Finding that your PSA has risen can be a sobering reminder of your mortality. Most of us know that the PSA - used by urologists to detect and monitor prostate cancer - is a very imperfect test and can be thrown off by everyday occurrences such as sex, prostatitis and vigorous exercise. Furthermore, many men with low PSA have been found to have existing prostate cancer.  And some men just seem to have high PSA's for no apparent reason.
All of that said, the PSA inching up over a year or two can also indicate prostate cancer and so it needs to be taken dead seriously instead of just being brushed off. Below I am going to suggest some radical steps - at least to some - to lower your PSA and, hopefully, offer protection from prostate cancer. Before I do that, let me give you Five Reasons You Should Try to Lower Your PSA Asap:
1. Death. If your PSA rises, you can ignore it and say to yourself, "Well, prostate cancer is usually slow to develop" and "I'll bet it went up because I really worked out hard the day before." That is incredibly dangerous thinking and the reason is simple: if you do have prostate cancer, it can eventually metastasize. Once it spreads to the bones or another organ, life as you have known it is forever changed. You will almost for sure be placed on androgen deprivation therapy - the polar opposite of HRT - and radiation and chemo may not be far beyond. Yes, it will shrink the tumor and perhaps save your life, but it is fraught with nasty side effects.
NEWS FLASH: I used a supplement and dietary strategy to lower my PSA from a high of 6.3 to 2.0. I tell the story in my page on How I Improved my PSA Score.
2. HRT Continuance. There is another reason that many of you will want to protect yourself from a rising PSA: you are on HRT and want to stay that way. Many men getting testosterone do not stop to think about what happens if their PSA goes too high (> ~2.5) or rises too quickly in a year (> ~1 point in a rolling 12 months). Most HRT clinics, PCP's and endo's will require you to get "urological clearance" if that happens and no urologist will likely clear you until you have either a) lowered your PSA or b) stabilized your PSA with a negative biopsy. Either way you are going to likely be months or even a couple of years off of testosterone therapy while you try to correct the problem. Bye bye muscle. Hello classic low T symptoms.
Yes, you can pull out Morgentaler's studies and try to preach to your urologist about how testosterone therapy will not increase prostate cancer risk. But I can tell you that almost for sure they will not listen.
CAUTION: Do NOT try anything on this page if you have a high PSA and/or past/existing prostate cancer without clearing it with your urologist. These are strictly ideas that should be discussed with him or her. Cancer is tricky and your doctor gets paid to be up-to-date on the latest research.
3. Nowhere to Hide. Prostate cancer is incredibly common. A common stat is that 1 in 6 men will develop prostate cancer. Dr. Morgentaler has gathered evidence that low testosterone men are likely at increased risk for reasons that are poorly understood.  Furthermore, almost all of us have eaten a Western Diet most of our lives. Fried meat - probably due to the HCA content - is a risk factor for developing prostate cancer along with overindulgence in dairy products, something I cover in my page on Prostate Cancer and Testosterone.
4. Reverse Prostate Cancer. Prostate cancer has been found to be in very high percentage of men, even men with low PSA values. Dr. Morgentaler's work shows that up to 15% of men may have latent prostate cancer.  Generally, this is not an immediate death sentence - there are nasty, fast moving prostate cancers - because prostate cancer generally develops slowly over years and even decades. So, if you are one of those guys, why not arrest or even reverse that existing prostate cancer before it becomes a life-changing and/or life-ending issue? The current solutions (in the U.S.) are ugly: prostate removal, which is a major surgery that leaves you with E.D. and incontinence for several months (at a minimum), radiation, etc.
A high PSA or a rising PSA is nothing but trouble. Again, this is why I think it's important to consider some radical steps to stop or ideally reverse existing prostate cancer. And for those of you without latent prostate cancer, why not take steps to prevent it from occurring in the first place considering that it is one of the most cancers in men?
Here are some ideas that can actually decrease your PSA:
1. Flaxseed. Many men are afraid of flaxseed, because it is high in phytoestrogens. However, it has been widely used as a food and recent research has provided substantial evidence that it not only can lower PSA but also greatly protect against the spread of prostate cancer. One 2008 study showed a 50% reduction in cancer cell proliferation from flaxseed consumption, something I document in my page on Flaxseed and Prostate Cancer.
This same study showed that it was flaxseed that had the greatest superpowers against prostate cancer, even more so than a Low Fat Diet. This is important, because a 2004 study showed that a Low Fat Diet coupled with flaxseed reduced PSA from 8.32 to 5.72. Again, most of the effect was likely from the flaxseed as you can read on my page above.
2. IP6 (Phytic acid). Phytic acid gets a lot of bad press from the Paleo and Low Carb communities and the reason is that it is a compound present in most plant foods that binds tightly to (primarly) iron and zinc but also (secondarily) to calcium and magnesium.  It is hard for your body to break out the minerals from phytic acid and so cultures that depend heavily on high phytic acid foods can end up with mineral deficiencies in the iron and zinc. Of course, meat eaters love to point out that this is a big disadvantage of vegetarian and vegan diets and you can read many pages on the web about the importance of sprouting and fermenting your grains to avoid these deficienciues.
In my opinion, most of the concern about phytic acid is overblown. Vegetarian and vegans, who generally consume a lot of phytic acid, have excellent health outcomes and some of the best documented mortality rates. Furthermore, many of the underlying assumptions against phytic acid have been called into question lately. First of all, some of the minerals - notably zinc and iron - have been found to be neurotoxic if consumed in overly high levels. Thus, phytic acid consumed in reasonable quantities may actually be brain protective as Dr. Neal Bernard points out. (Elevated iron causes a host of other problems as well, including cardiovascular.)
