The Pros and Cons of PSA Testing for Men

When it comes to prostate health, there are many different options and recommendations for screening, testing, and treatment. It can be overwhelming to say the least. And this is all made worse by shifting guidelines from experts as new research comes out.  

Prostate problems — including benign prostatic hyperplasia (BPH), prostatitis, and prostate cancer — are on the rise.

Prostate cancer is the second most common cancer in men after skin cancer. Estimates are that 1 in 8 men will be diagnosed with it during their lifetime. And according to the American Cancer Society, there are close to 270,000 new cases every year.¹  

In fact, North America has some of the highest rates of prostate cancer in the world.

So if you are struggling with prostate issues or simply want to prevent future problems, where do you start?  

In recent years, health experts have been reevaluating the accuracy and value of PSA tests (prostate specific antigen). Additionally, there is the issue of performing an unnecessary or invasive procedures based on a PSA number, such as a prostate biopsy.

A PSA, or prostate specific antigen, test is a blood test that screens mainly for prostate cancer. For years, this test was considered the best way to assess the health of a man’s prostate, as well as track any changes that might indicate cancer or other prostate problems.

Prostate specific antigen is a protein produced by the prostate gland, normally in very small amounts. When a man’s PSA level increases, it can indicate a potential problem such as prostate cancer. Having said that, PSA levels can also rise due to chronic inflammation and infection, which complicates things. 

PSA tests were once considered a lifesaver because they helped detect prostate cancer before other tests. Research suggests, however, that widespread PSA testing as a screening tool does not necessarily improve prostate cancer outcomes.  

Here is a look at some of the reasons for this:  

The PSA test alone does not measure prostate cancer aggressiveness. Many prostate cancers grow slowly and may never pose a threat to life or health. A relatively benign cancer can pose little threat to your health, but it can also mutate into a more aggressive form over time, particularly if a man is exposed to toxins, free radicals, and oxidative stress. A test may be helpful, but it does not show the complete picture.

The PSA test may also have trouble identifying aggressive cancers early. In other words, the test may be too quick to detect slow-moving cancers (leading to potentially invasive interventions) and too slow to detect aggressive ones (allowing a deadly, fast-growing cancer to gain a foothold). The level of PSA may not actually reflect the extent of disease and can sometimes be misleadingly low.  

Despite these observations, the PSA test is still an important tool when used with other prostate diagnostic methods to provide a comprehensive diagnosis.

It’s important to note that PSA results are affected by certain factors, including the following:

• Medications
• Seasonal variations  
• Time of the day
• Sexual activity
• Intense exercise like bicycle riding
• The actual size of the prostate (an enlarged prostate can lead to a higher reading)  

It is also important to repeat PSA tests at the same time of day and with the same laboratory, as methods for detecting PSA vary from one lab to another and can’t be accurately compared. 

If you have prostate cancer (with elevated PSA) or have other prostate symptoms and an elevated PSA, it’s useful to repeat a PSA test results — but do not rely on it.

You can reduce your PSA number with a specific supplement that helps decrease inflammation and resolve prostate infections. Reducing prostate inflammation is an essential component of prostate cancer treatment — it lowers the risk of the cancer mutating into a more aggressive form.  

There are many other diagnostics that can provide greater context for PSA levels, including:

Prostatic acid phosphatase (PAP) is a more traditional prostate test that complements the PSA test. PAP elevation may indicate that the cancer has metastasized to the bones and can point to the tendency for a more aggressive cancer in general, even in the absence of evident metastasis. 

Comprehensive hormone testing is critical for providing a more complete, individualized picture of prostate health. For example, men with higher testosterone levels respond more favorably to treatment. Estrogen is also a factor, as increasing levels of the hormone in men can correlate with increases in prostate cancer, as well as more aggressive disease. This is also true of prolactin.

