Prostate Drugs May Delay Prostate Cancer Diagnosis?>
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Prostate Drugs May Delay Prostate Cancer Diagnosis

by Health After 50  

A prostate cancer diagnosis may be delayed in men who use certain drugs for an enlarged prostate, according to a study from the University of California, San Diego, published in JAMA Internal Medicine.

A class of medications called 5-alpha-reductase inhibitors (5-ARIs) helps reduce symptoms of an enlarged prostate, or benign prostatic hyperplasia. 5-ARIs like finasteride (Proscar) and dutasteride (Avodart) are known to also lower prostate-specific antigen (PSA) levels by about 50 percent. Since PSA typically rises in men who have prostate cancer, the lower baseline PSA levels in men who take 5-ARIs must be taken into account when interpreting PSA testing.

But some doctors may not be doing so, the new study suggests. It found that a prostate cancer diagnosis was delayed for an average of two years in men using a 5-ARI compared with nonusers. 5-ARI users were also more likely to have a more advanced stage of the disease at the time of diagnosis, and they had a higher risk of premature death.

What you should do

Evidence shows that measuring PSA levels is most effective for men taking 5-ARIs when the observed PSA level is adjusted to obtain a "true" PSA level. If you take a 5-ARI—which also includes the drug Propecia—and choose to undergo a PSA test, ask your doctor how he or she will take into account the drug-related reduction in PSA levels to avoid misinterpretation of the test result.

This article first appeared in the October 2019 issue of UC Berkeley Health After 50.

Also see Treatment Options for Low-Grade Prostate Cancer.