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Biochemical Recurrence

Posts: 15
Joined: Oct 2016

I am 44 and recently had a robotic prostatectomy 8/16.  Pre op my gleason score was 3+3=6 and PSA was 3.69 4/16 which had roughly tripled since 2012.  The pathology report from the prostatectomy showed clear margins, clear seminal vesicles, and that the tumor was confined within the prostatic capsule with a Gleason score of 3+4=7.

My follow up PSA after 7 3/7 weeks is .29!!!!!  By definition this is a biochemical recurrence if the follow up level in 6 weeks comes back the same or greater.  The urologist said he thinks it is going to come back zero on follow up?  Has that ever happened?  I dont believe him.  I thinks he is being hopeful.  Of course I hope for the same outcome but realisticly I am very concerned.  Am I a dead man walking?

Old Salt
Posts: 808
Joined: Aug 2014

Sorry to hear about this result. But I would ask for a repeat PSA test right away. Mistakes do happen.

If the second test confirms the first one (biochemical recurrence), a course of adjuvant radiation may well lead to a satisfactory outcome and give you hope once again.

And who knows, maybe your urologist is right, he went to Med School and I didn't.

Posts: 15
Joined: Oct 2016

Thank you.  I will repeat it.  Also do you know anything about biotin affecting psa levels?

VascodaGama's picture
Posts: 3371
Joined: Nov 2010

You are correct in regards to your present biochemical failure if the repeated PSA test confirms the 0.29 ng/ml value (check the units). Remission levels after surgery should be kept lower than PSA< 0.05 ng/ml. Surgeons consider surgery a success when the PSA two weeks post RP is lower than 0.06, and then wait for the body to clear any detritus of circulating stuff. A value above 0.20 ng/ml represents recurrence. Depending on the case, salvage therapy is usually recommended at a PSA above 0.40 ng/ml.

Regarding Biotin influence in PSA, I would recommend you to inquire with your doctor. In any case, I wonder why and when did you start taking this supplement. 
For your information, at Biotin.com they inform of interferences of the drug with thyroid lab tests, particularly with the Free thyroxine (FT4) and Thyroid stimulating hormone (TSH), which makes part of our endocrine system controlled at the pituitary, the "center" sending down the "orders" for hormone production. Any drug that may disrupt this signaling system could influence indirectly all systems dependent on hormones/androgens.
The manufacturer also indicates that Biotin has therapeutic benefits for a number of illnesses including Breast cancer. It doesn't say how it manages to get those benefits but breast and prostate cancers are cells highly dependent on hormones to grow. Lower levels of androgens in circulation would keep this cells in an indolent status.
In other words, if Biotin's influence disrupts the pituitary signaling system causing lower levels of androgens in circulation, then one would expect to have lower PSA values. Your initial PSA results would then be doubtful, probably should be higher.


Best wishes for remission values in your next PSA test.

Welcome to the board,




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