The prostate gland is situated at the neck of the bladder. It resides within a capsule and surrounds the urethra, which carries urine from the bladder.
Cancerous changes within the prostate are very common with increasing age. Most cases involve only a small part of the gland and many do not cause any ill effects. However, if the tumour grows beyond the capsule, it can spread to other sites in the body. Secondary spread to the bones is particularly common.
Prostate cancers which have spread are treated in two ways. Radiotherapy is directed both to the prostate and to the painful areas of spread in the bones.
The second form of treatment is based on the fact that most prostate cancers require the male hormone testosterone for their continued growth. Since testosterone is mainly produced by the testicles, operative removal of the testicles is one option. A similar result can be achieved by "turning off" the production of testosterone using hormone injections given on a monthly basis.
The side-effects of treatment can be unpleasant. Sexual libido is reduced. Weight gain is common and hot flushes similar to menopause symptoms may occur. Radiotherapy can cause intestinal inflammation resulting in diarrhoea.
All forms of cancer cause the affected person to tire easily. Anaemia is common in patients with cancer, which can significantly reduce energy levels and make breathing difficult.
Pain is inevitable once secondary spread has occurred. This will commonly be in the back, the ribs and the thigh bone. It is treated with localised radiotherapy and with painkillers. Treatment with non-steroidal anti-inflammatory drugs is especially effective at reducing bone pain. However, most people will require treatment with morphine, usually in the form of a twice daily sustained release preparation.
Pain itself can cause a reduction in concentration and it inevitably affects mood. Morphine can cause intermittent confusion which could affect clarity of thought. Other side-effects include nausea and constipation.
Predicting survival time in terminal cancer is fraught with difficulty. It is not just a function of the disease itself but is influenced by the individual's will to live. However, stress will inevitably shorten both the quality and duration of the sufferer's life.
Most studies predict a median survival of 18 to 24 months in patients who present with secondary spread of prostate cancer.