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Dad's excruciating pain

User
Posted 22 Mar 2023 at 15:52

Hi everyone, this is my first post here and I'm new to the group (F, 27).

Last year (June) my Dad (67) was diagnosed suddenly with advanced prostate cancer, following an onset of pain in his hip and pelvis. Upon multiple scans and tests, it was found to have spread to the bones and lymph nodes. He was given what I now know to be the standard diagnosis of around 2-5 years.

He continued with hormone therapy and radiotherapy, but by November he was told treatment was no longer working. Then December came around and the consultant looked at his disease progression and said the prognosis was now due to be 3-6 months.

Up until two weeks ago, despite a decrease in mobility and gradual increase in pain, my Dad was still managing to enjoy the daily habits of life. However, the sudden onset of a few days of excruciating pain in the night led my Dad into our nearby hospice for "pain management" - basically to try and get on top of the pain he is feeling. It has been the most horrific thing to witness.

However, the problem is that he's been in the hospice for 2 weeks now (we thought it would be a few days), and they have been unable to get on top of the pain. Nothing seems to be working, and there is no light at the end of the tunnel. We have no idea now when he'll be able to come back out again, and it is getting pretty desperate for my Dad, who is a very active, sociable and independent person but one that has no idea what is going to happen to him.

Does anyone have experience with this stage of advanced metastatic prostate cancer? It is so difficult because while the focus is on the pain, we have no idea where the disease itself is actually at. He doesn't appear to have started the "dying" process at all, yet the pain is just excruciating. I don't feel misled - just confused, as the hospice said he would be going in until the pain is under control and then he could go back to a normal life, but now I'm worrying that he won't come out again or ever be the same. It is so hard.

Any advice or support would be appreciated. X

Edited by member 23 Mar 2023 at 17:27  | Reason: Not specified

User
Posted 24 Jul 2024 at 13:20

Hi all, I was sat thinking about my Dad and suddenly remembered this thread. Many don't feel able to post an update of what happened next and so thought I would do so.

My Dad passed away on the 29 April 2023, so only a month after I wrote this post. 

It's strange - looking back I realise things happened quite quickly, but at the time it felt like months. 

Without doubt, the pain was the most difficult part of Dad's end of life. Nights were the worst for him. What helped? Normality, chats over cups of tea, friendly faces, puzzle books, gentle massage, music, singing, humour. I didn't hide my tears, but I also didn't focus on them, just let them sit alongside us.

In the four weeks in-between this post and my Dad passing away, his mobility declined and he became visibly more frail. He was still eating, but he became more and more tired. He would hallucinate. It became clear he wouldn't be able to go home again and that he didn't have long left. He was aware of this, and we spoke about it. 

In the end, we were told by palliative nurses that the intense pain that he was experiencing was not only due to the way the cancer had spread across his body, but heightened by his emotional resistance. He really did not want to leave us. 

To help with this, we spoke openly about his passing, about life afterwards and how we would remember him, how we'd be ok, and to give permission for him to leave us. What's strange (and incredible really) is that despite the disease continuing to spread, once he'd moved to a better place of emotional acceptance his pain actually decreased. He wasn't aware that his medication and pain relief was decreased too.

Speaking to Dad about his death has undeniably helped me since his passing. We are not taught or told how to do this, or how hard these conversations will be. But I would encourage everyone on a similar path to start the journey of grieving together while your loved one is still with you. While nothing can bring back a bear hug from my Dad, the conversations we shared helped some way with the inner peace and acceptance afterwards.

Sending love to everyone reading this or affected in some way. Big hugs xxx

PS. On palliative RT - thanks so much for the advice. Dad did have this a few months before he went into the hospice, on the largest tumour on his spine, which did help for some time. It was not something that was then possible in the hospice.

Edited by member 24 Jul 2024 at 13:47  | Reason: Additional info

User
Posted 23 Mar 2023 at 17:21

Has anyone mentioned palliative RT? Again I have no experience of this, but some people have had RT on a tumour pressing on a nerve, to shrink that tumour and give relief. The consultant might not be aware of how much pain your dad is in so hasn't thought this a priority, the hospice may think it is not their responsibility to request it.

