What is Abiraterone?
Abiraterone acetate (Zytiga®) is a type of hormone therapy used to treat men with advanced prostate cancer. It works by stopping the body from producing testosterone, which prostate cancer cells need to grow. While it won't cure prostate cancer, it helps keep it under control and can extend the time before symptoms worsen.
Who is Abiraterone suitable for?
Abiraterone is typically offered to men whose prostate cancer has stopped responding to other hormone therapies. It may also be offered as a first treatment for advanced prostate cancer in some cases. However, if you’ve had a hormone therapy called enzalutamide, Abiraterone might not be suitable for you.
When might my doctor recommend Abiraterone?
Your doctor may recommend Abiraterone if:
- Your prostate cancer has stopped responding to other hormone therapies (hormone-relapsed or castrate-resistant prostate cancer).
- You can't have or don't want chemotherapy.
- You’ve had chemotherapy with docetaxel, and your cancer has stopped responding to it.
- In Scotland and Wales, it is available as a first treatment for high-risk localised or locally advanced prostate cancer.
Can I take Abiraterone if I’ve had Enzalutamide?
Generally, if you’ve already had Enzalutamide, Abiraterone might not be effective. However, if you experience severe side effects from Enzalutamide, your doctor might consider switching to Abiraterone.
How do Abiraterone and Enzalutamide differ, and which is better for me?
Both Abiraterone and Enzalutamide are hormone therapies but work differently. Your doctor will determine which is more suitable based on factors like:
- History of falls or seizures (fits): Abiraterone might be better.
- Cancer spread to liver or lungs: Enzalutamide might be preferred.
- Need for steroids: Abiraterone must be taken with steroids, which might not be suitable for everyone.
What other health issues should I discuss with my doctor before taking Abiraterone?
Inform your doctor if you have:
- Heart or liver problems.
- High blood pressure or low potassium levels.
- Diabetes, as the required steroids can increase blood sugar levels.
Discuss all other medications you’re taking, as Abiraterone can interact with various drugs, including painkillers like codeine and tramadol.
What if Abiraterone isn’t suitable for me?
If Abiraterone isn’t suitable, other treatments for advanced prostate cancer include:
- Chemotherapy with hormone therapy.
- Hormone therapy alone.
- Clinical trials.
- Radiotherapy in combination with other treatments.
- Alternative hormone therapies like Enzalutamide, if not previously taken.
How do I take Abiraterone?
Abiraterone is usually taken as two tablets once a day, on an empty stomach. Do not eat for at least one hour after taking the tablets. It is taken with a steroid (prednisolone or prednisone) to reduce side effects. If you are newly diagnosed, you will likely also continue another type of hormone therapy.
How long will my treatment last?
You will continue taking Abiraterone until it stops working or you experience severe side effects. Regular PSA blood tests will help monitor its effectiveness.
What Are the common Side Effects of Abiraterone?
- Fluid retention and swelling in the legs or feet.
- Low potassium levels, causing muscle weakness or heart palpitations.
- Liver problems.
- High blood pressure.
- Diarrhoea.
Less common side effects include:
- High fat levels in blood.
- Chest pain and heart problems.
- Severe infections.
- Indigestion and blood in urine.
- Skin rashes and broken bones.
Should I use contraception while on Abiraterone?
Yes, use a condom and another form of contraception while taking Abiraterone and for three months after. If your partner is pregnant, use a condom during sex to prevent potential harm to the baby.
How will my treatment with Abiraterone be monitored?
You will have regular PSA blood tests every two to three months, along with blood tests for potassium levels and liver function and monthly blood pressure checks.
What if my PSA level rises while on Abiraterone?
If your PSA level rises, it may indicate that the Abiraterone is no longer effective. Your doctor may order additional scans (CT, MRI, or bone scans) to check the prostate cancer's spread and discuss other treatment options if needed.
