Elevated PSA: Beyond the Scare – Understanding Your Prostate Health

[video transcript] This is a Men's Health (and the women who love them) episode today. I want to talk a little bit about prostates. Over the weekend, I was watching my beloved, beleaguered Arizona Cardinals play in the NFL, and on the field, they have this campaign every year: "Crucial Catch – Intercept Prostate Cancer." And I think it's really great to get that awareness out there. It is a leading cancer that men do get, but there are also a lot of misconceptions about it.

The main thing is that a man goes into the doctor and gets what's called a PSA blood test. It's prostate-specific antigen. This has been really great because I think one of the main reasons guys don't go to the doctor is because they think they're going to get a digital rectal exam – "Dr. Jellyfinger," as we like to call him – and it's an area where men just say, "You know what? I'm good." But PSA has helped to cut down on the need for that; it's kind of like the next level up.

I run the prostate-specific antigen blood test as a matter of course for any male wellness panel. And if your PSA is below four, if you're under the age of like 55, then you're usually fine. Now, we are also looking at related urinary symptoms. Enlarged prostate, for example, can cause peeing all night long, peeing during the day, dribbling, slow stream, hesitation – things like that are things that should be investigated. And there are really good herbs and particularly medications that really help to reduce that without having to resort to digital rectal exams and over-examination of the prostate. So, that's really important to know.

An Elevated PSA is NOT a Death Sentence

The other thing is, if the PSA is over four, it is not a death sentence; it does not mean cancer. There are many reasons that a PSA can be elevated above four for a man. I always get a urologist involved when it is above two, or we take a watchful waiting approach. But when it's above four, a lot of people get concerned because that's when the lab comes back, and you see it bolded out or in red, and all of a sudden, it's like, "Oh my gosh, what is this?" And you're off to the urologist for further testing.

Now, that's a really good thing, and many urologists are fantastic, but it's also kind of a hop, skip, and a jump to surgery when it comes to Western medicine, and that's not what I'm about unless something is a certainty. When you go to the urologist, they will do a digital rectal exam, and some others. They may retest your PSA, but they will also, if the PSA is high enough, try to do a biopsy, to get something called a Gleason score. If your Gleason is seven or above, then surgery is generally recommended. What they're doing is they're boring out the biopsy in multiple different locations and then taking the core samples essentially and saying, "Well, is there cancer in there? And how bad? And should we be concerned?" And then, of course, they go in; they recommend surgery to go in and either irradiate or remove the spots that have cancer. And in some cases, they're removing the entire prostate.

Well, that is extreme. And, you know, the prostate, while it is a pretty sedentary organ, it is a really important organ for men for erectile function. It helps to modulate the pH of semen, and it also helps to modulate the urinary process. So removing this organ kind of removes a vital part of being a man. Women have a G-spot for orgasm; men, this is our G-spot – it's the prostate. And so you can imagine if that gets removed, that's going to dull things out. Not to mention all the recovery from a treatment that may or may not have been unnecessary.

Explore All Your Options: Beyond Biopsy and Surgery

So the way I look at it is, could you have done as much as possible leading up to that point of needing surgery to get it handled? And there are so many other tests that we can do now that are not a digital rectal exam or simply a prostate-specific antigen blood test. There are things like the 4K score and things that can help to grade what it is, and then you can corral all that information and make an informed decision.

The other thing I want to go back to is BPH (benign prostatic hypertrophy). This is a condition of enlargement of the prostate. It can cause urinary symptoms, and it can cause that elevation in the PSA, and it doesn't necessarily mean it's cancer, and we correlate it with symptoms. And if it's hypertrophy, we aim to help reduce the size of the prostate or to palliate the symptoms, which can be really embarrassing and uncomfortable.

The other thing that it can be, I've seen this – PSAs run up to 10, 12, 15, 20 – because it was something called prostatitis. Now, if you've been watching my videos, anything with an "itis" just means inflammation of the fill-in-the-blank, in this case, the prostate, and it just means that there's a transient infection going on there. That gets treated, and all of a sudden, PSA comes down, and the cancer scare is averted.

And naturally, and naturopathically rather, there are just so many things that we can do before having to jump to surgery, but the main thing is awareness. If you have any questions, you can always ask me through my website. You can put in the comments below. And it is important to get that PSA and to get it checked, and then it's important to take a step back and understand the many different things that you can do. And we help to quarterback that for lots of men because these days, as you can see by the NFL's advertising, it is definitely a major concern.

I would say prostate cancer, heart disease, and just cancer in general are probably the three biggest concerns that I run into when I run executive wellness or male wellness panels. So that's a quick discussion of the prostate. I'm sure we'll continue to get into it here on this channel as we talk about men's health, but those are just some things to keep in mind. Just my kind of off-the-cuff comments about what I'm seeing. Again, advertising with the NFL creating this awareness is fantastic. And hopefully, you have a good naturopath or great urologist in your corner to discuss all the many options for good sexual wellness.

It's Dr. Wool. "Fix your gut, or in this case, fix your prostate, and solve your health."