Take A Pass on PSA

By David Blyweiss, M.D.

A major health organization—The American Cancer Society—has finally come around to my way of thinking. And, on behalf of men across the country, I must say that it’s about time!

The organization recently updated its advice about prostate cancer screening. Instead of condoning routine testing, they now want doctors to make it clear to men that this prostate test has its limits and may lead to unnecessary treatments that can do more harm than good. This comes on the heels of the group’s controversial move against routine mammograms and Pap smears for women.

What is PSA and why is it important? The prostate produces a substance known as the Prostate Specific Antigen (PSA). A small amount of this antigen continuously leaks into the bloodstream and levels can be easily measured. Since high levels of PSA can be associated with prostate cancer, most doctors have routinely relied on this test, combined with a rectal exam, to screen their patients for prostate cancer.

But, two big studies last year suggested that this prostate cancer screening doesn’t necessarily save lives. Any benefits it does offer can come at a high price since the widely used PSA test often spots cancers too slow-growing to be deadly. According to a six-year study of more than 3,300 men by researchers at Fred Hutchinson Cancer Research Center in Seattle, Washington, between 15 and 37 percent of prostate cancer cases are over-diagnosed based solely on PSA testing.

Based on these and other findings, the cancer society’s new guidelines urge doctors to:

  • Discuss the pros and cons of testing with patients, offering written information or videos that discuss the likelihood of false test results and the side effects of treatment.
  • Stop routinely giving the rectal exam because it has not clearly shown a benefit.
  • Use past PSA readings to determine how often follow-up tests are needed and to guide conversations about treatment.

While this is a step in the right direction, it still leaves the door open to too many unnecessary PSA screenings. Unless a man is at high risk of prostate cancer, I don’t recommend testing.

Raised PSA levels simply indicate that there is a problem with your prostate. While that could mean cancer, it could also be a sign of prostatitis or BPH. Or it could mean nothing at all since PSA levels also go up after some medical procedures, particularly after catheter use or a digital rectal exam. Lifestyle factors including smoking, weight changes and the use of calcium supplements can also cause unreliable PSA readings.
Scientists at the University of Texas found that men who are overweight or obese typically have lower PSA count—even if cancer is present. Bladder infections can also upset PSA levels, as can recent prostate massage. Certain medications, like the hair loss drug finasteride, can lower your PSA level while stress can raise it. And something as simple as a dietary change can impact your PSA.

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Another problem is that PSA screening isn’t foolproof. It can yield false-positive readings that result in unnecessary biopsies. And it can lead to treatments that can cause impotence and incontinence.

So what should you do? Here’s what I tell my male patients:

  • Don’t wait for prostate problems to arise. Adopt a prostate-healthy lifestyle that includes a whole foods diet based on lots of fruits and vegetables.
  • Reduce the amount of unhealthy trans and saturated fat you consume. Studies show that there is a direct link between a high-fat diet and prostate cancer.
  • Make exercise part of your daily routine.
  • Take an antioxidant-rich whole foods supplement like All-In-One. Because you take just one shot of this liquid gold daily, it’s highly convenient. Plus it is rapidly absorbed into the body so it provides protection to your prostate—and the rest of your body—quickly.
  • Take a prostate specific supplement like Prost-Xtra Plus to promote the long-term health of this all-important gland. Prost-Xtra Plus is a concentrated, comprehensive supplement that contains all of the protective nutrients your prostate needs to help prevent both BPH and prostate cancer.

Eventually, nearly all men experience some type of prostate problem. By taking action now, you may be able to avoid unnecessary PSA screenings and just might sidestep prostate issues entirely.


References:

Concato J. The Effectiveness of Screening for Prostate Cancer: A Nested Case-Control Study. Archives of Internal Medicine. 2006;166:38-43.

Kranse R. Dietary intervention in prostate cancer patients: PSA response in a randomized double-blind placebo-controlled study. International Journal of Cancer. 2005;113:835-840.

Stobbe M. American Cancer Society casts more doubt on value of regular testing for prostate cancer. Associated Press. 4 March 2010