Life Extension Magazine

Life Extension Magazine May 2013

As We See It

Federal Death Panels

By William Faloon

Easy Ways to Reduce PSA

We all know that if artery-clogging LDL is elevated, it can be reduced by lifestyle changes, nutrients, and drugs. Overlooked is the fact that elevated PSA can also be reduced in many men.

What this means is that PSA testing can enable men to identify prostate disease at an early stage when it might be reversible.

While conventional reference ranges state that PSA levels under 4.0 ng/mL are normal, we at Life Extension view any reading over 1.0 ng/mL with suspicion. We know that PSA readings over 1.0 ng/mL can indicate unhealthy activity, such as prostatitis, benign prostate hypertrophy, or prostate cancer.50,51              

Rather than watching PSA readings gradually elevate, there are interventions that reduce and/or stabilize the production of PSA, and thus shut down a mechanism used by cancer cells to escape confinement within the prostate gland. 

Life Extension suggests that men with PSA readings over 1.0 ng/mL initiate steps to reduce levels of this tissue-destroying enzyme. Dietary changes and nutritional supplements may be tried first, but drugs like dutasteride (Avodart®) are recommended to quickly reduce PSA, shrink prostate gland size (to reduce urinary difficulties), and to reduce prostate cancer risk.52 

Avodart® can slash PSA readings by nearly 60%.53 Critics of Avodart® mistakenly view this as bad because they think it may mask underlying prostate cancer. If properly used, Avodart®, along with dietary changes and nutrient supplements can markedly reduce the chances that isolated malignant cells in the prostate gland will mature into full-blown prostate cancer.

Proper use of Avodart® should also include testing free testosterone blood levels to ensure an aging man is not suffering a testosterone deficiency. When an aging man deficient in testosterone takes a drug like Avodart® that reduces dihydrotestosterone, the result can be increased risk of heart failure.54 The solution is to restore natural testosterone levels to a youthful range for systemic benefits and then initiate Avodart® (0.5 mg daily) to protect against benign prostate enlargement and prostate cancer. 

We at Life Extension are well aware that it is quite normal for men over age 50 to have PSA readings between 1.1 and 2.4. It is also “normal” for men over age 50 to get up frequently at night to urinate and for these same men to develop some stage of prostate cancer.

Our argument is that when a blood test shows a PSA reading over 1.0, this should be greeted as a friendly warning to initiate definitive steps to reduce it. In the process of reducing PSA by making healthier lifestyle choices and achieving youthful hormone balance, men should see a reduction in nighttime urinary frequency, along with reduction in risk for virtually all degenerative disease. That’s quite a benefit in return for taking steps to reduce just one blood marker, i.e. PSA!

Analogies to Testing Cardiac Risk Factors

Analogies to Testing Cardiac Risk Factors  

The medical establishment supports blood testing to identify risk factors that predispose people to vascular disease. When blood test results show elevated LDL, triglycerides, or glucose, steps are taken to lower these artery-blocking factors and thus slash coronary artery disease risk. 

The same can be done when a blood test reveals PSA over 1.0 ng/mL. Interventions can be readily employed to lower PSA and thus reduce prostate disease risk.       

Just imagine that a blood test reveals your triglycerides or glucose are high. Instead of lowering these risk factors, what if doctors instead performed invasive diagnostic techniques and even needless surgeries—as is done far too often today in response to an elevated PSA reading. If this type of medical mismanagement were done in the cardiovascular arena,  the United States Preventive Services Task Force would likely  recommend against glucose and triglyceride blood testing since too many false positives were occurring, resulting in expensive and side effect-prone procedures. What few doctors know today is that a rising PSA can sometimes be reversed without causing serious side effects. Since the United States Preventive Services Task Force had no idea that PSA itself contributes to carcinogenesis and that PSA is often controllable, they issued a blanket warning that all healthy men should avoid PSA screening. The lunacy of this archaic view is further exposed when one realizes how many different ways PSA levels can be controlled.

Staggering Statistics on Prostate Cancer

Prostate cells are very prone to gene mutation.55 Autopsy evidence indicates that prostate cancer is histologically evident in up to 34% of men aged 40-49 and up to 80% of men aged 80 and older.56,57 Most men, however, never progress to clinically diagnosed disease, indicating the presence of control mechanisms that keep prostate cancer cell colonies small and thus controlled.       

There is an increasing understanding of mechanisms involving gene regulation processes that enable cells to divide out of control and eventually form a prostate tumor. These new findings make it more important than ever for men to monitor their PSA blood levels to detect prostate cancer at its earliest stages.

