Castrate resistant prostate cancer is diagnosed when you are on hormone injections and: 

• Your blood testosterone is very low (below 50 ng/dL or 1.7 nmol/L) and 
• Your PSA is at least 2 ng/mL above your lowest result. Your lowest level of PSA after treatment, is often called the nadir. 

• Your last three PSA results have risen. They must be checked at least one week apart. Showing two increases by 50% over the nadir. 

  

or your scans show:

• Two or more new spots of prostate cancer in your bones or 
• One new spot of prostate cancer in any other body organ.

What are genes?

• Genes are found inside cells and are made up of DNA.
• They are carried from one generation to the next. 
• They control how our body grows and works. 
• They are also responsible for things like hair and eye colour.  

• You get genes from both of your parents.    

   

What are BRCA genes?

• BRCA genes are important in the fight against cancer.  
• Sometimes genes can carry faults (mutations). These can be inherited from your parents. 

• If the BRCA genes get a fault it can increase your chance of getting: 
  • Breast or ovarian cancer if you are a female. 
  • Prostate cancer if you are a male.

If you have not been treated with hormone tablets before:

You do not need to be tested. 

If you have had hormone tablets before:

Tissue from your prostate biopsy or sometimes a blood test, can be used to check for faulty BRCA genes.

If you have not had a biopsy before:

Your doctor might advise you have one.  This will be used to check your cancer for a faulty BRCA gene. 

Only about 1 in 5 people with prostate cancer will show a faulty BRCA gene. 

• Olaparib is usually prescribed by your Oncologist. 
• You can ask your hospital team for more information. 

• Olaparib is taken as a tablet.
• You take two tablets twice a day.

• This is usually 12 hours apart. 

  

Olaparib is a tablet taken by mouth. It should not cause you any pain. 

If you are taking Olaparib on its own, you will need to have:

• Regular blood tests to check for: 
  • Anaemia (low red blood cell count) or, 
  • Any problems with your liver and kidneys. 
• Regular PSA tests. 

If you are taking Olaparib with Abiraterone and Prednisolone, you will need: 

• Your blood pressure checked at least once a month at first.  
• A blood test to check your:
  • Kidney function and 
  • Blood potassium and 
  • liver function
• These will happen every two weeks for the first three months of treatment. Then they will change to monthly. As time goes on, the time between tests may change again.

• If you are diabetic, your blood glucose will be monitored. This is to check for low blood glucose.  

  

• You may need scans to check how your cancer is doing or how treatment is working. 

• You will be able to continue working if you feel able to do so.

• You will need to take time off work for regular outpatient appointments. 

  

You will have regular PSA blood tests.   If Olaparib is working, your PSA will either: 

• Lower or  
• Stop going up as quickly as it was before taking Olaparib. 

If your Olaparib: 

• Stops working, or 
• You cant take it due to side effects. 

Other treatments may be available. These will depend on what treatments you have had before and how well you are. 

Possible treatments could be: 

Chemotherapy (Visit our page on chemotherapy) 

Radium 223 (Visit our page on Radium 223) 

Low dose steroid tablets. 

• You will not be able to father children:
  • While taking Olaparib, or 
  • For three months after the last dose.
• It is not known whether Olaparib goes into your semen.  
• While you are taking Olaparib and for three months after your last dose, you must use a condom when having sex with a female. You must do this even if she is already pregnant.  
• Your female partner must also use a suitable method of contraception. 
• You must not donate sperm.
•  You can talk to your healthcare team about using contraception.