Enzalutamide 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. You can have enzalutamide before or after chemotherapy.
Your hospital doctor may offer you enzalutamide if you can’t have chemotherapy, or you don’t want to have it yet. Enzalutamide may be suitable if your cancer isn’t causing any symptoms or only mild symptoms.
You may be offered enzalutamide 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 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, you may be able to try enzalutamide.
If you’re having trouble getting enzalutamide, even though your doctor thinks it is suitable for you, please let us know.
There is evidence that some men may benefit from having enzalutamide 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.
Men who have just been diagnosed with advanced prostate cancer are usually offered a chemotherapy drug called docetaxel along with standard hormone therapy. But during the current coronavirus outbreak, you may be offered enzalutamide instead of chemotherapy. This is because chemotherapy can increase your risk from catching infections, including coronavirus. Chemotherapy also involves regular hospital appointments, which could put you at risk of catching coronavirus during those hospital visits.
Enzalutamide doesn’t affect your immune system as much as chemotherapy. It also doesn’t involve regular hospital visits. For this reason, enzalutamide may be safer for you than chemotherapy until the risk from coronavirus in the UK has reduced.
Enzalutamide is currently an option for men in England and Northern Ireland who’ve just been diagnosed with advanced prostate cancer. If you live in Scotland or Wales, you’ll probably be offered a different type of hormone therapy called abiraterone instead. Abiraterone is also available for men in England and Northern Ireland who get severe side effects from enzalutamide.
Your doctor will talk to you about your treatment options. You may also find it helpful to read our information about prostate cancer and coronavirus, or speak to our Specialist Nurses.
Enzalutamide or abiraterone?
Enzalutamide and abiraterone are both types of hormone therapy that treat advanced prostate cancer.
Your hospital doctor will talk to you about which drug is most suitable for you. For example, 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.
But 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.
Some men may 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. But some men want to avoid the tiredness that enzalutamide can cause, and prefer to take abiraterone.
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 if you have any heart or kidney problems. Enzalutamide may not be suitable for you if you’ve had seizures, a stroke or injury to your brain in the past, or if the cancer has spread to your brain.
Enzalutamide may affect how some other medicines work. And some medicines can affect how well enzalutamide works. Tell your doctor if you are taking medicines for any other health problems, including:
- high cholesterol
- severe anxiety or schizophrenia
- sleep problems
- heart problems or high blood pressure
- thyroid problems
Other treatment options
If enzalutamide isn’t suitable for you, or if you choose not to have it, your doctor may offer you a different treatment. Possible treatments for advanced prostate cancer that has stopped responding to other types of hormone therapy include:
- chemotherapy (docetaxel or cabazitaxel)
- less commonly, oestrogens.
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.