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PSA Nadir Level in Prostate Cancer

The absolute lowest level the PSA drops after treatment

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The PSA nadir is the absolute lowest level that the PSA drops after treatment. PSA is a protein produced in the prostate. The PSA nadir can tell your physician a lot about how successful a given treatment has been, and can even give your doctor an idea as to how likely you are to have recurrent prostate cancer.

What Is Prostate Cancer?

Prostate cancer develops in the prostate — a small gland that makes seminal fluid.

It is one of the most common types of cancer in men. Prostate cancer usually grows over time and in the beginning usually stays within the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.

Prostate cancer that is more advanced may cause signs and symptoms such as:

  • Difficulty urinating
  • Decreased force in the stream of urine
  • Blood in the semen
  • Discomfort in the pelvic area
  • Bone pain
  • Erectile dysfunction

Risk Factors

Factors that can increase your risk of prostate cancer include:

  • Older age. Your risk of prostate cancer increases as you get older.
  • Being black. Black men have an increased risk of prostate cancer compared to men of other races. In black men, prostate cancer is also more likely to be aggressive or advanced.
  • Family history of prostate or breast cancer. If men in your family have had prostate cancer, your risk may be increased.

  • Obesity. Obese men diagnosed with prostate cancer may be more likely to have advanced disease that's more difficult to treat.

Complications

Complications of prostate cancer and its treatments include:

  • Cancer that spreads (metastasizes). Prostate cancer can spread to nearby organs, or through your bloodstream or lymphatic system to your bones or other organs.
  • Incontinence. Both prostate cancer and its treatment can cause urinary incontinence. Treatment options include medications, catheters, and surgery.
  • Erectile dysfunction. Erectile dysfunction can be a result of prostate cancer or its treatment, including surgery, radiation or hormone treatments.

Prostate cancer treatment options depend on several things, from how fast the cancer is growing to how much it has spread.

Radiation therapy uses high-powered energy to kill cancer cells. Side effects can include painful urination, frequent urination, and urgent urination, as well as rectal symptoms, such as loose stools or pain when passing stools. Erectile dysfunction can also occur.

Hormone therapy prevents your body from producing the male hormone testosterone. Testosterone helps prostate cancer cells multiply. Cutting off the supply of hormones may cause cancer cells to die or to grow more slowly.

Side effects of hormone therapy may include erectile dysfunction, hot flashes, loss of bone mass, reduced sex drive and weight gain.

Surgery to Remove the Prostate

Surgery for prostate cancer involves removing the prostate gland (radical prostatectomy), some surrounding tissue and a few lymph nodes.

Radical prostatectomy carries a risk of urinary incontinence and erectile dysfunction.

Freezing Prostate Tissue

Cryosurgery or cryoablation involves freezing tissue to kill cancer cells.

Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered intravenously in your arm, in pill form or both.

Chemotherapy may be a treatment option for men with prostate cancer that has spread to distant areas of their bodies. Chemotherapy may also be an option for cancers that don't respond to hormone therapy.

Biological therapy, also called immunotherapy, uses your body's immune system to fight cancer cells.

One type of biological therapy called sipuleucel-T (Provenge) has been developed to treat advanced, recurrent prostate cancer.

PSA test for prostate cancer

Browse this section

  • Overview
  • What is the PSA test?
    • What is the PSA test?
    • Finding information about the PSA test
  • Deciding whether or not to have the PSA test
    • Deciding whether or not to have the PSA test
    • Why some men have not had a PSA test
    • Why some men have had a PSA test – symptoms
    • Family history and other concerns about cancer
    • Encouraged by family, friends and the media
    • Routine health checks
    • Follow-up after treatment
  • Results and treatment choices
    • Waiting for the results of a PSA test
    • Getting the results and understanding them
    • What may happen when a PSA test result is abnormal
    • Biopsy of the prostate
    • Choosing a treatment if cancer is diagnosed
  • Views about a national screening programme
    • The pros & cons of a national screening programme

What is the PSA test?

