Abiraterone to be available for high risk patients in England

Hello Sunburst22 my partner has been on Abireratone since October, tolerating well with no other noticeable side effects, hot flushes and fatigue have been present since starting degarelix in July. Bloods are initially checked every 2 weeks and we have had no issues at all.....I guess we all react differently though. Paul has stage 4 PC with widespread bone mets. 

Also, if a medication is not tolerated it can be stopped, dose reduced etc.

i've been on abiraterone since june 2019 .

Inclusion criteria here published by NHS England a few days ago.

Inclusion criteria
All patients with newly diagnosed high-risk, hormone sensitive prostate cancer or relapsing
prostate cancer with high-risk features planned for standard of care treatment with
radiotherapy (unless contraindicated) who meet the following eligibility criteria.
3 The evidence informing the development of this policy comes from a clinical trial where patients were
staged according to images obtained from CT, MRI and bone scans.
4
Newly diagnosed high-risk prostate cancer
Eligible patients are defined as:
• WHO performance status 0-2
AND
• Non-metastatic (M0)
AND EITHER
• Pelvic node positive (N1)
OR
• Node negative (N0) with at least two of:
o tumour stage T3 or T4
o Gleason score 8-10
o Prostate specific antigen (PSA) ≥ 40 nanograms/ml
Relapsing prostate cancer with high-risk features
Eligible patients are defined as previously radically treated prostate cancer with an interval
of ≥12 months without treatment and:
• WHO performance status 0-2
AND
• Non-metastatic (M0)
AND EITHER
• Pelvic node positive (N1)
OR
• Node negative (N0) with one of either:
o a PSA concentration ≥4 nanograms/ml with a doubling time of <6 months
o a PSA concentration ≥20 nanograms/ml).

:

excludes those with contraindications to abiraterone and "clinically significant cardiovascular disease".

The WHO performance status 0-2 is about being physically able to look after yourself not confined to chair or bed most of the time.

ADT must start first and then Abiraterone and prednisolone should be taken for 2 years.

https://www.england.nhs.uk/wp-content/uploads/2026/01/2312-clinical-commissioning-policy-abiraterone-acetate-and-prednisolone-for-high-risk-hormone-sensitive-non-metastatic-prostate-cancer-adults.pdf

Thanks for your reply. We spoke to consultant yesterday who said that as Simon (husband) is a year into his HR treatment they wouldn't offer Aberiterone but it's another tool for the future if necessary. we won't need it.

• I noticed that you've been to your local Maggie's Centre. Thank God for them️ They've kept Simon sane since Xmas as he's really emotional and depressed due to HR treatment. He was advised that he can stop the treatment but he doesn't want to thankfully. 

Good luck to you and Paul with his treatment

Hi It’s cheaper because it went genetic a couple of years ago, it used to be very expensive. Roughly 2.5- 3k a month . It’s a very good drug at keeping your PSA low. My husband had it for roughly three years. I wouldn’t worry if you get offered it, but it may Not suit all. One of its attributes is its ability to stop your body making a false testosterone for the cancer to feed from, weird as that sounds. (Allegedly, one of the only androgen blockers that can do this )  
L

Thanks BW.

Seems that darolutamide is under patent protection until 2038. I know NHS won't be paying list price of £4,040 per mth, but presumably still significantly more expensive than abariterone. 

I'm unclear whether or not I meet the new criteria and whether or not a "direct" replacement for my current combination. I'll consider before next meeting at Oncology.

I remain of the view that PSA "numbers" are of very little relevance to my prognosis.

Good luck all,

Dave.

Hello Sunburst22 

I can understand Simon's feelings, I've been on HT over 3 years and yes it does "nibble away" at you. Maggie's is a great place to get help, a couple of other things I can suggest are:

* We have the online HOPE Course - it's a course learning how to overcome the problems associated with cancer - link here:

HOPE Course (Help Over Problems).

* WE also have a "Buddy" service where we can allocate Simon a "Buddy" to chat to once a week - it can be about cancer - coffee or the price of bread - it's up to him - again - link here:

Macmillan Buddies.

There's also our Support Line on 0808 808 00 00 (8am to 8pm 7 days a week). They have access to both the above and plenty more information to help Simon.

I hope the above helps.

Best wishes - Brian.

Wow 4k a month!!! That’s crazy money ! Abiraterone has been generic for quite a while now, I’m surprised it’s taken so long to filter through to England and Wales NHS as a first line treatment. I suspect drug company contracts with other drugs like Enzalutamide? Were still in place? It makes you realise how fortunate we are to have the NHS and what’s available and choice now.
L

Yes, I sure couldn't afford it  -  and feel very guilty about so much being spent on someone my age when people dying in corridors because of lack of "resources".

When it was offered me, just a few weeks after approved for my circumstances, it sounded worth trying and I didn't know the cost. 

It seems to cause me few problems and I don't know if I am sufficiently principled to quit it. If I'm told abiraterone is likely as efficacious then I would change.

Good luck, Dave 

 Carl28 Yes don’t change! If it works for you and it’s available it’s a good thing!