Many patients have the concern that Serenoa repens (saw palmetto) extracts might interfere with the measurement of PSA and thus block a prostate cancer diagnosis. Many double-blind trials have shown no effect of saw palmetto on total PSA.
Prostate cancer cells, like many types of cancer (notably breast), have a different metabolic system than healthy cells. Healthy cells primarily use oxygen to make energy, which also requires a lot of the molecule known as citrate. Prostate cancer cells do not; instead they use a system that doesn’t require oxygen and doesn’t use citrate but instead uses choline (Johansson, et al. 2009). Avoiding foods high in choline may be important for reducing the risk of existing prostate cancer from getting worse/more aggressive.
Inguinal hernias are quite common in men. They occur in the groin area and are well-known to be associated with improper lifting technique. A hernia of this type is when a piece of small intestines moves through a weakness in the muscular wall of the body. Most do not cause any symptoms like pain or discomfort, and most others cause only mild symptoms.
If a hernia is causing severe pain, or has visibly moved into the scrotum or canal between the abdomen and scrotum (known as the inguinal canal), then surgery may be essential. If sudden, sharp, unrelenting pain occurs in the groin area then emergency care should be sought, as the hernia is said to have incarcerated or gotten blocked. This can be life threatening in very rare cases and should NOT be ignored in hopes it will “go away on its own.” Several classes of common medications lower serum total prostate-specific antigen (tPSA) levels according to a 2010 publication by Chang, et al. Statins, non-steroidal anti-inflammatory drugs (NSAIDs), and thiazide diuretics, among the most commonly used drugs in the world, all significantly lowered tPSA in this analysis of 1,864 American men over the age of 40 years. Use of a thiazide and a statin together for 5 years led to a 36% reduction in tPSA levels. Calcium channel blockers actually eliminated this effect of statins on tPSA. It is unknown how these medications cause this effect.
Two large randomized trials published in the New England Journal of Medicine dealt two further devastating blows to the idea of using the total prostate-specific antigen (tPSA) blood test to screen for cancer. I say tPSA to differentiate it from the less-commonly tested free PSA (fPSA) or complexed PSA (cPSA).
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January 2021
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