It is quite possible palliative RT has been looked at and rejected for some medical reason, but it is worth asking questions.

Palliative RT is not curative and may only last a limited time.

Dave

User
Posted 22 Mar 2023 at 15:52

Hi everyone, this is my first post here and I'm new to the group (F, 27).

Last year (June) my Dad (67) was diagnosed suddenly with advanced prostate cancer, following an onset of pain in his hip and pelvis. Upon multiple scans and tests, it was found to have spread to the bones and lymph nodes. He was given what I now know to be the standard diagnosis of around 2-5 years.

He continued with hormone therapy and radiotherapy, but by November he was told treatment was no longer working. Then December came around and the consultant looked at his disease progression and said the prognosis was now due to be 3-6 months.

Up until two weeks ago, despite a decrease in mobility and gradual increase in pain, my Dad was still managing to enjoy the daily habits of life. However, the sudden onset of a few days of excruciating pain in the night led my Dad into our nearby hospice for "pain management" - basically to try and get on top of the pain he is feeling. It has been the most horrific thing to witness.

However, the problem is that he's been in the hospice for 2 weeks now (we thought it would be a few days), and they have been unable to get on top of the pain. Nothing seems to be working, and there is no light at the end of the tunnel. We have no idea now when he'll be able to come back out again, and it is getting pretty desperate for my Dad, who is a very active, sociable and independent person but one that has no idea what is going to happen to him.

Does anyone have experience with this stage of advanced metastatic prostate cancer? It is so difficult because while the focus is on the pain, we have no idea where the disease itself is actually at. He doesn't appear to have started the "dying" process at all, yet the pain is just excruciating. I don't feel misled - just confused, as the hospice said he would be going in until the pain is under control and then he could go back to a normal life, but now I'm worrying that he won't come out again or ever be the same. It is so hard.

Any advice or support would be appreciated. X

Edited by member 23 Mar 2023 at 17:27  | Reason: Not specified

User
Posted 22 Mar 2023 at 17:20

Really sorry you find yourself here. I have no direct experience of this situation, sadly we have many members who have died, quite often it is the wives and daughters who are posting to get answers. In the two years I have been on this forum I have not heard of anyone for whom they could not get the pain under control.

There are a number of people who are resistant to morphine, but there are plenty of other drugs to try.

Hopefully one of the more experienced members will be more helpful than I can be.

Dave

User
Posted 22 Mar 2023 at 17:53
Sadly, men do not actually die of prostate cancer; they either die of organ failure (e.g. due to the mets or lymphodema), dehydration (they become too ill to eat or drink), infection (e.g. pneumonia) or as a result of the large amounts of pain relief. Some men slip away gently but for many it is a complete loss of mobility followed by a very painful, drawn out death. The problem is getting the balance right - enough morphine to kill the pain without putting the person into a state of constant unconsciousness. The hospice is the best place for finding this difficult balance.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 23 Mar 2023 at 14:52

Thanks both for your replies. Although it is difficult to hear, it is also helpful to know what to expect.

Unfortunately due to where the cancer is and how it has spread, Dad is experiencing extreme amounts of bone and neuropathic pain from his tumours pressing against the nerves, which is notoriously difficult to manage. However, the hospice have said it is unusual for them to have this much difficulty.  

He is still able to get up and about with a zimmerframe, chat normally, eat normally and we even sang together in the hospice yesterday (they gave him a keyboard to play) it's just that the pain fluctuates extremely. They are trying to get the balance of pain-relief drugs right - that will help him to cope with this pain but that also does not leave him in a 24/7 heavily sedated state and that will allow him to leave the hospice and be managed from home.

So here we find ourselves in the same position each day, hoping that some new drug or combination of drugs will be our answer and that he can finally go home. Yesterday my visit was a lot lighter and full of laughter, whereas the day before he was screaming out in pain. We will just keep muddling through and making the most of each day and the moments we have together.

I will keep updating this thread, in case useful for others too. 

