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Dexamethasone for wellbeing

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 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 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.

User
Posted 01 Apr 2026 at 14:17

Just to add to this conversation in case it helps others. Our oncologist has now recommended weaning off Dexamethasone again now that OH has suffered an insufficiency fracture in L5 because long term use is bad for demineralisation of the bone structure along with the same from ADH and radiotherapy to the spinal bone mets. He has had many bruises formed with a slight knock against something and thinning skin that easily breaks. Reading up a bit more on the use of Dexamethasone, short term use seems fine but take care over long term use. We are told it does help to reduce the PSA level but the gains versus the bad effects need to be considered at various points.

Edited by member 01 Apr 2026 at 19:53  | Reason: Not specified

 
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