Does Drinking Raise my PSA?
by Elliot Smith, July 5, 2020

Does Drinking Raise my PSA?

Now that we are a couple of days into Dry July we thought we would take a look at the question of alcohol consumption and prostate cancer. We first came across the question from one of our members. He asked: “Can drinking beer raise my PSA?”. Dry July seemed like a good time to investigate it.

We have gone through the latest research in this area to see what the science says. In short, there is some evidence that long term drinking can increase your risk of prostate cancer and a tiny bit of evidence that it can have a short-term effect on PSA. Read on to find out more.

Long term effects of alcohol on prostate cancer

There have been several studies looking at the long-term effects of alcohol consumption and prostate cancer. Similar studies exist for most types of cancer and the general rule of do not drink too much or too often seems to apply across the board. A US study looked at almost 295,000 men aged 50-70 and compared prostate cancer prevalence to how much they regularly consumed alcohol [1]. Men that drank more than 6 drinks a day saw an increased risk of about 25%. Those who drank 3 to 6 drinks per day saw an increase of 19%. Finally, men who drank 1 to 3 drinks per day saw an increase in risk of around 6%. This is similar to the increase seen across all cancer when drinking similar amounts. Overall, good advice is to limit your regular alcohol intake.

With any large population study like this it can be hard to pinpoint causation. Many are done based on self-reported studies, meaning that recent changes to alcohol consumption are more likely to be reported than long term trends. That is not to say there is no effect, it is simply hard to isolate. None of the studies we found aimed to differentiate the effects of different types of alcohol. We do not have any evidence to suggest beer has a bigger effect than wine or spirits for example.

Interestingly, one study we found looked at the reverse of this question. Do regular drinkers get PSA tests more often? [2] This study found a small but significant increase in PSA testing amongst regular drinkers. The effect was only strong amongst those that consumed alcohol every day. Given that PSA testing is not currently a national screening program this may explain some of the increase we see to prostate cancer risk as a result of alcohol. If men who drink more often get tested more often, we are likely to see an association.

While there is some increase in risk we know there are other risk factors that have a much larger effect. Family History, for example, is known to double a man’s risk of prostate cancer. Understanding how all the risk factors come into play is important when deciding about whether to start testing.

Short term effects of alcohol on prostate cancer and PSA

Short term effects of alcohol on PSA are less studied. These changes, if any exist, are likely benign and the same type of changes we see after sex or vigorous exercise. Sex and exercise can cause a short-term rise in PSA due to increased exertion or pressure on the prostate. That is why your doctor will ask you to refrain from sex, vigorous exercise or bike riding in the days leading up to your test.

A small study of 59 men looked to find differences in PSA levels between men who consume alcohol and tobacco [3]. In their study they did find some elevation of PSA in men who recently drank or smoked. This did not isolate alcohol as a cause and the small numbers make it hard to draw any major conclusions.

Another study asked men to refrain from several activities for eight weeks and looked at their PSA before and after the changes [4]. In that study, researchers found those that stopped drinking saw a fall in their PSA. They were asked to stop several other actives such as eating spicy foods and riding a bike, so it is unclear if these drops were solely from taking some time away from drinking.

So, what does all this mean? Firstly, not drinking to excess regularly is good for your health, that is probably nothing surprising. There may be a small effect on short term PSA levels if you have recently been drinking, these short-term increases can come from several places and require some further investigation. That is why so often a second PSA test is taken 1-3 months after an elevated PSA. Taking this second test helps determine if the PSA is elevated temporarily or something potentially more serious. With this second test, there is less chance of being sent for further, more invasive tests until your doctor feels certain.

If you’d like to talk to with a doctor focused on prostate cancer testing, consider becoming a Maxwell Plus member. We provide an online service for all men interested in testing. We have chosen to focus on just prostate cancer in order to deliver exceptional service.

Finally, if you haven’t already, take a look at Dry July. It is a great cause, helping provide support for those diagnosed with cancer. Their fundraising supports organisations like PCFA who provide ongoing support for men with prostate cancer.

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References

[1] J. L. Watters, Y. Park, A. Hollenbeck, A. Schatzkin, and D. Albanes, “Alcoholic Beverages and Prostate Cancer in a Prospective US Cohort Study,” Am. J. Epidemiol., vol. 172, no. 7, pp. 773–780, Oct. 2010, doi: 10.1093/aje/kwq200.

[2] T. J. Littlejohns, R. C. Travis, T. J. Key, and N. E. Allen, “Lifestyle factors and prostate-specific antigen (PSA) testing in UK Biobank: Implications for epidemiological research,” Cancer Epidemiology, vol. 45, pp. 40–46, Dec. 2016, doi: 10.1016/j.canep.2016.09.010.

[3] J. D. Escandriolo Nackauzi, R. H. Colla, G. R. Ravazzani, M. I. Gaido, P. Bertolotto, and A. B. Actis, “Prostate-specific antigen: its relationship with alcohol intake and tobacco,” Med. Oncol., vol. 29, no. 2, pp. 823–826, Jun. 2012, doi: 10.1007/s12032-011-9940-x.

[4] A. R. Zlotta et al., “The effect of lifestyle changes on serum PSA levels in a cohort of asymptomatic men with PSA between 2-10 ng/ml and normal DRE,” European Urology Supplements, vol. 18, no. 1, p. e1814, Mar. 2019, doi: 10.1016/S1569-9056(19)31314-4.