Who Is Eligible for — Abiraterone?

No genetic test is required to start abiraterone. Eligibility is based on your cancer diagnosis, imaging confirming metastatic spread, your hormone therapy status, and liver function blood tests. Your oncologist may separately recommend genetic testing — for genes such as BRCA1 or BRCA2 — to assess future treatment options, particularly whether a PARP inhibitor might be appropriate later. That testing informs future planning; it does not decide your eligibility for abiraterone now.

Time on hormone therapy alone does not decide it. What matters is whether the cancer has started progressing despite treatment — a consistently rising PSA, or new or growing lesions on a scan. If your disease is still stable on current hormone therapy, your oncologist may not yet recommend changing the regimen. At your next appointment, ask your oncologist to explain your PSA trend and what it means for your next treatment decision. That question opens the conversation about whether abiraterone is appropriate now.

Abiraterone is indicated for metastatic prostate cancer — disease confirmed to have spread to bones, lymph nodes, or other organs. For localised or locally advanced disease that has not yet spread, it is not part of standard treatment guidelines. If your oncologist is considering abiraterone before metastases appear, ask them to explain the specific evidence or trial supporting that recommendation in your individual situation. That is a reasonable and important question to ask.

No. Abiraterone is a hormone-based treatment, not chemotherapy. It works by blocking an enzyme called CYP17A1 that the body uses to produce androgens. Chemotherapy damages dividing cells throughout the body, causing widespread side effects including hair loss. Abiraterone is a tablet taken daily at home, and its side effects — which can include fluid retention, raised blood pressure, and fatigue — are distinct from those of chemotherapy. Your oncologist will explain what to expect before you start.

Abiraterone is processed by the liver, so your team will review the extent and likely cause of any abnormality before deciding whether to proceed. Mild elevations in liver enzymes may be monitored closely at standard dosing; more significant impairment may require a dose adjustment or mean abiraterone is not appropriate for you at this time. Once you are on the drug, liver function is checked regularly. If you develop yellowing of the eyes or skin, very dark urine, or significant abdominal discomfort while on abiraterone, tell your oncology team the same day — do not wait for your next scheduled appointment.

Abiraterone is a tablet taken at home, not a hospital infusion, so the daily treatment is managed independently. Your appointments at CION are for monitoring — blood tests for PSA, testosterone, and liver function, and scans at intervals to assess how the disease is responding. Your oncologist will give you specific instructions about when to take the tablet in relation to food; follow these carefully, as timing affects how well the drug is absorbed. If a PET-CT scan is needed for response assessment, CION coordinates this with partner imaging centres.