Boron Reduces PSA…Protects against Prostate Cancer

PSA and IGF-1 function as active growth factors in the prostate gland.63-66

In  mice, boron protects against the ability of PSA to degrade extracellular matrix and reduces expression of IGF-1 in prostate tumors.67

One animal study showed that  in response to both low- and high-dose boron supplements, PSA levels plummeted 87% on average, while tumor size declined 31.5% on average.67 Another study showed that boron inhibited proliferation of androgen-dependent and androgen-independent prostate cancer cell lines in a dose-dependent manner.68

A report from UCLA showed that men with the highest dietary boron intake reduced their prostate cancer risk by 54% compared to men with the lowest boron intake!69 While the authors noted that the observed association should be interpreted with caution because of the small case sample size and the nature of the cross-sectional study design, clearly these findings deserve further investigation.

If laboratory studies can be replicated in human patients, boron at doses ranging from 6 to 15 mg a day may become an effective and low-cost adjuvant therapy. Most Life Extension members already take 3-9 mg of boron contained in various multi-nutrient formulas.

Green Tea May Block PSA’s Detrimental Effects

Green tea
The SUPERIOR doctor prevents sickness;
The MEDIOCRE doctor attends to impending sickness;
The INFERIOR doctor treats actual sickness.
--Chinese Proverb

There may be another way to protect the prostate gland against its own PSA. Since consuming green tea has been reported to lower the risk of prostate cancer, scientists investigated the effects of the green tea flavonoid epigallocatechin gallate (EGCG) on the expression and activity of PSA by prostate cancer cells.

EGCG was shown to restrain PSA expression. In addition, EGCG inhibited tumor-promoting activities such as degradation of type IV collagen. EGCG’s beneficial effects were at blood levels close to those measured in serum following ingestion of green tea.70 The study authors proposed that green tea extract may be a natural inhibitor of prostate carcinoma aggressiveness.

Newer studies are uncovering additional mechanisms by which green tea protects against prostate cancer.71-73 Spurred by these anti-cancer effects, doctors at Louisiana State University gave prostate cancer patients 1,300 mg of green tea extracts (mostly EGCG) prior to the time of radical prostectomy. Their findings showed significant reductions in PSA and other tumor promoters such as vascular endothelial growth factor.  These findings led the doctors to conclude that there is a potential role for green tea extracts in the treatment and prevention of prostate cancer.74

The PSA Controversy

In May 2012 the United States Preventive Services Task Force (USPSTF) proclaimed that regular PSA testing should not be used as a screening tool for prostate cancer based upon their analysis.49

There were several problems with the USPSTF analysis. The report de-emphasized a major, high quality trial that showed robust mortality benefits by including in their analysis trials of poor/ lesser quality that did not show mortality benefits. This statistical manipulation diluted the over-all statistical effect of the higher quality trial on mortality (benefit) in their analysis. 

This high quality trial was the European Randomized Study of Screening for Prostate Cancer (ERSPC), which randomized 182, 000 men aged 50 to 74 from 7 countries to PSA testing every 2 to 7 years (depending on center and year) or to usual care. An analysis of 162, 243 men aged 55 to 69 found that screening was associated with a 20% reduction in prostate cancer-specific mortality.103  

After publication of the main ERSPC results, a participating center (Göteborg, Sweden) reported their results separately. This site determined that a PSA screening threshold of 2.5 to 3.0 ng/mL every 2 years in 20 ,000 men aged 50 to 64 years decreased risk for prostate cancer-specific mortality by 44% after a median of 14 years.104 This finding helps corroborate Life Extension’s long standing position that a PSA reading over 2.4 ng/mL should be viewed with suspicion, as opposed to standard reference ranges that state that PSA reading up to 4.0 ng/mL is normal.

Poor-quality trials included by the USPSTF in their analysis statistically diluted the beneficial effect observed in the higher quality ERSPC trial in their over-all assessment. Several lesser/poor quality trials found no difference between screening-invited and control groups in prostate cancer-specific mortality risk.105,106 Major methodological flaws in these trials included failure to adequately control for randomization and/or poor allocation blinding, poor attempts to capture lost data points, etc. One trial used by the USPSTF even used an exorbitantly high PSA cut point – 10 ng/mL, as a screening threshold.105

By including trials that erroneously classified high PSA readings (ranging from 2.5 to 10 ng/mL) as not being suspicious, is it any wonder that the USPSTF report concluded that PSA testing does not protect men against death from cancer? Said differently, some of the data reviewed by the USPSTF did not recognize that PSA readings over 2.4 ng/mL were indicative of possible prostate malignancy. The inevitable results were that men who could have received early treatment did not because their physicians failed to screen for prostate cancer even when PSA readings ranged from 2.5 to as high as 10 ng/mL.    

