Reduction of prostate-specific antigen after tamsulosin treatment in patients with elevated prostate-specific antigen and lower urinary tract symptoms associated with low incidence of prostate cancer at biopsy

Objectives: To evaluate the effect of tamsulosin on reducing the serum levels of prostate-specific antigen (PSA) in patients with lower urinary tract symptoms and an elevated PSA level. Methods: From June 2004 to July 2006, patients with lower urinary tract symptoms, a PSA level of <4 ng/mL, and a maximal flow rate of <15 mL/s received tamsulosin 0.4 mg daily for 2 months. They were then scheduled for 12-core prostate biopsy. PSA determination and a uroflow study were performed before biopsy. Results: A total of 80 patients completed the present study. The mean patient age was 66.3 years, and the mean PSA level was 7.8 ± 8.4 ng/mL at baseline and 7.1 ± 9.1 ng/mL after treatment (P < .001). A total of 29 patients (36.25%) were diagnosed with prostate cancer from the biopsy findings. A significant increment in the PSA level was observed in patients with prostate cancer (6.7 versus 7.9 ng/mL; P = .002). A significant decrease in the PSA level was observed in patients with negative biopsy findings (6.9 versus 5.1 ng/mL, P = .000). Of the 38 patients with a decrease in the PSA level, 1 (2.6%) was diagnosed with prostate cancer and 37 (97.4%) with an benign prostatic hyperplasia/prostatitis. Of the 42 patients with no change in the PSA level, 28 (66.7%) had prostate cancer and 14 (33.3%) had negative findings. A change in PSA level after treatment gave a sensitivity of 96.6%, specificity of 72.5%, and diagnostic accuracy of 81% for prostate cancer. Conclusions: Treatment with tamsulosin seemed to reduce the PSA levels and identified patients at high risk of prostate cancer.