Cancer is a serious disease that can lead to life-threatening events. The disease develops when cells start to grow and multiply too quickly.
As other healthy cells die off, these cancerous cells will remain active. Cancer can affect many different parts of the human body. Among men, prostate cancer is one of the most common types of these diseases.
According to recent studies, more than 1.2 million men are diagnosed with prostate cancer each year. The prevalence of prostate cancer is highest among older men. Research shows that the risk starts to increase at the age of 40 to 45.
Numerous treatment options can be considered among men with prostate cancer. While surgery is sometimes preferred, it can be hard to treat cancer once it spreads to other regions of the patient’s body.
Abiraterone is a potential treatment used in some instances. We look at what the drug is, how it is used, and what men should know about Abiraterone.
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What Is Abiraterone?
Abiraterone is a prescription medication that is sometimes used in the treatment of prostate cancer. The drug is generally only used among men. There are specific criteria that would qualify the patient for this drug. Before Abiraterone can be provided to the patient, certain tests need to be done.
Abiraterone acetate will not be provided to a man with a mild type of prostate cancer. Instead, it is considered a treatment option in advanced prostate cancer. The drug may be considered if the patient’s symptoms are rated from mild to moderate.
A patient with severe symptoms associated with prostate cancer might not be given Abiraterone as part of their treatment. It may also be used with metastatic prostate cancer. Patients with castration-resistant prostate cancer, or metastatic CRPC, may also be offered this drug.
Abiraterone is considered an effective alternative to other hormone therapies used in prostate cancer treatment. In the majority of cases, a doctor will first use other hormone therapies to facilitate the treatment process. If cancer does not seem to respond to the treatment, then Abiraterone prostate cancer treatment may be considered.
Abiraterone is often sold under the brand name Zytiga. There are cases where doctors may refer to the patient’s treatment with the brand name instead of the generic name.
The drug is approved for use in prostate cancer treatment. Notably, it is suggested that Abiraterone is used when treatment with Docetaxel is ineffective. It may help to improve the overall survival chances in a prostate cancer patient.
How Is Abiraterone Used In Prostate Cancer Treatment?
To understand how Abiraterone may be utilized in the treatment process, men should know how the drug works. Abiraterone is considered an alternative to other hormone therapies. It is often used when other treatments do not seem to work.
Sometimes, hormone therapy drugs do work, but only for a while. Cancer eventually stops responding to the treatment. In these scenarios, the doctor may consider switching the patient to Abiraterone.
Abiraterone falls in the drug class adrenal inhibitor. While also classified as hormone therapy, it works differently from the other drugs that are used. In most men, androgen deprivation therapy is the first line of treatment. The goal of these treatments is to reduce androgen hormones in the male body. When a man is diagnosed with advanced prostate cancer, a tumor in the gland may produce excess testosterone.
It should be noted that prostate cancer responds to hormones. This can cause excessive growth of the tumor. Eventually, the continued effect causes cancer to spread.
By reducing androgen hormones, these therapies may suppress the growth of prostate cancer. The treatment may also help to reduce the risk of cancer spreading.
Abiraterone does not reduce androgen hormones in the same way as other drugs used. This particular medication causes inhibition of a specific enzyme. The expression of this enzyme occurs in the adrenal gland, as well as the testicles. The same enzyme seems to be active in a tumor located in a man’s prostate tissue.
The primary purpose of the enzyme is to stimulate glands to release androgen hormones. This is why tumors tend to release excess testosterone. The use of Abiraterone causes the activity of these enzymes to be reduced. In turn, testosterone production will also start to decline.
An important factor that sets Abiraterone apart from other drugs is that it works in three of the most crucial testosterone-producing areas. This includes the actual tumor in the prostate, as well as the testes and adrenal gland.
Abiraterone or Enzalutamide?
When Docetaxel is ineffective, doctors will generally look at the available alternatives. Most cases would call for either Abiraterone or enzalutamide to be used.
Both of these are considered effective alternatives to standard hormone therapies used to treat prostate cancer. A clinical trial shows that the inefficiency of one drug means the other option will also not have a clinical benefit for the patient.
It is important to note that both of these drugs will not be used on the patient. They cannot be used at the same time. There are a few similarities to how enzalutamide and Abiraterone works. A doctor will assess the patient and decide which treatment option will be a better option for them.
Whether the patient takes enzalutamide or Abiraterone, the doctor is also likely to prescribe a daily prednisone dose. The combination is generally used to assist in treating prostate cancer.
Enzalutamide also holds potential. Several studies have shown it is an effective treatment for prostate cancer. Some studies show a significant decline in mortality among male patients treated with enzalutamide.
It is generally not advised for patients to switch from Abiraterone to enzalutamide or the other way around. The reason for this is due to similarities in the drugs. When enzalutamide is not effective, then Abiraterone will most likely also not be the right treatment.
There are, however, cases where the doctor will make a switch in the patient’s prescription. This is generally the case if side-effects on a specific drug are too severe. The patient might be taking enzalutamide but is unable to cope with the severe side-effects experienced. In such a case, using Abiraterone instead might yield less severe adverse effects.
While both drugs are effective, some studies do show that enzalutamide might be the superior option. In one paper, researchers compare the effects of Abiraterone to that of enzalutamide. The researchers note that a higher survival rate is found among men treated with enzalutamide. Furthermore, resource use in terms of treatment tends to be lower in this particular group too.
