Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

Prostate cancer: palliative care and pain relief

Prostate Cancer and Prostatic Diseases volume 7, pages 311–315 (2004)Cite this article

Abstract

Metastatic prostate cancer is incurable, and both the disease and other comorbidities as well as side effects from treatments can be very disabling for patients who are generally elderly. Past reviews on palliative care in prostate cancer have tended to concentrate on methods of active intervention with palliative intent rather than the principles of palliative care in a broader context. This paper is intended to introduce the principles and practice of modern palliative care as applied to care of patients with prostate cancer. Current National Institute for Clinical Excellence guidelines for urological cancers recommends provision of palliative care for all patients with prostate cancer, according to need. Palliative care aims to improve the quality of life of patients and their families. It is a holistic and personal approach to patient care, consisting of patient centred multiprofessional teams. Symptoms such as pain, psychological, spiritual and social problems are given equal weighting and tackled simultaneously. When treating pain, hormonal manipulation, radiotherapy, chemotherapy and surgery should always be considered alongside analgesic therapy, with realistic aims in mind. Towards the end of life, palliative care for patients will generally increase in line with increasing symptoms and other problems. Achieving a peaceful and comfortable death for our patients should be a priority in hospitals.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Office for National Statistics. Mortality Statistics—Cause, England and Wales, 1999. Stationary Office: London, 2000.

  2. Savage P, Waxman J . PSA and prostate cancer diagnosis. Eur J Cancer 1996; 32 A: 1097–1099.

    Article  Google Scholar 

  3. Newling DW . The palliative therapy of advanced prostate cancer, with particular reference to the results of recent European clinical trials. Br J Urol 1997; 79 (Suppl 1): 72–81.

    Article  Google Scholar 

  4. Kemp C . Metastatic spread and common symptoms. Part six: advanced cancer of the pancreas, prostate, stomach, and uterus. Am J Hosp Palliat Care 1999; 16: 673–681.

    Article  CAS  Google Scholar 

  5. Gleave ME, Bruchovsky N, Moore MJ, Venner P . Prostate cancer: 9. Treatment of advanced disease. CMAJ 1999; 160: 225–232.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. National Institiute for Clinical Excellence. Improving Outcomes in Urological Cancers Manual. NICE: UK, 2002.

  7. Twycross R . Introducing Palliative Care, 2nd Edn. Radcliff Medical Press: Oxford and New York, 1997; 2pp.

    Google Scholar 

  8. Fallon M, O'Neill B . Principles of palliative care and pain control. In: ABC of Palliative Care. BMJ Books: UK, 1998, pp. 1–4.

    Google Scholar 

  9. MacDonald N . Palliative care—an essential component of cancer control. CMAJ 1998; 158: 1709–1716.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Seely JF, Mount BM . Palliative medicine and modern technology. CMAJ 1999; 161: 1120–1121.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Pienta KJ, Esper PS . The Hospice Supportive Care Programme: a New “Transition-less” Model of Palliative Care for patients with incurable prostate cancer. J Natl Cancer Inst 1996; 88: 55.

    Article  CAS  Google Scholar 

  12. Meyers FJ, Linder J . Simultaneous care: disease treatment and palliative care throughout illness. JCO 2003; 21: 1412–1415.

    Article  Google Scholar 

  13. National Institute for Clinical Excellence. Improving Supportive and Palliative Care for Adults with Cancer—The Manual. NICE: UK, 2004.

  14. Rabow MW, Hauser JM, Adams JRN . Supporting family care givers at the end of life: ‘They Don't Know What They Don't Know’. JAMA 2004; 291: 483–491.

    Article  CAS  Google Scholar 

  15. Green JS . An investigation into the use of palliative care services by patients with prostate cancer. Am J Hosp Palliat Care 2002; 19: 259–262.

    Article  Google Scholar 

  16. Smith JA, Soloway MS, Young MJ . Complications of advanced prostate cancer. Urology 1999; 54: 8–14.

    Article  Google Scholar 

  17. Crawford DE, Rosenblum M, Ziada AM, Lange PH . Overview: hormone refractory prostate cancer. Urology 1999; 54: 1–7.

    Article  CAS  Google Scholar 

  18. Twycross R, Wilcock A . Symptom Management in Advanced Cancer, 3rd edn. Radcliff Medical Press: Oxford, UK, 2001; 18pp.

