PSA levels question

General Discussion
#1

Hi Guys,

This is a little off-topic, but figured it’s be a good enough place to ask.

My Dad takes a drug called tamsulosin for BPH. It’s an alpha-blocker.

Anyways, he went for a routine blood check recently and compared to his last blood check, his PSA had risen from 2.8 - 4.3.

He went for a biopsy, where they removed 10 tissue samples from each areas of his prostate and checked them for cancerous cells, however they all came back clear.

I’m not overly worried, but i just heard that finasteride (even though tamsulosin is a different product) can mask prostate cancer?

Or does it only mask the PSA test?

Any input very much appreciated,

Thanks,

David

#2

Fin can reduce PSA by approximately one half, so if you are taking it, the physician should be made aware of that fact and multiply any PSA score by 2, basically.

The FDA approval files on Propecia note this by the examiners, I don’t remember the exact page of which file, but its in there.

#3

Further to your post (although this one is from MERCK):

ncbi.nlm.nih.gov/pubmed/7490873

The effect of finasteride on prostate specific antigen: review of available data.

Guess HA, Gormley GJ, Stoner E, Oesterling JE.
Merck Research Laboratories, Blue Bell, Pennsylvania, USA.

PURPOSE: We reviewed the available data on the effect of finasteride on serum levels of prostate specific antigen (PSA), PSA velocity and PSA density in men with benign prostatic hyperplasia (BPH) and prostate cancer.

MATERIALS AND METHODS: To our knowledge all previously published analyses of PSA data from clinical trials of finasteride therapy for BPH and prostate cancer are reviewed.

RESULTS: The normal reference range of serum PSA levels in men with BPH and no evidence of prostate cancer who were treated with finasteride for 6 months or longer is half that in untreated men with BPH. The percent by which serum levels of PSA are suppressed after 6 months of treatment for prostate cancer does not tend to be greater than that for BPH.

CONCLUSIONS: To interpret serum PSA levels in men with BPH treated with finasteride for 6 months or longer, the serum PSA level should be multiplied by 2 and compared to either age-independent or age-specific upper limits of normal for serum PSA in untreated men with BPH. On the basis of limited data the sensitivity and specificity of this approach appear to be similar to those of the corresponding PSA limits in untreated men with BPH.

PMID: 7490873 [PubMed - indexed for MEDLINE]

Another:

prostatecancerfoundation.org … Marker.htm

“The reason that probably happened is that the multiplication factor of two to correct the PSA is inadequate and as men are on the drug longer that factor needed to be increased,” D’ Amico added."

#4

Thanks for the reply Mew, I’ll take a look through those articles now,

David