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