Most of us know PSA as an essential part of prostate cancer screening.
Not every patient will benefit from a PSA test, but if your doctor recommended one, there’s probably at least one reason to suspect a higher risk than usual.
But what if your PSA exam shows high levels of this enzyme in your blood?
The urologist will probably run a few more tests, but what can you do in the meantime?
There are ways to lower your PSA levels, but not all of them are appropriate. Some would simply hide the signs of the disease while the prostate stays the same. Others improve prostate health causing what we call a healthy drop in PSA levels.
Exercise is one of these beneficial measures. It is easy to do, portable, and has many additional health benefits. It works to lower your PSA levels and boost prostate health, and it is also helpful to prevent future prostate problems.
Keep reading to learn exactly how to lower your PSA levels with exercise.
First off, we should understand what PSA is and why it is so important. The PSA test is one of the most common screening procedures in urology.
It measures the levels of an enzyme in the blood serum. It is called prostate-specific antigen. This PSA is delivered along with sperm in the ejaculation but also leaks into the bloodstream.
In the sperm, PSA is an enzyme that breaks down sperm clots, increasing fluidity and facilitating the movement of sperm cells. As we age, the prostate grows very slowly, and this is expected after turning 40 years. But as the prostate grows, the PSA levels increase.
That’s why you won’t see a fixed upper limit for every man. It depends on your age. Moreover, comparing PSA levels in different ages is also helpful to find out if there is something wrong.
Why are high PSA levels “bad”?
Elevated PSA levels are considered “bad” because they indicate that your prostate has probably grown larger than usual. Such enlargement can be attributed to your age and the normal growing process of the prostate. But there’s also a chance that such growth is pathological.
Prostate cancer features high levels of PSA in most instances. It also happens in cases of benign prostatic hyperplasia or BPH. In either case, it is caused by an increase in the number of cells in the prostate tissue.
The prostate gland synthesizes more PSA than average, and it leaks to the blood in a higher proportion. Inflammation can also play a role because it increases blood flow to the prostate and the contact with PSA-producing cells. Thus, patients with prostatitis and inflammatory lesions may also have high levels of PSA.
The prostate can sometimes shrink, and inflammatory processes in the tissue may resolve. When this happens, the PSA could go back to normal. That’s why lowering PSA is important. It provides a hint about prostate health, and lower levels are associated with a lower prostate cancer risk.
Some patients with prostate cancer do not require treatment because they have slow-progressing localized prostate cancer. Thus, urologists decide on a type of management called active surveillance. They constantly run tests to evaluate prostate growth and monitor PSA levels.
In these patients, lowering PSA levels is a good sign that prostate cancer is under control, and no further action is required. Doctors also use something called PSA velocity, which evaluates how fast PSA levels increase as we age. Lower PSA levels and PSA velocity levels are signs of a good prognosis.
An elevated PSA concentration can indicate many things, and not only prostate cancer and BPH. Your PSA levels increase after a prostate massage, in case of urinary tract infections, after having sex, and after a prostate biopsy or another surgical procedure.
Thus, instead of raising your own conclusions, talk to your doctor about your PSA levels if you’re in doubt and follow recommendations.
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Can exercise lower your PSA levels?
PSA levels can be modulated by many things, as mentioned above. Some of them are not directly associated with prostate health and cause an error in the screening test.
Others favor prostate health, which is then translated into a lower PSA level. Exercise is one of the latter. It is useful for cancer prevention and as a complement to prostate cancer treatment.
Role of exercise in prostate cancer prevention
The Western lifestyle is associated with a higher risk of PSA and prostate cancer. This is noticeable in Asian individuals who move to Western countries and adopt their lifestyles.
Sedentary behavior is a part of this lifestyle that influences cancer incidence. A systematic review evaluated this effect showing that exercise reduced the risk significantly. By doing so, your PSA levels will stay low for a longer time.
Other studies indicate that even physical activity associated with the workplace reduces the risk of prostate cancer and a higher PSA level.
Exercise in prostate cancer active surveillance
Recent studies about exercise included as a measure to halt prostate cancer progression show promising results.
One of the studies evaluated PSA levels and other parameters in patients engaging in high-intensity interval training for 12 weeks. They reduced their PSA levels, and their PSA velocity reduced, too.
These patients inhibited prostate cancer cell growth and had a better prognosis. Testosterone levels remained unchanged the entire time. Thus, it was recommended by the authors as an additional measure to recommend during active surveillance.
Exercise and cancer prognosis
Recent studies show that PSA levels are not changing alone in prostate cancer. There’s also a 61% reduction in death risk and a 57% reduction in cancer progression. Thus, lower PSA does not constitute a diagnostic error and has a real effect on prostate health.
Which exercises can lower PSA?
To lower PSA levels with exercise, you can choose different types of physical activity:
This is an endurance activity characterized by low intensity and a longer exercise time. Brisk walking, jogging, swimming, hiking, and dancing are suitable examples.
In most cases, the benefits of aerobic exercise start with 30 minutes of physical activity 5 times a week.
Studies with a positive impact on the prostate gland usually feature 15-20 minutes of aerobic exercise for 12 weeks.
This is a type of exercise that uses weights with an increasing load to develop strength. It can be either gym exercises with weights or bodyweight exercises at home.
The benefits of this type of physical activity start with a minimum of 2 sessions every week. One of the studies with positive effects in prostate health used 3 sessions instead of two. The authors implement 9 exercises per session, with 1-3 sets and 6-10 repetitions.
How to lower PSA levels with exercise
The easiest approach to lower PSA levels with exercise is to engage in aerobic physical activity. This includes brisk walking and jogging, which is not difficult to adopt to in your everyday life.
Aim for a minimum of 30 minutes of physical activity for at least 5 days a week. Remember that perseverance is critical to see results in your PSA levels and your prostate health.
The benefit may start around week 3, but most studies are done in a minimum of 12 weeks. Some prostate cancer patients may experience the effects of exercise right away, while others may take extra time.
The ideal scenario would be bringing together physical activity and resistance training. To do so, keep your aerobic routine every day and include some weight training or bodyweight exercises 3 days every week. Choose different exercises for each body part aiming for 9 exercises total. You will do each exercise 2 or 3 times, and the number of repetitions for each set can be around 8.
If you haven’t been physically active for a long while, take it easy. Get started with light physical activity for 5-10 minutes a day and increase the time and intensity as you feel some progress.
PSA screening is an essential diagnostic and prognostic tool along with digital rectal examination in prostate cancer. Patients with risk factors should also screen for prostate cancer using this tool.
The idea is to maintain PSA levels as low as possible, and the right way to do it is by shrinking the prostate, resolving inflammation, and inhibiting prostate cancer cell growth.
According to studies, exercise and PSA levels are closely related. Increasing your physical activity reduces this blood marker, improves the prognosis of prostate cancer, and prevents the progression of the disease.
There are two main types of exercise to lower PSA levels. They are aerobic exercise (hiking, jogging, brisk walking) and resistance exercise (weightlifting, bodyweight training).
Combining both is the best option to improve prostate health, and you should do it gradually if you’re used to a sedentary lifestyle.