The Effect of a Pure Anti-inflammatory Therapy on Reducing Prostate-specific Antigen Levels in Patients Diagnosed With a Histologic Prostatitis.

OBJECTIVE

To investigate the effectiveness and the tolerability of a combined pure anti-inflammatory therapy not associated with antibiotics on reducing PSA levels.

METHODS

Patients with a previous biopsy negative for prostate cancer and showing persisting level of prostate-specific antigen (PSA) greater than 4 ng/dl were recruited. The specimens of previous biopsy were classified as benign or showing inflammation. Eligible patients were divided into 2 equal groups. In group 1, men with histological findings of inflammation at the previous prostatic biopsy were selected, in group 2, patients without such findings were included. Men of both groups were treated for 3 months with the same pure anti-inflammatory scheme including nimesulide, Serenoa repens, bromelain, and quercetin. After treatment, PSA levels were determined again. Independently by the second PSA determinations, all patients underwent a second 16 core biopsy.

RESULTS

A total of 140 patients were enrolled. No adverse reactions were reported. Total PSA lowered from 7.3 ng/mL at baseline to 4.6 ng/mL (P <.0001) after treatment in group 1, and from 7.2 ng/mL to 7 ng/mL (P = .0005) in group 2. Overall, we diagnosed a prostate cancer at the second biopsy in 27 men among 140 (19.2%). The percentage of cancer at re-biopsy was 20% (14 of 70) in group 1 and 18.5% (13 of 70) in group 2. We found no cancer at the second biopsy in cases of PSA reduction below 4 ng/mL in both groups.

CONCLUSIONS

Our protocol was very effective and safe in reducing PSA levels. The second biopsy failed to show prostate cancer in all patients with PSA lower than 4 ng/mL.