What to do before a PSA test including the impact of stress

There are a number of things that are suggested we should do or not do before a PSA test as they can impact on the result...here's some that seem to get forgotten starting with stress - yes I know this blog has covered this before but it is worth a mention again:

Stress

Yes stress can show up in a PSA test...it can raise cortisol which increases increases vascular permeability—making it easier for PSA to leak from prostate tissue into the bloodstream. In a community screening cohort, men with higher perceived stress had PSA levels approximately 0.5 ng/mL above their low-stress counterparts (Stone et al., 1999). A separate study found that cortisol plus stressful life events explained roughly 15% of PSA variation after controlling for age and metabolic factors (Gidron et al., 2011).

 
There are some who consider stress as playing more of a role in prostate cancer but also those who say it does not impact. However it is clear it can play a role in raising our PSA. Not easy if you are already anxious about the test. Dr Geo has three bits of advice before a PSA test (go to his website for details of his next book):
 
1. Protect your sleep on the two nights before. Poor sleep raises cortisol and inflammatory markers. Aim for 7–8 hours. Dark room, no screens, consistent bedtime.
 
2. Use breathing to shift your nervous system. Box breathing (4 counts in, 4 hold, 4 out, 4 hold) or 4-7-8 breathing activates the parasympathetic system—your body's rest-and-digest state. Practice for 5–10 minutes the morning of your draw, and again in the waiting room. It directly reduces cortisol release. Check out my blog on breath: https://myunexpectedguide.blogspot.com/2023/01/breath-and-cancer.html
 
3. Reframe the test before you walk in. PSA is a signal, not a verdict. One elevated number is not a diagnosis. You're gathering information. You will respond intelligently when you have it. Schedule the blood draw early in the day if possible so you're not sitting with anticipatory anxiety all morning.

Other things to be aware of....

Cycling; use padded shorts and stop cycling 48 hours before PSA test: https://cacyclinghub.com/how-long-should-i-stop-cycling-before-a-psa-test/

Exercise: refrain from vigorous exercise 48 hours before the test.

Sex: avoid ejaculation 48 hours before a test as semen can cause PSA to spike.

Medical procedures; avoid rectal exam 48 hours before test and many other procedures like a biopsy may need several weeks delay.

Alcohol; a study on Alcohol Consumption and PSA-detected Prostate Cancer Risk by NIH researchers found that excessive drinking can depress PSA levels.

Spicy and processed foods; there is apparently some limited direct evidence linking diet to immediate PSA levels.

Illness: infections can significantly elevate PSA levels, leading to misleading results.

Medications; get advice from your doctors.

Supplements, herbal treatments etc; I've not found advice re this but I have stopped these for the 48 hours before a test.

Hydration; always key for blood tests; dehydration can make it difficult for healthcare providers to draw blood.

News of new prostate cancer treatment

The article is about the use of immunotherapy - using the body’s own immune system to tackle the cancer. This is interesting as immunotherapy has been used with other cancers with good results but not until now has it been found useful with prostate cancer - although the research has not been peer reviewed yet. 

Prof Johann de Bono of the Institute of Cancer Research and the Royal Marsden NHS foundation trust led the work. He says in The Guardian: 

"Under the phase one clinical trial, funded by Vir Biotechnology, 58 men with advanced prostate cancer, and who had stopped responding to other treatments, were given VIR-5500. The researchers found the majority of patients – 88% – experienced only very mild side-effects. They then looked at the level of prostate-specific antigen (PSA) in the men’s blood – a biomarker whereby higher levels can be a sign of prostate conditions. 

"De Bono noted the trial started at low doses, with the dose increasing in stages. When the team looked at data for 17 men given the highest dose, they found that for 14 (82%) their PSA level fell by at least half after treatment, nine (53%) saw their PSA level fall by at least 90%, and five (29%) experienced a fall of at least 99%. De Bono described the results as unprecedented for a disease previously thought to be “immune-cold” – in other words resistant to immunotherapy. The team added that, of 11 patients given the highest dose and whose tumours were measurable, five showed tumour shrinkage. In one case, involving a 63-year-old man whose cancer had spread to his liver, the team found 14 cancerous liver lesions “completely resolved” after six cycles of treatment".

See Guardian article at: https://www.theguardian.com/society/2026/feb/28/researchers-praise-stunning-results-of-new-prostate-cancer-treatment

Foods that restrict prostate cancer?

Yet another trial that challenges those oncologists who say changing diet makes no difference.....I've covered this topic before but it was good to see a prostate cancer trial by Prof Robert Thomas of Addenbrooke's Cambridge. 