PSA (Prostate Specific Antigen) is an enzyme (a protein) substance made by the prostate gland. It is made by both normal cells and cancer cells (if present), and is secreted into the seminal fluid to keep it liquid. A small amount of PSA continually leaks from the prostate gland into the blood stream. Cancer cells produce more PSA than normal cells, and when prostate cancer cells multiply, more PSA spills into the blood. The PSA test measures the level of PSA in the blood.

Well PSA stands for prostate specific antigen and it’s a substance that can be measured in the blood and it comes from the prostate gland; and the purpose of people being interested in it is that they think it might help people to pick up prostate cancer early in such a way that the outcome of the disease, the prostate cancer, will be less likely to harm the patient.

Okay yes for those who aren’t in the medical field or field of cancer the term PSA, prostate specific antigen, test might seem rather foreboding, rather frightening, but essentially it’s a blood test, it’s from that blood, that blood sample that the prostate specific antigen is, the levels are checked, and as I said if a gentleman is presenting with symptoms of prostate cancer then the PSA test is a fantastic way to start things off, to start that process and just get things checked out. Now I’m not saying base everything on that but it’s a good yardstick by which to measure things.

But many other men we talked to seemed confused and expressed misunderstanding. One man, for example, suggested that too much PSA allowed the cancer to grow, and he said it was important to ‚kill the amount of PSA manufactured by the prostate gland‘. Some men found it hard to explain what a rise in PSA level in the blood might indicate, and others didn’t know what the letters PSA meant.

Public Health England has developed the Prostate Cancer Risk Management Programme (PCRMP):

Just in case somebody’s looking at this site and wants to know what happens when you have a PSA test would you mind just explaining what happens exactly?

Well I don’t think anybody should be afraid of having it [a PSA test], as it’s only a normal blood test. I think you know may be for some people when you say the prostate and it’s a test for prostate problems they think that the test involves some squeamish, you know, invasive test on their genitals or something and they don’t even realise it’s a blood test. I mean I think one has to not assume anything and not assume that people know what a test involves you know. I mean

So the doctor at the end said ‚Is there anything else while you’re here, I see you so rarely?‘ And I basically said, ‚Well it suddenly came into my mind and I said ‚Well look I’ve got no symptoms, I’ve got no logic for asking for this except it seems a sensible thing to do, can I have a PSA test?‘ And his reaction was quite interesting he certainly wasn’t very keen on giving me one, he said basically he said, ‚Well it’s not always accurate and therefore we can raise fears and uncertainties that you know you might not cope with.‘ His second reason was, ‚Well, men generally don’t cope with the uncertainty and I’ve found it creates more negatives than positives, and thirdly if you haven’t got any symptoms,‘ you know, which was my argument, ‚why go looking for a problem?‘ And I suppose it was his, his logic of putting me in this group that all men can’t handle problems and that all men can’t face issues, without any discussion of how I might deal with it, was just a kind of broad categorisation, so I suppose that was, as is like a red rag to a bull so I thought well I would exercise my rights. So I basically said, ‚Well look have I a right to have one?‘ And he said, ‚Definitely‘. So I said, ‚Well despite all your arguments I would like one,‘ and well basically he proceeded to do it albeit it was patently reluctantly. And I suppose it’s interesting the experience just to quote one example that subsequent to this I recommend it to another man who went to his doctor specifically and was sent home to think about it for a month and come back if he still wanted it. So it’s quite interesting that my doctor, whilst anti, others felt even more strongly and even told this particular man to go away for a month and only come back if he was really, you know really wanted it.

A digital rectal examination is often seen as an important part of the prostate examination. Some other factors, such as ejaculation, urinary infection or a prostate biopsy in the last 6 weeks can also affect the PSA level in the blood, making it appear abnormally raised. It is not clear whether or not vigorous exercise, such as cycling, affects the PSA level, but doctors had told some men to avoid such activity just before their PSA test and the PCRMP information also recommends not having a PSA test for 48 hours after heavy exercise .

