Prostate cancer – questions and answers

Proven content

Find answers to frequently asked questions about prostate cancer.

It is a substance secreted by the prostate gland, and in an increased amount by the cancer cells of this organ. Its concentration is measured in the blood. To find out if there are any metastases, X-rays of the chest, ultrasound of the abdominal cavity, and if the PSA concentration is high, also bone scintigraphy. Scintigraphy is an examination using a special radioactive tracer which shows if there are no metastases in the bones – such metastatic lesions capture the tracer more intensively. It is a safe test for the patient, because the radioactive tracer ceases to be active in a very short time. Very important data is provided by the microscopic examination after prostate biopsy. Based on all this information, your doctor (urologist, radiotherapist or oncologist) will help you decide on the best treatment method for you.

Which of these methods is better for you may be suggested by your doctor, taking into account your age, the presence of additional diseases (especially hypertension, coronary artery disease, diabetes) or contraindications to surgery. Your opinion on this subject is very important. If there are no clear medical reasons in favor of one or the other method, the decision rests with the patient.

As with any treatment method, radiation therapy also has its own side effects, the so-called radiation reactions. They usually affect the urinary tract (burning, pain when urinating), the end of the digestive tract (diarrhea, painful bowel movements, blood in the stools) or the skin (dry and peeling skin, discoloration).

Radiation reactions may appear during treatment, as well as many months after its completion. Typically, in most cases, radiotherapy is combined with hormonal treatment, which is usually started 3 months before radiotherapy and is continued during and often several months after radiotherapy. Another type of radiotherapy is brachytherapy in patients with low stage of neoplastic disease. It consists in introducing a radioactive isotope directly into the area of ​​the tumor through needles inserted through the perineum (the procedure is performed under full anesthesia). This treatment reduces the likelihood of side effects because it reduces the so-called the irradiation field most often only to the neoplastic tumor.

Radiotherapy in patients with prostate cancer may not only be a radical treatment. Sometimes it can be used in post-prostatectomy patients who have relapsed (so-called local recurrences), but only in the place where the prostate was previously removed. If bone metastases and related pain have occurred, irradiation (one or more fractions) may also be used to a specific area affected by metastases, e.g. to the spine, pelvis or ribs. Such treatment reduces pain and prevents fractures of bones weakened by tumor metastases. Palliative treatment (limiting disease development and pain) is also possible with the use of an orally administered radioactive isotope. The type of therapy is decided by the oncologist and radiotherapist.

Most of the male hormones are produced in the testicles. The classic method of hormone therapy that has been used for many years is the surgical removal of both testicles (the so-called surgical castration). This procedure is relatively simple technically, but many men do not agree to this method for psychological reasons. Today we have hormonal drugs that lead to the so-called pharmacological castration – that is, they also reduce the level of male hormones to almost zero. Subcutaneous drugs (implants) are used for hormone therapy, administered on average every 12 weeks. Oral hormone medications also exist. The urologist or oncologist decides about the type of therapy. After starting hormone therapy, PSA levels decrease and the course of the disease slows down. However, it is not possible to cure the disease completely, but only to keep the disease under control, even for many months or years.

Until recently, malignant neoplasm of the prostate was considered a cancer that was not very sensitive to chemotherapy. Recent studies with new drugs have refuted this claim. The initiation of chemotherapy usually takes place when the cancer stops responding to hormone therapy and the disease progresses. After a certain period of time (the period may differ for each patient) of hormonal treatment, the tumor cells become resistant to this treatment. We are talking then about hormone-resistant prostate cancer. The first sign that this is happening is usually a systematic increase in PSA concentration. In patients with slow PSA build-up, the time from PSA rise to metastasis can be many months or years. The oncologist, based on the previous course of the disease, assesses how often to repeat additional examinations (bone scintigraphy, X-ray of the chest or bone, ultrasound of the abdominal cavity) using the standards set by international groups of experts.

If the tests show new disease foci, i.e. metastases, in many cases they may not cause discomforts felt by the patient, then the decision on when to start chemotherapy treatment rests with the oncologist. The use of chemotherapy can reduce pain, reduce PSA levels or inhibit its growth, improve the quality of life (e.g. improve the daily activities performed by the patient), but most of all extend the survival time.

