Can you reduce your PSA levels?

I get a lot of calls from men wanting to “reduce” their PSA levels.

These men have usually just received their test results that show an above-average PSA, and their doctor has recommended a biopsy of the prostate.

Or they have had a negative biopsy in the past, but their PSA is still higher than average and they want to avoid another biopsy.

Most of the time, though, it’s because they have just had a blood test and their doctor has told them that their PSA is high.

Frightening Information

PSA testing is a scary process for men, but it need not be; a high PSA is not always an indicator of prostate cancer. My own tests show a constant PSA of 3.7 down from a score of 5 from a test 10 years ago. Most doctors would try to biopsy me every six months, which is not going to happen!

Those who have read my emails in the past know that I am “genetically” predisposed to a high PSA that has nothing to do with my prostate cancer risk. I had two biopsies 10 years ago and haven’t had one since. The urologist just wanted me to keep coming back until he found “something,” even if nothing was to be found!

The thing is that the PSA test in the past has been the main basis for the medical profession to process men through aggressive treatments, many of which are unnecessary.

Recent American Cancer Society National guidelines recommended that no man get tested for prostate cancer using the PSA blood test unless he is in a high-risk group or has a family history of prostate cancer. And even then, he should only have the test after he is 50 years old.

When this was announced last year, I had the two main private prostate cancer treatment hospitals in America call me within the same week asking me: “How are we going to get more patients?”

These institutions had been relying on the PSA test as the feeding ground for patients they could operate on, burn and radiate for so many years it seemed they had forgotten the principle basis of their profession (and the Hippocratic Oath) “to do no harm.” Now they were genuinely worried that all those radiation procedures, robotic prostatectomies and other machine functions were going to be put by the wayside. How were they going to make money?

The process that had worked for them in the past was pretty simple.

First: PSA test. Second: biopsy. Third: cut, radiate or poison. Oh, and fourth: incontinence, loss of sexual function and other side effects. The system worked well. Everyone was making money. Now it seemed that the amount of men that were being fed in to the pipeline for treatment was drying up.

Was this a bad thing and whom did it benefit?

Personal Problem

My problem is personal and it also affects a lot of men. I went through a system that was flawed, invasive and only designed to process me through a medical system geared toward unnecessary treatment. I was lucky enough to find a urologist who took me out of the system and got me back on track. But not all men are that lucky.

My message is not that the PSA test is bad. While the experts still have different recommendations for the PSA test, they all agree that the PSA test is one important tool you can use to monitor your prostate and general health. You should get the PSA and DRE (digital rectal exam) regularly, especially if you have a family history of prostate cancer.

My concern has always been, however, the “rush to biopsy” after any sign of an above-average or above-normal PSA level. And then, the often-unnecessary aggressive treatment of men with low-grade prostate cancer (less than Gleason-6) that studies on humans and many trials have shown can be cured through lifestyle, diet and other factors. Yes, many low-grade prostate cancers can be either cured or managed without treatments. And these low-grade cancers are more often than not the ones in men treated with medical procedures that leave them incontinent and sexually diminished. Let’s also remember that of the more than 1 million prostate biopsies performed in the United States on men each year more than 75 percent are negative! That’s more than 750,000 men put through the procedure unnecessarily at a cost of approximately $2.2 billion to the healthcare system.

A Question Of Normality

So what is the takeaway?

First, there is no normal PSA. It is what is normal for you based on a number of factors. You cannot compare individual PSA levels against a normal range. Instead, there are many factors to take in to account: age, genetics, presence of BPH, prostatitis or any injury to the prostate region. Other factors such as weight and sexual activity also play a part in your PSA levels.

Second, don’t rush in to a biopsy based on your initial results unless your doctor thinks you definitely have a risk of prostate cancer. And prepare for your PSA so you can get an accurate reading when you are tested. For example:

In the 48 hours before your PSA test you should NOT:

• Ride a bike or anything that puts pressure on the prostate.
• Participate in vigorous exercise that will jostle the prostate.
• Get a prostate massage.
• Have a digital rectal examination (make sure your doctor does this type of exam after your PSA test).
• Ejaculate or participate in any sexual activity.

