PSA levels in 2 studies found not to reflect prostate cancer growth

Thanks to a blog at 'Dan's Journey through Prostate Cancer' I saw this interesting piece of research into PSA levels. The Cornell Chronicle shows that PSA levels do not reflect prostate cancer growth - see the article here. They write: 

"The recent study, published in the Journal of Clinical Oncology, analyzed data from more than 2,500 men enrolled in two multinational phase 3 clinical trials testing enzalutamide to slow or stop tumor growth in patients with advanced prostate cancer. This drug targets the androgen receptor, a protein that prostate cancer cells use to receive growth signals from male hormones such as testosterone. The trials (ARCHES and PROSPER) assessed cancer spread or growth on imaging scans, alongside changes in PSA levels during treatment. The researchers examined cases of radiographic progression – when cancer growth or spread is detected by imaging such as X-rays, CT scans or bone scans."

The results showed up to roughly 25% of patients had radiographic prostate cancer progression without any rise in PSA levels, and they had worse outcomes. The study also found that patients often didn't have new symptoms and felt well, despite the cancer advancing. Both groups were similar and this suggests it may be a broad issue across advanced prostate cancer.

The results surprised researchers and they suggest that "patients receiving potent androgen receptor inhibitors such as enzalutamide may benefit from periodic imaging in addition to routine PSA monitoring, particularly during the first two years of treatment". 

Keto not right for prostate cancer?

Since my diagnosis I've viewed with interest Jane McLellands' approach to starving cancer - I've read her book and done her course - but also struggled to get my head around how to actually do it. Indeed so much so that I've followed other approaches with support of a Functional Medicine practitioner.

However over the years evidence is growing for her approach - I particularly welcomed her recent Substack article which looked at prostate cancer among other cancers. In particular why a ketogenic diet might not be right for prostate cancer. This is not new info to this blog as I've had doubts re keto for prostate cancer - see one of my previous blogs here: https://myunexpectedguide.blogspot.com/2021/09/keto-low-carb-or-what-for-prostate.html Nevertheless it is worth a read.

See Jane's Substack here: https://substack.com/home/post/p-194447244

See more here re Jane's approach: https://myunexpectedguide.blogspot.com/2018/09/can-we-starve-our-cancer.html and here a great documentary: https://myunexpectedguide.blogspot.com/2020/10/starving-cancer-new-documentary.html

Petition to get debate in Parliament on prostate cancer screening.

So I heard on the news this week that the UK National Screening Committee (UK NSC) finalised its recommendations on prostate cancer screening, limiting this to men with a known BRCA2 gene variant who have relevant family history. Sadly this recommendation excludes the vast majority of men, including those at highest risk, such as Black men and those with a family history, and falls far short of what is needed to save lives through earlier diagnosis. 

As noted previously in this blog the issue of PSA tests is not straight forward and has led to over treatment in many cases. However it is clear to me that those at highest risk should be part of a screening programme. Do consider signing the petition at teh end of this post.

Here's part of an email with details of the new petition from Prostate Cancer research:

"We are deeply disappointed....But while this is not the outcome we fought for, it is not the end of this campaign. Because of you, we have built something powerful. Over the past two years, more than 300,000 of you signed our petitions. Tens of thousands of you wrote to your MPs. As a result, more than 250 MPs from across political parties have signalled their support for change. 

You helped unite 18 leading organisations across the clinical, charity and research community behind a shared call for reform, and brought major national newspapers, including the Daily Mail, The Telegraph and The Times, firmly behind this issue. This support has continued over the last few days, with the UK NSC recommendation generating significant national media attention, with coverage across The Times, The Telegraph, the Daily Mail, the BBC, GB News and many others, many expressing strong concern about the implications of the recommendation. 

Your support also made it possible for us to commission an independent review of the UK NSC’s modelling by the York Health Economics Consortium (YHEC). That review identified serious flaws in the model underpinning this decision, including assumptions that do not reflect how screening would work in practice and a failure to account for modern MRI-led diagnostic pathways. 

Together, we have shifted this debate further than ever before. And that progress matters. 

While we did not secure the outcome we fought for, we have achieved an important breakthrough. For the first time, the UK NSC has committed to keeping their model ‘alive’ – meaning it can be updated as new evidence emerges and the decision can be revisited without waiting another five years. 

This is a significant shift. It means the door is not closed for a generation, and that is because of you. Over the next two years, we will look towards opportunities to generate new evidence that could challenge this decision and secure a broader, risk-based screening programme. 

At the same time, we will continue to fight for men in other ways, pushing for delivery of the National Cancer Plan, accelerating access to better diagnostics through the innovations we fund, reaching more men through our education and community programmes, and expanding Prostate Progress, our national data platform, to transform understanding of this disease. 

