Emotional side effects of treatment for prostate cancer

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Hi,

My dad was diagnosed with metastatic prostate cancer (Gleason 9) about 2 months ago. 
He’s been receiving hormone treatment since June and is also on medication to prevent osteoporosis. Tomorrow he is due to commence enzalutamide. 

My dad has been having mood swings and emotional meltdowns at home. We don’t see this but my mum reports he can appear heightened and tearful. My dad hasn’t opened up about how he is feeling and isn’t wanting to access emotional support through forums and groups. 

He has been advised to engage in 150mins of cardio activity per week and strengthening exercises to prevent loss of muscle mass. However, he seems completely demotivated and isn’t really doing any of this. I’ve been gently encouraging ideas to him, hoping he might take something on board, but he isn’t. I don’t want to overwhelm or put pressure on him, but I also don’t want him to neglect himself.

I wonder if he feels the joy has been taken out of his life. He had a serious injury at work resulting hearing loss which impaired his quality of life and he was forced to retire - and now his cancer diagnosis feels an even bigger struggle. 

I wonder how to support my dad when he is struggling emotionally behind closed doors but not opening up. Also, how to try and gently encourage him to engage in healthier living habits such as exercise when he is clearly feeling demotivated and experiencing low mood? His only real interest is playing golf but that’s slowing down now that the winter is coming in. He doesnt do anything during the day except sit on the sofa, watch sport or sleep… 

Please can you signpost me to any tools or services (but not support groups as he doesn’t want this) where he can access support for his mental health and overall wellbeing?

He has unpleasant side effects from the drugs which impacts on his ability to sleep, eat, rest. He also has diverticulitis which is very uncomfortable for him. I worry that with the addition of enzalutamide commencing too he might find it harder to cope with any more adverse effects.

The oncologist told my dad to maintain a positive outlook but I fear he isn’t and I don’t want him to go down a slippery slope. How can we support without pushing him, but ultimately want to make sure he’s giving himself the best chance of peace, relaxation, fulfilment and general wellbeing. 

Many thanks. 

  • Dear Happycats25c6ea5b

    Thanks for getting in touch with us and welcome to our online community. I hope you find it a helpful and a supportive way to communicate with others. My name is Joanne and I’m one of the Cancer Information Nurse Specialist’s on the  Macmillan Support Line.

    I’m sorry to hear about your dad’s recent diagnosis of metastatic prostate cancer. Receiving any cancer diagnosis can be challenging, but more so if your cancer is advanced. Your dad is not alone in feeling the way he is and although it may seem like a long time, 2 months is still very early days to process such a life changing diagnosis.

    We understand that he isn’t ready to reach out to support groups or forums but that does increase his risk of becoming isolated. It’s good that you are able to see this and can gently encourage him to remain engaged in day-to-day activities.

    His mood swings and emotional meltdowns are probably a combination of his emotions and the effect of his hormone therapy. It may be wise to encourage your dad to talk to his specialist team about how he is feeling as there may be things they can do to help. Sometimes it can be easier, with his permission, for a family member to start this conversation. You mention he is having side effects from the hormone therapy, and you are concerned about adding Enzalutamide. This is a valid concern, and he should talk to his specialist team so they can assess the best options for him.

    If your dad is struggling with motivation 150 minutes of cardio activity can feel overwhelming. Maybe encourage him to break this down into more manageable pieces, for example, thirty minutes a day broken down into three ten minutes bursts. A brisk walk is enough and would give him a starting point to build on. Sometimes having a purpose to the walk can be motivating, going to a destination for example.

    It is a little concerning that he is spending his days sitting or sleeping. These are classic symptoms of depression. If this continues, he may need to see his GP. It can be hard in these circumstances if he refuses, but you may need to be firm.

    There are numerous websites that you could look at that help with mental health and wellbeing, Anxiety UK, Mind and Every Mind Matters all have information on managing mental health. Penny Brohn is a UK charity whose focus is on wellbeing after a cancer diagnosis.

    It’s great that you are able to support your dad but it can be very difficult caring for someone with cancer and it is important to look after yourself too. You may find our friends and family forum helpful.

    If there is anything else we can help you with please, feel free to get back in touch.

     

    Best wishes

    Joanne, Cancer Information Nurse Specialist

     

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.

     

    Ref/ JF/KE