Enzalutamide for Prostate Cancer Treatment

Enzalutamide is a second-generation androgen receptor inhibitor that works by blocking androgens from binding to prostate cancer cells, with the goal of stopping cancer growth.

It is an oral treatment used for the treatment of castration-resistant prostate cancer and metastatic castration-sensitive prostate cancer. It can be used as either a first or second-line treatment strategy, depending on your case. Additionally, it’s usually combined with androgen deprivation therapy.

The drug was developed following advances in understanding how androgens continue to influence cancer growth, even in castration-resistant prostate cancer. It was found that using enzalutamide to block other mechanisms triggered by androgens helped to overcome resistance to existing first-line hormone therapies.

Enzalutamide works by attaching to the usual binding sites for androgens in prostate cancer cells, taking their seats and preventing them from exerting their usual growth-promoting effects on prostate cancer. It also binds much better to these sites than the first-generation of these inhibitors.

A few things you should take note of when considering enzalutamide:

• There is a low risk of developing seizures while under enzalutamide.

You should avoid activities where losing consciousness suddenly could seriously harm yourself or others.

• If you experience rapidly worsening symptoms of seizures, headaches, reduced alertness or vision, you should contact your doctor immediately due to the risk of posterior reversible encephalopathy syndrome, a neurological disorder.
• You may experience allergic reactions that include swelling of the face or throat.
• Enzalutamide is associated with an increased risk of heart disease and high blood pressure.

If you experience chest pain, irregular heartbeats or fainting, you should inform your doctor immediately.

• If you are prone to balance issues or reduced muscle strength, you should take note that there is a higher risk of falls and fractures for those taking enzalutamide.
• Due to the risk of fetal toxicity, if your partner is of reproductive potential, effective contraception should be used when needed, up to three months after the final dose.
• If you intend to conceive after, you should note that there is a risk of infertility for you.

Unfortunately, this risk is generally commonly associated with prostate cancer treatments as most target the reduction of the sex hormones or the removal of the prostate in order to limit cancer spread.

Below are some common side effects of enzalutamide. You may not experience all of these side effects, but there is a risk that you may encounter a few of these at the same time.

The side effects commonly reported in over 1 in 10 people include:

• Physical weakness/fatigue
• Back pain
• Hot flushes
• Constipation
• Joint pain
• Reduced appetite
• Diarrhea
• High blood pressure

Overall, with extensive clinical trial data, enzalutamide has been established to be a safe and effective treatment for castration-resistant prostate cancer and metastatic castration-sensitive prostate cancer. While there remains a small risk of severe side effects, as is common with cancer treatments, noting changes of concern and reporting them early to your doctor will help to mitigate their impact on your life.