognise the people around them. They might see or hear things that are not actually there. This can be caused by sleepiness, changes in the body or medicines. This can be upsetting. It can help if you and your loved ones know that this could happen. And it can help to be in a peaceful environment.

Feeling restless or agitated

Some men feel restless or agitated. These feelings can be caused by many things. They might be caused by worries about what is happening, or your surroundings. They can also be caused by physical problems such as difficulty emptying your bowels (constipation) or problems urinating. Your doctor and nurse can look at things that could help. For example, they might make sure you are in a calm environment or answer any questions you have. They may give you medicines to help you feel less anxious or to manage physical problems.

Changes in skin temperature or colour

Some men’s hands and feet may feel cold for other people to touch. Their skin may become blotchy or blue. This can be caused by changes in their blood flow. It isn’t usually painful or uncomfortable.

Changes in breathing

Most men’s breath will become shallower and they might have longer pauses between breaths. This is because the body needs less oxygen. There might also be a slight groaning (rattling) noise when you breathe. Although this can sound distressing, it shouldn’t be uncomfortable. It might help for someone to change the position you’re in so that you’re lying on your side. And there are medicines that may help.

Loss of appetite

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Some men don’t feel like eating or drinking. And in the final stages, you won’t need any food or drink. If you’re not drinking, your mouth may feel dry. Getting someone to moisten your lips or mouth can make you feel more comfortable. Your doctor may also talk to you and your family about whether to use a drip to keep you hydrated.

Changes in urinating or bowel movements

Some men have fewer bowel movements and urinate less because they are eating and drinking less. Pain-relieving medicines can also cause constipation. Tell your doctor or nurse if you feel constipated. They may be able to give you medicines to help empty your bowels and make you more comfortable. Or they might suggest that you drink more water or eat different food. Some men lose control of their bladder or bowels. This is because the muscles in these areas relax. Nurses and other people looking after you can help to keep you clean and comfortable.

Feeling or being sick

Some men get nausea (feeling sick) or vomiting (being sick). This might be because of treatments, medicines or changes in your body. Your doctor or nurse may be able to give you medicines to help with the sickness. It is sometimes easier to have these medicines via an injection under the skin or via a syringe driver as it can be hard to swallow tablets when you feel sick.

Stopping medicines

Your doctor or nurse will review your medicines as you approach the end of your life. They will discuss with you if you wish to stop taking any medicines or look at other ways to give your medicines, such as injections or a syringe driver, if you have difficulty swallowing.

prostatecanceruk.org - What to expect | Prostate Cancer UK

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