Apalutamide for prostate cancer: what patients should know

It is generally used alongside treatment that keeps testosterone low. Whether it suits you depends on the cancer's stage, its response to hormone suppression, your other health conditions, and medicines that could interact with it.

Prostate cancer cells may use signals from androgens, including testosterone, to grow. Apalutamide blocks the androgen receptor inside the cells. It is not chemotherapy and does not replace the injections or surgery used to suppress testosterone when those remain part of the treatment plan.

The oncology team follows response with symptoms, examinations, blood tests, and imaging when appropriate. Common concerns include tiredness, skin rash, hot flushes, reduced appetite, weight change, joint discomfort, falls, fractures, raised blood pressure, and an underactive thyroid.

Take apalutamide at the same time each day exactly as prescribed, with or without food. Swallow the tablets whole unless your pharmacy has given you an approved alternative method. If a dose is missed or vomited, check the medicine instructions or contact the cancer pharmacy rather than doubling the next dose.

Give the team a complete list of prescriptions, non-prescription medicines, vitamins, and herbal products because apalutamide can alter how other medicines work. Keep planned blood-pressure, thyroid, and bone-health checks. Report rash early, and mention dizziness, weakness, or any fall so supportive measures can be considered.

Seek urgent medical help for a seizure, fainting, severe confusion, sudden weakness on one side, trouble speaking, chest pain, or marked breathlessness. A widespread rash with blistering, peeling skin, mouth sores, facial swelling, or breathing difficulty also needs immediate assessment.

Call the oncology team promptly after a fall, suspected fracture, rapidly worsening rash, or new symptoms that prevent eating, drinking, walking, or taking medicines. New or worsening difficulty passing urine warrants clinical assessment, particularly when accompanied by inability to urinate, fever, severe pain, or blood in the urine.

Ask which feature of your prostate cancer makes apalutamide appropriate, what other hormone treatment continues with it, and how the team will judge response. Clarify which medicines may interact, how bone strength and fall risk will be managed, and whom to contact if a rash starts outside clinic hours.