HomeAnswersMedical oncologymetastasisMy father has hiccups after stopping steroids. Why?

Is there a chance of cancer spreading faster if biopsy is done?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At July 10, 2018
Reviewed AtFebruary 16, 2024

Patient's Query

Hello doctor,

My dad has been diagnosed with metastases and it has spread to his spines and lungs. He had prostate problems for past five years. Doctor on consultation here gave him few medicines which included Dexon. Once he stopped the medicine, he is hving hiccups continuously. Kindly advise on medicine to be taken.

Hello,

Welcome to icliniq.com.

Will you be able to provide me with details like:

  1. Does he have any other medical conditions like diabetes, heart disease or kidney problem?
  2. When was he diagnosed with malignancy and has he received any treatment?
  3. What exactly do you mean by prostate problems?
  4. What other medications were prescribed and how long did he take them?
  5. Since when did he stop taking them?
  6. What other problems than hiccups?

I am answering assuming few things like he is heavy metastatic prostate cancer recently diagnosed and must have been started on some medication (probably androgen deprivation) along with steroids (Dexona).

It looks like a metastatic prostatic carcinoma stage IV. If he has been diagnosed recently and has not yet taken any kind of hormonal treatment (antiandrogen medications), then the best treatment option for him is to go for a small surgical procedure known as orchiectomy or removal of both the testes.

Dexona for short-term use has some benefits but for long-term use, it has got a lot of side effects in many patients, for example, blood sugar increase (can lead to diabetes) increased blood pressure, gastritis, insomnia, weakening of bones, muscle weakness, etc. Dexona cannot be stopped at once, it has to be tapered off slowly as per your physician's advice.

For hiccups, he should take tablet Ranitidine (Aciloc) 150 mg twice daily for one week and tablet Metoclopramide (Reglan) 10 mg three times a day for three days.

I want to know whether he had prostatic problems due to cancer or due to benign prostatic enlargement. If you can send me the biopsy report, bone scan report, blood reports, PSA (prostate-specific antigen), and serum testosterone level report, I would be in a better position to give you more valuable suggestion.

For more information consult a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist

Patient's Query

Thank you doctor,

I am attaching the reports. At this stage, we are very afraid to get a biopsy done. His age is 74. He has BP but no cardio or kidney problems.

Hello,

Welcome back to icliniq.com.

Well, based on these reports (attachment removed to protect patient identity), I would think towards prostate cancer first. His PSA levels are not much high for this extensive disease.

Does he have a history of smoking? There is a possibility that he is having metastatic lung cancer. It is still stage-4. If his general conditions are good, I would still advice for a biopsy because treatment will differ for both. Even stage-4 prostate and lung cancer can be managed now with currently available medicines.

For more information consult a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist

Patient's Query

Thank you doctor,

He has a history of smoking about 25 years ago and he used to take tobacco though.

Hello,

Welcome back to icliniq.com.

How is his general condition? Is he able to do daily activities, his work? What symptoms is he having currently?

I would advise tapering Dexona slowly. Can you tell what dose he is taking and for how long?

Also, he should take some antacids like Rantac and Metoclopramide for his current symptoms for three to four days.

For more information consult a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist

Patient's Query

Thank you doctor,

He is having hiccups continuously and it stops while he is asleep. He is having weakness. He has stopped Dexona since last seven to eight days but hiccups are not stopping. Otherwise, he is alright. Taking these medicines, I just wished to know one thing that he might not get used to it for stopping his hiccups?

Hello,

Welcome back to icliniq.com.

No, these are very commonly used medicines and have very minimal side effects. So, I think he can take them without much worry.

For more information consult a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist

Patient's Query

Thank you doctor,

I have started medicines as advised by you but kindly answer the above query.

Hello,

Welcome back to icliniq.com.

I did not get what exactly you wanted to ask. But if you are worried about him getting used to these drugs then there is a very slim chance. As I said, these are very commonly used drugs with minimal side effects.

For further queries consult a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist

Patient's Query

Thank you doctor,

If we get a biopsy done, is there a chance of cancer spreading at a faster pace?

Hello,

Welcome back to icliniq.com.

No. This is one of the most common misconceptions. If properly done, there is usually no chance that the biopsy will cause further spread of cancer.

For more information consult a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist

Patient's Query

Hello doctor,

Thank you for your guidance. He is having body pain, what medicine would you suggest? The removal of testicles will be done by a urologist or an oncologist? Accordingly, we will take him.

Hello,

Welcome back to icliniq.com.

It is done by a urologist.

Actually, body pains can be due to skeletal metastasis. He can take analgesics like Tramadol for a few days. Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent. Once his treatment is started, these symptoms will go abate.

But first, go to an oncologist. As I said, he might not have prostate cancer. It can just be age-related hypertrophy. And the real problem might be in his lungs. So, I would advise you to first meet an oncologist and go ahead as per his suggestions.

For more information consult a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Pawar Satyajit Jalinder
Dr. Pawar Satyajit Jalinder

Medical oncology

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