What Are The Side-Effects?
Even though there have been reports of Abiraterone being highly effective, it is important to note that side-effects can also occur. In some patients, serious side-effects have been noted.
For this reason, patients are advised to understand the possible adverse effects beforehand. It is also vital that patients know when to stop using the drug and call their doctor. Looking out for signs of serious side-effects may help to reduce the risk of life-threatening events.
Abiraterone has been associated with hypertension. The use of this drug may cause an increase in blood pressure levels. High blood pressure may lead to blood vessel damage. It can also increase the risk of cardiovascular complications.
Some of the most common side-effects associated with Abiraterone include:
- Potassium levels tend to decline.
- Headaches are common.
- Some men feel tired while using the drug.
- It is possible to experience joint pain.
- Men have a greater risk of catching a cold.
- Anemia is a possible side-effect.
- Triglyceride and blood cholesterol levels may increase.
- Blood sugar levels may increase.
- Some men experience hot flushes.
- Diarrhea has been reported.
- Some men find that the drug causes a consistent cough.
- There have been cases of vomiting as a side-effect.
- There is a risk of infections in the throat, sinuses, and nose.
- Some men experience swelling in their feet or legs when they use this drug.
Several serious concerns should also be raised when looking at Abiraterone. There is a risk of hypoglycemia in men who also take medicine for diabetes. There is also a risk of severe liver dysfunction when the patient uses the drug.
Other serious adverse effects that men should note:
- There is a higher risk of experiencing bone fractures.
- Infections in the adrenal gland may occur. This can lead to adrenal gland damage.
- Fluid retention, along with cardiovascular complications, has been reported.
What Happens After Treatment?
Researchers have shown that early treatment with Abiraterone leads to a more positive outcome. Thus, doctors are advised to monitor a patient’s progress carefully while treating other hormone therapies. If no response is observed, then switching to Abiraterone may be an effective strategy.
Once the course of treatment with Abiraterone is completed, the patient will usually be asked to undergo a few tests. These tests will help the doctor determine whether the treatment was successful. The doctor will use the test results to determine what actions to take next.
If cancer responded well to the treatment, then monitoring may be advised. In some cases, additional treatments may be required, or the doctor may advise the patient to use the drug for a longer period. Median PFS may also be frequently measured during the initial recovery period.
Radiographic progression is considered an important part of after-care. Using imaging tests, disease progression can be tracked. Androgen biosynthesis and levels may also be monitored. This tells the doctor if androgen receptors are becoming more active in the male body. The hazard ratio of the patient needs to be considered. If they have a higher risk, the patient will be tested more frequently for prostate cancer cells.
PSA progression needs to be carefully monitored. This is important for men with metastatic disease and those with localized cancer. If PSA levels remain the same during treatment, the doctor may request imaging scans. This can include CT scans and MRI scans. A constant PSA level does not always indicate an ineffective treatment. There have been cases where PSA levels did not decline, yet treatment with Abiraterone was effective.
If cancer continues to grow while taking Abiraterone, the doctor may suggest considering other treatment options.
Alternative Treatments For Prostate Cancer
There are alternative treatments that may be considered. A doctor will generally consider alternatives if Abiraterone does not seem to be the most effective option. The doctor may also suggest an alternative if this drug does not work. The patient’s Gleason score is likely to be considered before an alternative treatment is considered.
Enzalutamide is an alternative to Abiraterone, but only if the drug causes severe side-effects.
The doctor may also consider the use of chemotherapy as an alternative treatment. This is one of the most common treatment options for cancer. Chemotherapy treatment may include the use of cabazitaxel or Docetaxel.
There are also steroids available for patients with prostate cancer. The use of steroids may be suggested in various situations. Steroids may help to reduce the size of a tumor. Some studies also suggest that steroids are effective in killing cancerous cells. The treatment may help reduce inflammation in the patient’s body and, essentially, contribute to a reduction in symptoms.
Steroids and chemotherapy are sometimes used together to provide a more effective treatment. Patients are generally provided with steroids for a maximum period of three months.
Radium-223 is another potential alternative. This treatment is sold under the brand name Xofigo. It is used when cancer starts to spread. Xofigo is generally advised for cases where prostate cancer spreads to the patient’s bones. At this point, the patient may experience pain symptoms.
The use of Xofigo may assist in reducing pain too. Xofigo includes the use of a radiotherapy technique. A small radioisotope is injected into the patient’s blood system. The radioisotope will move toward the areas of bone that have been damaged by cancer.
Clinical outcomes show that 70% of men experience a relief in pain when Radium-223 is administered. The treatment is also known as a type of radiation therapy. The treatment may also be suitable for reducing the rate at which the cancer is spreading. Thus, the median survival rate might be improved with this treatment. It may be used alongside other options, such as androgen deprivation therapy, to help treat prostate tumors.
Another option may be to utilize a PARP inhibitor, which reduces the poly ADP Ribose Polymerase enzyme activity.
A patient with high-risk prostate cancer may be advised that surgery is a good option. This may include surgical castration in some cases.
Treatment for prostate cancer can sometimes be difficult and even ineffective. In patients with advanced prostate cancer, treatment may stop working for the cancerous cells at some point. In these situations, the patient’s doctor may consider Abiraterone. The treatment is generally provided to men with more advanced prostate cancer. It holds potential, especially when administered during an early stage.