In your final months of life with prostate cancer, symptoms are likely to be more frequent and more severe. Symptoms like fatigue, shortness of breath, and loss of appetite may emerge in the final days or weeks.

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Early screening for prostate cancer means that doctors find most cases early, leading to a high survival rate. Advances in treatment have also helped improve these rates over the last 20 years.

Even so, the American Cancer Society expects about 34,700 people to die from prostate cancer in 2023. And despite the high survival rate, it’s still the second leading cause of cancer death in people assigned male at birth in the United States.

Death from prostate cancer is more likely if you have advanced prostate cancer, meaning it has spread to other areas in your body. At this point, there’s usually no path to curing your cancer. Treatment will focus on slowing its growth or managing symptoms.

When measures to treat the cancer fail, you may start to experience more severe symptoms. At this point, a medical team may suggest focusing on supporting your quality of life for your remaining time. Here are some symptoms showing that your prostate cancer may be in its final stages.

A 2018 study found that people within 6 months of dying from prostate cancer experience many of the same symptoms as other people with the disease, but with greater frequency and severity.

In your final weeks, some symptoms become more prevalent. As you get nearer to the end of life, you may notice the following:


You may have experienced pain as a symptom of advanced prostate cancer. People often experience pain in the groin, hips, or back. This can be due to the tumor pressing on a nerve or cancer that has spread to your bones.

Groin pain may also be due to excess lymph in your lymph nodes. When cancer spreads to your lymph nodes, they can’t drain as easily.

Pain, even in the final stages, is usually manageable with medication.


You’re likely to feel excessive tiredness when you are dying. This may mean sleeping for long periods, feeling drowsy when awake, and even drifting in and out of consciousness.

Loss of appetite

Your body’s metabolism slows down in your final weeks of life. This reduces its need for sustenance, causing many people not to feel the need to eat or drink.

You may also experience trouble swallowing, which can cause you to eat and drink less.


You may have trouble recognizing the people around you or understanding your surroundings. You might answer questions very slowly or stop responding to others entirely. This could be due to drowsiness or the medications you’re taking.

It may be helpful for loved ones to introduce themselves each time they enter the room or start talking.


Many people experience terminal restlessness, which can present as feeling agitated, anxious, or distressed. You may even experience delirium or hallucinations.

A care team can provide medication to help with these symptoms. A calm environment can also help.

Changes in urination or bowel movements

Changes in metabolism combined with reduced food and drink intake means you’ll also experience changes in your waste functions. These could include:

Talk with a medical professional or care team if you feel constipated. They can provide you with laxatives or a suppository if you have difficulty with bowel movements.

Changes in breathing

You’re more likely to experience shortness of breath in your final days and weeks. This could be due to the cancer, loss of muscle strength, or your body needing less oxygen.

A care team can provide opioids or other medications to help with this symptom. They may also be able to provide oxygen therapy. Family members can assist by helping you sit up and aiming a cool fan at your face.

Death rattle

Fluid may build up in the back of the throat because you are too weak to clear it. This can cause a distinctive gurgling sound known as a “death rattle.”

A death rattle doesn’t cause discomfort but can be distressing for your loved ones to hear. It usually indicates that death is imminent. Your loved ones can help by repositioning you or limiting your fluid intake.

Skin changes

Your hands and feet may be cool to the touch. They may even turn blue. This is due to changes in blood flow to the extremities.

A nonelectric blanket might help keep your hands and feet warm.

Is prostate cancer always painful in the end?

Not everyone with prostate cancer experiences pain when dying. You may feel bone pain if prostate cancer has spread to your bones. You may also feel nerve or muscle pain, depending on the effects of the tumor.

But there are many options to help reduce pain. You can try changing sitting or lying positions. Pain medications are also available to take by mouth, patch, or injection.

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In the final stages of prostate cancer, you may choose to enter palliative care or hospice care. Although similar, these are not the same.

Palliative care

You can receive palliative care at any stage of prostate cancer. But a 2018 Swedish study found that it could be especially helpful to people with prostate cancer in their final 6 months of life.

Palliative care seeks to improve your quality of life by managing symptoms and providing mental health support. With prostate cancer, palliative care may include:

Hospice care

You may also choose to enter hospice care. Unlike palliative care, hospice care doesn’t try to treat the cancer. The goal is to provide support and comfort at the end of life.

Death from prostate cancer usually occurs if the cancer spreads (metastasizes) to other parts of your body. Metastases in these other parts of your body can impair their function, leading to death.

Some sites of prostate cancer metastasis that can lead to death include:

  • bones
  • lymph nodes
  • lung
  • liver
  • brain
Key statistic

According to a 2021 study, about 1 in 6 deaths of people with metastatic prostate cancer are due to noncancer causes, like heart disease, stroke, or chronic obstructive pulmonary disease (COPD).

If you have prostate cancer, your outlook depends mostly on how soon doctors can diagnose it. But in some people, the type of prostate cancer may be a more aggressive or may be less likely to be caught before it spreads. These types include:

  • ductal adenocarcinoma
  • squamous cell carcinoma
  • small cell prostate cancer

The median age of death from prostate cancer in the United States is 80 years old.

African Americans

African Americans are twice as likely to die from prostate cancer than people from other racial groups. They tend to develop prostate cancer earlier in life. They also often develop more aggressive forms that are already advanced at time of diagnosis.

But inequalities in access to care may be the most significant factor for this disparity. A 2020 study found that when access to care was equal, the mortality rate was actually slightly lower for African Americans.

About 1 in 41 people assigned male at birth in the United States will die of prostate cancer. Despite having a high survival rate if caught early, prostate cancer can be terminal for some people. About two-thirds of those who die from prostate cancer are over 75, and more than one-third are Black.

Symptoms like fatigue, loss of appetite, and shortness of breath may indicate that you are nearing the end of your journey with prostate cancer. This can be a difficult time for you and your loved ones. Care options are available to help manage your symptoms and provide some comfort in your final days.

Resources for support

The final stages of prostate cancer can be distressing for you and your loved ones. The following resources may provide support for the potentially challenging decisions and your emotional well-being:

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