Life Extension advocates the use of PSA screening to prevent prostate cancer deaths, with an important caveat– PSA results should be tracked and monitored over time (i.e., PSA velocity) with less emphasis being placed on individual test results. 

Life Extension has examined this issue in detail. For more information please see the Life Extension magazine multi-part series entitled "The PSA Controversy" that appeared in the December 2012 issue.

Treating Advanced Prostate Cancer with Lycopene

In a study of twenty patients with metastatic hormone-refractory prostate cancer, each patient received 10 mg a day of lycopene for three months.  No other treatment was given. One patient achieved a complete response, defined as a reduction of PSA (to under 4 ng/mL) and the absence of any sign of the disease for eight weeks. Six patients (30%) had a partial response, defined as a 50% reduction in PSA and alleviation of other symptoms such as bone pain if present. The disease remained stable in 10 patients (50%) and progressed in three (15%). A remarkable 63% (10 of 16) with bone pain were able to reduce their daily use of pain-suppressing drugs. The study concluded:

Lycopene therapy appears to be effective and safe in the treatment of hormone-refractory prostate cancer.”75

In another study, 54 metastatic prostate cancer patients were castrated and half of them were given 2 mg of lycopene twice daily. Castration (removal of the testes) reduces testosterone levels and is a treatment for those with androgen-dependent prostate cancer. After six months, PSA declined significantly in both groups, but more so in the group receiving lycopene. After two years, 40% of the castrated group reduced their PSA level to less than 4 ng/mL, compared to 78% in the lycopene group. Bone scans showed that twice as many patients in the lycopene-plus-castration group attained a complete response compared to the castration-only men.

The author concluded:

“Adding lycopene to orchidectomy (castration) produced a more reliable and consistent decrease in serum PSA level; it not only shrinks the primary tumor but also diminishes the secondary tumors, providing better relief from bone pain and lower urinary tract symptoms, and improving survival compared with orchidectomy alone.”76

What is impressive about these two studies is that only small doses of lycopene (4-10 mg/day) were used. That low doses of lycopene produced such favorable results in these late-stage prostate cancer patients is quite remarkable and worthy of further study.

The Optimal PSA Range Controversy

Many men have noticed that there are several “optimal” ranges for PSA, making it confusing for those who are trying to maintain superior prostate health.

Most mainstream labs (e.g. LabCorp & Quest) currently use a reference range of 4.0 ng/mL or less on PSA blood test results and most doctors don’t get too concerned until the PSA is above that level. 107,108

Studies done on healthy young men with normal prostate glands, as assessed by clinical exam of the prostate, report a range of 0-2.6 ng/mL as normal.50 Some doctors use a more stringent range of 2.5 to 3.0 ng/mL or less as an optimal PSA range.51

Other doctors prefer to use age adjusted ranges that increase as a man ages. Typically in this scenario a man younger than 50 should have a PSA 2.5 ng/mL or less while a PSA up to even 6.5 ng/mL is considered normal for a man in his seventies. Another take on this age adjusted approach is looking at cutoff levels where the sensitivity and specificity of the PSA test is maximized for different age groups.

Doctors using this approach may use a PSA range of 2.0 ng/mL or less for men less than 50 years old, 3.0 ng/mL or less for those aged 50-59, 4.0 ng/mL or less for ages 60-69, and 7.0 ng/mL or less for  men over age 70.109

Life Extension suggests that the most stringent approach is to consider a PSA above 1.0 ng/mL as the earliest possible warning sign that changes may be occurring and those interested in superior prostate health should engage in methods to reduce it. This is not to say someone with a PSA of 2.0 ng/mL has prostate cancer, prostatitis, or BPH. It may indicate a normal prostate or it could be the earliest warning sign of small cellular changes occurring in the prostate.

It is also important to note that PSA readings should be confirmed with repeat testing and one of the most important aspects of PSA testing is getting a baseline value and looking for changes over time. Doctors especially look at the doubling time for PSA as well as the PSA velocity combined with symptoms and results of the prostate exam to further assess prostate health.110

Federal Death Panel Advises All Men to Avoid PSA Testing

PSA testing alerts aging men that they have a prostate problem. A wide range of safe approaches can be utilized to attempt to bring PSA to optimal ranges of under 1.1.

