Finasteride and dutasteride lower serum PSA by roughly half after six to twelve months of treatment. A PSA that looks normal in a man taking one of these drugs may in fact be raised. Record the baseline PSA before starting, and when interpreting later results, roughly double the measured value. A rise from the on-treatment nadir, even within the normal range, warrants evaluation for prostate cancer.
- Check and record PSA before starting finasteride or dutasteride.
- Roughly double the PSA value after six months or more on a 5-alpha reductase inhibitor.
- Investigate any confirmed rise from the on-treatment nadir.
- Note 5-alpha reductase inhibitor use clearly on PSA requests and referrals.
Why it matters
Benign prostatic hyperplasia treatment can mask a rising PSA, delaying a cancer diagnosis.
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