The doubling thing is just a rule of thumb, and is pretty useless. Think of the finasteride as a reset of your PSA such that it is more diagnostic of the cancer and less of other things. In this study
, among men on Active Surveillance who took 5ARIs for a year, over half of them had a negative follow-up biopsy. In this study
, it reduced prostate cancer progression by 38% vs placebo. It's long been known to prevent low grade cancer, now it seems it can also cure low grade cancer or at least slow it down in some cases.
There's another test that just became available called PHI that has a role in AS. it is more sensitive than PSA in detecting higher Gleason scores, higher tumor volumes, and metastases. In this study
, they found that low PHI predicts better AS outcomes.
Your doctor can order it through Innovative Diagnostic Labs at the following site:
They guarantee that your health insurance will cover it, or they will pay for it, which is nice.
There may be some cancer that was undetected in your first biopsy. If you get an mpMRI or a saturation biopsy, they may be able to find it. That would take some of the guesswork out of tracking it on AS.