Accurate information about possible side effects is provided by the oncologist, who will select the appropriate chemotherapy and drugs to minimize the likelihood of side effects. Therefore, you should always inform your doctor about any other illnesses you have.

Observation is based on the determination of PSA and urological examination at appropriate intervals. It is the doctor who decides whether it is safe to leave the neoplasm under observation. Many patients, however, fear that an untreated cancer may develop faster, which makes them anxious while waiting for their next appointment. Talking to your doctor about your expectations and concerns will help you choose the best solution.

Sometimes treatment starts with chemotherapy to shrink a tumor that can only be operated on afterwards (this is called neoadjuvant chemotherapy). Sometimes it is not possible to stop the spread of cancer despite multi-stage treatment. Then chemotherapy can be used to relieve the symptoms associated with the progression of the disease.

One cycle of chemotherapy is also called a course, and the entire treatment (commonly known as the line of treatment in disseminated disease) usually consists of 6-9 cycles. The interval between courses (or cycles) is usually 21-28 days, although some (non-prostate) programs are given medication every week. Sometimes three courses of chemotherapy precede surgery and another three follow it.

Usually, for the administration of chemicals, it is enough to insert a puncture into a peripheral vein, most often in the hand or forearm. Sometimes, however, especially when treatment is long-term, venipuncture, even for a very experienced nurse (and cancer nurses are the best in this respect!), Is a real problem. Then it may be advisable to assume the so-called port. It is a small plastic or metal disc placed under the skin and attached to a catheter placed in a large venous vessel. The catheter remains in place throughout the treatment period. It may be hard to believe, but usually it does not cause the patient the slightest problems, and allows you to avoid several painful attempts to insert a cannula before each course.

In some patients, despite the high advancement of the disease, the concentration of the marker most often associated with a given cancer may still be normal. On the other hand, markers are well suited to assess (monitor) the effectiveness of chemotherapy. If the marker concentration was elevated before treatment and it decreases during subsequent courses, it means that the disease is relieved by treatment. It is worth remembering, however, that at the beginning of treatment, the concentration of the marker may increase temporarily and this is not related to disease progression, but to the breakdown of the tumor under the influence of cytostatics. And the last two remarks – the concentration of markers may also increase in non-neoplastic diseases, and in completely healthy people it is usually not zero, but is sometimes within wide normal limits.

Treatment of internal diseases must be carried out in parallel to chemical treatment and may take place under the supervision of a family doctor. It sometimes happens that the doses of the drugs used so far will be changed. For example, if someone with diabetes has a lower appetite while on chemotherapy, your insulin dosage may need to be changed. You must inform the chemotherapy oncologist about all additional recommendations from other specialists. After all, it is important not only to treat one disease, but also to care for a patient whose cancer is one of the diseases.

It is like putting all the arguments about a given patient and his disease on two weighing scales – what can we gain from chemotherapy and what can we lose? Although the most common side effects are unpleasant and bothersome, they are manageable and will not have lasting consequences. And the lasting consequences are exceptional cases.

Some patients experience itching or even a pain in the scalp that precedes baldness. Hair can fall out suddenly, in full handfuls, or gradually. There are patients who prefer to shorten their hair before it begins to fall out, or even shave the entire head to avoid this unpleasant effect. For the duration of chemotherapy, you can get a wig, the purchase of which is partially reimbursed in Poland by the National Health Fund – all you need to do is ask your doctor for an appropriate application. You have to remember that the skin during chemotherapy is more sensitive and it is worth using a delicate shampoo or a soft hairbrush and avoid sunbathing.

The scalp can be especially sensitive after hair loss. It is also necessary, if strong solar radiation is unavoidable, apply a cream with a high sunscreen (at least 30, preferably 50). Moisturizing creams will also help with proper skin care. Avoid perfumes and colognes containing alcohol. Instead of long, hot and aromatic baths, it is better to take a quick shower and then gently rub the skin with a moisturizing cream.

Contact your doctor if you are in any doubt or if these drugs are not effective. If your muscle aches and pains are accompanied by a high fever or other symptoms of infection (feeling crushed, coughing), you should see a doctor right away. Such symptoms can mean flu, which can be long and severe in the presence of lowered immunity.