Edited by member 23 Mar 2023 at 14:53  | Reason: Not specified

User
Posted 27 Aug 2024 at 06:59

Dear Ally thank for for your post 12 months after your dad died, it was so helpful for me you telling about your dads last days at the hospice, how supportive you were and accepting of his death, you were very brave.

My husband diagnosed in 2008, we are both 80 years old now, he is experiencing severe pain from widespread bone metastases, he is under the care of our local hospice home care team.

The pain is getting worse even though increased medication now Butec 15 weekly patches + Oxynorm solution which he can take up to 8 times a day, but doesn’t and the recent introduction of Amitriptyline at bedtime, which initially wiped him out. Limits the use of opioids because of the side effects, he is becoming more fragile needing help with personal care, decreased mobility and we both worry about him falling, necessary use of aids, fatigue, constipation, dry mouth, lack of appetite;  have an appointment on the 28th August 2024 with the doctor at the hospice following up the pain medication which is limited because takes Warfarin and a review, kept a daily diary.

Since Radiotherapy in 2019 has suffered rectal Proctitis so with discussion with colorectal team haven’t rushed to have further radiotherapy, but the pain is so severe decided to go ahead as it’s reported is very effective for bone pain and he doesn’t want to take more opioids.

Had an appointment a week ago with Oncologist team, agreed to do a single fraction radiotherapy, full bloods done, CT Scan booked but there is a months waiting and a further month for results, do you have to have a CT scan before you can have radiotherapy.

Love and best wishes to all you men and their families who are fighting this devastating disease, Jan

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User
Posted 22 Mar 2023 at 17:20

Really sorry you find yourself here. I have no direct experience of this situation, sadly we have many members who have died, quite often it is the wives and daughters who are posting to get answers. In the two years I have been on this forum I have not heard of anyone for whom they could not get the pain under control.

There are a number of people who are resistant to morphine, but there are plenty of other drugs to try.

Hopefully one of the more experienced members will be more helpful than I can be.

Dave

User
Posted 22 Mar 2023 at 17:53
Sadly, men do not actually die of prostate cancer; they either die of organ failure (e.g. due to the mets or lymphodema), dehydration (they become too ill to eat or drink), infection (e.g. pneumonia) or as a result of the large amounts of pain relief. Some men slip away gently but for many it is a complete loss of mobility followed by a very painful, drawn out death. The problem is getting the balance right - enough morphine to kill the pain without putting the person into a state of constant unconsciousness. The hospice is the best place for finding this difficult balance.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 23 Mar 2023 at 14:52

Thanks both for your replies. Although it is difficult to hear, it is also helpful to know what to expect.

Unfortunately due to where the cancer is and how it has spread, Dad is experiencing extreme amounts of bone and neuropathic pain from his tumours pressing against the nerves, which is notoriously difficult to manage. However, the hospice have said it is unusual for them to have this much difficulty.  

He is still able to get up and about with a zimmerframe, chat normally, eat normally and we even sang together in the hospice yesterday (they gave him a keyboard to play) it's just that the pain fluctuates extremely. They are trying to get the balance of pain-relief drugs right - that will help him to cope with this pain but that also does not leave him in a 24/7 heavily sedated state and that will allow him to leave the hospice and be managed from home.

So here we find ourselves in the same position each day, hoping that some new drug or combination of drugs will be our answer and that he can finally go home. Yesterday my visit was a lot lighter and full of laughter, whereas the day before he was screaming out in pain. We will just keep muddling through and making the most of each day and the moments we have together.

I will keep updating this thread, in case useful for others too. 

Edited by member 23 Mar 2023 at 14:53  | Reason: Not specified

User
Posted 23 Mar 2023 at 17:21

Has anyone mentioned palliative RT? Again I have no experience of this, but some people have had RT on a tumour pressing on a nerve, to shrink that tumour and give relief. The consultant might not be aware of how much pain your dad is in so hasn't thought this a priority, the hospice may think it is not their responsibility to request it.

It is quite possible palliative RT has been looked at and rejected for some medical reason, but it is worth asking questions.