Ask your doctor to test you for the following hormones: hormones estrogen, progesterone, prolactin, DHEA-S and DHT (dihyrdrotestosterone), a metabolite of testosterone that is stronger and leads to stimulation of prostate cells. 

There are several of important, non-hormonal prostate markers that are also useful, including:  

Carcinoembryonic Antigen (CEA) or insulin-like growth factor type-1 (IGF-1): Elevated level may indicate cancer aggressiveness or other underlying conditions that need attention. 

Prostate Cancer Gene 3 (PCA3): This gene-based test helps determine a man’s risk for prostate cancer. This is a simple urine test done after a digital rectal stimulation by a doctor. This test can be used as a follow-up for low-risk prostate cancers, and it may even be ordered as a replacement for the risky practice of annual biopsies (as part of the watchful waiting/active surveillance approach). 

Other genetic tests of the biopsy tissue itself are becoming available that can provide further information about cancer aggressiveness on a gene expression level.  

Imaging should play a key role in diagnosing prostate cancer. MRI, MRI-S, PET, CT, color Doppler ultrasound, and bone scans all help determine the severity of prostate cancer. The field of prostate cancer imaging is constantly evolving with newer, more accurate methods on the horizon.  

Galectin-3 (Gal-3) is a master alarm protein produced by the body in response to trauma, injury, infection and other stressors. With more than 3,000 published studies to its credit, Gal-3 is increasingly recognized as a key driver of chronic disease. It controls the inflammatory cascade and fuels the development of fibrosis (uncontrolled scar tissue build up) that leads to organ failure. Gal-3 is also called “The Guardian of the Tumor Microenvironment” because it is actively involved in tumorigenesis, cancer proliferation/metastasis, and immune evasion. 

Because Gal-3 aggressively fuels chronic inflammation, it has been recognized as an active marker for prostatitis, BPH, and prostate cancer. A study published in The American Journal of Pathology showed that controlling levels of Gal-3 inhibited prostate cancer metastasis.²

 A study published in Oncotarget reported that the Gal-3 blood test is an important complement to PSA test results. Researchers found Gal-3 at higher levels in the prostate serum of prostate cancer patients.³ 

Within the fast-growing body of research on Gal-3 in cancer and other conditions, one natural therapy has become recognized in the published literature as the most-researched Gal-3 inhibitor: Modified Citrus Pectin (MCP).

With more than 75 published studies, MCP is the only available ingredient shown to enter the bloodstream from the GI tract and bind to excess Gal- 3 in the circulation, as well as at specific problem areas throughout the body.  
 
Several studies have found that MCP helps inhibit cancer, including prostate cancer. Here is a quick look at the research: 

• A 1995 animal study, published in the Journal of the National Cancer Institute, found that MCP blocked prostate cancer adhesion to endothelial cells, reducing lung metastasis by 50 %.⁴ 
• A 1999 clinical study presented at the International Conference on Diet and Prevention of Cancer in Finland found that prostate cancer patients who received MCP significantly slowed down their PSA doubling time.⁵ 
• A 2003 phase II clinical study published in Prostate Cancer and Prostatic Diseases analyzed the effects of MCP in men with biochemical relapse of prostate cancer after local therapy. Results showed that 5 grams of MCP three times per day for one year slowed PSA doubling time in 70% of subjects.⁶ 
• A 2007 clinical study published in Clinical Medicine: Oncology found that  cancer patients with advanced solid tumors who were treated with MCP stabilized and experienced improved quality of life.⁷ 
• The most recent study, a 2019 double-blind clinical study published in European Urology Open Science, demonstrated that MCP effectively slowed cancer progression in patients with biochemically relapsed prostate cancer.⁸ 

These recent clinical results come from a multi-center Phase IIb clinical trial in a group of prostate cancer patients who received localized treatment for their cancer and experienced a non-metastatic relapse (biochemical relapse) of the tumor. Eighteen months of treatment with 15 grams per day of MCP showed significant improvement against prostate cancer. Sixty-five percent of subjects had no disease progression, and 50% of subjects had a lower PSA, or PSADT lengthening time, compared to their baseline 18 months prior.  

