Are prostate tests worth it? - Ask the experts: answers to your questions from the leaders in natural medicine

My doctor wants me to start getting PSA tests next year when I turn 45. I've heard that they often give false positives. What should I do?

ROBERT ANDERSON, M.D., REPLIES: I would suggest that you go for the test, which checks for prostate specific antigen, or PSA. Getting checked at your age may actually be more important than at 65 or 70. Although prostate cancer is uncommon in men in their 40s, when it occurs it's much more aggressive than in older men. Ask your doctor to look at the ratio of total PSA to a subfraction known as "free PSA"; this calculation has been shown to lead to fewer false positives.

According to the National Cancer Institute, false positives are prevalent in men over 50. For example, 12 out of 15 men who are 50 or older and show elevated PSA levels will turn out not to have cancer. The confusion arises from the fact that not only cancer but also prostatitis and benign enlargement of the prostate, which are common in men over age 50, can heighten PSA values. (High PSAs sometimes occur for unknown reasons when none of these conditions is present.) Besides the time involved, the main downside to getting tested is that an elevated reading may lead to an unnecessary biopsy. Getting a biopsy takes additional time and money and causes worry.

In addition to getting the test, I suggest adopting the following habits, which research shows can lower the risk of prostate cancer for men of any age: exercising aerobically, limiting saturated and hydrogenated fats, adding greens (like spinach) and cruciferous vegetables (like broccoli, cauliflower, and cabbage) to meals, and eating tomatoes, nuts, beans like lentils, and cold-water fish like salmon. I also recommend you take daily: 5,000 IU of vitamin A, 1,000 mg of vitamin C, 400 IU of natural vitamin E (d-alpha tocopherol), 200 mcg of selenium, 15 mg of zinc, and 15 mg of lycopene.

Quick Tip

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ROBERT ANDERSON M.D., is a semiretired family doctor and president of the American Board of Holistic Medicine. He is an advisor for the medical journal Alternative Therapies in Health and Medicine and author of A Clinician's Guide to Hotistic Medicine (McGraw-Hill, 2000).

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