Cancer patient develops 'uncontrollable' Irish accent in rare case: U.S. researchers

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Researchers in the United States are reporting an unusual and rare case of a man diagnosed with prostate cancer who developed an "uncontrollable 'Irish brogue' accent" despite not having one before.

The researchers from Duke University in Durham, N.C., and Carolina Urologic Research Center in South Carolina say the patient, a man in his 50s, had metastatic hormone-sensitive prostate cancer.

Twenty months after his cancer diagnosis, the researchers say the patient's speech changed.

"His accent was uncontrollable, present in all settings and gradually became persistent," the researchers say in their report, published in late January in BMJ Case Reports, a copy of which BMJ provided to CTVNews.ca.

Although he lived in England briefly in his 20s and had Irish family and friends, the researchers say the patient had never been to Ireland or spoke in an Irish accent before.

The man also had no history of psychiatric disease, head trauma or any known psychosocial stressor before his speech change appeared, the report says.

Even as his condition worsened, the researchers say the man still kept his Irish accent up until his death months later.

The researchers believe the situation is a case of foreign accent syndrome (FAS), also referred to as pseudo-FAS and dysprosody, which they describe as a consistent change in speech that makes it seem as if a person has a foreign accent.

It can often occur due to stroke, although documented cases exist of FAS being associated with earlier head trauma and history of psychiatric disease, the researchers say.

The report points to paraneoplastic neurological disorder (PND) as the most likely cause of the patient's FAS.

The U.S.-based Mayo Clinic describes paraneoplastic syndromes of the nervous system as a group of uncommon disorders that develop in some people who have cancer, specifically when the immune system's cancer-fighting agents attack parts of the brain, spinal cord, peripheral nerves or muscle.

The BMJ report says past research has suggested an association between paraneoplastic syndromes and disease progression in prostate cancer, as was the case with this patient.

The man also developed paralysis in his legs and arms, which the researchers say is "suspicious" for paraneoplastic syndrome.

The researchers found only two other similar reports in the scientific literature — one in 2009 involving a woman in her 60s with breast cancer, and another in 2011 of a woman in her 50s with seizures.

"To our knowledge, this is the first case of FAS described in a patient with prostate cancer and the third described in a patient with malignancy," the report says.

The report goes on to conclude that, "This unusual presentation highlights the importance of additional literature on FAS and PNDs associated with prostate cancer to improve understanding of the links between these rare syndromes and clinical trajectory."