Two new reports about smacking back prostate cancer — the second most common cancer guys get — snapped even doctors’ heads around this week. One says taking vitamin E, once thought to lower prostate cancer risk, actually boosts it. The other says healthy guys can stop getting PSA tests, the gold standard of prostate screening.
We YOU Docs are pretty healthy guys, and here’s our take: Don’t delete “Get PSA test” from your planner. Do toss your vitamin E.
Let’s start with E. A big new cancer study found that taking 400 IU of E daily raises men’s risk of prostate cancer 17 percent. Why isn’t clear, but we don’t recommend taking capsules of E anyway. We get some E in our multivitamin (30 IU is common) and some from food, but food’s not the worry. Besides, it’s hard to consume a lot of E unless you eat nothing but almonds, sunflower seeds and spinach. Unlikely!
As for PSA blood tests — which measure prostate-specific antigen, an enzyme made in the prostate — the test ain’t perfect. We’re with the new report on that. High levels can mean cancer. Or not. The test can’t tell. It also can’t distinguish between aggressive cancers and slow-growing tumors you may never even notice. So plenty of guys with high PSA counts say yes to biopsies, surgery and radiation that they might not have needed.
But here’s the but: Before PSA tests, 80 percent of prostate cancer was discovered after it had fatally spread.
Today, the combo of the test and better treatments saves 9,000 lives a year. New genetic follow-up tests are coming soon that will be able to sort out aggressive prostate cancer.
Meanwhile, here are the PSA questions you’re likely to face and what we think your answers should be.
1. Are you at high risk for prostate cancer? Start annual PSA tests early. Begin at 45 if you’re African-American or if your father or a brother has had prostate cancer, especially before 50; that doubles your risk. Smoking and excess pounds also up your odds.
2. Are you at average risk? Start PSA tests at 50. Keep them up until your physical age — your body’s RealAge, not its calendar age — is 65. The younger and healthier you are, the longer you should be screened for prostate cancer.
3. Do you need an annual, manual check? A yearly rubber-glove exam of your prostate, plus a digital rectal exam, can catch the 25 percent of problems a PSA test misses. If something unusual turns up, get a PSA test.
4. What if your PSA is high? Take a breath. Only 18 to 30 percent of high PSAs actually mean prostate cancer. First, get a retest. An infection or even a roll in the hay shortly beforehand could have temporarily boosted your PSA level. Also, ask about “percent free” PSA, a type that floats around in your blood, unattached to other molecules. The less you have, the lower your cancer risk.
5. What if you get a scary diagnosis? Don’t rush to radical surgery. Get a second and maybe third opinion. Up to 40 percent of guys with early prostate cancer can opt for “active surveillance,” which monitors the cancer with regular PSAs, prostate exams and biopsies. If trouble arises, treatment starts. We love this approach because it lets you make healthy changes that are proven to keep PSA levels lower even after a cancer diagnosis. The changes: more fruit and veggies, more workouts, more meditation; no red meat, no added sugars and no syrups.
The YOU Docs — Mehmet Oz, host of “The Dr. Oz Show,” and Mike Roizen of Cleveland Clinic — are the authors of “YOU: Losing Weight.” For more information go to www.RealAge.com.
Sensible prostate precautions
- Start annual PSA blood tests at 50 (Start PSA at 45 if you have high risks)
- Get an annual manual checkup
- Only 18-30 percent of high PSAs really mean prostate cancer
- Up to 40 percent of early prostate cancers can safely choose active surveillance
- Get a second opinion before surgery