Most importantly to us here, phytic acid (IP6) has also been found, at least in a couple of animal studies, to reduce prostate cancers. Researchers believe that this may be the reason that fiber is considered protective against prostate cancer, since IP6 is present in plant fiber.
Researchers first accomplished many studies with IP6 and various prostate cancer tumor cell lines and later with grafted human prostate cells into mice.  Three studies have now been done on TRAMP mice, a breed of mice that are predisposed to prostate cancer and considered a good model for humans. A 2012 study produced the most profound results and the study authors noted a "profound reduction in tumor size."  In other words, IP6 actually shrunk prostate tumors in this mouse model!
What is the secret of IP6? Researchers have found that it has many metabolic superpowers, but one of them probably lies in its ability to lower VEGF (Vascular Endothelial Growth Factor).  Many cancers occur in the endothelial cells of various organs. Endothelial cells refer to the lining of the organ in question where there are fast growing cells that replace themselves fairly rapidly, i.e. have a high turnover. This higher cell creation can leave us vulnerable as we age to the creation of cancer cells. VEGF is one of the body's natural chemicals that governs this and, as we age, it is probably wise to put the brakes on VEGF for cancer protection, especially for those of those who have lived the typical Western lifestyle with all of its toxins and heavy oxidative load. More on this below.
Of course, what is missing is a human trial such as has been done with the flaxseed. However, researchers are already recommending that a large human study take place, since IP6 is without any known side effects.  I also have not been able to find any recommended dosing levels. I can tell you that one of the most popular IP6 supplement manufacturers recommends 1.6 grams twice per day.
CAUTION: The only downside that I know with IP6 is that one study shows that it slows down telomerase activity. This is similar to green tea. Slowing down telomerase may not be good for anti-aging but does, in some cases, appear to be good for cancer protection.
3. Soy and Tomatoes. I have been cautious about soy, because, as I document in my link on Soy and Men, soy may have some brain-shrinking effects (in males) due to its high phytoestrogen effects. The rebuttal to this is that the Okinawans ate fairly high levels of soy and enjoyed incredible longevity and health. And for prostate cancer protection, soy appears to be a powerful food-based protective agent, especially when combined with tomatoes. (The lycopene in tomatoes is well-known for its prostate assisting abilities.) Better yet, these cancer-fighting abilities have been verified in a couple of human studies. The first was a study that looked at men with high PSA values and/or steadily increasing PSA values and thus likely had prostate cancer. The combination of a soy isoflavone and lycopene supplement essentially stopped any growth in the PSA, indicating that cancer had been at least halted or stopped in its tracks. 
NOTE: Soy, at reasonable dosages, does not appreciably lower testosterone as is often asserted per a number of studies. Soy also boost nitric oxide.
A study published the following year (2008) found even more promising results in men that had active prostate cancer. About a third of the men had actual reductions in PSA, indicating that the prostate cancer was actually being reversed.  Thus, for men with active prostate cancer - and you could very easily be one of them without even knowing it as I discussed above - this could potentially be a life saver (and/or a sex life saver).
4. A Vegan, Low Fat Diet (Ornish Style). The flaxseed study above as well as a genetic study by Dr. Dean Ornish showed that a Low Fat Diet can have powerful anti-prostate cancer effects. The best evidence, though, was a follow-up study headed by Dr. Ornish that looked at men with early stage, diagnosed prostate cancer. He then put them on his standard Low Fat protocol with a few additional supplements:
Results were excellent. The control group's PSA rose by 6%, whereas those following the vegan, low fat diet had a decrease in PSA of 6%.  However, the primary change was that cultured prostate cancer cells taken from the men showed 8X less profileration than control. In other words, the ability of the prostate cancer cells to proliferate and grow was greatly limited. NOTE: To read the whole study, check out this link.
3) Anticancer Res, 2005 Jul-Aug, 25(4):2891-903, "Prostate cancer and inositol hexaphosphate: efficacy and mechanisms"
4) Clin Cancer Res, Jan 1 2004, 10:244, "In Vivo Suppression of Hormone-Refractory Prostate Cancer Growth by Inositol Hexaphosphate: Induction of Insulin-Like Growth Factor Binding Protein-3 and Inhibition of Vascular Endothelial Growth Factor"
5) Cancer Prev Res, Jan 2013, 6:40, "Inositol Hexaphosphate Inhibits Tumor Growth, Vascularity, and Metabolism in TRAMP Mice: A Multiparametric Magnetic Resonance Study"
6) Nutrition and Cancer, 2006, 55(20), "Protection Against Cancer by Dietary IP6 and Inositol"
7) Biochemical and Biophysical Research Communications, 3 Nov 2006, 349(4):1361â€“1367, "Inositol hexaphosphate represses telomerase activity and translocates TERT from the nucleus in mouse and human prostate cancer cells via the deactivation of Akt and PKCÎ±"
8) Nutrition and Cancer, 2007, 59(1), "Lycopene and Soy Isoflavones in the Treatment of Prostate Cancer"
9) Nutrition and Cancer, 2008, 60(2), "A Combination of Tomato and Soy Products for Men With Recurring Prostate Cancer and Rising Prostate Specific Antigen"
10) The Journal of Urology, Sep 2005, 174(3):1065-1070, "INTENSIVE LIFESTYLE CHANGES MAY AFFECT THE PROGRESSION OF PROSTATE CANCER"
11) J of Urology, Sep 2005, 174:1065-1070, "INTENSIVE LIFESTYLE CHANGES MAY AFFECT THE PROGRESSION OF PROSTATE CANCER"