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Dexamethasone for wellbeing

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User
Posted 20 Aug 2025 at 13:57

My OH has advanced castration resistant metastatic prostate cancer (mCRPC) diagnosed March 2023, T3b N1 M1 with latest PSA 63.  He has been prescribed dexamethasone for his wellbeing and I have a few questions about this. He had primary resistance to Abiraterone with both prednisolone and a switch to dexamethasone and was taken off Abiraterone after 7 months.  He then started to feel bad with great fatigue and complete loss of appetite.  In the meantime, a PSMA PET CT scan showed progression of new mets in his thoracic spine.  When we reported to his consultant in July, she put him back on dexamethasone to address this and we are now waiting for Ra-223 treatment.  It is unclear to me if the Abiraterone has damaged his adrenal glands which is why he is feeling so bad or if this fatigue and loss of appetite is just another effect of his prostate cancer progression.  Will he need to take dexamethasone all the time and are there any bad side effects from long term use.  Grateful for any views.

Good luck to everyone

User
Posted 09 Oct 2025 at 05:56

Since he stopped taking Abiraterone, his body’s adrenal glands may have trouble reproducing adequate cortisol, leading to adrenal insufficiency. This is a known, potentially serious complication, and the symptoms are exactly what he experienced. Dexamethasone is a great medication used in palliative care, specifically to treat cancer-related fatigue, stimulate appetite, and promote a sense of well-being by reducing inflammation.

 

Shania O'Reilly - Survival Race

Edited by member 14 Oct 2025 at 10:54  | Reason: Not specified

User
Posted 12 Oct 2025 at 16:42

My hubby has been on dexamethasone a couple of times, the latest since June to try to reduce his PSA.  His only side effect has been thin skin so that he’s a mass of cuts and bruises on his arms and hands where he’s always catching himself on things and it peels back the skin.  If he puts a plaster on, it then tears more skin when he peels it off.  He’s had to have antibiotics twice for infected cuts.

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User
Posted 21 Aug 2025 at 06:47
Re the fatigue I assume he has had his blood checked for anaemia?
User
Posted 21 Aug 2025 at 06:53

Hi francij1, yes he has been having regular full blood counts for when he was on the Abiraterone and all seems okay there.  Also before the Ra-223 starts when the funding for that has been approved his blood is assessed each time, his last blood test was yesterday.

User
Posted 09 Oct 2025 at 05:56

Since he stopped taking Abiraterone, his body’s adrenal glands may have trouble reproducing adequate cortisol, leading to adrenal insufficiency. This is a known, potentially serious complication, and the symptoms are exactly what he experienced. Dexamethasone is a great medication used in palliative care, specifically to treat cancer-related fatigue, stimulate appetite, and promote a sense of well-being by reducing inflammation.

 

Shania O'Reilly - Survival Race

Edited by member 14 Oct 2025 at 10:54  | Reason: Not specified

User
Posted 12 Oct 2025 at 16:42

My hubby has been on dexamethasone a couple of times, the latest since June to try to reduce his PSA.  His only side effect has been thin skin so that he’s a mass of cuts and bruises on his arms and hands where he’s always catching himself on things and it peels back the skin.  If he puts a plaster on, it then tears more skin when he peels it off.  He’s had to have antibiotics twice for infected cuts.

 
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