High PSA But No Cancer
It is 12/27/2013 and would you believe I have been off of HRT for almost
weeks?!? Well, I can't believe it either.
If you have poked around my site much, you know that HRT was a
life-changing experience for me and cleared out mental fog, anxiety, fatigue and
gave me morning erections for the first time in my life. So I was not
happy when my HRT clinic director told me I had to stop.
What happened? Well, I had a high PSA reading of 6.3.
I was absolutely shocked, because my PSA readings have always been below 1.5,
which is pretty good for a guy in his early 50's on HRT. Ideally, it would be
below 1.0, but HRT bumps it up a bit as does exercise, intercourse, etc.
My lasting reading was 1.4, so this was a quadrupling of my PSA.
Actually, my clinic director did not take me off immediately but asked me to
retest the following week with abstinence and minimal exericse. The
result? A PSA of 5.0! The usual jump-up-and-down prostate cancer
screening level is around 2.5-3.0, so this did not look good. They said,
"Don't come back until you have urological clearance" and sent me on my way.
The next couple of weeks were very stressful. The urologist felt my
prostate and it was quite small (30 mm?), i.e. I did not have an enlarged
prostate. An enlarged prostate can cause an increase in PSA, so this was
good and bad news. My urologist pointed out that it just eliminated another non-cancer possibility
and he highly recommended that I get a biopsy, because he said it could
definitely be cancer.
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For those of you who have never had a prostate biopsy, it's a relatively benign
procedure. You have about a 1 in 50 chance of getting a nasty
go-to-the-E.R. prostate infection from it, but, overall, it's not too bad.
But let me tell you what is bad: waiting the 7-10 days for the
pathologists report! This is agonizing as you and your loved ones wait to
see if you have prostate cancer or not.
Managing prostate cancer, if you have it, is ugly and controversial at this
point. If it's bad enough, urologists can remove the prostate, but you can
end up with medium term incontinence and erectile dysfunction as the nerves
heal. There's also radiation treatment, but that is risky: the
prostate ends up so scarred that urologists can not do a prostectomy, which
leaves you potentially at the mercy of a future advanced stage prostate cancer. Yes, there
is a new ultrasound treatment for handling prostate cancer, but it's only
available in Mexico, so it's still quite a mess and not a road that I wanted to
The story has a happy ending however: I got the biopsy results back today
and they found no cancer in any of the 12 samples. Furthermore, there were
no precancerous (PIN) samples either. They also found that a couple of the
samples had signs of inflammation, which is actually a good thing - relatively
speaking - as I'll explain below.
So I asked my urologist his take on the results and he said that the good news
was it was extremely unlikely that I had cancer at this point. The biopsy
does not sample everwhere on the prostate, but he said that it was still very unlikely
that I had cancer at this point. He went on to say that the root cause was
likely inflammation based on the pathologist's report and he sees fairly often a
spike in PSA that will go away after a few months. Of course, I tried to
pin him down on what would cause the inflammation and he had virtually nothing
to say on the subject. Basically, he said, "We don't know."
NOTE: I was tested twice for bacteria and both came back negative. So
it appears I have some kind of mild abacterial prostatitis. This was a
complete surprise to me, since I do not really have any symptoms. Many men
suffer quite a bit with this type of chronic prostatitis, but I would not have
even noticed if it was not for the high PSA reading.
I then asked him if the plan could be for me to try to lower my PSA through
natural means and test it monthly in order to get my urological clearance back
for HRT as soon as possible. He then shocked me by saying that
1. He would give me urological clearance for HRT effective
immediately, because it was
extremely unlikely that I had a prostate cancer. (And, I assume, even if I
did, it would show itself by a rising PSA on an ongoing basis.)
2. I should NOT test my PSA monthly, because my prostate is now inflamed
from the biopsy and likely would give me high reads for a couple of months.
Of course, I was overjoyed to get permission to go back on HRT and even more
excited to know I very likely did not have PC. However, the whole experience was very sobering and
realized that my ability to stay on HRT depends on keeping my prostate extremely
healthy. I have to guard against an enlarged prostate, inflammation of the
prostate, precancerous growth and, of course, cancer itself.
Now this is no small task as one of the men on
The Peak Testosterone Forum pointed out. He struggled with chronic, abacterial prostatitis
and said that he has noticed that the key is to keep good blood flow and nitric oxide to the prostate, because the prostate does not have particularly good
vascularization. Let me actually quote some of his commentary: 
"Naw, I do not believe that I have CPPS. My main symptom especially during flare
ups is I feel I cannot empty my bladder completely. CPPS symptoms seem to be
more severe. Pain in the genitals or anal area, very painful urination, and
The prostate gets very little blood flow. So it is extremely difficult to "flush"
any irritants from it. That is why I try to limit the toxins I take into my
body. I try to limit my ingestion of chemicals and pesticides. So, if one eats
foods high in pesticides, for instance, these poisons eventually end up in the
prostate. It takes I long time for the prostate to eliminate these things. Also,
in my case, I believe Kegels increase oxygenation and blood flow to the pelvic
area. Moreover, Kegels sorta give the prostate a massage.
So, I will try to anything that helps blood flow. Exercise, reduce systemic
inflammation, beetroot juice, etc. I am hoping that by improving my arteries and
blood flow it will in turn help with my prostate issues. I do feel much better
than a year ago...certainly my eating and exercise habits have helped more than
the antibiotics and Advil that the uro's prescribed me."
This is a case, I believe, of the patient have much better ideas and knowledge
than the docs!
When you look at the big picture, I have to guard against inflammation and
prostate cancer primarily and this caused me to implement some important changes to
Soy. [For the record, I am a little scared of soy for reasons that I
document in my page on Soy and Men. However, it's prostate protecting powers have
been verified by multiple studies.]
Low Fat Veganism. [I already eat Low Fat but am not a true vegan. However,
I am going to avoid animal foods, because there is some evidence that it
provides protection against endothelial cancers. I hope to do a page on
I know that to many of you, some of the above measures will seem extreme. However,
they are all research-backed as I how in my pages on
How to Lower Your PSA,
Flaxseed and Prostate Cancer and A Potential Prostate Cancer Cure.
I never want to go through the stress again
of wondering if I am going to leave my family in a tough situation, since I provide the great majority of our income. And who wants to die
a grisly death from cancer? I knew a man once who died of
prostate cancer that metastasized and it's fugly - that's not the way I want to go and if I can do anything in my power to avoid it, I
am going to do it.
Finally, I do NOT want to ever be off of HRT again. I'm a believer in the Replacement Philosophy (in general) and I think having
youthful testosterone levels is healthy for most men. However, this whole experience made me realize just how fragile HRT is:
one high PSA reading could
take me off of HRT for months and that's not something I want to deal with again.
If I can get my PSA down by doing the above, I may go off of a strict vegan diet
and then monitor my PSA after eating some Low Fat
Meats. One thing at a time though. I am just glad not to have cancer...