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There has been a lot of news about the prostate of late. No kidding around this week because this is serious business and I’m steamed at the ignorance in the reporting. So let’s get right to it.
 
PSA tests  Good or Bad?
The big flap last week was over a blood test called “Prostate Specific Antigen” (PSA) and whether giving that test to healthy men ultimately causes more harm than good. An expert panel, the U.S. Preventive Services Task Force, said the test was so poor at predicting lethal prostate cancers that the millions of test lead to a high proportion of unnecessary procedures and a huge cost. As examples of the harm they list, biopsies cause an increase in infections and surgeries can cause death and more often impotence and incontinence. Even hormone treatments can turn a man’s life upside down. This is the same philosophy discussed by one of our radio guests Anthony Horan, MD author of The Big Scare: The Business of Prostate Cancer. Hear archived interviews: 10/24/2009 and 12/12/2009.

Naturally, with the exception of Dr. Horan, urologists (the doctors who usually administer the tests) and drug makers strenuously objected.  They say the test saves lives by detecting cancer at least some of the time.

Here’s the thing-despite the name, PSA is not very specific for the prostate. Women have no prostates but do have psa levels. PSA is even found in breast milk. Nor is that particular antigen very specific for cancer.  It can be elevated in association with benign prostate enlargement, excess body fat, recent sexual activity and generalized inflammation. Even the much dreaded digital rectal exam can increase the level. Also, levels naturally increase with age. One would think that perhaps the rate of increase from one test to another would be useful but that isn’t very reliable either.

This is the bottom line in my view: Having the test done may not be very useful but it really isn’t a big deal either. The critical factor is what a man does with the information if the report shows an elevation. It can be a good thing IF a guy uses a high reading as a wakeup call to:

Lose weight (excess fat is associated with prostate cancer)
Get more exercise
Eliminate sources of inflammation (e.g. smoking, sugar, refined foods and Trans fats)
Increase anti-inflammatory supplements such as fish oils and magnesium
Build immune strength with vegetables and supplements such as vitamin D
Avoid chemicals like plasticizers that interfere with hormones
Assure that his hormones are balanced (Testosterone is often suspected, but then shouldn’t 16 year olds have the highest rates of prostate cancer? Men’s levels of testosterone decline as they age but their estrogen levels go up. The body’s fat cells make estrogen. Is that one reason fat is associated with prostate cancer? Many chemicals act as estrogens. Hmm…is a pattern developing here? LINK)
Perhaps see if a prostate supplement improves symptoms. (Zinc and Saw Palmetto are the most common.)
Take a balance of protective antioxidants (see below)

A very conservative guy might be afraid not to have the test, but at the first sign of an elevation should remember that a little watchful waiting is often the most conservative approach. He can have periodic rectal exams and follow-up PSA tests. (Note, happily the test level can go down even faster than it went up.) If, in spite of taking the positive actions above, symptoms worsen and the PSA continues to go up, then a biopsy may make sense.  On the other hand, if a high reading leads, without thought, to a biopsy and life-altering treatments, that may not be prudent.

News on Vitamin E & Prostate Cancer
Researchers recently followed up a study a year and a half after it was halted. Their results showed a slight increase in prostate cancers among those who had taken vitamin E. I put my reaction to the misleading reporting on that study into the following letter to the editor of the Dallas Morning News:
 
“Reports on the “SELECT” vitamin E / prostate study fail to mention that it also studied the mineral selenium. I wish the National Cancer Institute had used SELECT to confirm an earlier selenium study that showed a dramatic 63% reduction in incidence of prostate cancer, large decreases in other cancers and fewer deaths from all causes. The NCI included selenium in the SELECT study, but not the same natural form, methylselenocysteine, that delivered the impressive benefits. Instead they used the much less effective selenomethionine. NCI also included a synthetic vitamin E that is less effective than natural vitamin E pills. (Hormone replacement therapy painfully taught us that you can’t fool the body-synthetics can actually block protective effects of the real thing.) Notably, SELECT subjects who took both vitamin E and selenium showed no statistically significant increase in prostate cancer risk. That makes sense because nutrients work in teams. Study results suffer when researchers isolate nutrients out of balance and treat them as drugs. A healthful diet is key, but I’ll also continue to recommend natural vitamin E supplements (ideally as a complex of 8 members of the vitamin E family) along with other balancing antioxidant nutrients like Vitamin C.” 

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My first book : Natural Alternatives to Nexium, Maalox, Tagamet, Prilosec & Other Acid Blockers. Subtitle: What to Use to Relieve Acid Reflux, Heartburn, and Gastric Ailments.

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The information contained in this newsletter has not been evaluated by the Food and Drug Administration and is not intended to diagnose, treat, cure or prevent any disease. The contents are for informational purposes only and should not be used as a substitute for professional medical advice.

Copyright 2011 Martie Whittekin, CCN