5mg Finesteride prescribed for rising PSA

[BuckheadJim]

In 2002 I had RRP surgery and radiation treatment.  My PSA remained .02 or less for 8 years and then began to slowly rise.  At .03 PSA in 2011 my Urologist prescribed Finasteride to stop the conversion of  dihydrotestosteone and the PSA dropped to .02 and remained there for several years.  On a later visit to the urologist I commented on this drug to control my PSA and he vehemently denied it was for PSA control but said it was prescribed for urinary issues.  That was not true-I had never complained to him about urinary issues.  I chose to see another urologist at another medical practice.

I told the new urologist about the discussion with the prior urologist and ALL he would say was that Finastaride is not indicated for PSA reduction.  He repeated this several times in answer to all my questions about my use of this drug.  I can not understand why I can not get a clear answer about the use of this drug for my PSA control.  It has occurred to me the first doctor has later found some medical/legal issue with prescribing this drug although both doctors renewed my Rx for the drug and did not counsel me on how to use the drug.

I am not looking for any problem with either doctor, I only want to know if this is the proper drug to help control the PSA.  If it should be replaced with something else I would like to know. I believe the drug may be responsible for some growing problems such as muscle loss, loss of interest and ability for sex and yes, I do realize these issues may be, in part, due to my increasing age (74).

Can someone with knowledge of the use of this drug inform me of how I should proceed?  I continue on the drug with a daily 5mg tablet.

Thanks.

[BonzoDog]

I’m not surprised - I’ve seen studies on recurrent prostate cancer (rising PSA after prostate cancer surgery or radiation) that used Finasteride along w/

[BonzoDog]

Sorry - rest of message was cut off! I was saying I’ve seen studies using Finasteride along w/ Lupron for recurrent prostrate Cancer. This cancer feeds off Testosterone & other Androgens, DHT is an even stronger one than T, so it makes sense that lowering DHT could also have a positive effect on slowing the progression & lowering PSA. Not sure why the Dr. denied using it for that purpose - it makes sense & is not unheard of...

[BonzoDog]

Prostate, not ‘prostrate’ - that was a typo, there’s no 2nd ‘r’ there...

[rpw631]

Finasteride is given for enlarged prostate.  
Enlarged prostate in turn raises the PSA.
I’ve been on it for years and it cut the size of my prostate in half.
I did not have prostate cancer but if I went off the finasteride the prostate Would and did enlarge again.
Finasteride is kind of a indication if you have prostate cancer and if you’re on it for 3 to 6 months and your PSA does not go down that would be a bad sign,
don’t know why they gave it to you after having prostate removed, although it is a hormone.
Yes your libido goes down chest might get flabbier
Among other things.
Finasteride is somewhat controversial some say it can possibly cause aggressive prostate cancer,  some say it can prevent low-grade cancer my urologist and another urologist I now seem to like it.
Seems to be beneficial to me.
With all that said,,,again don’t know why you’re prescribed that after having your prostate removed,
Maybe just a somewhat mild hormone which should lower your PSA.

Blessings,  Rick

[BuckheadJim]

Thanks for the comment.  While the drug did lower my PSA, that reading has now returned to .03 with the drug.  That is still a very low reading but the doctor initially said that is the level where cancer cells can be detected.  Since the drug has the tendency to cut the PSA in half, my true reading is probably closer to .06.  Still a far cry from the 4. the doctor said would be the level where aggressive therapy would be considered.  I am thinking with the current progression of the PSA level I can outrun the cancer and be in my grave before it is the thing that sends me there.  

Late this year-and sooner if the PSA rises further- I will seek another opinion from a third doctor as to whether I should stay on the drug or something else.