Palliative RT is not curative and may only last a limited time.

Dave

User
Posted 23 Mar 2023 at 18:13

I‘m sorry I can’t help with any advice Ally but just wanted to say how sorry I am to hear about your dads situation. I really hope they can get his pain under control and that you can make the most of spending quality time together. 

Very best wishes 

Elaine x

User
Posted 27 Mar 2023 at 21:25

Hi there, so very sorry that you find yourself here and that your dad is struggling so much with pain. 

i lost my dad back in September and check in every now and then just to see what’s happening out there. It sounds silly but in some ways it helps me feel closer to him. 

I wondered about palliative radiotherapy too. My dad had a session for pain about a year before he died and it worked incredibly well. I would say it’s definitely worth a conversation with your dad’s consultant - there may be a reason it’s not an option but, from what we were told, this sounds like the exact type of pain it was intended for. 

Sending love and hugs xxx

User
Posted 24 Jul 2024 at 13:20

Hi all, I was sat thinking about my Dad and suddenly remembered this thread. Many don't feel able to post an update of what happened next and so thought I would do so.

My Dad passed away on the 29 April 2023, so only a month after I wrote this post. 

It's strange - looking back I realise things happened quite quickly, but at the time it felt like months. 

Without doubt, the pain was the most difficult part of Dad's end of life. Nights were the worst for him. What helped? Normality, chats over cups of tea, friendly faces, puzzle books, gentle massage, music, singing, humour. I didn't hide my tears, but I also didn't focus on them, just let them sit alongside us.

In the four weeks in-between this post and my Dad passing away, his mobility declined and he became visibly more frail. He was still eating, but he became more and more tired. He would hallucinate. It became clear he wouldn't be able to go home again and that he didn't have long left. He was aware of this, and we spoke about it. 

In the end, we were told by palliative nurses that the intense pain that he was experiencing was not only due to the way the cancer had spread across his body, but heightened by his emotional resistance. He really did not want to leave us. 

To help with this, we spoke openly about his passing, about life afterwards and how we would remember him, how we'd be ok, and to give permission for him to leave us. What's strange (and incredible really) is that despite the disease continuing to spread, once he'd moved to a better place of emotional acceptance his pain actually decreased. He wasn't aware that his medication and pain relief was decreased too.

Speaking to Dad about his death has undeniably helped me since his passing. We are not taught or told how to do this, or how hard these conversations will be. But I would encourage everyone on a similar path to start the journey of grieving together while your loved one is still with you. While nothing can bring back a bear hug from my Dad, the conversations we shared helped some way with the inner peace and acceptance afterwards.

Sending love to everyone reading this or affected in some way. Big hugs xxx

PS. On palliative RT - thanks so much for the advice. Dad did have this a few months before he went into the hospice, on the largest tumour on his spine, which did help for some time. It was not something that was then possible in the hospice.

Edited by member 24 Jul 2024 at 13:47  | Reason: Additional info

User
Posted 25 Jul 2024 at 07:23

Hi Ally,

Im so sorry to hear about your dad, please accept my sincerest condolences. How brave of you to come on here and give us an update, your post really moved me.
I wish you and your family all the best for the future.

Derek

User
Posted 25 Jul 2024 at 19:50

AllyM95,

I'm so sorry to hear of your Dad's passing, and thank you for taking the time to update us.  It sounds like you had a very special relationship with your Dad and I hope that closeness will ease some of your pain at his passing.

Best wishes,

JedSee.

User
Posted 27 Aug 2024 at 06:59

Dear Ally thank for for your post 12 months after your dad died, it was so helpful for me you telling about your dads last days at the hospice, how supportive you were and accepting of his death, you were very brave.

My husband diagnosed in 2008, we are both 80 years old now, he is experiencing severe pain from widespread bone metastases, he is under the care of our local hospice home care team.

