Prostate Cancer Medicines Explained: How Abiraterone and Enzalutamide Work
                     Prostate cancer: symptoms, 
PSA, treatment
A Patient & Caregiver Guide (2026)
01 02 03
Prostate Cancer Diagnosis and Staging Treatment Options
Fundamentals Process By Stage
Table of 
Contents 04 05 06
Modern Medicines Abiraterone v Comprehensive Care
A comprehensive guide to 
Androgen-Targeting Enzalutamide Beyond Medicine
understanding prostate cancer, Comparison
from diagnosis to treatment and 
daily care 07 08
Patient Questions Resources & 
Practical Guidance RTruesfteerde Snocurecses
What is Prostate Cancer?
Definition In the Philippines Early Detection
Cancer that develops in the Rising prevalence among Filipino Screening and early diagnosis 
prostate gland, a small walnut- men, making it one of the most significantly improve survival rates 
shaped organ found only in men common male cancers in the and treatment outcomes
country
Prostate cancer is a serious but treatable disease when detected early. Understanding the basics helps 
patients and families make informed decisions about screening and care.
Early Signs and Symptoms
Urinary Changes Blood Presence
Frequent urination, especially at night, or weak and Blood in urine or semen may indicate prostate 
interrupted urine flow problems requiring medical evaluation
Pain or Discomfort Asymptomatic Cases
Pelvic pain, bone pain, or discomfort during urination Many early prostate cancers show no symptoms, 
in advanced cases making regular screening essential for detection
The Prostate Gland
Location Function Cancer Growth
● Positioned below the ● Produces seminal fluid that ● Abnormal cell growth in 
bladder and surrounds the nourishes and transports the prostate can remain 
urethra, the tube that sperm during ejaculation localized or spread to 
carries urine out of the body nearby tissues and bones
Diagnostic Process Overview
Medical History and Symptom Review
Your doctor will ask about urinary symptoms, family history of prostate cancer, and overall health status
PSA Blood Test
Prostate-Specific Antigen (PSA) test measures protein levels in blood; elevated levels may indicate prostate problems 
and prompt further testing
Additional Evaluation
If PSA is elevated or symptoms are concerning, your doctor will recommend further tests such as imaging or biopsy
Physical Exam and Imaging
Digital Rectal Exam (DRE) Multiparametric MRI (mpMRI)
During a DRE, your doctor gently inserts a ● • Creates detailed images of the prostate
gloved, lubricated finger into the rectum to feel ● • Identifies suspicious lesions
the prostate gland. This simple exam helps 
detect lumps, hard areas, or enlargement that 
may suggest cancer. Guiding Treatment Decisions
● • Targets biopsy to abnormal areas
● • Helps plan surgery or radiation
01 Sample Collection
Thin needle guided by ultrasound 
or MRI removes tissue samples
Prostate 02 Pathology Review
Biopsy is required to confirm prostate Specialist examines cells under 
cancer; small tissue samples are taken microscope to detect cancer
for lab analysis.
03 Diagnosis Confirmation
Results show cancer presence and 
how aggressive it is
Cancer Staging and Grading
TNM System Gleason Grade Group Treatment Planning
• T: Tumor size and extent • Scores cell appearance • Stage determines 
• N: Lymph node • Grades 1–5 show prognosis
involvement aggressiveness • Guides therapy selection
• M: Metastasis to other • Higher grade = faster • Predicts treatment 
organs growth outcomes
Localized Cancer (Stage 1–2)
Active Radical Radiation Therapy Treatment 
Surveillance Prostatectomy Outcomes
Monitor slow low-risk Surgical removal of the External beam or High cure rates with 
tumors entire prostate gland brachytherapy early detection
Early-stage prostate cancer offers excellent treatment success and long-term survival for most patients.
