Prostate Cancer — SCE Medical Oncology MCQ
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Correct answer: E — CYP17 inhibition reduces cortisol synthesis, increases ACTH drive and accumulates upstream mineralocorticoid-active steroids
Abiraterone inhibits CYP17, reducing cortisol synthesis and increasing ACTH-driven upstream mineralocorticoid precursors. Sodium retention produces hypertension and oedema, while renal potassium and hydrogen loss cause hypokalaemic alkalosis. The suppressed renin supports mineralocorticoid activity rather than salt wasting.
Reference: Abiraterone 500 mg UK summary of product characteristics (Current UK SmPC, accessed August 2026): https://www.medicines.org.uk/emc/product/14222/smpc