How to manage persistent hiccups and diarrhea in prostate cancer patients?

Question

Hi doctor,

My dad is a cancer patient. He has prostate cancer, which has migrated to the spine and lungs. He was having severe pain in the back and spine region and could not excrete or urinate. A catheter was used for urination, and an enema was given. A Tramadol injection and a few painkillers were also given, but he is having diarrhea and hiccups now. Looking at his age, we have not gone for a biopsy, chemotherapy, or radiation. We are giving him herbal medicine. But since the pain increased a lot, we had to give him painkiller injection. Please advise for hiccups, diarrhea, and pain. Presently I am giving him Aciloc 150 mg twice a day and Reglan thrice a day for the past three days but no relief in hiccups.

Answer 1

Hi,

Welcome to icliniq.com.

I thoroughly read your query and understand your concern.

The pain is often difficult to control if cancer has spread to the spine. The patient may need radiotherapy for the spine for pain control. When an enema is given for constipation, it often causes loose motion and will subside by itself. For prostate cancers, he should take an antiandrogen tablet and an injection of Zoladex (Goserelin acetate). If urinary symptoms do not subside, he may need palliative surgery. He needs good supportive care to control his symptoms.

Hope this has answered your queries.

Kind regards.

Answer 2

Hi,

Welcome back to icliniq.com.

I understand your concern.

I would suggest to him a tablet of Baclofen 10 mg three times a day, a tablet of Chlorpromazine 10 mg twice for one day, and then if required (SOS), continue Reglan (Metoclopramide) and Aciloc (Ranitidine). If still not controlled, the tablet Serenace (Haloperidol) 0.25 mg can be given if required (SOS). Both Serenace and Chlorpromazine cause sleepiness, so do not repeat if the person is sleepy or drowsy. Chlorpromazine comes with the brand name of the tablet Largactil. If 10 mg is not available, it comes in a strength of 50 mg, in that half tablet can be given.

Hope this helps.

Thanks and regards.

Answer 3

Hi,

Welcome back to icliniq.com.

I understand your concern.

When did he pass stool? He needs a USG (ultrasonography) of the abdomen and an abdomen X-ray for swelling.

Hope this has answered your query.

Kind regards.

Answer 4

Hi,

Welcome back to icliniq.com.

I understand your concern.

What was there in the USG abdomen report? If he has fluid in the abdomen, it needs to be drained.

Hope this helps.

Thanks and regards.

Answer 5

Hi,

Welcome back to icliniq.com.

I understand your query.

A bloated belly is often due to fluid in the stomach.

Hope this helps.

Thanks and regards.

Answer 6

Hi,

Welcome back to icliniq.com.

I understand your query.

For dry mouth, as such, there is no medicine. However, I suggest he have frequent sips of water and menthol lozenges, which will also help with dry mouth.

Hope this helps.

Thanks and regards.