During chemical treatment, protection against pregnancy should be considered, as cytostatics can damage the genetic material and thus lead to birth defects in the fetus. Up to 48 hours after the chemotherapy course, it is worth remembering about a condom, as some cytostatics penetrate into the semen. Sometimes cytostatics can cause erection problems, but this is often a typical psychogenic effect – a man who is embarrassed to talk to a doctor about sex during chemotherapy automatically assumes that the treatment will definitely impair his ability to have intercourse. It doesn’t really have to be that way.

There may be times when you get abdominal pain, bloating, and even diarrhea with more raw fruits and vegetables and juices. So it is probably better to eat easily digestible, boiled or grilled foods instead of heavy, fatty and fried foods. An additional problem may arise in the case of side effects on the part of the mucous membranes. Swallowing solid foods can then be difficult and even painful. You need to see a doctor as soon as possible, remember to drink plenty of fluids and provide the body with the right amount of calories, for example in the form of liquid mixed meals or ready-made preparations containing proteins, carbohydrates and minerals. In extreme situations, it may even be necessary to feed intravenously or using a gastric tube.

It is very popular among patients that certain foods or drinks have a beneficial effect on the results of blood counts tested before the course of chemotherapy. It is to this that beetroot juice owes its enormous popularity. Unfortunately, the effect of cytostatics on bone marrow is so strong that even hectoliters of beetroot juice are not able to prevent anemia. It is also good to think about the liver – it will have a lot of work during chemical treatment! After all, it will have to neutralize all the “poisons” that the oncologist treats us to. It is certainly not served by hard-to-digest dishes, fried, fatty, thick sauces, mushrooms and a large amount of salads. If we want a dish from this forbidden menu – you can succumb from time to time, but in moderation! To sum up – we focus on diversity.

In the minds of people, pain is inextricably linked with disease, it is almost its synonym. Pain can have many causes and variations. Acute, chronic, well-localized or diffuse, crushing, stinging, stinging, throbbing. In fact, one person can experience several types of pain at the same time. To deal with pain, first of all, you need to find out its type and cause. The doctor will ask about the nature of the pain, the circumstances of its occurrence and disappearance, location and intensity. For example, he will ask the Lord to rate the severity of pain on a scale of 0 to 10, where 0 is no pain and 10 is the greatest pain we can imagine, unbearable pain.

Pain management can be complicated at times. Many manuals have been written on this subject, and there are still patients who fall outside the rules and standards. That is why in cancer centers there are teams of pain specialists who are always ready to help in the most difficult cases. Not all pain must be attributed to cancer immediately. If a 55-year-old man who has a stressful job, smokes 2 packs of cigarettes a day, does not practice any sports, and is 3 years after the end of testicular cancer treatment, suddenly develops crushing pain behind the sternum with exercise – we think primarily of a heart attack.

Compiled by: Wojciech Michalski, MD, PhD edited by: Iwona Skoneczna, MD, PhD

Neoplastic disease and mental state – emotions, beliefs, behavior at various stages of the disease

The diagnosis of a neoplastic disease is most often a shock for the patient. Even if someone expects, on the basis of their symptoms, that they are at risk of being diagnosed with cancer, when their fears are confirmed, it is usually difficult for them to believe what they have heard. A natural reaction may be to deny the disease, isolate from loved ones and the environment. Such a response may be needed to mobilize resources to cope, both physically and emotionally, with the disease. Often there are difficulties in deciding what to do next, for example related to a sudden need to take care of one’s health, which is in conflict with the willingness to actively fulfill the current life roles. At this initial stage, it is extremely important to get the information needed to start the healing process – what will the treatment involve and how my body might respond; what activities are advisable and what are not; what to do after leaving the hospital; what changes to introduce in everyday life, e.g. diet.

Conversations with other patients may turn out to be valuable – about the emotions they experience, shared experiences. The feeling of being understood is often very supportive in these first moments. According to Dr. Elisabeth Kübler-Ross, there are five psychological stages of reaction to the news of a serious illness. The first is the denial mentioned above, isolation (thinks, “That’s impossible!”). The next stages are anger (thinks: “It’s not fair!”), Negotiating (“If I survive, never again …”), depression (“It’s monstrous, it’s so hard for me to believe it”) and accepting your situation, both cognitively, which is associated with an active attitude in the recovery process as well as emotionally, which prevents energy being spent on the process of dealing with negative emotions such as anger, sadness or frustration. The above stages do not always have to be in this order, it is also possible to return to the previous stages several times before the acceptance stage, which gives a sense of peace and harmony.

