If a patient on finasteride has a PSA of 10 ng/mL and a baseline of 30 ng/mL, what is the next step?

In the context of a patient being treated with finasteride, it's essential to understand how the medication affects prostate-specific antigen (PSA) levels. Finasteride is known to decrease PSA levels by approximately 50% in men with benign prostatic hyperplasia (BPH). Therefore, when interpreting PSA values for patients on this medication, the reported PSA must be adjusted to account for this effect to evaluate the possibility of prostate cancer accurately.

In this case, the patient's PSA level on treatment is 10 ng/mL. Given the influence of finasteride, the interpretation of this value should consider that the actual PSA prior to any treatment impacts could be doubled to get a more accurate estimate of the patient's PSA level. Thus, if you multiply the treatment PSA value of 10 ng/mL by 2, this adjustment leads to a comparison to the baseline PSA level.

By doing this calculation, the adjusted value of 20 ng/mL serves as a more appropriate measure when assessing the risk for prostate cancer or determining the need for further investigation. Since the patient previously had a baseline PSA of 30 ng/mL, this increase prompts further evaluation, likely necessitating a biopsy or additional diagnostic procedures. Therefore, the correct action is to multiply the