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Urology (Expert Forum)
Dexamethasone - Abrupt cessation of medication - Prostate Cancer patient
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Dexamethasone - Abrupt cessation of medication - Prostate Cancer patient
by Monica__0__0, May 31, 1999 12:00AM
Posted by Monica on May 31, 1999 at 00:04:46
My father was diagnosed with prostate cancer 8 years ago - recently (16 months ago) his PSA level increased and he was given the steroid dexamethasone to reduce the level of testosterone produced. ( I have been unable to find any info on this treatment to lower his PSA) but in February of this year his physcian told him he could stop taking this steroid- just like that - He ended up in the hospital for several days since he couldn't eat (vomitting and nausea - fatigue etc) They then put him back on the dexamethazone and put him on a program to wean him of the medication. It has been three weeks since he has completely stopped taking the medication. He is still misserable and was admitted to the hospital for three days this week because he is exhasusted and has no appetite, He tries to force himself to eat but can only keep down a little milk and some fruit -
My question is how long will the withdrawl symptoms last since he was on the medication for such a long period and is it normal to leave a patient on this medication for this long.
Over the 16 month period he took .5mg each day and when they weaned him off it was .5mg every other day for two weeks and then .25mg every other day for 2 weeks - then nothing.
Thanks for any information you can give - He is starting to get very discouraged and any help you can give will be greatly appreciated
Posted by HFHS M.D.-CK on June 02, 1999 at 18:18:15
Dear Monica,
Prostate cancer is the most common cancer in older men, and is the second leading cause of cancer deaths. Treatments used are based on the stage (how widespread) of the cancer, the grade (how aggressive) of the cancer, and the patients symptoms and overall health. Use of hormonal manipulation is usually reserved for metastatic cancer (spread to lymph nodes or bones). Testosterone is a male hormone produced mainly in the testicles, but smaller amounts are produced in other tissues including the adrenal glands. Lowering the testosterone is a mainstay of treatment for metastatic prostate cancer. This is done by decreasing testicular production with medicines, or by removing the testicles. Use of steroids such as dexamethasone can decrease production of remaining testosterone by the adrenal glands. This shuts down normal activity of the adrenal glands. If steroids are used in high doses over a long term, then abrupt discontinuation can lead to symptoms from a deficit of steroids produced by the adrenal glands. Thus, steroid drugs used this way are tapered off slowly.
Further treatment will be based on PSA blood tests, bone scans, and symptoms. Sometimes experimental protocol drugs are indicated for pain control.
This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available through our department at the Henry Ford Hospital and its suburban locations (I-800-653-6568).
Sincerely;
HFHS M.D.-CK
* Keyword: metastatic prostate cancer, adrenal suppression
