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KMID : 1001020120100020056
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Korean Journal of Urological Oncology
2012 Volume.10 No. 2 p.56 ~ p.62
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PSA Kinetics after Use of 5?-reductase Inhibitors
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Kim Hyeon-Woo
Ha Hong-Koo
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Abstract
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The aim of this review is to provide a discussion of serum prostate specific antigen (PSA) after use of 5?- reductase inhibitors (5?RIs). The 5?RIs that are used to treat benign prostatic hyperplasia may reduce operation risks and acute urinary retention. However, it causes alteration of serum PSA level requiring clinician’s attention. After two large studies, Prostate Cancer Prevention Trial (PCPT) and Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study, many literatures has showed that 5?RI reduces the prevalence of prostate cancer, especially in low grade cancer. However, the incidence of high grade prostate cancer increased in 5?RI group than placebo group. Recently, some authors revealed that serum PSA sensitivity to prostate cancer increased in the 5?RIs arm than placebo using serum PSA doubling rule, serum PSA density and increasing serum PSA after nadir level. The serum PSA is usually doubled in patients with 5?RIs more than 12 months because these decrease serum PSA level down to approximately 50% at 1 year compared to baseline. It seems to be such a simple method but may yield serum PSA overestimation during first 6 months and underestimation after 4 years of the use of 5?RIs. Some authors have reported serum PSA density is useful in increasing sensitivity to prostate cancer after 1 year use of 5?RI that reduce serum PSA noising effect of benign prostatic hyperplasia. Recently, increasing serum PSA after nadir level has been seemed to be an attractive method to detect prostate cancer in patients with use of 5?RIs.
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KEYWORD
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Prostate-specific antigen, 5-alpha reductase inhibitors, Prostate neoplasms
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