Enzalutamide and Abiraterone

Enzalutamide and Abiraterone are advanced drug therapies which have recently been developed and integrated into oncological management, particularly in patients with advanced stage prostate cancer, such as metastatic castrate-resistant prostate cancer (mCRPC). Specifically, Enzalutamide and Abiraterone are second-line hormonal (anti-androgen) therapies provided to cancer patients (usually following chemotherapy) to suppress androgen signaling in blood and bone marrow. The optimal dosage and sequencing of these two pharmacological agents following chemotherapy is yet to determined, however, this is an effective therapy in such an advanced stage of cancer.

The provision of Enzalutamide and/or Abiraterone can lead to undetectable levels of testosterone (less than 1 pg/mL). While this may provide an effective and targeted approach to minimising prostate cancer growth and spread, there are also dramatic and negative side-effects on muscle and bone tissue (similar to those evident during androgen-deprivation therapy). However, the combined administration of these two novel agents have demonstrated no life-threatening side-effects, and no considerable polypharmacy effects.

There are numerous short-term and long-term side-effects, including:-

Short Term Effects Long Term Effects
Tiredness Fatigue
Nausea Bone Loss
Muscle Pain Muscle Loss
Weakness Bladder or Urinary Issues
Hot Flushes Joint Pain or Swelling
Diarrhea Loss of Fertility


Exercise during Enzalutamide and Abiraterone:

Exercise has been shown to be safe and effective in patients with advanced prostate cancer. However, if you are in the advanced stages of your cancer, with a high burden of treatment, you will need modified exercise programs and therefore must consult with an accredited exercise physiologist and your treating physicians prior to engaging in exercise. Despite being in the advanced stages of disease, it is important that you still exercise, as the physical stress placed upon you creates useful biochemical changes that may have anti-tumour effects, to suppress the growth and spread of your cancer, in conjunction with your other treatments. Similarly, exercise will help you tolerate your other treatments, whilst preserving muscle and bone mass and strength; important factors to maintain physical function, quality of life and overall wellbeing. As your symptoms transiently change, you might need to further modify your program beyond those given to you by your accredited exercise physiologist; so please keep them informed of any side-effects as they occur.