@bikeman1
You have to take prednisone while on abiraterone (zytiga) . I always wondered why so I checked and abiraterone shuts down your adrenal glands. One more complication! The -amides, like darolutamide ( nubequa) don’t do that. And I think it might cause more heart issues - Mrs Surf can tell you more.
That said, several people on this forum have benefited from abiraterone - everyone responds differently.

@bikeman1
I am happy to explain : ))) - it is VERY effective drug !
It additionally suppresses testosterone levels by blocking enzymes that are used in testosterone production in testicles, adrenal glands and even in tumor cells (yes, even they eventually learn how to make testosterone when there is a lack of it - just horror ).
But, unfortunately abiraterone has many side effects and some are mitigated by adding prednisone which has a slew of it's own side effects *sigh : (((. It is an older drug that now comes as generic and is very affordable unlike new generation of drugs that block testosterone receptors on cell surface. Now, even those have side effects and out of all of them the newest one is named Nubeqa (darolutamide) and it has the lowest amount of SA but is extremely expensive here in the USA , I mean, astronomical prices ! Without insurance it is about $12,000 to $18,000 for 30 day supply !!! Abiraterone is $100 to $250 without insurance so that is the reason why Abi is prescribed - not because it is the best at present time but because it is the cheapest.

You can Google side effects of Abiraterone +predinsone , SA are numerous and very dangerous like heart fibrillation, possible permanent adrenal gland shutdown, onset of diabetes , extreme tiredness, and so on : (. Since you have heart issue and Nubeqa is approved for use for cases like yours since 2025 - you should demand it. You have very caring and knowledgeable cardiologist and he will make the case for you and I am sure that your insurance will be obliged to cover Nubeqa 💗.

Abiretarone is used the most (the most often prescribed) for reasons I already addressed and many, many patients use it without much trouble but some have a LOT of trouble and if one can get Nubeqa, it is a better choice. We will try to get it , but it always depends of a doctor - how reasonable or unreasonable he/she is and if he wishes to fight for the patient (argue with insurance) or not. At the end, one can refuse to take it 🤷‍♀️, we are really hoping that we will be able to avoid Abiraterone if at all possible.

Since you have known heart problem I think that there is absolutely no reason for them NOT to prescribe it for you. 🌺 I am sure that you will get it - just be outspoken and demand it. 👍 Most doctors count on us being meek and ignorant, unfortunately.

PS: Ha ha for tattoos : ))), and so nice that your kids are so supportive <3, that means a lot, I know.

@bikeman1 I want to repeat what I have posted several times elsewhere--my husband took Zytiga with prednisone with no substantial side effects. It kept his cancer suppressed for over three years. Please do not refuse it simply because others have had negative side effects. It might be worth trying it in order to keep the other options available for future treatment. If the side effects are intolerable, he can always change oral meds to something else to try.