Darolutamide is a treatment for prostate cancer that has stopped responding to other types of hormone therapy, but has not yet spread to other parts of the body. You may hear this called non-metastatic castrate-resistant (or hormone-relapsed) prostate cancer (nmCRPC).
- Non-metastatic – the cancer hasn’t spread to other parts of the body.
- Castrate-resistant – the cancer is growing, even though your testosterone levels are being kept low by standard hormone therapy (androgen deprivation therapy) or an operation called an orchidectomy.
Darolutamide will only be an option if tests show your prostate cancer has started to grow and is likely to spread to other parts of the body. This will usually be if your PSA level is 2 ng/ml or higher, and has doubled in the last 10 months. You may hear this described as a PSA doubling time of 10 months or less.
You’ll need to have scans to make sure your prostate cancer hasn’t spread to other parts of your body. These may include a bone scan, a computerised tomography (CT) scan, or sometimes a positron emission tomography (PET) scan.
If your cancer has spread to other parts of your body, darolutamide won’t be an option for you. Your doctor will talk to you about treatments for advanced prostate cancer instead.
If scans show the cancer has spread to lymph nodes near the prostate, you may be able to have darolutamide. But if the cancer has spread to lymph nodes in other parts of your body, darolutamide won’t be an option.
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. This is because darolutamide might affect how some other medicines work. And some other medicines might affect how well darolutamide works. Your doctor will talk to you about whether darolutamide is suitable for you.
If you have moderate or severe liver problems, or severe kidney problems, you may be given a lower dose of darolutamide (300mg, twice a day).
Other treatment options
If darolutamide isn’t suitable for you, or if you choose not to have it, you will usually continue with your first type of hormone therapy – even though it’s no longer working so well. This is because it will still help to keep the amount of testosterone in your body low.
Although your prostate cancer is no longer responding so well to your first type of hormone therapy, it may respond well to other types of hormone therapy or a combination of treatments. For example, your doctor may suggest adding an anti-androgen or steroid to your usual hormone therapy.
Speak to your doctor about your treatment options. They can also tell you about any clinical trials that might be suitable for you.
Problems getting darolutamide?
Darolutamide was approved for use on the NHS in England, Wales and Scotland in November 2020. The Northern Ireland Department of Health hasn’t yet decided whether darolutamide should be available through the Health and Social Care (HSC) service in Northern Ireland. This means your hospital may not have started offering darolutamide to patients yet.
If you think darolutamide may be a suitable treatment for you, speak to your hospital doctor. If they agree that it is suitable, but you’re still unable to get it, please let us know.