What a coincidence, yesterday I wrote about my being curious about what was going to be the effect on my PSA as a result of my cutting back the non-steroidal anti-inflammatory drugs (NSAID) that I have been taking to treat my arthritis. A quick review, my rheumatologist cut my drugs in half out of concern for my heart. I have already begun to feel aches and pains because of the medication change. I am waiting to see if this change will also affect my PSA. Today, I came across an article speaking exactly to this issue.
A study, conducted at Vanderbilt University, looked at the use of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) on PSA levels, especially among men with prostate cancer. In this large (1,277) analysis (known as the Nashville Men’s Health Study) of men who were referred for prostate biopsies, approximately 46 percent of these men reported taking an NSAID, mostly aspirin (37 percent of all men). After adjusting for age, race, family prostate cancer history, obesity, and other variables that have independent effects on the size of the prostate organ, cancer risk, and PSA levels, the researchers found that aspirin use was significantly associated with lower PSA levels.
PSA levels were 9 percent lower in men taking aspirin (the NSAID most commonly used) compared with men who did not use aspirin.
The researchers first thought that there might be a correlation between the lower PSA values, lower prostate gland volume and the use of the NSAID. However, they found that the aspirin users and nonusers had the same prostate volume. They concluded that aspirin was not changing PSA by changing the prostate volume but, was doing something different and in fact was having a beneficial effect on cancer development.
They also found the effect of aspirin on PSA was only somewhat evident among men without prostate cancer but was very strong in men who were found to have prostate cancer at the biopsy.
From a historical view, there have been prior studies that showed anti-inflammatory drugs like NSAIDs are associated with lower prostate cancer risk. The data from this study also suggests that NSAID might have a beneficial effect on prostate cancer growth.
On the downside, this data also indicates that NSAID use could affect our ability to detect prostate cancer, regardless of any reduction in prostate cancer risk.
For me and the effect it might have on my slowly increasing PSA is still up in the air. We will find out.
Joel T Nowak, MA, MSW
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