Prostate cancer is the most common cancer occurring in men. Approximately 230,000 men a year are diagnosed with the disease, while 29,000 of them will die from it - a 90% survival rate. We don't know if the 29,000 who die have died from the actual treatment of the disease, versus the cancer itself. The risk of prostate cancer increases with age, and most cases are diagnosed after age 65. It is rare under age 40.
There is much controversy regarding prostate cancer treatment. Most cases are indolent, meaning they don't spread outside of the prostate itself and that the patient will die from something else before prostate cancer becomes a mortal threat. Men with low risk prostate cancer need no treatment and are good candidates for active surveillance.
If your PSA is between 1.5-4, you have a 15 times greater risk of prostate cancer than men with a PSA < 1.5. So if you're told that your PSA is high, or on exam you have a nodule that is suspicious, the only option that has been offered until now was a 3D color doppler or MRI, and prostate biopsy. However, there is concern that a biopsy may contribute to spread of the disease past the capsule of the prostate, and that if left alone it would have stayed encapsulated, causing no health issues. 80% of men who undergo biopsy, which is a painful and bloody procedure, have either no cancer or an indolent form of cancer.
This may explain why there have been studies showing that those who did nothing with a diagnosis of prostate cancer have the same survival as those who were treated.
What should you do if told you either have, or may have, prostate cancer?
Get a test called a 4K score (4Kscore.com). This is a specialized blood test that is sent to the 4K lab, and can help to differentiate if the tumor you have is one that is likely to be more indolent, or one that is more likely to be aggressive and requires treatment. If it comes back low risk, then you can talk to your doctor about active surveillance. Meaning, just watch it for now. And avoid the pain and possible risks of prostate biopsy.
The test is covered by insurances and Medicare, and is simple to do.
You can reduce your risk of ever developing prostate cancer, and also reduce the size of the prostate with a few simple measures:
1) Take vitamin D, and have your levels checked -- it should be between 70-90. A low vitamin D is strongly associated with prostate cancer.
2) Have your testosterone and estrogen levels checked. A low testosterone is associated with prostate cancer, as is a high estrogen level. If your testosterone is low, get your levels up using bio-identical testosterone, and if the estrogens are high, you'll need to lower your levels. I often use a drug called anastrazole to lower estrogen in men.
3) Use a supplement to reduce the size of the prostate and to reduce PSA. I like one by Xymogen, called Prostate Flo.
It's an excellent product for the prostate, a combination of zinc, saw palmetto, pygeum, cranberry fruit, B6, and beta-sitosterol. Zinc is highly concentrated in the prostate and a lack of zinc has been associated with a reduction in the repair of DNA damage in prostate tissue. Zinc is also necessary for the production of testosterone.
For a much more comprehensive review of alternative views in the treatment of prostate cancer, go to SurvivingProstateCancer.org.
By Dr. Susan Ashley, M.D.