A 62-Year-Old Man With High-Risk Localized Prostate Cancer

EP: 1.A 74-Year-Old Man With Metastatic Castration-Resistant Prostate Cancer (mCRPC)

EP: 2.Assessing Tolerability and Clinical Considerations in Abiraterone Formulation Selection

EP: 3.Formulation Matters: Tailoring Abiraterone Dosing for Optimal Absorption and Tolerability

EP: 4.The Impact of Comorbidities, Adherence, and Access on mCRPC Treatment Decisions

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EP: 5.A 62-Year-Old Man With High-Risk Localized Prostate Cancer

EP: 6.The Role of Genomic Classifiers in Guiding Therapy for Localized High-Risk Prostate Cancer

EP: 7.Decision-Making and Multidisciplinary Counseling for Nodal Involvement on PSMA PET

EP: 8.Managing Abiraterone Intolerance: Alternative Dosing Strategies in Practice

EP: 9.Incorporating Micronized Abiraterone and Low-Fat Meal Dosing: Monitoring Efficacy and Tolerability

EP: 10.Approaching Corticosteroid Selection With Abiraterone in Patients With High-Risk Localized or Locally Advanced Prostate Cancer

Managing Comorbidities and Drug Interactions

This segment addresses the complex management of patients with metastatic castration-resistant prostate cancer who have multiple comorbidities, particularly focusing on diabetes and liver disease considerations. Patients with diabetes and their health care providers often express concern about the steroid component (prednisone or prednisolone) required with abiraterone therapy, fearing disruption of glucose control. The segment explains that these steroids primarily serve to replace mineralocorticoids suppressed by abiraterone rather than providing excess steroid exposure.

Regular monitoring becomes essential for patients with comorbidities, including frequent blood glucose checks for diabetics and liver function monitoring for all patients on abiraterone. Although hepatotoxicity remains relatively rare with abiraterone therapy, systematic monitoring allows for early detection and management of potential complications. The discussion emphasizes the importance of coordinated care between oncology, primary care, and specialty providers to ensure comprehensive patient management.

When patients experience tolerability issues with traditional abiraterone formulations, documented inability to comply with fasting requirements provides justification for switching to microformulation alternatives. This approach ensures that treatment decisions are based on objective clinical assessments rather than subjective preferences, supporting both optimal patient outcomes and appropriate insurance coverage considerations.