Broccoli, organic ginger, turmeric, pomegranate, cranberry and green tea were all in the trial and when the men took for 16 weeks both the foods and a probiotics blend of 5 lactobacillus probiotics their PSA progression slowed by 44%.

See summary at CancerActive here.

Chemo?

I think this is a useful article looking at chemo from The Life Organic blog by Dale Atkinson (Stage IV cancer); 'Chemotherapy: what it can cure, what it can’t, and what we have to own after the drip stops' https://thelifeorganic.com/chemotherapy-what-it-can-cure-what-it-cant-and-what-we-have-to-own-after-the-drip-stops/

The article covers lots more but in terms of prostate cancer here is a brief summary:

Prostate cancer: In metastatic hormone-sensitive disease, chemotherapy can offer survival benefits alongside androgen deprivation, but it is not curative in this metastatic stage. Guidelines and large trials agree on this: https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq 

Make your own probiotics

I regularly get the Embracing Nutrition newsletter (sign up at bottom of page of their website) and there are some great recipes and articles. A newsletter from last September highlighted 9 simple recipes for homemade probiotic foods - all dairy-free, gluten-free, and vegan-friendly. However what I found most interesting was how you can create starter cultures from probiotic tablets. I hadn't really thought about it before but it seems so obvious and a great way to cut costs.

See their blog on importance of gut health here: https://embracingnutrition.co.uk/new-discoveries-in-microbiome-gut-health/

And here's part of what they wrote in the blog about creating probiotics:

Understanding Fermentation Starters

To make probiotics at home, you need a starter culture. This is what introduces the beneficial bacteria or yeast that ferment your food or drink. There are several ways to get started:

• Probiotic capsules or powders – simply open a capsule containing live strains like Lactobacillus or Bifidobacterium and stir the powder into your base (such as coconut milk or cashews).

  
  

• Commercial starter cultures – vegan yoghurt starters, kefir grains, SCOBYs (for kombucha), tempeh spores, and koji (for miso) are all available online and give consistent results.

  
  

• Using an existing fermented food (backslopping) – you can add a spoonful of live yoghurt, kefir, or raw sauerkraut to kickstart a new batch. This is the most traditional method and often produces great results.

And their recipes here:

Homemade Live Cashew Probiotic Cheese
Homemade Live Kombucha
Homemade Live Fermented Pickles with Mixed Vegetables
Homemade Live Tempeh
Homemade Live Miso (simplified)
Homemade Live Kimchi
Homemade Live Sauerkraut
Homemade Live Coconut Water Kefir
Homemade Live Coconut Yoghurt

ESMO 2025: Prostate highlights

Dr María Natalia Gandur Quiroga gives her pick of the key prostate cancer abstracts from the European Society of Medical Oncology 2025 -this is all about improvements to standard drug treatments - however it although only 6 mins long it requires good concentration for those of us not so well versed in drug names! See it at: https://ecancer.org/en/video/12536-esmo-2025-prostate-highlights

At last an explanation for prostate cancer that makes more sense!

Mark Lintern, architect of the Cell Suppression Theory of Cancer shares his recent insights into the nature of prostate cancer in this great radio show.

Yes to Life write: "Prostate cancer has tended to be an anomaly amongst cancer types, failing to support even the most accurate theories, and has managed to elude rational explanation – as of course has cancer as a whole.

"Mark Lintern has recently turned his attention to this anomaly to see if he is able to explain its workings within his novel Cell Suppression Theory of cancer. His conclusion is that yes, he can explain the process of cancer within the same model as other cancers, but also that the reason its behaviour appears different is due to the signature cell metabolism that sets it apart from other tissues".

I will be sending this link to my oncologist to see what her thoughts might be regarding this.

You can listen to this show “Prostate Proposition” via the link below:

https://yestolife.org.uk/radio-shows/

Or at: https://ukhealthradio.com/blog/episode/prostate-proposition-mark-lintern-architect-of-the-cell-suppression-theory-of-cancer-shares-his-recent-insights-into-the-nature-of-prostate-cancer/

See more of Mark on this blog including links to the podcasts explaining his work: https://myunexpectedguide.blogspot.com/2024/08/mark-lintern-and-his-inspiring-look.html

And here are three articles by Mark on Substack:

https://marklinterncst.substack.com/p/prostate-cancer-a-new-explanation

Here's part two: https://marklinterncst.substack.com/p/prostate-cancer-a-new-explanation-ffe