Sperling Prostate Center

How Can You Avoid a PSA False Alarm?

When it comes to men’s health, you’re a responsible guy, right? You don’t overdo it on dietary fats, sugars, red meat and alcohol; you work out regularly; and you have an annual physical. And, your annual exam includes a PSA blood test if you’re over age 45 (age 40 if you have known risk factors). Or does it?

PSA confusion

PSA guidelines over the past 10 years have been conflicting. Get the test. Don’t get the test. Talk about getting the test. Get the test but include additional PSA derivatives. Why all the confusion?

Well, it’s the nature of the test itself. An abnormally high or rising PSA often sends a false alarm because PSA (Prostate Specific Antigen) does not always mean prostate cancer (PCa). It’s just a harmless protein shed by healthy and unhealthy prostate cells into the bloodstream. If something disturbs the gland, it sheds more PSA. Disturbances that cause PSA to rise commonly include infection, inflammation, bike riding, sex, even the Digital Rectal Exam (DRE). However, so does a cancerous tumor.

About one million needle biopsies of the prostate are done annually in the U.S., and in most cases, it all started with an elevated PSA. You see, cautious doctors who want to make sure that an abnormal PSA does NOT mean PCa often recommend an immediate needle biopsy. If a man goes through that scary, sometimes painful invasion of his gland—with its risks of side effects—only to get a negative report, it’s possible that his high PSA was a false alarm after all.

Avoiding a false alarm

A 2021 paper published in the journal Urology suggests a common-sense way to keep your PSA at normal levels by adding another lifestyle practice to the ones we hope you’re already doing. A research team from the Miller School of Medicine (U. of Miami, Miami, FL) explored the impact of a plant-based diet and PSA levels.[i]

Using data on demographics, diet and PSA levels taken from the National Health and Nutrition Examination Survey, they identified 1399 profiles for which they had all factors. From these, they calculated scores called the Plant-based Diet Index (PDI) and Healthful Plant-based Diet Index (hPDI) using food frequency results in the database. The higher the score, the greater the consumption of plant-based and healthy plant-based foods. They found that men with high hPDI had lower probability of elevated PSA than men in all other groups, including the PDI score.

What’s the difference between basic plant-based diet and healthful plant-based diet? Well, eating fruits, nuts and vegetables doesn’t mean a person is getting all the nutrients he/she needs. Essential vitamins and minerals, as well as a good balance of protein, carbohydrates and fats are all part of the nutritional formula we need. U.S. News ranked the Mediterranean Diet the #1 best over-all diet for heart health, weight loss, diabetes control—and easiest to follow. It also reduces chances of PCa.

However, if plant-based eating is new to you, and you’re not ready to dive in with both feet, consider a “plant-forward” gradual transition. Take to heart the conclusion of the U. of Miami paper: There is a significant association between increased consumption of a healthy plant-based diet and lower PSA levels.

Maintaining a stable, normal PSA is a sure route to avoiding an unnecessary prostate biopsy. There is also a way to ensure that a rising PSA may be a false alarm before heading into a biopsy: a multiparametric MRI (mpMRI) of the prostate. This noninvasive scan excels at detecting the presence of significant PCa. Significant PCa means your elevated PSA is a genuine alarm, and requires the most accurate diagnosis by means of a real-time, MRI-guided targeted biopsy. But let’s hope it never comes to that!

Not only can more responsible diet keep your PSA levels low, it helps lower the risk of PCa. In short, healthy plant-based diets offer two great advantages: avoiding a PSA false alarm, and avoiding a PCa real alarm! Here’s to your health.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] Mouzannar A, Kuchakulla M, Blachman-Braun R, Nackeeran S et al. Impact of Plant-Based Diet on PSA Level: Data From the National Health and Nutrition Examination Survey. Urology. 2021 Jul 22;S0090-4295(21)00675-0.

About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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