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Advanced Prostate Cancer
Caregiving Team is Critical to a Man's Cancer Survival and Good Health
 Men play important roles in every society — as mentors, spouses, heads of households, grandfathers, fathers, sons, coaches, income earners and friends. So when they are diagnosed with prostate cancer in an advanced stage, it can affect a large number of people. For many men, however, it is a challenge for them to embrace being part of a caregiving team while maintaining their privacy.
“A cancer diagnosis is a personal thing, but survival is really a team effort. We men take pride in not getting sick, not missing a day of work — manning up,” said COL (Ret.) James E. Williams, Jr., principal, Williams and Associates, current Chairman, International Cancer Council, patient advocate, and 19-year prostate cancer survivor.
“What usually happens with men diagnosed with advanced prostate cancer is there is one scenario where they ‘suck it up’, communicate poorly, and may have the attitude that they are going to handle this on their own. A second scenario can involve the man regressing to where he only participates in his treatment by doing just what he is told. You have to find a balance because surviving cancer and living well is a team activity that needs to include at least the man, the caregiver and his physicians, and the patient is an important part of that team.”
When prostate cancer is diagnosed early, the statistics for five-year survival are overwhelmingly positive. The detection of advanced prostate cancer indicates that the cancer has spread beyond the prostate gland itself and either the cancer has grown, or the treated cancer has recurred. In either case, men are often disheartened, slow to believe the diagnosis, or even in denial.
Initially, a caregiver can be helpful by scheduling appointments, accompanying the man when he meets with his health care professional, taking notes and asking questions. Prostate cancer, even in the advanced stages, can be slow growing and a man can live in good health for years. Treatment options and their side effects, however, may require continued physical, emotional, and spiritual care.
“Cancer is a rude wake-up call to how vulnerable we all are. Never is this more acute than when metastatic or recurrent disease happens,” Phyddy Tacchi, RN, CNS, LMFT, LPC, Psychiatric Advanced Practice Nurse, MD Anderson Cancer Center, said.
“There is also a constellation of tasks that the caregiver may have to do. They have to look at the practical and emotional aspects of providing care for their patients, as well as managing the side effects of medicine and other attendant medical problems.”
Experts stress that healthy communication is a key factor to successfully navigating the tasks and decisions involved with advanced disease. Good communication can also aid in minimizing difficult emotions such as fear and frustration. Support groups are often good resources to enhance communication between a man living with advanced prostate cancer and his caregiver.
“One of the problems is that men, for the most part, do not have a connection or a liaison with the medical community until they are told they are sick, as when they have been diagnosed with prostate cancer,” COL Williams explained. “When a man is diagnosed with cancer, he just wants to be fixed up. That’s the way we are oriented. If it’s not an easy fix, fatalism can set in. On the other hand, there are 12 million Americans walking around who are cancer survivors, like myself. A positive caregiver can encourage that man and tell him that he can work through this.”
There is, however, a fine line for caregivers between being appropriately positive and becoming frantic. According to Ms. Tacchi, many caregivers falsely begin to operate under the belief that if they do enough, they can keep their loved one alive. The fever-pitched activity, or even caring for their loved one for a number of years, can become emotionally and physically exhausting. She said, “A caregiver does not have the power to keep their loved one alive, but rather a more realistic goal may be to keep their loved one comfortable. A confident caregiver is one who can identify, build and use their strengths in service to their loved one.”
Should the cancer continue to worsen and spread, COL Williams is a strong believer in the benefits of having hospice involved earlier, rather than later. “The introduction of hospice is a critical part of a peaceful transition at the end of life, and while it’s not unique to prostate cancer, most of us don’t ask for that type of support until the last few days. Hospice can be a very important support system for both the caregiver and the patient.”
Many cancer centers offer support groups or educational programs, and there are outstanding resources on the Internet.
Additional Sources of Information
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