Back to Search
Start Over
PSA response to finasteride challenge in men with a serum PSA greater than 4 ng/ml and previous negative prostate biopsy: preliminary study.
- Source :
-
Urology . Sep2002, Vol. 60 Issue 3, p464-468. 5p. - Publication Year :
- 2002
-
Abstract
- <bold>Objectives: </bold>To determine, in a prospective study, the prostate-specific antigen (PSA) response to finasteride challenge in men with a serum PSA greater than 4 ng/mL who had undergone previous biopsy. Patients with a serum PSA level greater than 4 ng/mL who have undergone repeated prostate biopsy with prostate cancer (CaP) that was not detected present a diagnostic dilemma. The magnitude of PSA reduction after administration of finasteride has been well documented. In addition, doubling of the PSA value after 1 year of finasteride has been touted to be a more useful paradigm for diagnosing CaP than PSA alone.<bold>Methods: </bold>Thirty-eight men with a baseline serum PSA level greater than 4 ng/mL and a normal digital rectal examination who had been previously biopsied a minimum of two times, with CaP not detected, were given 5 mg finasteride daily. The PSA level was measured at 6 and 12 months with repeat transrectal ultrasonography and biopsy (12 cores) performed at 1 year. Changes in prostate volume, serum PSA, PSA density, and the incidence of CaP at 1 year were assessed.<bold>Results: </bold>The mean age of the group was 60.5 years (+/-7.6). For the group, the average number of previous biopsies performed was 2.9 (range 2 to 6). The baseline PSA level for the entire group was 6.32 ng/mL (+/-3.2), and the baseline prostate volume was 37.3 cm3 (+/-12.4). At 1 year, the PSA level had decreased to 3.73 ng/mL (-41.0%), and the prostate volume had decreased to 30.4 cm3 (-18.5%). In the 11 men (29%) in whom CaP was detected, the serum PSA decreased from 7.3 to 5.2 ng/mL (-28.8%) and the prostate volume decreased from 37.3 to 32.3 cm3 (-13.4%). CaP was detected in 0 of 10 men with a serum PSA decrease of 50% or higher, in 6 (32%) of 19 men with a PSA decrease between 33% and 50%, and in 5 (56%) of 9 men who had a PSA decrease of less than 33%.<bold>Conclusions: </bold>The data in this preliminary study suggest that the magnitude of change in serum PSA after 1 year of finasteride challenge may be useful in diagnosing CaP in patients with elevated PSA levels and prior negative prostate biopsy. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CLINICAL trials
*COMPARATIVE studies
*ENZYME inhibitors
*FINASTERIDE
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*NEEDLE biopsy
*PALPATION
*PHARMACOLOGY
*PROSTATE
*PROSTATE tumors
*RESEARCH
*TUMOR classification
*PROSTATE-specific antigen
*EVALUATION research
*PHARMACODYNAMICS
Subjects
Details
- Language :
- English
- ISSN :
- 00904295
- Volume :
- 60
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Urology
- Publication Type :
- Academic Journal
- Accession number :
- 138035503
- Full Text :
- https://doi.org/10.1016/s0090-4295(02)01760-0