After the diagnosis of cancer, the patient may experience various emotions, such as: anxiety, anxiety, fear, terror, uncertainty (related to thoughts such as “I will die soon” or “I will suffer and die prematurely in agony”). There may also be emotions of helplessness, hopelessness or depression (thoughts such as “I will lose my physical fitness and be a burden to others” or “My family cannot take it, they cannot do without me”). Another group of emotions is regret, frustration, rage, anger (thinking like “I will not make my dreams come true”). The above thoughts and associated emotions are very difficult and make the experience of the disease burdensome not only physically but also mentally. These elements make up the so-called disease stress. Of course, not all people have the same emotional response to illness, and it depends on many factors. What matters here are factors such as age, gender, whether a person is a believer or not, personality, and the importance given to the disease. The life situation of the person at the time of hearing the diagnosis is also extremely important, as is previous experience of the disease in general, including cancer (both in one’s own disease and in the family, in the immediate vicinity). After the first stage of hearing and responding to the diagnosis, a person with cancer begins the treatment stage.

At this point, she begins to deal with a series of experiences, often quite new in her life. If the symptoms of the disease remain with the start of treatment, a sudden increase in the sense of hope and the belief that “There is really nothing serious wrong with me” may arise. The beginnings of hospital life can be difficult, and stereotypes related to hospitalization are often triggered. Paradoxically, a long stay in the ward may contribute to an increase in the sense of security through contact with other people in a similar situation. It gives you the opportunity to share your emotions and fears with a sense of being understood. Upon leaving the hospital, there may be concerns about the reactions of the environment, as well as concerns about the patient’s ability to cope with a lifestyle change situation. Finding yourself back in the “world of the healthy” may not be easy. Most of all, patients are often anxious about the possibility of relapse. This anxiety can become a dominant area in everyday life, preventing normal functioning. There may also be difficulties in accepting losses incurred as a result of the disease, for example full physical fitness or gender attributes.

Sometimes the consequence of my illness is that I have to go on a disability pension and it always takes some time to adjust to such a change in my life. This change may involve the need to revise the existing goals and set new life goals. Unfortunately, sometimes, despite starting treatment and following medical recommendations, the disease does not go away or even continues to develop. In such a situation, the greatest challenge is often the feeling of helplessness and the feeling of being dependent on other people, but also the loss of the sense of security associated with the need to be confronted with the possibility of dying from an illness.

An important aspect in cancer are beliefs about cancer in general and your specific situation. A negative factor may be phrases of a doctor such as: “Statistics are not on your side” or “You have six months of life left”. In such a situation, it is important to separate facts from possibilities. Statistics cannot tell which group of people – survivors or those who died – this particular person is. Likewise, a doctor cannot know 100% how much life is left for the simple reason that no one knows the future until it becomes the present. Other beliefs that can strongly increase the stress of the disease are thoughts such as: “It’s my fault that I have cancer” or “It’s not fair!”

Of course, in the past, we may have undertaken behaviors that increase the risk of cancer, but we are never fully responsible for the development of the disease, if only because cancer is a disease with a complex etiology. It is important to realize that using the mindset of “my fault – not my fault” or “fair – unfair” will simply not be of benefit to a diagnosis of cancer, but can take up a lot of the resources needed to deal with the disease.

The direction that is desired in the process of adaptation to the disease is the increase in the sense of hope and the sense of influence on the situation. It is not about the absolute belief that “I will definitely get better,” or the belief that “I have absolutely not everything under control.” Hope means believing that I will get better, despite the slim chance of it.

