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Man with prostate cancer starts speaking with Irish accent: what’s the rare complication

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Man with prostate cancer starts speaking with Irish accent: what’s the rare complication

A prostate cancer patient in his 50s suddenly began speaking with a thick Irish accent. He was affected by a rare condition called “foreign accent syndrome”

A US man with prostate cancer has developed as complication a strong Irish accent. It may seem absurd, but Foreign Accent Syndrome or FAS (acronym for Foreign Accent Syndrome) it’s a medical condition well known, of which more than 100 cases have been described in the scientific literature. Very often it occurs as a result of a head injury, a stroke or other events and diseases – such as tumors and multiple sclerosis – which cause damage to areas of theleft hemisphere of the brain delegated to control speech. But peculiar associations are known such as that of the Californian patient, who developed the of him “Irish brogues” – i.e. strongly accented – about two years after receiving the diagnosis of the disease, due to which he sadly passed away.

The clinical case of a man with prostate cancer who developed foreign accent syndrome was described by an American research team led by scientists from the Department of Internal Medicine of the Duke University Health System, who collaborated closely liaised with colleagues in the Division of Medical Oncology, Duke Cancer Institute Center for Prostate and Urologic Cancers, and Carolina Urological Research Center. The scientists, coordinated by professors Amanda Broderick and Andrew J Armstrong, after observing the emergence of the English accent, subjected the patient to neurological exams e magnetic resonance imaging which they did not highlight brain abnormalities. Plus the man didn’t have one psychiatric history which could have explained the appearance of this curious Irish accent, which has become “gradually persistent”.

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The man was suffering from a metastatic prostate cancer hormone sensitive, which despite androgen deprivation therapy and chemotherapy treatment with abiraterone acetate/prednisone has evolved into an even more aggressive form. In fact, biopsy tests confirmed that the neoplasia had turned into a small cell neuroendocrine prostate cancer (By PC), with the development of numerous brain metastases. Simply put, the cancer had spread to his brain, setting off a “probable ascending paraneoplastic paralysis” which unfortunately led to the death of the man, who was about 50 years old. The cancer had also reached his liver and bones.

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As explained by Professor Broderick and colleagues, the patient was not of Irish ancestry, had never been to Ireland and had never spoken with an Irish accent before, although he had been in England some time 30 years ago. The foreign accent syndrome would have manifested itself precisely because of the evolution of his disease in the most aggressive form which also involved the brain, probably affecting the areas that control language. As explained by the experts, the presentation of the condition “was more consistent with an underlying paraneoplastic neurological disorder (PND).”

It must be emphasized that patients affected by FAS do not actually begin to speak with a foreign accent, but express themselves in a different way than normal due to the alterations induced by the disease, to the brain centers of language, to the nerve connections that control the movements of the jaw and tongue and vocal cord function. A foreign accent is something the listener perceives, so according to some experts, it doesn’t even really exist as a medical condition.

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This is the first time a case of FAS has emerged following prostate cancer, but at least two other events triggered by malignancies are known. The details of the research “Foreign accent syndrome as a heralding manifestation of transformation to small cell neuroendocrine prostate cancer” have been published by the authoritative scientific journal British Medical Journal.

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