Living with Prostate Cancer on Abiraterone: Real Patient Experiences
Oct, 30 2025
When you’re told you have prostate cancer, the first thing you think about isn’t the drug names or clinical trials. It’s: What does this mean for my life now? For many men, abiraterone becomes part of the answer-but not the whole story. It’s not just a pill you swallow. It’s a shift in routines, relationships, and even how you see yourself.
What abiraterone actually does
Abiraterone isn’t chemotherapy. It doesn’t kill cancer cells directly. Instead, it stops your body from making testosterone-the fuel that most prostate cancers grow on. You take it as a tablet, usually once a day, on an empty stomach. No food for two hours before and one hour after. Sounds simple, right? But that timing becomes a rhythm you never forget.
Doctors prescribe it when the cancer has spread but still responds to hormone therapy. It’s not a cure, but it buys time. Studies show men on abiraterone live longer than those on older hormone treatments alone. In one large trial, men lived nearly 16 months longer on average. That’s not just a statistic-it’s another birthday, another family barbecue, another chance to see your grandkids grow.
Side effects you don’t hear enough about
Everyone talks about fatigue, joint pain, or high blood pressure. Those are real. But the quieter side effects? Those sneak up on you.
Some men notice their muscles feel weaker. Not from skipping the gym-just from the drug. One man in Brisbane, 68, told me he used to walk 10,000 steps a day. After six months on abiraterone, he could barely make it to the mailbox without stopping. He started doing seated leg lifts while watching TV. Small things. But they kept him moving.
Fluid retention is another hidden issue. Your ankles swell. Your shirt feels tight. You’re not gaining weight-you’re holding water. Your doctor might prescribe a water pill, but that means more trips to the bathroom. At night. And if you’re already waking up to pee because of prostate issues? Now it’s worse.
And then there’s the mood stuff. Some men get irritable. Others feel flat. No big crying spells, just… emptiness. One patient said, “I didn’t feel sad. I just didn’t feel like myself.” That’s harder to explain to your wife or your kids than a sore back.
Life on a strict schedule
Abiraterone doesn’t care if you’re at a wedding, on a road trip, or stuck in traffic. You have to take it on an empty stomach. That means planning meals around the pill. Breakfast? You skip it. Or you eat it at 8 a.m. and take the pill at 10 a.m. No coffee, no toast, no banana.
Travel becomes a puzzle. You pack extra pills. You check hotel minibars aren’t stocked with snacks. You carry a water bottle and a note from your doctor explaining why you can’t eat during a flight. One man told me he once missed a dose because his flight was delayed. He panicked. He called his oncologist at 2 a.m. The nurse told him: “Just take it when you land. Don’t eat for an hour.” He slept through the rest of the flight, terrified he’d messed up.
And don’t forget the cost. In Australia, abiraterone is subsidized under the PBS, but you still pay part of it. For some, that’s $30 a month. For others, it’s $200 if they’re not eligible. That’s not just money-it’s stress. One man skipped a dose for two days because he couldn’t afford the refill. He didn’t tell anyone.
Relationships change
Prostate cancer doesn’t just affect your body. It changes your home.
Sexual side effects are common. Low libido, erectile dysfunction. That’s expected. But what’s harder is when your partner doesn’t know how to talk about it. One couple told me they stopped cuddling because he felt “broken.” She didn’t know how to bring it up. They didn’t speak about it for six months.
Then there’s the silence. Men often don’t want to talk about cancer. “I don’t want to be a burden,” is a phrase you hear a lot. But that silence eats away at families. One father said his 12-year-old daughter started drawing pictures of him in a hospital bed. He didn’t know she thought he was dying. He finally sat her down and said, “I’m taking medicine to stay alive. I’m not going anywhere.” She hugged him and said, “Okay. But you have to tell me next time.”
What helps-more than the medicine
Abiraterone works. But what keeps men going? It’s not the drug. It’s the people.
Support groups. Not the clinical ones. The ones where men sit in a circle and say, “I couldn’t sleep last night because my back hurt,” and someone else says, “Same. I took a hot bath and it helped.” That’s the kind of advice you won’t find in a pamphlet.
Exercise-even small amounts-makes a difference. Walking. Stretching. Swimming. One man started doing tai chi in the park every morning. He didn’t do it for the cancer. He did it because he missed feeling strong. After three months, he said, “I don’t feel like a patient anymore. I feel like me.”
And nutrition? It’s not about fancy diets. It’s about avoiding processed food. Too much salt makes fluid retention worse. Too much sugar makes fatigue worse. One man switched from white bread to sourdough. He stopped drinking soda. He started eating eggs for breakfast. Simple. But he said it gave him back a sense of control.
When to speak up
Not every side effect is normal. If you’re dizzy, confused, or your urine turns dark, call your doctor. Those could be signs of liver issues. Abiraterone can stress your liver. Blood tests every few months catch it early.
And if you’re feeling hopeless? Say it. Depression isn’t weakness. It’s a side effect of the disease and the treatment. There are counselors who specialize in prostate cancer. They don’t just talk. They help you find ways to live again.
It’s not a battle. It’s a journey.
No one talks about this enough: You’re not fighting prostate cancer like a war. You’re learning to live with it. Some days are good. Some days, you just want to stay in bed. That’s okay.
Abiraterone gives you time. But how you use that time? That’s yours. Whether it’s fixing the car, planting tomatoes, or just sitting with your grandchild in silence-it matters. The drug keeps you alive. But your choices keep you living.
How long do people usually stay on abiraterone?
There’s no fixed timeline. Many men stay on abiraterone for years, as long as it keeps working and side effects are manageable. Doctors monitor prostate-specific antigen (PSA) levels every few months. If PSA stays low, treatment continues. If cancer starts growing again, they may switch to another therapy. Some men take it for over five years.
Can I drink alcohol while taking abiraterone?
Small amounts-like one beer or a glass of wine-are usually okay. But alcohol can stress your liver, and abiraterone already does that. Heavy drinking increases the risk of liver damage. Your doctor will check your liver enzymes regularly. If levels rise, they’ll tell you to cut back or stop. Always check with your oncologist before drinking.
Does abiraterone cause weight gain?
Not directly. But fluid retention can make you feel heavier, especially in the ankles and belly. Some men also gain fat because they become less active due to fatigue. Muscle loss can happen too, which lowers your metabolism. The key is staying active and watching your salt intake. Weight gain isn’t inevitable-it’s manageable.
What happens if I miss a dose?
If you miss a dose and remember within a few hours, take it right away-but only if you haven’t eaten. If it’s been more than a few hours, skip the missed dose. Don’t double up the next day. Missing one dose won’t ruin your treatment, but regularly skipping doses can make the cancer resistant. Set phone reminders. Keep spare pills in your bag or car.
Can I still work while taking abiraterone?
Yes, many men continue working full-time. Fatigue is the biggest challenge. Some adjust their hours, work from home on tough days, or take short breaks. One man worked as a mechanic and started scheduling his pill for 7 a.m., then took a 30-minute nap after lunch. He said it helped him get through the afternoon. Talk to your employer. Most are willing to help if they understand.