Such belief increases the chance of saving resources often devoted to coping with anxiety and devoting them to coping with the disease and enhancing the healing process. When it comes to the influence on their situation, of course, the sick person has no influence on the fact that they have been diagnosed with cancer, however, it is worth realizing that there are still many areas 100% dependent on them. A sick person can take care of themselves while in hospital, by exercising their rights in the ward. He may also ask for support from a psycho-oncologist and relatives in order to provide himself with the best possible help. In addition, he or she may be familiar with a variety of physical pain management techniques to reduce its impact on your mental state. Eventually, he can introduce a number of health-promoting behaviors into his life, increasing his chances of recovery and significantly improving the quality of his life.

1. Rights of the sick (to be informed about the disease and treatment)

Due to the fact that the information about the disease is often a shock, and the sudden, so frequent contact with doctors, something unknown – at the beginning patients may find it difficult to care for their own rights in contact with medical staff due to the overwhelming amount of information and actions. First of all, the sick person has the right to receive full information from the doctor about the planned method of treatment and diagnostics, provided in a fully understandable manner. The patient also has the right to consent to any tests, treatments and to make the final decision regarding the method of treatment. An unsuccessful diagnosis is not a reason why a doctor can withhold it – a sick person has the right to always know his diagnosis, and has the right to be answered questions related to his or her health condition. Moreover, this information should be provided with respect for the patient – in private, calmly, with attention and time for possible questions. If the patient expresses the will not to learn the truth about his health, the doctor is also obliged to respect this will.

In such a situation, the patient may, for example, choose the person or persons who will contact the doctor. Or a sick person may not want anyone, including family, to know about his or her state of health. Only after agreeing to provide information to the family, the doctor has the right to do so. The doctor is also obliged to relieve the suffering of patients, which means that he should try to, for example, relieve the physical pain of the sick person every time he or she asks for it, and the doctor sees an opportunity for it. If a sick person has any doubts regarding their rights and obligations of doctors, they can read the Patient Rights Charter and report any doubts to the Patient Ombudsman.

1. Where to go for help About the role of psycho-oncology

There are many factors that can determine how the person diagnosed with cancer will handle cancer. These include past experiences that most often shape the perception of the disease (e.g. whether the patient had a cancer disease until the diagnosis, if so, whether it was a cure or not). As a result of these ideas, a sick person may have a changed perception of future threats and begin to experience a fear of something that in their situation poses a minimal risk to them, not exceeding the degree of risk in a healthy person (e.g. fear of a complete loss of physical fitness). The currently possessed resources are also important in the process of coping with the disease, both physiological (e.g. general health condition, previous diseases), emotional and psychological (e.g. private life situation, level of depression, level of social support, personality), as well as resources related to social conditions (e.g. housing conditions). Mere awareness of many of the previously described aspects of the disease can help a person diagnosed with cancer in the process of coping with the disease. Just knowing what may await us, what to expect, what is natural and what should be worrying can be supportive, reducing the uncertainty that often causes the build-up of negative emotions. It is worth remembering, however, that the diagnosis of a neoplastic disease is a very difficult situation, often assessed as extreme. This means that it can be difficult to deal with alone or even with the support of loved ones.

A person specializing in helping patients suffering from oncological diseases is a psycho-oncologist. Psychoonocology itself is an interdisciplinary field in which the impact focuses on the psychological aspects of neoplastic disease, but also covers a wider range. The first is the prevention and promotion of health, in which it is extremely important not only to promote behaviors aimed at preventing and early detection of the disease, but also behaviors that facilitate treatment when cancer is diagnosed. The second aspect is minimizing the psychological effects of the disease and treatment, not only for the patients themselves, but also for their families.

Psycho-oncology also deals with activities aimed at medical staff, focusing on psychoprophylaxis and introducing the staff to the mental and emotional situation of patients. This field also creates a space for including psycho-oncology issues in students’ curricula. The aim of the psycho-oncologist’s work in contact with a person diagnosed with cancer is to alleviate emotional pain and other psychological consequences of the disease and treatment. This overarching goal of a psycho-oncologist’s work gives patients the opportunity to benefit from specialist support. Receiving such support is important for several reasons. First of all, the pain and physical discomfort associated with the disease themselves reduce the quality of life. In addition, there are the frequent psychological consequences of illness and treatment described above. Contemporary research in the field of psychoneuroimmunology shows that low mood and severe stress can negatively affect the functioning of the immune system, the role of which in the fight against disease and side effects of treatment is invaluable. This means that receiving specialist help in the event of a neoplastic disease may not only improve the quality of life, but perhaps also the recovery process.

