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.
