Starting Abiraterone and predniSONE

[dac500]

Tomorrow morning I take my first dose of Abiraterone (Zytiga) and predniSONE for metastatic castrate resistant prostate cancer. I don't know what kind of side effects I would get. I hope I would tolerate the treatment well.

Reaching this stage of my cancer I reflect on my 12 year journey with prostate cancer.

Chapter 1: Diagnosis Gleason 3 +3 prostate cancer in February 2011 with a PSA of 3.4. Treated with brachytherapy (seed implant) June 2011. PSA drops to 0.1 in two years.

Chapter 2: Local recurrence with extraprostatic (extracapsular) extension. Cyberknife with ADT October 2016 to April 2017.

Chapter 3: Metastatic prostate cancer in many pelvic and abdominal lymph node October 2018. PSA reached 4.48, the highest in my life, in November when ADT treatment with Lupron started. Metastatic cancer hormone sensitive until October 2022.

Chapter 4: Metastatic cancer becomes castrate resistant confirmed by increase in PSA while on Lupron and PSMA PET/CT scan, November 2023. Starting tomorrow Abiraterone (Zytiga) and predniSONE and on continuous LUpron.

[RyderLake1]

My experience over the last year with Zytiga has been positive with no serious side effects. Prednisone, however, is a different matter. It is driving me crazy. It has caused the skin on the back of my hands to be very thin almost like parchment paper. The slightest bump and I get a blood bruise. Cuts are worse. They seem to take forever to go away. The cancer team reduced the amount of Prednisone I take to one pill a day. That has helped a bit.

[Izzygirl1]

I’m hoping your new treatment works and helps you for many years!! 🙏

I believe my husband may be in your situation after a little more then his year diagnosed. I’m going to ask about Zitiga And Prednisone for him.

[Ian99]

Hi. Am also Castration Resistant. Brief history Dx T3b m0 n0 Dec 2014, G9. Details on profile. On Zoladex from Aug/21, and Zytiga + Prednisolone from Jan/22. Mets present in pelvis (3) and ribs (2) but no radiographic progression thus far.

I have personally found Zytiga to be tolerable, am generally feeling ok. I take it first thing, an hour before breakfast. As Ryderlake mentions, I have also noticed a sort of blood bruise when I get a knock, I put it down to aging (76) but it may be related to the steroid (5mg/day), IDK. Overall I think I’m on the right medication. Good luck.

[dac500]

When you start abiraterone do the side effects hit immediately or gets worse later?

[Professorgary in reply to dac500]

I had very little side effects with Lupron but went on Zytiga two months ago. The heat flashes I barely noticed on lupron were very noticeable on Zytiga for the first month. Now pretty much like before, very mild. I do not know if it makes a difference on side effects but I take 250 mg with a low fat breakfast instead of 1000mg on an empty stomach. Just had my blood tests and Psa dropped 87% in two months and all other numbers are great. I also take 2800mg of curcumin extract. ADT has a negative effect on many things in the body. Lipids, glucose, bp etc. Curcumin relaxes blood vessels and makes the body more insulin sensitive and also helps balance lipids. I also take magnesium. Both these supplements promote heart health which is needed when on adt. Best of luck, God bless.

[dac500 in reply to Professorgary]

I am very glad you are tolerating Zytiga so well. I am just curious to whether anyone had a faster fall in PSA from Zytiga?

[Professorgary in reply to dac500]

Not sure what you are comparing it to. Psa peaked at 5664 May 2022 and came down to 6 Apr of 23 then went up to almost 20 by Sept. Dropped to a little under 5 in less than a month and now 2.6. When you look at prognostic indicators they use 50% at 4 weeks as excellent, mine was 75%. It is more important how long it stays down than how fast it comes down. Personally I’d like it to take 10 or 15 years to get to nadir.

[MateoBeach]

Zytiga probably won't give additional side effects, usually mild to none. However the prednisone needs to be monitored and adjusted if too low or too high. Watch for swelling and monitor BP carefully in first month. And blood work (Chem panel and CBC) should be checked. When the Prednisone dose is correct it will not have additionnal side effects.

[Hidden in reply to MateoBeach]

Add Liver function blood tests to Zityga.

Very important.