GP says once a year.

But at my request he doesn't send me the results.  If the PSA started to
rise I assume he would have to contact me.

jimhoney

My doc has requested that I have my PSA checked every 3 months for the 1st
year then every 6 months for the next 4.

Sandy K.
Age 47
2/04 PSA 4.9
6/17/04 RRP

Once a year is the standard, I believe.  I would be on that now, actually, if I
had followed the normal course.

My urologist told me to have tests every 3 months for two years and
every 6 months for another to years to be followed by once a year
subsequently.  I am about it have my last 6 months test in about a week.

I think this is just a matter of which protocol your doctor decides make
sense to him.  My urologist uses one similar to what Walsh used to
recommend, but now Walsh recommends less frequent testing.  My cancer
was a Gleason 7, which might have something to do with it, but I think
these guys just adopt a standard procedure and stick to it for a while.
 Some change quickly and others are more conservative and want to see
more data.

I think Walsh would recommend once a year, but if you have any doubts,
call your urologist and ask him.

I wonder if anyone knows the real answer to this question.

In theory, I would think the answer would depend on
whether early intervention after PSA failure provides
more chance for a cure, or at least for a longer life.

Clearly, in the early stages after RP, many failures
are caused by metastases in the immediate region of
the prostate bed, where salvage radiation can reach
and possibly cure them.  Rates of cure with salvage
radiation are shown to be directly proportional to how
quickly it is applied - though obviously if the metastases
are distant it doesn't matter how soon you radiate -
you can't reach the cancer.

Some doctors argue that hormone therapy too is more
effective if begun immediately after PSA failure.  Some
disagree.  I don't know if there is a consensus among
the experts on that yet.

Finally, I don't know whether the options for salvage
radiation are still viable in the case of PSA failure two
or more years after treatment.  If so, then early
detection would seem to be desirable.

The only possible arguments I can think of for not
doing frequent PSA tests are:

1. It doesn't matter - but see above.  We don't know
that it doesn't matter.

2. There is extra cost.  But that seems penny wise and
pound foolish to me.  The cost of the test is low.

3. The psychological burden for some men may be
increased by frequent testing.  But on the other hand
it may be reduced in other men.

So to my mind it all boils down to one issue: Can early
detection of PSA failure lead to a better chance of curing
the cancer or at least of prolonging life?

If the answer is "Yes" (and I don't know if it is) then I
would think that once per year isn't ideal.  If the answer
is "We don't know", then it seems like more than once
per year is a more conservative strategy than once per
year.

   Alan

I suspect your GP is ill-equipped to have an opinion post-PCa and post-RP.

My uro's plans, as laid out before my RP, was quarterly for two years then
semiannually for a couple of years, then annual.