The pain is getting worse even though increased medication now Butec 15 weekly patches + Oxynorm solution which he can take up to 8 times a day, but doesn’t and the recent introduction of Amitriptyline at bedtime, which initially wiped him out. Limits the use of opioids because of the side effects, he is becoming more fragile needing help with personal care, decreased mobility and we both worry about him falling, necessary use of aids, fatigue, constipation, dry mouth, lack of appetite;  have an appointment on the 28th August 2024 with the doctor at the hospice following up the pain medication which is limited because takes Warfarin and a review, kept a daily diary.

Since Radiotherapy in 2019 has suffered rectal Proctitis so with discussion with colorectal team haven’t rushed to have further radiotherapy, but the pain is so severe decided to go ahead as it’s reported is very effective for bone pain and he doesn’t want to take more opioids.

Had an appointment a week ago with Oncologist team, agreed to do a single fraction radiotherapy, full bloods done, CT Scan booked but there is a months waiting and a further month for results, do you have to have a CT scan before you can have radiotherapy.

Love and best wishes to all you men and their families who are fighting this devastating disease, Jan

User
Posted 13 Sep 2024 at 16:07

Jan, I'm so sorry to hear about your husband and the pain he has been experiencing. My Dad also had widespread bone metastases and I know how difficult the pain is to manage - for both your husband and for you to see him suffering. 

It sounds like it has been a journey for you both over the last 16 years since your husband's initial diagnosis. I know the constant cycle of appointments and medication seems never-ending and the decision-making can be exhausting. I hope you've had support around you and a great team of carers to take some of the weight off. 

Thinking of you and your family and wishing for peaceful times ahead for you all.

User
Posted 14 Sep 2024 at 19:54

Ally,

I'm so very sorry to hear of your Dad's passing.  I hope that you have all the support from family and friends that you need.

Best wishes,

JedSee.

User
Posted 15 Sep 2024 at 15:56

Thank Ally for your reply and your empathy and understanding, your  Dad, You and Your Family have been through it, so you know 

To all members:

When Tony was diagnosed we were looking forward to retirement and as Ally says the 16 years has been taken up with treatments and hospital appointments, heartache at times and much anxiety, but we worked until we were 71 years old and travelled the world in spite of Prostate Cancer, until Radiotherapy and COVID, we haven’t let it beat us until completely until now.

The treatments did change Tony physically, he has lost 5” in height, lack of energy, fatigue and mentally the anxiety waiting for the next PSA or test result, but in spite of this Tony kept a positive attitude and kept his humour treasuring each day as it came.

Speaking to our GP on the phone last week, loud speaker on so we could both hear & speak, we both laughed and  I said it a good job we can still laugh after sitting in a chair for 17 hours in the Acute Medical Assessment waiting for treatment as no beds available the GP said it’s because you are resilient, PC sufferers have to be resilient to  battle this disease.

The GP has stopped Warfarin, aware of the risks, but seemed right decision because of rectal bleeding from proctitis the side effect of Radiotherapy 2019. This might have be avoided if a rectal shield was use, but not used because of cost. Short sighted, would have avoided the cost of managing Proctitis, appointments and tests with colorectal and  gastroenterology teams, blood transfusion for Low Hb and mostly Tony’s poor QOL since 2019, which received very little attention until now and too late.

Found and article that if a PET Scan is done before R223 it would show who would NOT benefit. We should have been told this before starting treatment. I asked the consultant when they stopped treatment because of met progression and pain which he hardly had before, why this wasn’t done said the hospital doesn’t do PET Scans, presume because of cost.

Had a CT scan on Tuesday and NM Bone Scan on the 17th with a hope that Single Fraction Radiotherapy might be appropriate for pain management as Oxynorm has the side effects, of hallucinations and panic attacks.

Since having the CT Scan on Tuesday which was very painful getting on and off the scanner the pain has moved from his back to his chest. The chest pain is far more painful than the back pain and debilitating, concern about the stairs, stopping in bed, waiting for appointment with the Consultant at the Hospice to review pain treatment.

Hope that research will find a cure, but Men in the meantime need to take action, shout for routine checks the same as women have, so this cruel disease is managed, receive early diagnosis which disease can be cured and if not ongoing treatment scans and investigation giving patient choice of all available treatments which are not decided on funding.

 
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