Keep in the mind that if you also have a bacterial urinary tract infection, you should postpone your PSA until six weeks after you have completed your antibiotics.

There are a few other procedures that should cause you to wait six weeks for your PSA test: If you are undergoing a prostate biopsy, a cystoscopy, a transurethral resection of the prostate (TURP), a urethral catheter or another procedure involving the prostate, you should wait six weeks before having a PSA test so that the results are not affected by these procedures.

Reason To Wait

Other things that could affect your PSA test results include:

• Having chemotherapy.
• Medications prescribed for an enlarged prostate like Proscar/Flomax that may “mask” PSA levels.
• Injuries to the pelvic region.
• Having prostatitis.
• Having benign prostatic hyperplasia (enlarged prostate).
• A genetic predisposition to a high PSA.

Also, let your doctor know your recent medical history and about any medications, injuries or treatments you have recently undergone.

Remember: While a high PSA can indicate a problem with your prostate health, it does not mean you have prostate cancer. To the initial question of: “How can I reduce my PSA?” My response is that is a misguided question. Measurement of rising PSA antigen levels produced by the prostate is a symptom of something, but is not a disease in itself.

There are healthy habits you can adopt that may lower your PSA. These habits also provide the benefit of lowering your risk for prostate cancer and other benign prostate problems such as BPH. But the lower effect is a result of adopting lifestyle and other habits that increase your overall health, including your prostate health.

Change Your Meals

You can start by eating less meat and more vegetables. Tomatoes have also been found in studies to help lower PSA, as has pomegranate juice. Get plenty of exercise and manage your stress level. Supplements that support prostate health also help.

There are also new and upcoming tests for prostate cancer. The good news about these tests is that they can tell you more specific information than the PSA test alone. You and your doctor can use the new urine test for prostate cancer to let you know if you have low-risk or high-risk prostate cancer, and this can help you make more informed decisions about further testing and treatment.

Also, a new genetic test that predicts prostate cancer is on the way. This, too, will provide better information about the aggressiveness of tumors so so you can make the right treatment decision.

Remember also, as I mentioned above, some men like me have a specific gene variant that gives them a higher PSA reading. This is a gene variant I found out about when I had a genetic profiling done by the company 23andMe. They gave me my full genetic history and profiling for specific disease risk factors. Before this test, I wouldn’t have known that I was genetically predisposed to having a higher natural PSA level. Also, some men’s prostates are naturally big and produce more PSA. So it’s not a one-size-fits-all as far as testing and the results are concerned.

And there’s another alternative option that I am personally excited about as this technology gets more and more advanced: Ask your doctor about a guided MRI before having a biopsy. It can localize any potential tumor.

The field of targeted MRI technology is growing. It can more accurately target tumors less invasively than a biopsy. If I were faced with a sharply spiking PSA and thought I needed more diagnosis, this is the technology that I would look to in order to get the most accurate reading as to what was going on. Read about this technology here.

Talk to your doctor about your risk factors for prostate cancer. Knowing these factors along with your PSA level are some of the first steps in getting on track with your prostate health. Just be sure that you avoid doing any of the activities that can affect your PSA level for the 48 hours leading up to your test and be aware of the other factors that can affect your PSA.

Personally, I believe all men should be tested starting at age 30: More and more men are getting prostate cancer in their 30s.

The biggest problem I have is not with the PSA test. It is what urologists do after the test. There is a massive rush to biopsy and aggressively treat (read harm) patients who show anything suspicious, rather than promoting better lifestyle, diet, nutrition and other factors that have been clinically shown to reduce and eliminate low-grade cancers.

I treat my PSA like a dashboard gauge, telling me that something is going on that I need to pay attention to! The engine (my prostate) may not have cancer, but something is not healthy that needs my attention. And it allows me to make better choices every day to manage and prevent further disease. Just don’t use the American Cancer Society recommendations as a reason to avoid the PSA test. Get checked and get informed. That’s the way I stay healthy and avoid any more unnecessary biopsies.

Have a great day, and I hope this information helps. It is obviously not meant to be medical advice, but it might form the basis of a more intelligent discussion with your doctor if you are concerned about your PSA readings.

For more great posts on male health, check these out:

Top 3 foods for better male sexual health

8 worst foods for prostate health