Appetite Changes in Advanced Prostate Cancer Patients

Q: Appetite Changes in Advanced Prostate Cancer Patients

Hello： 1. <br>In terms of PSA, there should be no deterioration, but recurrence cannot be ruled out. <br>Stage IV prostate cancer can be well controlled, but it is not considered cured, so there is no issue of recurrence. <br>2. <br>It is advisable to consult the original oncolog

Prostate cancer patients suddenly experiencing poor appetite and nausea?

My father has always had a normal appetite and cannot go without eating.
Four years ago, his appetite suddenly decreased.
Although he felt very hungry, he became extremely sensitive to the taste of food, to the point of feeling nauseous and unable to eat, even vomiting.
Later, a lump was discovered in his neck, and after examination, he was diagnosed with stage 4 prostate cancer.
He underwent treatment with medication and injections, and his appetite returned to normal.
For the past four years, his condition has been stable, with PSA levels approaching zero.

A few days ago, my father fell and had X-rays and ultrasounds of his knee and abdomen, which showed no issues.
However, since the fall, his appetite has suddenly decreased again.
He feels very hungry but is extremely sensitive to food flavors, leading to nausea and an inability to eat, even to the point of vomiting.
He is so hungry that his voice has become weak, reminiscent of the situation from four years ago, which worries us greatly.
He had his PSA tested in August, and the levels were close to zero.
The next check-up is not until late September, and we are concerned about not being able to get an earlier appointment.
I would like to ask the doctor: 1.
What is the relationship between the sudden drop in appetite and the recurrence or metastasis of prostate cancer? 2.
If the correlation is minimal, which specialist should we take my father to see as soon as possible? (I apologize for asking this question, as it may be somewhat off-topic, but I would still like to know your advice.)

Wei, 40~49 year old female. Ask Date: 2023/09/10

Dr. Jian Weihong reply Urology

Hello: 1.
In terms of PSA, there should be no deterioration, but recurrence cannot be ruled out.
Stage IV prostate cancer can be well controlled, but it is not considered cured, so there is no issue of recurrence.
2.
It is advisable to consult the original oncologist who is most familiar with the condition and treatment medications.
If there are significant difficulties, you can have your father's internist perform blood tests for evaluation.
Assuming there are no internal medicine issues, then consult a gastroenterologist for further assessment.
Wishing you good health.

Reply Date: 2023/09/10

More Info

Understanding appetite changes in advanced prostate cancer patients can be complex, as various factors can influence a patient's desire to eat. In your father's case, the sudden decline in appetite after a fall raises several important considerations.

1. Appetite Changes and Cancer Recurrence or Metastasis: While appetite changes can sometimes be associated with cancer progression, they are not exclusively indicative of recurrence or metastasis. In advanced prostate cancer, factors such as hormonal changes, the side effects of medications, and the psychological impact of living with cancer can all contribute to fluctuations in appetite. In your father's situation, it is reassuring that his PSA levels are near zero, which typically indicates that the cancer is well-controlled. However, the sudden change in appetite following a physical injury could suggest that the issue may be more related to the trauma from the fall rather than a direct link to cancer recurrence. Stress, pain, and discomfort from the fall could lead to nausea and a reduced desire to eat, mimicking the symptoms he experienced four years ago.

2. Next Steps and Specialist Consultation: Given the recent changes in your father's appetite and the context of his medical history, it would be prudent to consult with a healthcare professional. Since the appetite issues have resurfaced, it would be advisable to see a primary care physician or an oncologist who specializes in prostate cancer. They can conduct a thorough evaluation to rule out any potential complications from the fall, such as pain or discomfort that could be affecting his appetite. Additionally, they can assess whether any medications he is currently taking might be contributing to his symptoms.

If the primary care physician or oncologist deems it necessary, they may refer your father to a gastroenterologist to evaluate any gastrointestinal issues that could be causing nausea or loss of appetite. It is also essential to consider psychological factors; therefore, a consultation with a mental health professional specializing in oncology may be beneficial if emotional distress is suspected.

In summary, while appetite changes can sometimes signal cancer progression, the context of your father's recent fall and his stable PSA levels suggest that the cause may be multifactorial. Promptly consulting with a healthcare provider will help determine the underlying cause of his appetite changes and guide appropriate interventions. It is crucial to address these symptoms early to ensure your father's overall well-being and quality of life.

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