Need inputs on Abi side-effects for bed-ridden patient

[MadrasMarina]

Patient

68yrs, male, bedridden for 2 years because of metastatic cord compression from advacnced(stage 4) prostate cancer. Taking Zolodex 10.8 every 3 months for last 2 years with some regular tablets like hypertension, multivitamins etc.

First time in 2 years PSA is starting to go up, so wanted feedback. Overall physical condition is largely same and no visible changes/deterioration.

Just got the next test done yesterday and it seems to be on an increasing trend.

Last month, oncologist had said that he will start Abiraterone in case the trend is increasing and also that he needs to see the patient once.

Does Abiraterone have any significant side-effects? My dad has been completely bed-ridden for over 2 years now.

[JohnInTheMiddle]

Here's a comment limited to the question of taking meds while lying down in bed. It is important to lie on one's right side when doing this. My comment is based on the little bit of good research which I found.

Digestion is apparently dependent on gravity; the exit from the stomach, which is the duodenum, should be at the "bottom" of the stomach. Normally this works when one is standing up; seems to be okay when one lies and one's right side. Lying in any other orientation is a bad idea.

[Benkaymel in reply to JohnInTheMiddle]

Interesting. I remember reading somewhere that lying on your left side was best for both digestion and heart circulation??

[JohnInTheMiddle in reply to Benkaymel]

There is a lot of traditional commentary you can find on the web that says lying on your left side is a good idea for digestion. This may or may not be true related to heartburn etc. My question however concerned taking Abiraterone in the morning and then lying down.

Here's what the nice people at Johns Hopkins say in particular related to taking pills. They say pills are absorbed the fastest when lying on the right side.

hub.jhu.edu/2022/08/16/the-...

[jfoesq]

I might not be correct about the following so I apologize for asking these but why hasn't he already been on Aberaterone?

Is he on Lupron? My understanding, which is limited, is that triplet therapy is best for newly diagnosed metPC.

It is also my limited understanding that Lupron, Abi and perhaps chemo can sometimes shrink tumors, at least for a period of time, which, if I am correct about, might possibly help with his compression issues.

What am I missing here?

[MadrasMarina in reply to jfoesq]

We are based in India. Here we started on Zoladex which seems to be similar to Lupron. Not sure why the doctor didn't start Abi initially but is considering it only now after Zolodex seems to have lost efficacy.

Regarding chemo, the doc here was of the view that it will create complications for bed ridden patients and we can explore it if/when my dad regains some mobility.

Two years back the disease had spread to his spine, resulted in a tumor on the spine that impacted his nervous system and hence bed-ridden. It had also spread to his arm resulting in a fracture. Over the last two years, apart from being bed-ridden there have been no significant deterioration in his external physical condition.

[j-o-h-n]

India?

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 09/23/2023 8:19 PM DST

[MadrasMarina]

Yeah, you're right. We are based in India.

[GAdrummer]

Abiraterone is generally given with prednisone. Over time, the skin becomes very fragile from the prednisone. Watch out for pressure sore development. The effort to turn in bed may cause the skin to tear. The slightest bang against a rail may cause a blood blister on the back of a hand that grows until the skin bursts open. Nail care is important as rough nails can tear itchy spots. Many times I wished I could wrap my husband in bubble wrap to stop the damage.

[MadrasMarina in reply to GAdrummer]

Thanks much. This is quite concerning since my dad already has some skin issues like eczema etc.