What should you know about olaparib and prostate cancer?

PARP inhibitors block a DNA-repair pathway. Cancer cells that already have difficulty repairing DNA may be especially sensitive to this approach, but a test is needed to look for relevant changes. The oncology team considers whether the change is inherited, found only in the tumour, or absent, as well as the cancer’s extent, previous medicines and general health.

Olaparib is taken as tablets on an individual schedule. Possible effects include tiredness, nausea, reduced appetite, diarrhoea, headache and low blood counts. Blood tests and review of kidney and liver function help the team decide whether treatment should continue or be adjusted. Other prostate cancer treatments, including radiotherapy or surgery, may still have a role.

Ask whether tumour or inherited testing has identified a DNA-repair change and whether the result affects treatment choices for your prostate cancer. Give the team a complete list of prescriptions, over-the-counter medicines and supplements. Take tablets exactly as directed, do not double a missed dose without instructions, and tell the team about swallowing difficulty, persistent nausea or new urinary symptoms. A treatment plan may also include hormone therapy or another cancer-directed approach.

Call the oncology team promptly for fever, chills, repeated infections, unusual bruising, bleeding, severe tiredness, breathlessness, persistent vomiting or diarrhoea, or a sudden decline in strength. Seek urgent help for chest pain, fainting, confusion, severe breathing difficulty or inability to pass urine. Difficulty passing urine can have several causes and needs prompt assessment, especially when it is sudden or painful.

What gene finding is relevant to my treatment? Was testing done on the tumour, through inherited testing, or both? How often will blood tests be needed? Which medicines should I avoid? What is the plan if side effects become troublesome? How will scans, symptoms and prostate-specific tests be used to review the treatment?