A man with cancer has woken up to find he suddenly has an Irish accent – despite never being in the country.
The American had been battling an advanced form of prostate cancer for almost two years before seeking advice for his ‘out of control brogue’.
Doctors diagnosed the man in his 50s with extraordinarily rare foreign accent syndrome (FAS).
This means he is just one of the few people to have ever suffered from the speech impediment, which usually occurs as a complication of a stroke or head injury.
But doctors in North Carolina – who treated him and shared clips of his voice before and after the bizarre change – believe his cancer was to blame. He died later.
The American had been battling an advanced form of prostate cancer for almost two years before seeking advice for his ‘out of control brogue’. Pictured is Classiebawn Castle, Mullaghmore, Sligo
The man in his 50s had been battling an advanced form of prostate cancer for almost two years before seeking advice for his ‘uncontrollable brogue’. Pictured above are MRIs of the man’s brain released by doctors at Duke University Health System. A-scans are T2-weighted images, while B-scans are smooth attenuated inversion recovery images
Presenting his case in the British Medical Journal case reports, the Duke University Health System team said they believed the man had developed a paraneoplastic neurological disorder (PND).
Foreign accent syndrome: what do we know?
Foreign accent syndrome is a rare disorder that sees the patient speak with an accent that is different from their natural speaking style.
It is usually the result of a head or brain injury, with strokes being the most common cause.
FAS can also occur as a result of brain trauma, brain bleeding, or a brain tumor. Other causes have also been reported, including multiple sclerosis and conversion disorder.
It has only been recorded 150 times worldwide since its discovery in 1907.
FAS has been documented in cases around the world, including accent shifts from Japanese to Korean, British English to French, and Spanish to Hungarian.
This causes sufferers to pronounce vowels in different ways, move their tongue and jaw differently while speaking to produce a different sound, and even substitute words for others they don’t normally use.
In some cases, no clear cause has been identified.
Foreign accent syndrome can last for months or years, or sometimes it can even be permanent.
These are rare complications of cancer, caused by immune system cells that fight disease and mistakenly attack the nervous system.
It usually causes problems with muscle movement or coordination, but it can also affect thinking skills and memory.
The man, who has not been identified, was being treated at “an outside facility” for prostate cancer that had spread through his body.
In 20 months, he had received androgen deprivation therapy – hormone therapy to suppress or block the production or action of male hormones, as well as radiation therapy.
Worried about his sudden change, the man revealed he had never been to Ireland and had never spoken in an Irish accent before.
He did, however, tell doctors that he had Irish family and friends and had briefly lived in England during his twenties.
Doctors said his new accent was “uncontrollable, present in all settings and becoming progressively persistent”.
Prior to his language change, he also had no known head trauma and had not suffered from any psychiatric illnesses.
Although he had unintentionally lost weight, he did not report any other symptoms.
Results of a brain MRI also showed no abnormalities, ruling out the usual causes of foreign accent syndrome.
But a CT scan of his abdomen and pelvis revealed that his prostate cancer had spread further, with “a new cluster of right pelvic lymph nodes above the bladder”.
Due to his progressive prostate cancer, he was referred to the Duke Cancer Institute three months later for further treatment.
At this point, the man was still speaking with the “Irish brogue” accent, doctors noted.
But his cancer had developed into neuroendocrine prostate cancer (NEPC), a deadly variant of prostate cancer.
According to doctors, there are many known cases of PND presenting as symptoms of patients with NEPC.
In the UK, prostate cancer is the most commonly diagnosed cancer. One in eight men will be diagnosed with the disease in their lifetime, charities say.
The current outlook for patients with advanced prostate cancer, however, is poor, with few treatment options available.
Some 12,000 men die each year from the disease in the UK – 33 a day – with nearly 35,000 deaths each year in the US.
Doctors wrote that the man was quickly transferred to palliative care at home, due to his “rapid clinical deterioration” as his cancer progressed despite chemotherapy.
He died “soon after,” they noted.
“His brogue-like Irish accent was maintained until his death,” they wrote in the BMJ publication.
Foreign accent syndrome can also occur after brain trauma, brain hemorrhage, or brain tumor.
There have only been around 150 documented cases worldwide since its discovery in 1907.
It differs from the foreign language syndrome. The condition occurs when people suddenly forget to speak their native language and instead rely on a second language. It may be a language they haven’t spoken in years.
WHAT IS PROSTATE CANCER?
How many people does he kill?
More than 11,800 men a year – or one every 45 minutes – are killed by the disease in Britain, compared to around 11,400 women who die of breast cancer.
This means that prostate cancer is behind only the lung and intestine in terms of the number of people it kills in Britain.
In the United States, the disease kills 26,000 men each year.
Despite this, it receives less than half of the funding for breast cancer research and treatments for the disease are at least a decade behind schedule.
How many men are diagnosed each year?
Each year, more than 52,300 men are diagnosed with prostate cancer in the UK – that’s more than 140 every day.
How fast is it growing?
Prostate cancer usually grows slowly, so there may be no signs that a person has it for many years, according to the NHS.
If the cancer is at an early stage and not causing symptoms, a policy of “watchful waiting” or “active surveillance” may be adopted.
Some patients can be cured if the disease is treated at an early stage.
But if diagnosed at a later stage, when it has spread, then it becomes terminal and the treatment is to relieve the symptoms.
Thousands of men are put off seeking a diagnosis due to the known side effects of treatment, including erectile dysfunction.
Tests and treatment
Prostate cancer screening tests are haphazard, and accurate tools are only just beginning to appear.
There is no national prostate screening program because for years the tests were too inaccurate.
Doctors have difficulty distinguishing between aggressive and less serious tumors, making it difficult to choose treatment.
Men over 50 are eligible for a ‘PSA’ blood test which gives doctors a rough idea of whether a patient is at risk.
But it’s not reliable. Patients who test positive usually receive a biopsy, which is also not foolproof.
Scientists don’t know exactly what causes prostate cancer, but age, obesity and lack of exercise are known risks.
Anyone with concerns can speak to the specialist nurses at Prostate Cancer UK on 0800 074 8383 or visit prostatecanceruk.org
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