    Google Scholar 

  19. Ashby MA, Kissane DW, Beadle GF, Rodger A . Psychosocial support, treatment of metastatic disease and palliative care. MJA 1996; 164: 43–49.

    CAS  PubMed  Google Scholar 

  20. Cleeland. et al. Pain and its treatment in outpatients with metastatic disease. N Engl J Med 1994; 330: 592–596.

    Article  CAS  Google Scholar 

  21. Larue. et al. Multicentre study of cancer pain and its treatment in France. BMJ 1995; 310: 1034–1037.

    Article  CAS  Google Scholar 

  22. Zenz. et al. Severe under treatment of cancer pain: a 3 year survey of the German situation. JPSM 1995; 10: 187–191.

    CAS  Google Scholar 

  23. Hanks GW et al. Morphine and alternative opioids in cancer pain: the EAPC recommendations. Br J Cancer 2001; 84: 587–593.

    Article  CAS  Google Scholar 

  24. Iscoe NA, Bruera E, Choo RC . Prostate cancer: 10. Palliative care. Can Med Assoc J 1999; 160: 365–371.

    CAS  Google Scholar 

  25. Davis CL, Hardy JR . Current issues in cancer palliative care. BMJ 1994; 308: 1359–1362.

    Article  CAS  Google Scholar 

  26. Haut MJ et al. Progressing prostate carcinoma. Oncol 2001; 6: 183–196.

    CAS  Google Scholar 

  27. Farrugia D et al. Stilboestrol plus adrenal suppression as salvage treatment for patients failing treatment with luteinizing hormone-releasing hormone analogues and orchidectomy. Br J Urol Int 2000; 85: 1069–1073.

    Article  CAS  Google Scholar 

  28. Harland SJ et al. Hydrocortisone and stilboestrol in combination for castration-relapsed prostate cancer. Abstract ASCO 1251 1998.

  29. Hardy J, et al. A prospective survey of the use of dexamethasone on a palliative care unit. Pall Med 2001; 15: 3–8.

    Article  CAS  Google Scholar 

  30. Periera J, Hanson J, Bruera E . The frequency and clinical course of cognitive impairment in patients with terminal cancer. Cancer 1997; 79: 835–842.

    Article  Google Scholar 

  31. Ellershaw J et al. Care of the dying: setting standards for symptom control in the last 48 hours of life. JPSM 2001; 21: 12–17.

    CAS  Google Scholar 

  32. Mills M, Davies HTO, Macrae WA . Care of dying patients in hospital. BMJ 1994; 3309: 583–586.

    Article  Google Scholar 

  33. Smith R . Death, come closer, editor's choice. BMJ 2003; 327: 169.

    Article  Google Scholar 

  34. Ellershaw J, Ward C . Care of the dying patient: the last hours or days of life. BMJ 2003; 326: 30–34.

    Article  Google Scholar 

  35. Adam J . ABC of palliative care: the last 48 hours. BMJ 1997; 315: 1600–1603.

    Article  CAS  Google Scholar 

  36. Glare P et al. A systematic review of physicans' survival predictions in terminally ill cancer patients. BMJ 2003; 327: 1048–1049.

    Article  Google Scholar 

  37. Meier DE, Morrison RS, Cassel CK . Improving palliative care. Ann Int Med 1997; 127: 225–230.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Palliative Medicine, Barts and the London NHS Trust, London

    E Kaya & D Feuer

  2. Homerton University Hospital NHS Foundation Trust, London

    D Feuer

Authors
  1. E Kaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D Feuer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D Feuer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kaya, E., Feuer, D. Prostate cancer: palliative care and pain relief. Prostate Cancer Prostatic Dis 7, 311–315 (2004). https://doi.org/10.1038/sj.pcan.4500747

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.pcan.4500747

Keywords

Search

Advanced search

Quick links