Locally Advanced Cancer (Stage 3)
Radiation+Hormone Surgical Options Adjuvant Therapy
s
Radiation combined with Surgery for selected patients Adjuvant therapy after primary 
hormone therapy controls after urologist assessment treatment reduces recurrence 
growth better than either alone risk
● • Shrinks tumor before ● • Radical prostatectomy ● • Reduces recurrence risk
radiation ● • For selected cases only ● • Targets microscopic 
● • Improves treatment disease
success
Advanced/Metastatic Cancer
Treatment Goals Palliative Care Multi-Modal Therapy
Focus on controlling spread and Palliative care manages pain, Combine hormones, 
relieving symptoms to preserve fatigue, and function with the chemotherapy, and targeted 
quality of life oncology team drugs to treat advanced disease
● Control cancer growth ● Symptom management ● Hormone therapy
● Relieve pain and symptoms ● Emotional support services ● Chemotherapy and targeted 
drugs
Personalized Treatment Planning
Cancer Characteristics 1 2 Patient Factors
Stage, grade, and PSA level guide Age, overall health, and personal 
treatment selection preferences matter
Shared Decision-Making 4 3 Multidisciplinary Team
Patient actively participates in Urologist, oncologist, and 
choosing treatment radiologist collaborate
Abiraterone: Androgen Synthesis Inhibitor
Mechanism Blocks androgen production throughout the body
Stops hormones that fuel prostate cancer cell growth
Admin Taken orally once daily with prednisone
Must be taken on an empty stomach for proper absorption
Monitoring Regular blood pressure and liver function checks
Potassium levels monitored to prevent complications
Benefits Extends survival in advanced prostate cancer
Effective for hormone-sensitive metastatic disease
Enzalutamide: Androgen receptor 
blocker
●
Mechanism Blocks androgen receptors on cancer cells, preventing hormone signals from 
reaching the cells
● Oral capsules taken once daily, with or without food
Administration
● Watch for fatigue, dizziness, and rare seizure risk
Monitoring
● Highly effective in hormone-resistant prostate cancer
Effectiveness
How These Medicines Work
● Prostate cancer cells require androgens (male 
Androgen Dependency
hormones) to grow and multiply
●
Abiraterone Action Stops androgen production in adrenal glands, testes, 
and tumor tissue
●
Enzalutamide Action Blocks androgen receptors, preventing hormones from 
activating cancer cells
●
Combined Effect Both medicines starve cancer cells of growth signals, 
slowing disease progression
Safety and Adherence
Take as Prescribed Regular Report Side Never Stop 
Monitoring Effects Suddenly
Same time daily for Blood tests for liver and Contact doctor Always consult your 
consistent blood levels electrolytes immediately if new doctor before stopping
symptoms appear
Adherence to your prescribed treatment plan is essential for the best outcomes and your safety
Abiraterone vs Enzalutamide
Abiraterone Enzalutamide
Androgen synthesis inhibitor Androgen receptor blocker
Requires prednisone No steroid needed
Blood pressure and potassium Seizure precaution required
monitoring Taken with or without food
Taken on empty stomach
Side Effects Profile
Abiraterone Enzalutamide
• Fluid retention and swelling • Fatigue and tiredness
• High blood pressure • Dizziness
• Low potassium levels • Hot flashes
• Liver enzyme elevation • Rare seizures (uncommon)
Choosing the Right Medicine
Cancer Stage Comorbidities Side Effects Oncologist Advice
Oncologist reviews if Existing conditions like Tolerance of side effects Specialist weighs 
cancer is new, heart disease, and lifestyle preferences evidence, test results, 
progressed, or hypertension, or guide treatment and health to pick the 
hormone‑resistant seizures affect drug selection safest, most effective 
choice drug
● Disease progression ● Heart disease ● Tolerance level ● Evidence-based choice
● Prior treatment response ● Seizure history ● Daily lifestyle ● Personalized recommendation
Physical Activity and Exercise
Muscle and Bone Health Reduces Fatigue
Regular physical activity helps maintain muscle strength Exercise is proven to reduce treatment-related tiredness 
and bone density, which can be affected by hormone and boost energy levels throughout your cancer journey.
therapy.
Cardiovascular Fitness Emotional Well-being
Staying active improves heart health and circulation, Physical activity enhances mood, reduces anxiety, and 
supporting overall physical resilience during treatment. promotes a positive outlook during cancer treatment.
Nutrition and Diet
1 Balanced Meals
Include vegetables, fruits, whole grains, and lean protein in every meal to 
support healing and strength.
2 Stay Hydrated
Drink at least 8 glasses of water daily to help your body process 
Support Your Body medicines and maintain energy.
During Treatment
3 Limit Harmful Foods
Reduce processed foods, excess salt, and alcohol to minimize side effects 
and support treatment effectiveness.
4 Consult a Dietitian
A registered dietitian can create a personalized nutrition plan tailored to 
your treatment and health needs.
Follow-up Care and Monitoring
Schedule appointments with your oncologist every 3 to 6 months to monitor 
Regular Visits
your treatment progress and overall health.
Regular PSA blood tests track how well your treatment is working and detect 
PSA Testing
any changes in cancer activity early.