By recommending that aging men avoid PSA testing, the United States Preventive Services Task Force is condemning a huge segment of the aging population to develop painful metastatic prostate cancer that is considered virtually incurable.

Equally important, and perhaps more important, the Task Force recommendations would exclude the use of PSA testing as a key biologic marker for prostate health.  PSA values above the threshold of 1.0 ng/mL inform the medical team of disease processes affecting the prostate that may involve prostatic hyperplasia (BPH), prostatitis and/or prostate cancer.  Such processes can be evaluated with various medical testing and changes in the patient’s environment (external and internal) can alter the course of these diseases and change the entire course of health of that individual. This is medicine at its best—it is preventative medicine, and it is far more compassionate than treating advanced diseases that remain subclinical for many years prior to overt manifestation. 

My Personal Triumph Using PSA Testing
Total PSA 4.1

I was traveling to meet a new oncology group near the end of April 2003 when I called Life Extension’s Blood Lab to see if my most recent test results were ready. I asked Life Extension to fax these results to my hotel. What came out of that fax machine was beyond shocking. My PSA had shot up to 1.4 ng/mL—it had always been below 1.0 ng/mL. (See copy of lab reports above and below.)

My reaction was a controlled panic. As far as I was concerned, there were early-stage tumor cells lurking in my prostate gland that had to be eradicated. I’d seen too many cases where PSA jumps to 1.4 ng/mL and quickly moves up to the danger ranges (above 2.4 ng/mL).

All plans were cancelled that night as I searched computer databases to identify every single nutrient and lifestyle change that had ever been shown to reduce PSA levels. I noted each nutrient, extrapolated a human equivalent dose, and then took a quadruple-amount of almost every anti-cancer ingredient. Just some of the quadruple-dose nutrients I took included:

  • Milk thistle extract77-79
  • Green tea extract (decaffeinated)80-85
  • Curcumin86,87
  • Vitamin D88-91
  • Cruciferous vegetable extracts (like I3C)92-94
  • Gamma tocopherol95-98
  • Genistein (soy) extract99,100

I made sure to take the prescription drug metformin101,102 on a consistent basis, slashed my consumption of red meat, and vowed to stay on this ultra-high dose regimen until there was a reversal of my PSA. As members have seen from the blood tests I have previously posted, my PSA has been around 0.5 ng/mL for the past several years---a more than 60% reduction compared to nine years ago (when I was younger).

I am convinced that had I not had regular PSA blood tests and used the findings to radically alter my dietary choices and nutrient-drug intake that I would be dealing with serious prostate issues now that I have turned age 58. In fact, at my age, prostate problems are normal.

In the December 2012 issue of Life Extension Magazine®, there was an article about a prostate cancer patient who used even more aggressive strategies to reverse his PSA and keep his cancer stable without resorting to toxic radiation or mutilating surgeries. If this patient had not discovered he had a prostate problem early on (via PSA testing) and treated it aggressively with non-toxic therapies, he might not be alive today.

As you can see from my most recent blood test, my PSA dropped to 0.4 ng/mL in 2013 from 1.4 ng/mL in 2003. If I had not checked my PSA regularly, I might very well have prostate cancer now. It does run in my family.

Total PSA 0.4

Government Wants You to Die Sooner!

The demarcation line between the pro-longevity principles of Life Extension and the pro-death edicts of the federal government grow wider each year. As a Life Extension member, you not only gain access to novel ways of living longer, but you learn the “other side” of the story about proven disease-reduction methods that our government is trying to censor.

Your support has enabled us to expand our four-decade campaign against the blatantly unscientific propaganda spewed by government-sponsored “task forces” that recommend against vitamin D supplements and PSA screening.

Deaths from prostate cancer have been in decline as more men find out they have prostate cancer and cure it before it spreads outside the prostate gland. We refer to the United States Preventive Services Task Force as a Federal Death Panel because their recommendation to avoid PSA testing will cause the needless deaths of tens of thousands of men—young men, middle aged, and older.

To make matters worse, this same Federal Death Panel proclaims that since low-dose vitamin D confers zero benefits, no one should take any vitamin D. Since higher-dose vitamin D may slash cancer incidences by over 50%,3 these misguided policy statements will create an epidemic of cancer in aging humans if the truth is suppressed.

Based on an overwhelming volume of peer-reviewed published science, virtually every American should be taking around 5,000 IU each day of vitamin D. Men over age 40 should have their PSA checked annually.