DEAR MAYO CLINIC: Can red wine or diet affect the PSA count?

ANSWER: Although it's difficult to know for certain whether red wine directly impacts the PSA (prostate-specific antigen) count, evidence indicates that a person's overall diet and health can play a role in prostate cancer risk, which could translate into PSA levels.

PSA is a protein that's made in the prostate -- a small gland about the size and shape of a walnut, although it usually enlarges with age. The prostate sits below a man's bladder and produces substances that help form semen. Normally, small amounts of PSA circulate in the blood. But cancerous prostate tissue usually releases more PSA than healthy tissue. The lower the PSA level, the lower the chance of having prostate cancer. The higher the PSA level, the higher the chance of prostate cancer. Generally, a PSA of 4.0 nanograms per milliliter of blood or more is considered to be in the high range, although other factors such as age (older men have higher levels and younger men should have lower levels) need to be considered when determining the significance of an individual man's PSA level.

Measuring PSA isn't a definitive test for prostate cancer. High levels of PSA may indicate the presence of cancer, but other conditions, such as an enlarged or inflamed prostate, may also increase PSA. In addition, even with a normal PSA level, a man can still have prostate cancer, and men with high PSA values may not have prostate cancer. Generally, determining a man's PSA level, along with a digital rectal exam, are the first measures in screening for early signs of prostate cancer. If cancer is suspected based on these screenings, the doctor may recommend a biopsy to determine if cancerous tissue is present.

In April 2009, Mayo Clinic presented the results of a research study that found men who took statins -- drugs used to lower cholesterol -- were less likely to develop prostate cancer, compared to men who did not take statins. In addition, recent evidence indicates that cholesterol levels can also correlate with prostate cancer risk. The higher a man's LDL ("bad") cholesterol and the lower his HDL ("good") cholesterol, the higher his risk of prostate cancer.

With these research findings in mind, I encourage my patients to take care of their heart -- because what's good for the heart is also good for the prostate. A heart-healthy lifestyle consists of exercising for at least 150 minutes each week, quitting smoking, managing stress and eating a healthy diet. A diet that's good for the heart typically includes whole grains; lean meat, poultry and fish; and at least five servings of fruits and vegetables a day. Red wine in moderation can also be part of a heart-healthy diet. The guidelines are no more than one drink a day for women and two drinks a day, at most, for men.

Red wine is considered heart-healthy because the alcohol and certain substances in red wine, called antioxidants, may help prevent heart disease by increasing levels of "good" cholesterol and protecting against artery damage. Plus, substances in red wine might harbor anti-cancer properties. However, don't start drinking red wine just for the possible heart benefits. And, remember that too much of any type of alcohol can have many harmful effects on the body.

The bottom line is that, although drinking red wine in moderation could affect your PSA level, it's more important to engage in a heart-healthy lifestyle overall. Not only can it reduce your risk of heart disease, but it also may decrease your risk of getting prostate cancer.

-- R. Jeffrey Karnes, M.D., Urology, Mayo Clinic, Rochester, Minn.

Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care

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(c) 2009 Mayo Clinic