One thing you can do today is help to ensure this decision on screening is given an opportunity to be scrutinised by MPs. We need more people to the Official Parliamentary petition to get it to 100,000 and trigger a debate in Parliament.

Cancer art exhibition @ Southmead Hospital

Regular blog readers will be aware of Flourish - a magazine by and for people impacted by cancer. I helped establish this collection of beautiful and powerful artwork and written word pieces when it was a joint collaboration between Yes to Life and Artlift charities. The last issue was a year ago but funding has now been secured by Artlift for a further 4 issues - but just as exciting is our exhibition at Southmead Hospital, Bristol: 

• featuring a diversity of visual arts work by community and professional artists impacted by cancer and/or other health conditions
• available to visit until 23 August 2026
• in the Sanctuary Gallery in the Blue atrium behind the piano in Southmead Hospital’s Brunel Building.
• click here for travel and access information
• the exhibition marks the first opportunity to start celebrating Artlift's forthcoming 20th Anniversary as one of the first Arts on Prescription providers in the UK.

The Flourish exhibits are enriched by inspiring collaborative artwork and poem from North Bristol Trust's 'Fresh Arts'  and creativeShift's Arts on Referral participants.The exhibition partners are pioneers in Creative Health. Their NHS and public health supported programmes have been academically proven to impact positively on the health and wellbeing of adults living with a diversity of health challenges including mental health, chronic pain, cancer, and neuromuscular conditions.

Read Flourish at: https://artlift.org/artlift-programmes/flourish/flourish-magazine/

And below a screenshot with more about Flourish:

Reduce nightly visits to loo

One of the challenges of prostate problems plus taking hormones can be the many trips to urinate at night. Indeed it is accepted by many that once over 60 you need to wake in the night. In fact we should be taking this seriously - advice is definitely to talk to your medical team. However I found this video useful as it is not just how much water you drink, but when, how, and what type of water you consume throughout the day that determines your sleep quality.

In this video the research quoted is based on clinical studies and looks at how kidney function, bladder sensitivity, hormone rhythms, and hydration habits all interact to affect your sleep.

See this video from Urologist Dr William Li on the Eat to Heal TV YouTube channel: https://youtu.be/s72I8RPTP7I?si=D98AtmNEX6FBChrL

Of course this is not the whole picture - pelvic floor exercises are also key. Another useful article on this issue is at: https://www.verywellhealth.com/managing-urinary-changes-after-prostate-cancer-treatment-11901857

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

Metformin and prostate cancer

The charity Yes to Life brought my attention to this aspect of the major UK study; the STAMPEDE trial. It recently explored whether adding metformin, a commonly used diabetes medication, to hormone therapy could improve outcomes for men starting treatment for advanced prostate cancer.

The results were not a simple yes or no.

As Yes to Life note "the study did not show a clear improvement in overall survival for most people. But it did show something quieter, and still important. Metformin helped reduce some of the physical strain that hormone therapy can place on the body, including weight gain and changes to blood sugar and cholesterol."

This is a wonderful reminder that care is not only about the tumour. It is about the whole person. The body that is carrying the treatment.

Yes to Life write: "It is also a reminder of why evidence matters. Integrative support should never be about quick fixes or promises. It should be about thoughtful, well-informed care that works alongside medical treatment, not instead of it."

If you would like to read the full article, you can find it here: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(25)00231-1/fulltext

It is also worth mentioning that Metformin maybe takes a key role in the treatment of other cancers using off-label drugs and others to 'starve' the cancer. See more about that at: https://myunexpectedguide.blogspot.com/2018/09/can-we-starve-our-cancer.html

Say no to Palantir in the NHS

NHS England is rolling out software to run our health records from Palantir – a US spy-tech firm that has supported mass deportation in the US and enabled genocide in Gaza. One of Palantir’s founders is also openly against the NHS. Peter Thiel claimed it “makes people sick” and said that the British people love the NHS because we’re suffering from Stockholm syndrome.

We can’t let a company like this take control of our healthcare system. I've already sent an email to Gloucestershire Health Services - please join me in sending your health services an email.

The Good LawProject have set up a simple tool so you can find out if your local NHS trust has started using the software, and then send an email demanding they say no to Palantir. With the government putting NHS trusts under pressure to adopt the software, we need to act right now. 

If you want to keep Palantir out of our NHS, send an email to your local trust and Wes Streeting, secretary of state for health.

Click on ,link now:

https://notopalantir.goodlawproject.org/email-to-target/stop-palantir-in-the-nhs/

Update 1.2.26: Useful article linking to more on Palantir: https://www.thenerve.news/p/technofascism-us-america-fascism-trump-palantir-peter-thiel-uk-nigel-farage-reform