I started taking dustasteride about 1 month ago because of high DHT and my PSA dropped from 10 to 5.5. I've read that you are supposed to double the PSA to get an "equivalent" non-dutasteride level of 11. Does anyone understand why we are supposed to double the PSA value when taking dutasteride?
Dutasteride and PSA dropping - Prostate Cancer N...
Dutasteride and PSA dropping
Total PSA is a mix of benign and cancerous cells origin. Dutasteride suppresses the former but not the latter. PSA doubling compensates for the suppressed benign part.
Dutasteride eliminates the PSA caused by BPH, but not PCa. On the average, it cuts PSA in half. It is important to not get lulled into a false sense of security by the lower PSA. It makes PSA more specific for PCa. Any increase while taking it may be due to PCa.
As per some guys in my metastatic PCa support group, in some cases Dutasteride has pretty dramatically slowed doubling time. A little more than a year ago I started my 3rd break from ADT after being undetectable (PSA<0.006) for a year. I decided to try both Dutasteride and Metformin hoping to slow. recurrence. In my case (GL8 wit BRCA2 mutations and history of one mets) they did not nothing and within about 4-5 months I had a massive proliferation of bone mets and rapid PSA rise. And yes, while on Dutasteride we doubled my PSA reading to track progression. I am now back on ADT, presumably for life (Orgovyx, Zytiga, Prednisone) and thankfully back to undetectable, for however long we can make that last. If I were you, with PSA over 1, I would be getting a PSMA PET to see where my cancer in proliferating. If you have fewer than 5-10 mets, you may be able to pursue focal RT to zap them. Best of luck!
it is a weak anti androgen so it drops Psa but not to the very low levels that ADT does
Johns Hopkins recommends doubling PSA during first 24 months, then up to 2.5 at 7 years.