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Multisystem toxicities: case report A 60-year-old man exhibited liver dysfunction during treatment with abiraterone for advanced metastatic prostate cancer. Additionally, he exhibited erectile dysfunction, loss of libido, loss of muscle mass, weight gain, fatigue, reduced bone density and struggle to maintain endurance during treatment with abiraterone, bicalutamide and leuprorelin for advanced metastatic prostate cancer [routes and times to reactions onsets not stated; not all dosages stated]. The man had been diagnosed with advanced prostate cancer in May 2017. On 31 May 2017, he visited oncologist, and from that day onwards, he started receiving bicalutamide for 2 weeks. He also started receiving leuprorelin injection. In early July 2017, he started receiving abiraterone 1000mg daily but he experienced liver function issues. His AST increased. He was found to have developed side effect of abiraterone in the form of liver dysfunction. The man’s abiraterone therapy was withheld for 6 weeks and restarted again (multiple times). His AST level reached to 300 unit/L at one stage. Finally, he started receiving abiraterone at a reduced dose of 500mg daily, following which his liver function recovered. His oncologist advised to stop abiraterone but he insisted for another 3 weeks. In these 3 weeks, his liver function stabilised and remained at high end of normal range thereafter. He was an athlete, and his oncologist suggested that he can resume his training once his underlying stress fractures healed. Further, he experienced side-effects of hormone therapy in the form of loss of muscle mass, weight gain, fatigue and reduced bone density, and he struggled to maintain endurance. His running got tougher. Prior to the diagnosis of cancer, he used to ran 5km in 22 minutes, and following the diagnosis and treatment, he covered the same distance in 26 minutes on a really good day. Subsequently, he experienced loss of libido and erectile dysfunction as additional side effects of hormone therapy. He reported negative impact of erectile dysfunction on his sense of masculinity as well as sexual relationship. He received therapeutic support from a psychosexual therapist. He did not have a strong enough erection to have penetrative sex again, even with unspecified chemical support. After the initial diagnosis of his cancer and discussion, his prostate-specific antigen (PSA) level reduced dramatically with leuprorelin and abiraterone treatment, and reached an unrecordable level in 10 months. In July 2020 (over 3 years post-diagnosis), his PSA level remained at the unrecordable level [not all outcomes stated]. Collier T, et al. Living with Advanced Hormone-Sensitive Prostate Cancer and Treatment with Abiraterone and Androgen Deprivation Therapy: The Patient, Nursing and 803521289 Physician Perspective. Oncology and Therapy 8: 197-207, No. 2, Dec 2020. Available from: URL: http://doi.org/10.1007/s40487-020-00132-2

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Reactions 19 Dec 2020