Abiraterone

I can't offer much advice, but can very much relate to your feeling. I was on Abiraterone 1000mg for two years, and straggled with fatigue, tiredness and brain fog. I know a few others on the forum had much fewer side effects, but I found it very difficult. Just thinking aloud, if the side effects are too much, can you move to another 2nd generation drug like Darolutamide?

Unfortunately not. I was told that I couldn’t change as I’d been on Abiraterone for more than 3 months

i was on 1000mg originally and it was hell

500mg is getting the same but they tell me it’s the lowest dose

Hi,

I read your profile and you've really been 'through the mill' I feel for you...

I've been on Abi since Feb. Yes, the fatigue is a real pain, but the results are brilliant I'm undetectable and in remission after 6 months...long may it last.. So I'm determined to make the 'investment' for a good chance of 'cure' or at least long-term remission. 

On a brighter note, I complained bitterly about the fatigue and 'negotiated' a reduction in my 'sentence' Just the 2yrs Abi now (18months remaining) and drop the 3rd year of orgyovix. Some consolation. How much longer are you recommended to be on Abi?

If you are interested, below is an extract from my profile on how I am dealing with the fatigue. Maybe you are not up to this, but you did ask and maybe some ideas/hope there for you.

Stay strong as you possibly can.. Good Luck

David

Fatigue Update July 2026,

I'm now nearly 4 months on from end of RT. So I conclude, sadly, that the RT effects are not driving the fatigue. It's for sure the orgovyx/aberaterone combo is the driver. (Good news is that even in this heatwave, hot flushes are hardly noticiable, guess I got  lucky, there..) Having read up on this site, many 'blame' the abbi as the driver. Certainly I had much more energy on orgyovix alone. Tentatively looking forward to returning to this for my final (3rd) year of my sentence. I am learning to manage this level of fatigue as the 'new normal' My rules are:-

• Don't let it rule your life - 'Push through it' whenever possible.
• Imagine your energy level as  a finite amount of 'gas in the tank'
  • Plan your day around (for me) my 1pm power nap where possible. 
  • Do routine exercise (eg DIY and gardening, walking or cycling) when you have the energy
  • After 30m resistance training I get tired. I leave 2 days recovery before next session
    • Recovery includes routine exercise of course - But LISTEN TO YOUR BODY
• I am still managing nearly an hour of tennis per week
• Walking is challenging - I need to sit down for a couple of minutes every 15 minutes. I prefer cycling.
• Good night's sleep is important. I sleep well apart from (initially) 3-4 toilet visits per night. I continue to take tamsulosin at 5-6pm and stop drinking at 4-5pm (except social occasions where wine and beer features ;-) This has reduced nocturia to 1-2 times per night and lessens fatigue.

Exercise, Muscle Wastage, Osteoporosis and Weight Gain Side Effects

It is well established that the best remedy here is exercise, especially resistance training. I have read a great book 'My Exercise Medication For Cancer'. I was already convinced but doubly determined to apply this now. I have found a great physio locally (was lead physio to Canadian Rugby Union team for 8 years) and he is helping me find a way through. The conundrum is finding the balance between the fatigue and the tiring effect of exercise. Key points are:-

• You must push yourself to 'failure' ie till it hurts with the exercises to build muscle but:- 
  • Don't overdo it - limit to 2-3 times per week for 20-30 mins
  • Rest days are crucial
  • Listen to / be kind to your body
  • It's ok to rest
• Do what you enjoy, so for me it's to integrate into my weekly schedule:-
  • Tennis
  • Yoga - weekly class and some at home - great for flexibility, mindfulness and positive attitude
  • Cycling - I bought an electric bike at Christmas and am finally allowed to use it (prostate settling in)
  • I'm no fan of walking (Unusual, I know, but I find it boring. But that's ok - not essential.
• Measure your baseline strength
  • Plank/side plank/ sit ups/lunges/grip strength/sit ups/push ups, etc..
• You don't need to join a gym if you don't like it / can't access/can't afford it
  • Many of these exercises can be done at home with a minimum of equipment
    • Yoga mat
    • Resistance bands
    • Dumbells
• Consider creatine supplement to help build muscle, bone indirectly through more exercise and possible cognitive benefits
  • May lead to weight gain, but if muscle not fat, it's good weight.
  • I have switched to sugar-free creatine gummies in June 2026
• I'm Treating this as a bit of a project / challenge for next 2-3 years

Great post David ( DavidEBe8c214 )

Thank you for taking the time to post this. Not only is it useful for people already on this treatment - it’s bloody good information for those of us who may be heading in that direction in the future.

I wish you well with your own journey.

Best wishes - Brian.

Excellent post. Thank you

Thanks for the information. There are some good points in there
Unfortunately I'm on Aberitorone until it stops working so no 'light at the end of the tunnel' for me.
Walking the dog twice a day is all I can manage at the moment but occasionally, if I feel up to it I take one of my motorbikes out for a spin which in itself is good exercise
I usually need a couple of days rest afterwards(Oh to be young again)
I'm still managing to work full time. I'm in IT and work from home so that's a help but I have to make myself stand up and move around a bit every hour otherwise my back starts to hurt

There is always light at the end of the tunnel, when this medication stops working they will try something else. As time goes by, further treatments come onboard. Have you seen that breakthrough announcement today on skin cancer ? It’s a distinct possibility that this could be adjusted and developed for prostate cancer. Never lose hope. 

best wishes 

Gra