If your PSA level rises or symptoms worsen, your doctor may order CT, MRI, or 
Imaging Scans bone scans to check for cancer spread.
Early detection of treatment side effects or cancer recurrence allows your 
Side Effect Watch medical team to adjust your care plan promptly.
Medication adherence and symptom 
reporting
Take your medicines at the same time every day to maintain steady levels in 
Daily Routine
your body and maximize effectiveness.
Set up a pill organizer or phone alarms to help you remember your daily 
Use Reminders
doses and avoid missing any medication.
Keep a written or digital record of any side effects or symptoms you 
Symptom Diary experience and share it with your doctor at each visit.
Contact your healthcare team immediately if you notice new or worsening 
Report Changes side effects so they can adjust your treatment if needed.
Emotional Health and Support
Include loved ones in appointments and treatment discussions. Shared 
Family Involvement
understanding helps everyone support the patient better.
Connect with other patients facing similar challenges. Sharing experiences 
Support Groups
reduces isolation and provides practical coping strategies.
Professional counseling helps manage anxiety, depression, and treatment-
Counseling Services related stress. Mental health is as important as physical health.
Emotional and psychological health directly impacts treatment outcomes. 
Holistic Well-being Address mental health needs alongside medical care for best results.
Frequently Asked Questions
Q1 Is prostate cancer curable?
Yes; when found early, localized prostate cancer often cures with surgery or radiation
Q2 What PSA level is concerning?
PSA above 4 ng/mL usually needs further evaluation; age and other factors also matter
Q3 Are all prostate cancers aggressive?
No; many prostate cancers are slow‑growing and may not need immediate treatment
Q4 Are Abiraterone and Enzalutamide chemotherapy?
No; these are hormone therapies that block androgen signals, not chemotherapy
Treatment Timing and Active Surveillance
Immediate When is immediate treatment needed?
High‑risk or symptomatic prostate cancer needs prompt surgery, radiation, or hormone therapy to 
prevent progression and complications.
What is active surveillance?
Surveillance
Low‑risk, slow‑growing tumors are closely monitored without immediate treatment to avoid side 
effects while maintaining safety.
How is surveillance conducted?
Monitoring
Regular PSA tests, digital rectal exams, and periodic biopsies are used to track cancer behavior; 
frequency is based on individual risk.
When does treatment begin?
Transition
If PSA rises, biopsy shows progression, or symptoms appear, the oncologist will advise switching from 
surveillance to active treatment.
Daily Life During Treatment
●
Work & Activities Many patients continue working and daily routines during treatment. 
Communicate openly with your employer about medical appointments and any 
needed accommodations.
● Plan rest periods throughout the day. Balance activity with adequate sleep. Fatigue 
Managing Fatigue
is common but manageable with proper pacing.
● Maintain hobbies, friendships, and social activities. Staying engaged improves 
Social Connections
mood and provides emotional support during treatment.
● Treatment aims to control cancer while preserving your quality of life. Discuss any 
Quality of Life
concerns about daily functioning with your healthcare team.
Trusted Medical Resources
International Guidelines Global Organizations
NCCN (National Comprehensive Cancer Network), EAU American Cancer Society (ACS) and World Health 
(European Association of Urology), AUA (American Organization (WHO) offer patient education materials and 
Urological Association) provide evidence-based cancer statistics.
treatment guidelines.
Philippine Medical Oncology Philippine Urology
Philippine Society of Medical Oncology (PSMO) connects Philippine Urological Association (PUA) offers expertise in 
patients with oncologists and provides local treatment prostate health, diagnosis, and surgical treatment options 
standards and support. in the Philippines.
Medical Disclaimer and Contact Information
1 This presentation is for educational purposes only
Information provided is general in nature. It does not replace professional 
medical advice or diagnosis.
2 Consult qualified healthcare professionals
Always discuss your specific condition, treatment options, and concerns 
Educational Purpose with your oncologist or urologist.
Only 3 LetsMeds provides medicine access support
LetsMeds assists patients in accessing prescribed medications. They do not provide 
medical advice or treatment decisions. You contact Letsmeds At
Call/whatsapp: +91 7428091874, Email: [email protected] and Website: 
www.Letsmeds.com
4 Contact your oncologist for personalized advice
Your healthcare team will create a treatment plan tailored to your cancer 
stage, health status, and personal preferences.
Thank You
Connect With LetsMeds
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Email: [email protected]
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