Abiraterone is a treatment for advanced prostate cancer. It is most commonly offered to men whose cancer has stopped responding to other types of hormone therapy. You may hear this called hormone-relapsed or castrate-resistant prostate cancer.
Abiraterone may be suitable if you have no symptoms or mild symptoms. Your hospital doctor may offer you abiraterone if you can’t have chemotherapy, or you don’t want to have it yet. Or you may be offered abiraterone if you’ve had a chemotherapy drug called docetaxel and your cancer has stopped responding to it.
If you’ve already had a type of hormone therapy called enzalutamide, abiraterone probably won’t be an option. And if you’ve already had abiraterone, enzalutamide probably won’t be an option. This is because research suggests that men who have already had one of these drugs don’t respond so well to the other drug. However, if you get severe side effects from abiraterone or enzalutamide, you may be able to try the other drug.
If you're having trouble getting abiraterone, even though your doctor thinks it is suitable for you, please let us know.
There is evidence that some men may benefit from having abiraterone at an earlier stage, when they are first diagnosed with advanced prostate cancer. You may hear this called hormone-sensitive prostate cancer, as the cancer is likely to respond to standard hormone therapy.
In Scotland, abiraterone is available on the NHS as a first treatment for advanced prostate cancer. In England, Wales and Northern Ireland, abiraterone isn’t currently available for these men. The National Institute for Health and Care Excellence (NICE) is looking at whether abiraterone should be available as a first treatment for advanced prostate cancer. You can read more about this on our What we think and do page. Until NICE announces its decision, men in England, Wales or Northern Ireland who have just been diagnosed with advanced prostate cancer may be able to have abiraterone if they pay for treatment or have private medical insurance.
Abiraterone or enzalutamide?
Abiraterone and enzalutamide are both types of hormone therapy that treat advanced prostate cancer. If you've just been diagnosed with advanced prostate cancer, you probably won't be offered enzalutamide. But if your prostate cancer has stopped responding to standard hormone therapy and you haven't yet had abiraterone or enzalutamide, you may have a choice between these two medicines.
Your hospital doctor will talk to you about which drug is most suitable for you. For example, abiraterone may be a better option than enzalutamide if you’ve had:
- any falls
- any seizures (fits) or you have an increased risk of seizures
- extreme tiredness (fatigue)
- problems with memory or concentration.
This is because enzalutamide can increase your risk of these problems.
But enzalutamide may be a better option than abiraterone if your cancer has spread to the liver or lungs, or if you can’t take steroids. Abiraterone must be taken with a steroid.
Some men prefer to take abiraterone because it is less likely to cause tiredness than enzalutamide. But some men find enzalutamide easier to take because, unlike abiraterone, you don’t need to take it on an empty stomach and you don’t need to take steroids.
Speak to your doctor or specialist nurse about which treatments might be suitable for you and when to have them. You can also talk things through with our Specialist Nurses.
Other health problems and medicines
Tell your doctor about any other health problems you have. You should also tell them about any other medicines you’re taking or have taken recently, including any painkillers, such as tramadol. This is because abiraterone may affect how other medicines work. And some medicines can affect how well abiraterone works. Your doctor will talk to you about which prostate cancer treatment would be best for you.
If you have heart or liver problems, you may not be able to take abiraterone. If you have high blood pressure or a low level of potassium in your blood, you may need treatment for these before you start taking abiraterone.
If you have diabetes, the steroids that you need to take alongside abiraterone may increase your risk of high blood sugar levels. Your doctor or nurse may advise you to check your blood sugar levels more regularly than usual. If you take tablets or insulin to treat your diabetes, your doctor may suggest taking enzalutamide instead of abiraterone.
Other treatment options
If abiraterone isn’t suitable for you, or if you choose not to have it, your doctor may offer you a different treatment.
If you've just been diagnosed with advanced prostate cancer, other possible treatments may include:
Some men may also be offered radiotherapy together with one of the main treatments listed above.
If you have advanced prostate cancer that has stopped responding to standard hormone therapy, other possible treatments may include:
Speak to your doctor about your treatment options. They can also tell you about any clinical trials that might be suitable for you.
Read more about treatment options after your first hormone therapy.