The prostate makes a protein called PSA that is secreted into the blood. The normal range for white males is 0 to 4 ng/ml and for African American men over age 50 is 0 to 3.5 because a study involving 400 African-American men at Walter Reed Army Medical Center showed that nearly 40% of prostate cancers were missed if the normal limit of 4 ng/ml was used.
About 20% of men with prostate cancer have a PSA less than 4 ng/ml. Only 25% of patients with PSA in the 4 to 10 ng/ml range, however, will have prostate cancer.
As men age, the prostate usually enlarges due to benign prostatic hyperplasia and consequently, the PSA rises.
Table 1. Age-Adjusted Normal PSA Values
40 to 49 years old 0 to 2.5 ng/ml
50 to 59 years old 0 to 3.5 ng/ml
60 to 69 years old 0 to 4.5 ng/ml
70 to 79 years old 0 to 5.5 ng/ml
An elevated PSA can occur from any of these (other than cancer)
· Benign prostatic hyperplasia
· Prostatitis (inflammation of the prostate) – PSA should return to patient’s normal after proper treatment
· Bike riding for extended periods of time; Marathon Running12
· Ejaculating within the last 24 hours
· Mechanical manipulation: Digital rectal exam before the PSA test, Biopsy, Cystoscopy, Foley catheter placement and TURP.
PSA Does Not Extend Life. There is no conclusive evidence that routine use of PSA screening in all men decreases the death rate from the disease. This is because even if prostate cancer is detected early, aggressive management of prostate cancer provides little or no improvement in survival rates. Furthermore, prostate cancer develops over a long period of time. It is often said that men die with prostate cancer, not from it. Early detection will increase the number of prostate cancer cases resulting in anxiety, depression and fear for patients who are unlikely to suffer from any symptoms of the disease. In an effort to “do something” many patients will undoubtedly be treated resulting in unnecessary suffering from side effects and expenditure of health care dollars on unnecessary treatments.
If you are borderline, the new approach to treatment is called “Active holistic survailance”. I often co-manage these cases with clients MD’s and some of the things I do in practice are recommend natural anti-inflammatories, use AHCC, check vitamin D3 levels, use fish oils, reduce red meat, and recommend exercises.