How I Improved My PSA Score

As some of you may know, my PSA shot up from about 1.4 ng/ml to a high of 6.3 in early December of 2013. Yeah, Merry Christmas! I was immediately forced off of HRT (testosterone therapy) for a month and ended up with a prostate biopsy. Fortunately, they found Only Inflammation and No Cancer.

This was a sobering experience for me as I consider myself to be very healthy overall. To this day, I still do not really know what caused the prostate inflammation. However, I do have good news: last week (4/25/2014) I found that my PSA was down to 2.0! So it took about five months, but I almost have my PSA back down to my original baseline levels. I had an interim read of 3.9 as well, even though my prostate was likely still inflamed from the biopsy, so I was showing improvement almost right away.

Of course, I'd like to have a baseline PSA less than 1.0 like some of the young guys on the Peak Testosterone Forum, but I’m on HRT, am sexually active – hallelujah! – and exercise every day. All of these will tend to raise PSA and so a PSA of 1.4 is not too unreasonable for a guy in his early 50’s in my opinion.

And, of course, I am very excited that I have reduced my PSA now by over three times in just a few months and thought I'd share – humbly of course – what I have done. Before I go on, let me say thanks to Mike Shedlock who gave me the core ideas for a good deal of what you see below on the supplement side of things and who was a role model for all of us by dropping his PSA with an innovative nutraceutical solution. I cover all this in my link on A Cure For Prostate Cancer and am a regular reader of Mike Shedlock’s blog at Global Economic Analysis.

CAUTION: I want to caution anyone reading this with actual prostate cancer. PC is a tricky disease and you have to be careful. I highly recommend that you run anything that you are considering below by your urologist and a good oncologist. (Most urologists are woefully ignorant on the underlying cancer mechanisms behind prostate cancer from what I have seen.) And, of course, stay up on the latest research and share it with me!

  • SUPPLEMENTS:
  • Turmeric Extract (400 mg as extract with 93% curcuminoids of 372 mg twice per day)
  • IP6 & Inositol (800 mg and 220 mg, respectively, once per day)
  • Quercetin (250 mg once per day)
  • Bromelain (125 mg once per day)
  • Red Tart Cherry – Freeze Dried Skin Concentrate in Capsules (1000 mg once per day)

    NOTE: Almost everything in my current regimen is anti-inflammatory. Both prostatitis and prostate cancer are, in general improved by anti-inflammatory strategies, so this is a pretty safe bet in my opinion. I should point out that the long term effects of supplements, especially megadosing are largely unknown.

  • FOOD:
  • Curry once per day
  • Soy Protein once per day. (For a few cautions, see my link Soy and Men. In addition, keep in mind that some study work shows that soy increases IGF-1 and higher IGF-1 levels are linked with increased prostate cancer risk. [1])
  • I put 3-4 tablespoons of flaxseed in my smoothie every day. (See my link on Flaxseed and Prostate Cancer for some additional information.)
  • Diet is completely vegan except for
  • a) (BPA-free) sardines three times per week and
  • b) Undenatured whey which one study showed did not increase IGF-1

    NOTE: I am not anti-meat as you can see in my link on Low Fat Meats. However, some study work shows that veganism lowers IGF-1 to more natural cancer-protecting levels, so I am currently playing it safe.

    NEWS FLASH: My latest PSA in mid late 2015 was 1.75. I was very please with that, because this is almost to my old levels when I first started testosterone cypionate. Lately, the only direct PSA-lowering strategies have been turmeric extract and flaxseed, along with my standard plant-based flexitarian diet, exercise routines and anti-aging supplement strategy.

  • MODIFICATIONS from MISH’s PSA-Lowering Protocol:

    As you can see,I took MISH's PSA-lowering protocol as my starting point and simply did a few tweaks. Keep in mind, though, that he dropped his PSA dramatically and he had actual prostate cancer detected, so his results are particularly impressive.