A psycho-oncologist can provide support in the process of accepting the disease, as well as in making various difficult decisions that face the person with the diagnosis, including the decision about treatment. In addition, it deals with expanding patients’ skills in coping with stress, also through the use of relaxation techniques. The role of the psycho-oncologist may change depending on the stage of the disease. Of course, the help is always tailored to the current needs of the sick person, but at different stages the needs of patients may be similar. In the first phase, when a patient is suspected of having cancer but not yet diagnosed, the main area is support in coping with anxiety and stress enhancement through the belief, “It is definitely cancer and it is definitely incurable.” After the diagnosis of cancer and the initiation of treatment, the area of ​​assistance is often the side effects of administered drugs and chemotherapy or radiotherapy.

At this stage, it is extremely important to consider the losses and benefits of treatment and to strengthen your motivation. The treatment process can turn out to be extremely difficult for an affected person, and it is their mental state that can decide whether or not they will be able to continue treatment. In the case of recurrence of the neoplastic disease, the role of the psycho-oncologist is to support dealing with this information, while at the remission stage the main area is working with the fear of relapse, worrying, and scanning the body for cancer. At this stage, the psycho-oncologist encourages healthy self-observation, i.e. one that is not based on fear, but allows you to be careful about the functioning of your body. This attitude allows you to make life changes to reduce the risk of relapse. In addition, the patient can benefit from support in the process of becoming independent after the illness, returning to their everyday life roles – social and professional. The psycho-oncologist also provides support in the palliative care phase, focusing on pain management and treatment focused on minimizing symptoms. The psycho-oncologist’s care is of course also available when the sick person is in the terminal phase, by providing psychological and spiritual help to the patient.

People dealing with psycho-oncology have various possibilities of providing support to the patient. The patient can benefit – depending on the needs – from individual therapy and a support group, he can get help in a crisis through crisis intervention. Usually, psychotherapeutic help is provided in the cognitive-behavioral trend, an example is rational behavior therapy, the aim of which is, inter alia, reducing stress, unlocking the possibility of further active attitude or gaining a sense of control over the situation. Patients together with their families or other supporters can take advantage of various workshops or relaxation classes, as well as marriage counseling. Illness is often an extremely difficult time for a close relationship and it is only natural that a couple may need the support of a specialist. The offer of psycho-oncology also includes the so-called Simonton’s program, which includes many of the above-described techniques, and also offers, for example, a method of visualization, which aims to support the healing process.

The family of the patient may also receive help, regardless of the stage of the disease on which the patient is at present. Supporters can benefit from emotional support through individual talks, psychoeducation or family therapy. Caring for your needs as a support person can be difficult due to the misconception, “Now he (the sick) comes first.” It is understandable that the energy after the diagnosis of cancer is concentrated around the person with the diagnosis, but for the support process to be effective and for the support person to retain the strength that may be needed for a very long time, it is necessary for them to replenish their physical, emotional and emotional resources. mental. In turn these resources are supplemented by taking care of oneself and one’s own needs. Nowadays, many studies show that using psycho-oncological support when dealing with cancer may be helpful on many levels.

It has been shown that better mental state is associated with better functioning of the immune system, which is so important in the recovery process. The positive effect of relaxation techniques has also been proven. Participation, for example, in the Simonton Program was associated – as shown in the studies – not only with a decrease in perceived side effects of treatment, but above all with an increase in the overall quality of life.

1. Non-pharmacological methods of coping with pain

Undoubtedly, one of the factors that reduce the patient’s quality of life most strongly is physical pain. It is associated not only with physical but also mental suffering. It also has negative physical consequences, such as sleep problems or lack of appetite, and psychological consequences, such as feelings of anger, depression. It also has social consequences, such as withdrawing in close relationships. Fortunately, today there is a wide range of pharmacological pain management options.

The doctor is obliged to react every time the sick person complains about pain. However, it is worth remembering that there are also other techniques that help reduce the severity of pain, and their advantage is that the patient can use them both during hospitalization and at home or elsewhere.

