This leaflet provides information on a course of treatment called enzalutamide. The leaflet will explain what this is, when and how it will be given. It will also tell you about common side effects that you may experience. Contact telephone numbers are given at the end of the leaflet.
What is enzalutamide?
Enzalutamide is a new hormonal treatment which is given as capsules. Testosterone can stimulate prostate cancer growth. Hormonal treatments for prostate cancer work by reducing testosterone levels.
Why am I having enzalutamide?
Your doctor has prescribed this therapy because it has been found to be effective in some patients with prostate cancer.
Enzalutamide works in a different way to other hormone treatments given for prostate cancer. It can be used when other treatments have stopped working.
How often will I see the specialist team?
You will be seen monthly in clinic, at first, then less regularly, about 3 monthly. At these appointments you will have blood tests and we will monitor your blood pressure. We will check how you are feeling and discuss any problems you may have. This is so we can check how the treatment is affecting you.
Can I bring relatives and friends with me?
Currently due to the need to ensure 2m space between patients during COVID-19 we do not usually allow anyone to stay with you during your treatment. If you have any concerns about this please speak to your team before your treatment starts. We may be able to make some exceptions but we will need to be aware of this before the day of treatment.
How should I take the enzalutamide capsules?
Enzalutamide capsules should be taken once a day. Capsules can be taken anytime up to 10pm, but try to take them at approximately the same time every day. The capsules should be swallowed whole with a glass of water. They must not be chewed or crushed.
How many enzalutamide capsules will I need to take?
It is usual to take 4 capsules once daily but sometimes your doctor may alter the dose. The amount you need to take will be clearly marked on the box.
What should I do if I forget to take my capsules?
What if I take too many capsules?
Please contact Velindre Cancer Centre immediately for advice. The telephone number is at the end of the leaflet, please ask for the treatment helpline.
How should I store the capsules ?
Your capsules should be stored in their original packaging and in a safe place away from children. They should be kept in a cool dry place (below 25oC).
Any unused capsules should be returned to the hospital pharmacy or your local chemist for safe disposal.
What are the possible side effects?
This treatment is usually well tolerated but there are some possible side effects that you need to be aware of. The doctors, nurses and pharmacists can give you advice or answer any questions you may have.
Tiredness and fatigue
The treatment can make you feel more tired than usual. It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able. Some people find it beneficial to take gentle exercise as well as taking rest.
High blood pressure
This treatment may cause a rise in blood pressure for some patients. We will check your blood pressure before you start treatment, and at each clinic visit. Please tell us if you are already receiving treatment for high blood pressure. If you have suffered from high blood pressure in the past but it is well controlled, you will still be able to receive this treatment.
Hot flushes
Some patients may also experience hot flushes.
You may notice warmth in your neck, face and skin. This can last from a few seconds up to 10 minutes.
To help to reduce hot flushes, try cutting down on nicotine, alcohol and hot drinks that contain caffeine, ie: tea and coffee. If the hot flushes become a problem for you, discuss this with your oncology doctor in clinic.
Blood clots
A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further. It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain.
Blood clots can be very serious. However, most clots can usually be successfully treated with drugs to thin the blood. Your doctor or nurse can give you more information
Other side effects and information
If you have concerns about the symptoms below: please discuss them with your specialist nurse or with your oncology doctor in clinic
A very small number of patients (less than 1%) can develop fits while taking enzalutamide. It is important that you tell your doctor if you have ever had a fit, or are currently receiving treatment for fits. Also tell your doctor if you have had a brain injury within the last 12 months, or if you have ever had a brain tumour or a stroke. If you do experience a fit you should stop taking your enzalutamide and telephone Velindre Cancer Centre on the treatment helpline; the telephone is at the end of the leaflet.
Some patients may experience headaches or joint aches and pains whilst taking enzalutamide. This can be treated with whatever painkillers you would usually take.
Some patients experience mood changes, such as anxiety whilst on Enzalutamide.
Some patients may have some problems with their memory and concentration.
Some patients notice some breast tenderness or fullness.
Some patients experience a reduced sex drive and /or erectile problems whilst on enzalutamide. We can offer treatment for this: discuss this with your oncology doctor or specialist nurse.
Patients can develop bone thinning or osteoporosis over time. This may increase your risk of falls and fractures of your bone. Regular walking and exercises that offer resistance, such as lifting weights can help with this. A healthy diet can also help with this. Discuss this with your specialist nurse or oncology doctor in clinic.
Some patients develop dry skin or itching: use a non-perfumed moisturiser to help with this.
Contraception
It is important you do not father a child whilst having this treatment and for 3 months afterwards. This is because enzalutamide may damage the unborn baby. You will need to use a condom and a 2nd form of birth control if you are in a relationship with someone who is of childbearing age.
Is it alright to take other medicines?
If you are taking other medicines please inform your doctor, nurse or pharmacist know the medicines you are taking. This includes prescription and non-prescription medicines, vitamins or herbal supplements, as there are a small number of medicines that you may have to avoid.
Sometimes cancer drugs can have very serious side effects which rarely can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effect
Contact telephone numbers
Urology Specialist Nurses 029 2061 5888 ext: 4275
Monday – Friday 9am – 5pm
Velindre Cancer Centre 029 2061 5888
For urgent advice at any time of the day or night please ask for the treatment helpline
Pharmacy department 029 2061 5888 ext 6223
Monday – Friday 9am – 5pm for queries about your medicines
Tenovus freephone 0808 808 1010
cancer helpline
Macmillan freephone Helpline 0808 808 0000
This leaflet was written by health professionals. The information contained in this leaflet is evidence based. It has been approved by doctors, nurses and patients. It is reviewed and updated every 2 years.