Prostate Cancer Canada Network

In The News

Well-Done Meat Consumption May Increase Prostate Cancer Risk
Research into the dietary habits of about a thousand men from the Cleveland area has found that a high consumption of meats, especially of red meat prepared by grilling, is positively associated with an increased risk of developing aggressive prostate cancer. This particular study, which was led by Dr. John Witte of the University of California, San Francisco (UCSF), has a number of limitations, but it does add support to other investigations connecting meat consumption with cancer risk.

Toronto researchers speculate regarding a link between prostate cancer and oral contraceptive use
Very preliminary and speculative research, designed to spark further inquires, suggests that there may be a connection between oral contraceptive use and rising rates of prostate cancer. One theory is that the widespread use of birth-control pills in various populations may result in a higher level of estrogen in the environment, which might, in turn, increase prostate cancer risk.

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Palliative Therapies

The main aim of palliative therapies is to alleviate the symptoms of a disease, symptoms such as pain, nausea, or anxiety. In other words, palliative therapies are not designed to cure prostate cancer or even to slow cancer growth-they are therapies that make you more comfortable.

These therapies can be used at any time during your treatment, but they become ever more important to men who have not been cured and whose prostate cancer has spread to parts of the body that are essential for life. These men are said to be in "palliative care" because the medical profession, having used all approved curative treatments available and likely to be effective, now turns its attention to therapies that cannot cure but that alleviate pain and improve a man's quality of life. Many treatments that kill cancer cells or slow cancer growth are used in both the curative and palliative phases of illness (e.g., external beam radiation). And systemic or system-wide treatments for prostate cancer, such as hormone therapy or chemotherapy, are discussed elsewhere in this website, although both are used as palliative therapies.

PALLIATIVE RADIATION THERAPY
Radiotherapy is a mainstay of palliative care for men with metastatic prostate cancer. It is used most often to relieve the pain caused by metastases to the bone, but it can also relieve the symptoms caused by the growth of prostate cancer in the area surrounding the prostate. Also, if cancer causes spinal compression, swelling of the legs or of affected lymph nodes, or back pain, palliative radiation might be considered.

Physicians use both external beam radiation and radiation therapy involving radioactive isotopes to relieve the bone pain caused by metastatic prostate cancer. This second therapy, which is not used outside of palliative situations, involves the injection of radioactive material that attaches to a bone. Once in place, this material emits radiation that kills some of the cancer in the bone, which relieves a man's pain. This therapy is sometimes called radionuclide therapy or radiopharmaceutical therapy.

OTHER METHODS OF PAIN CONTROL
Of course, other drugs are used to control pain. These range from standard analgesics, such as acetaminophen with codeine, to opioid analgesics (e.g., morphine). Bisphosphonates are also often prescribed to relieve bone pain. These are usually administered intravenously (through the vein) or subcutaneously (under the skin). Depending on the site of metastases, men may need medication for "neuropathic" pain. (A light touch may cause discomfort to men affected by "neuropathic" pain, which is caused by damage to the nerves.) Steroids (e.g., prednisone and dexamethasone) and other anti-inflammatory drugs are also frequently prescribed.

It is important that men seek out support early in the palliative phase of their illness. A good palliative care team can help you remain comfortable, without the unpleasant side effects of overmedication, for as long as possible. And support at home or in a hospice setting can assist you in following the various medication schedules designed to keep you pain free and comfortable.

TREATING GASTROINTESTINAL SYMPTOMS
Prostate cancer that has metastasized can affect the digestive system too. Some men experience severe anorexia, which is often treated with megestrol acetate. Chronic nausea and constipation can also be problems. Most men with advanced prostate cancer need laxatives, either because of the progress of their disease or because pain medication is causing constipation. Bowel movements should be monitored, and men should watch for urinary retention as well.

SUPPORT FOR YOU
Currently, a man in the palliative phase of his illness can find support in many places. Most hospitals have palliative care teams that include doctors, nurses, psychologists, social workers, pastors or other spiritual counsellors, various therapists (physical, art, music, movement), and bereavement counsellors, not to mention volunteers. And hospice services are available throughout Canada. (For further information, consult the Canadian Hospice Palliative Care Association's Directory of Hospice Palliative Care Services, which provides a list of hospice services by name, province, or medical condition). There are also numerous national, provincial, and local organizations that can help, from informal groups of doctors interested in palliative care to the Canadian Cancer Society. And finally, your local prostate cancer support group can put you and your family in touch with people who have personal experience of prostate cancer. Many become dedicated to helping men with advanced prostate cancer after someone whom they love-a husband, father, or brother-uses his palliative care period to leave a legacy of meaningfulness, courage, and grace.

To find a local support group, move your pointer over the “Support Group” button and then over “Find a Group Near You,” and click on the appropriate Canadian region.

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