finasteride and psa

No, that's absolutely wrong. Do NOT stop taking finasteride before your PSA -- that would really screw up everything. Finasteride improves the diagnostic accuracy of the PSA test by eliminating the PSA due to BPH, but not the PSA due to prostate cancer. It resets the baseline (usually about 50% lower - but that can vary a lot). While you're taking it, any increase in PSA will be due to prostatitis or prostate cancer.

There's another test called Prostate Health Index (PHI) that includes PSA that is even more accurate.

Of course, avoid sex and bike riding for 48 hours before te blood draw.

No need to double it - just track it.

I assume that you had a PSA test when you were diagnosed with BPH - what was it then? How often to have it depends on what it shows. If it is high (say, >4), you may want another one in 6 months. If it is low (say, <2), two years is probably fine. Your prostate size should also be taken into account - i assume it's pretty small by now. As I said, get PHI instead. And have a DRE.

Finasteride makes PSA a better indicator of prostate cancer, rather than a worse one.

I was a 20 year user of finasteride. I took it for hair loss. So when I was diagnosed last February- PSA 3.3 that I double to 6.6, I was unsure what to do. One RO told me to get off it at once, the other doctors thought I could stay on it. After searching the web as well I discovered that there was nothing definitive. In the six months between diagnosis and surgery I still took finasteride, but less often. Either every other day or once every three days. After my surgery and adverse pathology, I quit finasteride. I then had persistent PSA after the surgery. Still unsure the role finasteride has had in my PCa.

There have been three major clinical trials on finasteride (Avodart). I believe they went by PREVENT, CONFIRM and COMBINE. The first showed effectiveness in preventing low grade PCa and finding high grade PCa at a much earlier stage. Due to a misinterpretation and publicity from a renowned PCa oncologist there was a charge that Finasteride caused high grade cancer. So another trial CONFIRM was conducted that disproved the allegation. The third trial, COMBINE, used a combination of Finasteride and tamsulosin (Avodart and Flomax). This showed that used together the two were each more effective than used separately. This developed the drug Jalyn.

My urologist was a lead investigator on each of the trials. He put me on Jalyn as part of ADT3. THis was only a few months after it’s approval and I had to educate my pharmacist as he had not seen it. He uses Avodart regularly in his practice for both BPH and PCa. He also uses it to isolate PSA trends to reduce the number of investigative biopsies. The national average is that only 50% of biopsies are positive. He says this indicates too many biopsies are unnecessary and further investigation should be pursued before a biopsy for most men. He has a procedure he uses before he moves to a biopsy. His positive rate is 93%. He did not take me through the procedure as I had PSA of 59 and he distinctly felt the tumor during the DRE. I had my biopsy just two days after my initial exam.

JNF
Finasteride is actually generic proscar not avodart.
Dutasteride is generic avodart.
Bob