Non-pharmacological pain management approaches include psychological, muscle, and dietary management. The latter include introducing changes in the diet, such as: reducing salt, sugar, animal products and highly processed foods, while enriching the diet with fresh vegetables and fruits, or such agents as steamed ginger. The aim of the action is to reduce inflammatory processes in the body, toxicosis, water accumulation and swelling. Psychological and muscular effects in coping with pain are related to the dependence of the level of pain perception on the mental state.

Modern research has clearly shown that the higher the level of tension and stress, the more physical pain is felt. This means that a sick person’s poor mental state may intensify their pain sensation, and at the same time reducing tension and perceived stress may reduce the level of physical pain. One of the methods is, of course, relaxation training or conscious breathing techniques, which reduce muscle tension, relax and, as a result, stimulate the body’s natural processes, such as healing or the release of endorphins.

In the area of ​​purely psychological interactions in coping with pain, sick people can benefit from working with imagination. Techniques such as visualizing pain, talking to pain or scaling pain help to strengthen the feeling of control over your own body. A paradoxical reaction takes place here, because it is precisely the concentration on pain that is an active factor that reduces the level of pain perception. It is also related to mobilizing the body to control it while focusing on your own pain. The visualization itself increases the hope for recovery, as well as releases emotions such as anxiety and fear, which intensify the pain sensations.

You can also find it helpful to work with beliefs about pain. Among the beliefs that lead to negative emotions, very common is the belief that there is absolutely no possibility of pain control (“The pain will increase with every minute”, “I will always be so in pain”, “I will never function normally again”). Changing these beliefs based on facts and the present situation rather than fear of the future can significantly reduce the level of pain experienced. Keeping in mind that pain is one of the worst ailments that people struggle with, learning techniques to minimize it is certainly worth considering.

1. Health-promoting behaviors

Although for many people the moment of diagnosis seems to be too late to introduce pro-health behavior in life, it is exactly the opposite. These behaviors are, of course, intended to be prophylactic, but their impact is equally great in the healing process. Pro-health accusations are activities that are aimed not only at protecting health, but also at improving the current condition. These behaviors include: avoiding stimulants such as cigarettes, alcohol or coffee, maintaining a balanced diet, excluding unhealthy products, and containing the highest percentage of healthy foods, such as vegetables, fruits and whole grains.

In terms of nutrition, there is also care for the hygiene of eating, i.e. regular meals or not eating just before going to bed. Another element is maintaining physical activity (adapted to the current physical condition) and taking care of regular sleep and rest, also being aware of how much sleep our body needs individually.

Pro-health behaviors also include improving skills in coping with stress and learning about my own abilities in this area – what is my individual stress resistance? What are the limits that I shouldn’t cross so that I can feel good? Numerous studies show that there are three more important areas that caring for can contribute to the improvement of not only mental but also physical condition. The first is maintaining positive contacts with loved ones – family, friends or acquaintances.

The second area is to ensure frequent contact with nature, of course, according to our preferences – it can be walks, trips, playing with a dog or cat, depending on what gives us the greatest joy.

The third area is the care for arousing positive emotions in everyday life by increasing the activity that brings a sense of fulfillment, commitment and joy. These can be our interests, hobbies, but also the previously mentioned contacts with loved ones or with nature. Extremely important in increasing the amount of pro-health behaviors is that they help strengthen the sense of influence on your life.

Cancer often makes the sick person lose their sense of control over what is going on in their life. This, of course, is more psychologically demanding and may lead to a decrease in motivation for treatment. Introducing changes in our lives, such as taking care of pro-health behavior, makes us feel that there is an area for which we are fully responsible. Of course, the sick person still has no influence on the fact that they are diagnosed with cancer or the end result of treatment, however – and it is really worth emphasizing it again – suddenly they may notice that there are many areas that are still affected by this. He may find that when he changes his diet he feels better, that taking care of regular sleep reduces e.g. physical ailments and that providing himself with joy and fun every day,

by secreting endorphins, it reduces pain. As a result, it may turn out that even in such a difficult situation as cancer diagnosis, the sick person is by no means helpless and can still do a lot to feel better.

Developed by: Joanna Bylinka, MA

The answers to the questions come from the Patient’s Guide prepared for the needs of the Prostata for years campaign