Modified citrus pectin has also been shown to increase the efficacy of certain chemotherapy drugs and reduce side effects. For example, Doxorubicin (Dox) is an effective anti-cancer drug, but it’s also very toxic with the potential to cause severe heart and immune system damage.

While the compound can be useful in treating advanced prostate cancer patients, the issue is dosage-dependent toxicity. Due to its high toxicity, it can be difficult to give patients a sufficient dose of Dox to inhibit the cancer without causing significant side effects. 
 
A study published in the journal Cell Biology International showed that combining Dox with MCP increased the anti-cancer activity of both agents.

MCP synergistically enhanced the cytotoxic effects of Dox in both androgen-dependent and androgen-independent prostate cancer, leading to a significant reduction in the dosage of Dox.⁹ 

One of the keys to success in integrative cancer treatment — not just prostate cancer but many others as well — is the application of individualized protocols based on a diverse range of diagnostic and therapeutic approaches.

The Gal-3 prostate biomarker is a unique example of both. It serves as an important diagnostic tool and is becoming a powerful therapeutic target for numerous conditions — from prostate cancer to nearly every other type of cancer; cardiovascular disease, kidney disease, and much more.

When it comes to supporting prostate health, MCP is recognized for its ability to block pro-cancer, metastatic, pro-inflammatory and pro-fibrotic actions — making it an important tool in the treatment of prostate cancer and numerous chronic conditions.

Sources

1. https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html

2. Wang Y, Nangia-Makker P, Tait L, Balan V, Hogan V, Pienta K, Raz A. Regulation of prostate cancer progression by galectin-3. Am. J of Pathol. 2009 Apr; 174 (4): 1515-23. 

3. Balan V, Wang Y, Nangia-Makker P, Kho D, Bajaj M, Smith D, Heilbrun L, Raz A, Heath E. Galectin-3: a possible complementary marker to the PSA blood test. Oncotarget. 2013 Apr;4(4):542-9. 
 
4. Pienta KJ, Naik H, Akhtar A, Yamazaki K, Replogle, TS, Lehr J, Donat TL, Tait L, Hogan V, Raz A.  Inhibition of spontaneous metastasis in a rat prostate cancer model by oral administration of modified citrus pectin. J Natl Cancer Inst 1995 87(5):348-53 
 
5. Strum S, Scholz M, McDermed J, McCulloch M, Eliaz I. Modified citrus pectin slows PSA doubling time: a pilot clinical trial. Paper presented at: International Conference on Diet and Prevention of Cancer. May 1999. Tampere, Finland. 
 
6. Guess B, Scholz M, Strum S, Lam RY, Johnson HJ, Jennrich RI. Modified citrus pectin (MCP) increases the prostate specific antigen doubling time in men with prostate cancer: A Phase II clinical trial. Prostate Cancer Prostatic Dis. 2003;6(4):301-4 
 
7. Azémar M, Hildenbrand B, Haering B, Heim ME, Unger C. Clinical benefit in patients with advanced solid tumors treated with modified citrus pectin: a prospective pilot study. Clinical Medicine: Oncology 2007 Dec (1): 73–80. 

8.  Dresler, H. et al. Long term effect of PectaSol-C modified citrus pectin treatment in non-metastatic biochemically relapsed prostate cancer patients: Results of a prospective phase II study. European Urology Supplements, Volume 18, Issue 11, e3467.
 
9. Tehranian N, Sepehri H, Mehdipour P, Biramijamal F, Hossein-Nezhad A, Sarrafnejad A, Hajizadeh E. Combination effect of PectaSol and Doxorubicin on viability, cell cycle arrest and apoptosis in DU-145 and LNCaP prostate cancer cell lines. Cell Biol Int. 2012 Jul 36(7):601-10.