I don’t distinguish between finasteride (Proscar) and dutasteride (Avodart) in PSA results. I expect the PSA to drop 40% after 6 months and 50% after a year. I tell my patients that both are associated with a 20% shrinkage of the gland, and a 3 ml/secondary improvement in flow rate after one year, with results occurring marginally sooner with dutasteride.

Dutasteride may lessen the overall chances of developing prostate cancer, perhaps by 25%, but no reduction has been shown in high grade or aggressive prostate cancer. Moreover, it’s been argued that this isn’t a true protective effect at all, rather the drugs are temporarily shrinking small, not very aggressive tumours that were unlikely to be lethal anyway. A similar effect was already shown with finasteride in 2003.

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