Need meal ideas for low-dose abiraterone

[HikerWife]

First post! My husband (dx Oct '22, PSA 270, advanced PCa with extensive bone mets), is about to start the low-dose abiraterone regimen (250mg with small low-fat meal - 300 calories, max 9g of fat) (this has been discussed with two oncologists, including one at Dana Farber, so please - respect our decision). I have been googling like crazy, and can find pretty much nothing online for meal ideas - when I search, all I get is endless articles about the concept itself. I was hoping to find some patient handouts from dieticians at cancer centers, but nope. Is there anybody out there who has done this or is doing it? I have a couple of ideas, but want to provide some variety. He's never been big on "breakfast" foods, and is happy to eat unusual/ethnic flavors - so anything goes, flavor-wise. It just has to be 300 calories and 9 or less grams of fat. Thanks in advance!

[Tall_Allen]

If you are doing this to save money (and there is no other reason to do it), the lowest price I've seen is $158.40 for one month of 1000 mg pills without food.

costplusdrugs.com/medicatio...

[HikerWife in reply to Tall_Allen]

That is a superb price, thank you for the link. I'd be curious to know why you feel so strongly about taking the 1000mg on an empty stomach, vs the 250mg with food. I have already carefully figured out several appropriate meals for him to eat, and am confident that all of them conform to the correct protocol. I am trying to see what others might have done, to provide some variety. Except for working out the meals initially, we feel that this protocol will be easier on my husband and disrupt his life less. As I mentioned, our 2 MOs are very comfortable with it. Our local MO has been supervising patients on this protocol for over 2 years, and has has very good results. We double-checked with our Dana Farber MO, and he has no reservations. We feel comfortable with the decision.

[Tall_Allen in reply to HikerWife]

250mg with food gives around the same bioavailable dose as 1000 mg without food. Same bioavailability=same adverse events (the same amount of abiraterone is reaching the bloodstream either way). But the issue with food is the uncertainty. As you are questioning - what exactly is the amount of food that renders the bioavailability the same? And does it vary from individual to individual? It probably depends on the unique microbiome of each individual. So if there is so much uncertainty with food, some men will get too much (=higher adverse events), and some men will get too little (=lower effectiveness). If you can afford it, you are more certain to get the right bioavailable dose if you take it without food.

[HikerWife in reply to Tall_Allen]

I have been told to aim for 300 calories, and no more than 9 grams of fat.

[Murph256]

Black beans and rice, fat free refried beans, baked sweet potatoes with honey, salads with chick peas and veggies with a lemon and mustard dressing, baked tilapia with garlic powder and peprika, banana blueberry and almond milk smoothies with plant based (from peas) protein powder, chick pea and lemon hummus with reduced fat crackers (wheat thins), tofu and veggie stir fry with soy sauce over rice. The problem is getting enough protein in a fat free diet.

[HikerWife in reply to Murph256]

Thanks, Murph! Those are some excellent ideas. He likes beans a lot, so the black beans & rice, and nonfat refried beans are great. Hummus and reduced fat crackers too. Those are all easy to throw together - he has very early work meetings sometimes. We have a Trader Joe's with excellent packaged roast chicken slices - he likes the idea of that on bread with lettuce & low fat mayo (I bought packets for portion control). Also worked out a Canadian bacon (very lean) and lowfat cheese on English muffin sandwich. I guess we're getting there. Thanks for adding some extra ideas, much appreciated! - Susan

[Concerned-wife]

I included the word “ plan” after diet and found info. Try adapting your search. Perhaps suggestDana Farber develop such a plan. They seem very patient oriented. cinj.org/sites/cinj/files/d...

[HikerWife in reply to Concerned-wife]

Thank you, that's helpful info. I really DO wish DF or another cancer center would develop more detailed recipes/plans for those doing this regimen - I was really surprised to find nothing specific as a patient hand-out. A lot of men are doing this. Thanks again.

[Concerned-wife in reply to HikerWife]

I would suggest it. Seems like their dietitians would like to be the first. And would be easy for them

[Guber]

I have an egg on toast or an egg with cheese and wash the pill down with a glass of milk.

[HikerWife in reply to Guber]

Thanks, Guber! Unfortunately, my husband does not like eggs (he's from Mars😆), so that makes things a little tougher. I was really surprised that one of the big cancer centers hasn't tackled this problem already. I mean, I can figure things out - but it would save a heckuva lot of time to have a list of ideas from nutritionists online!

[Bethpage in reply to HikerWife]

How about the egg white "cups"? You just spray a muffin tin, pour in egg white (pure protein), top with 1/4 tsp. whipping cream, salt & pepper and a little smidge of shredded cheddar. Bake at 425 F for 15 min. That 1/4 tsp. of whipping cream and the smidge of shredded cheddar totall transforms the egg white. I hate eggs, but love these egg white cups. They're filling.

[HikerWife in reply to Bethpage]

Hi, Bethpage - it sounds yummy to me, but he WILL NOT eat eggs at all, unless they're baked into something. Thanks, though!

[HikerWife]

Thanks, Smurtaw. You pretty much said what I've been thinking. We figure if we tightly control what he eats *with* the dose from day to day, then he should be absorbing pretty much the same amount of drug from day to day. And as you pointed out, even on the 'on-label' 1000mg dose, not every guy will metabolize and absorb it exactly the same as every other guy. One of our MO's said she's got a number of patients using low-dose, and the MO at Dana Farber didn't bat an eye and said he has no reservations about us doing it. Thanks for the links too - have read most of them already. Much appreciated!

[HikerWife]

Thanks anyway, but he dislikes eggs.

[Guber]

I started with a bowl of cereal, and that seemed to work all right too.

[dhccpa]

A handful of nuts might do it.

[HikerWife in reply to dhccpa]

Thanks for the suggestion! He's not big on nuts though (unlike me....)

[Shams_Vjean]

sent you PM/chat message. Good Luck!