PSA has been likened to the check engine light on your car. It says "something is happening inside your prostate", and more looks are needed to identify what it might be. Lots of things cause PSA to rise, and cancer is only one of them. If you have a slow steady rise--say a doubling time of a year or less, then that is indicative of cancer. If it fluctuates a lot, then it's probably not cancer.
All very true that PSA is not a specific cancer test, and that other prostate related things can cause it to rise or drop, or simply stop rising. But, especially for those of us already diagnosed and treated, it is about
all we've got, isn't it?
If they give us a drug, or treatment, and it drops our PSA we and our docs are happy, right? Until there is evidence to the contrary(mets or PSA starting back on a rapid rise) don't we consider it evidence that things have improved re: our PC? But for some reason we don't think the same thing if diet and/or supplements seem to have the same effect on our PSA?
It is certainly even less clear for those of us who still have a prostate. Because there are so many variables- other than cancer- that can cause our PSA to rise or fall. But for all of us, or at least for me, that raises an interesting question. Since there are a number of eating plans and/or supplements out there for which there is a whole lot of non-RCT level evidence of benefit for various health issues, cancer, and even prostate cancer, which has been previously linked to at this site in copious amounts, should we avoid all of those approaches because they might lower our PSA but not actually help our cancer, thus delaying us from being treated while our cancer spreads?
Since there are not many RCTs showing benefits for any of these things against cancer(but some, see previous links to RCTs of vitamin D supplementation vs breast cancer and a few others) and no RCTs in favor of it for PC(endless association, but no RCTs for or against), then should we avoid vitamin D or other vitamins or various eating plans because they might lower our PSA without actually helping our prostate cancer? And thus delaying, by way of a fake out, our treatment?
In fact, should we not only avoid those things, but do whatever possible that might raise our PSA in order to quickly get to either diagnosis and treatment or further treatment if already treated?
I don't know the answer to those questions. However, I act as though the answer is no to all of those questions. Unless my doctor specifically tells me otherwise(in fact it has been more like being the opposite), if there is anything out there that is rumored to help, and for which there is no solid proof against it and maybe even proving it actually hurts, then I am likely to do it. Assuming it is something I can stand do, rather than say food I cannot stand to eat, or a way of eating that I find it intolerable. Or perhaps a supplement that I either find disagreeable for whatever reason or perhaps horrendously expensive, then I probably won't be doing that.
But if there is no good RCT showing that it is harmful, or at least useless, and if it is not very expensive, and if there are lots of studies (non-RCT) showing strong association with various benefits(Including against PC), then I am probably going to do it. I can't think of any reason not to, particularly if my doctor has no problems with me doing so.
Regarding vitamin D, there is of course one RCT showing that a single massive monthly dose had no benefits against PC, but also zero harm. However, as it is so often the case, when I dug into the details of that study I found several very questionable attributes, in addition to the concept of one massive monthly dose, which seemed problematic to me compared to a much smaller but steady daily dose. So since there was one questionable(To me) RCT showing no benefits or harm re: PC, and at least one other RCT showing significant benefits for breast cancer, as well as 2 other RCTs showing benefits for flu, and for various diabetes related issues, plus all of those endless associations for various positive health outcomes(including for those with PC) in those who have the highest blood levels a vitamin D, I think I will wait for further RCTs before tossing it out my vitamin D.
And after all, how does one get a high blood level of vitamin D without supplementing or sunbathing? (Barring the tiny percentage that would have some sort of medical problem causing a high level?) And how many of us are doing a lot of sunbathing? So if there is a ton of previously posted studies showing that the men with PC(especially high risk PC) and the highest levels a vitamin D do better, isn't that effectively saying that those who supplement with vitamin D do better than those who don't?
I know there is the old argument that asks the question:" Is it the low vitamin D level causing the high risk PC cancer, or is it the cancer causing the very consistent low vitamin D level?". But, I seriously doubt it is the lack of High risk PC cancer causing the highest levels a vitamin D. I know of no way that most people are showing high levels vitamin D in their blood without supplementation. So again, because of all of that, I think I will wait for additional RCTs before being convinced it is useless, for PC or anything else, as one famous past poster here was fond of saying. (also, see polls here at HFPC regarding the consistent low levels of vitamin D among our members, at least in the few who were tested before supplementing. Especially among the high risk guys)
Sorry, I didn't mean to get off into vitamin D, which I know many think I am a fanatic about
. It's just that there is so much non-RCT information out there about
it. I actually am even more of a fanatic about
blood insulin levels versus an entire host of diseases, including many cancers and even including PC.(See the current thread about
keto). Also, I consider many other supplements as quite possibly helpful, but again there is so much information on vitamin D, it is hard not to use it to make a point.
But as for now, there is very little RCT level evidence about
any of this stuff, pro or con, with the possible exception the one (flawed IMO) study showing vitamin D useless for PC, versus the other studies showing impressive results against breast cancer. Also, there are plenty of studies showing how to lower insulin and prevent or treat diabetes with various low carbohydrate eating plans. So, considering the strong evidence of high blood insulin levels promoting many diseases including cancer in general and even PC specifically, one might come up with the conclusion that it is better to eat in a fashion leading to lower blood insulin in order to improve prostate cancer outcomes. As well as general health. But not yet any RCTs pitting low carb eating or fasting against PC. I'm not holding my breath waiting for that one.
Post Edited (BillyBob@388) : 3/13/2019 12:28:47 PM (GMT-6)