When can I stop PSA testing?

Are you doing any other bloodwork besides PSA as part of your annual health checkup?

Since the PSA test is so easy, I'd say you should stop it when you die.

Yes....All the other "normal" - "regular" things that are included in an annual exam.

You need to do more than consider when to stop testing? Your PSA has risen a lot, To the point that you really need to get it checked. You could actually have a PSE test done, It would tell whether or not there is cancer in your body and whether or not you need to do a biopsy.

You should see a urologist about the PSA.

I’m 77 and I’m only this old because I had treatment and took the drugs when I needed to. You’re definitely not too old.

That's a good question. Why are you thinking of stopping? Do you feel that you're at an age where you wouldn't want to treat prostate cancer if it were discovered, or do you have other concerns?

Then, continuing to include PSA testing with all your other bloodwork doesn’t cost you anything. I would keep doing it.

Consider that at 75y, your PSA isn’t high (just elevated). The Mayo Clinic recommends using age-based PSA reference ranges for PSA screening. Generally, the upper limit for PSA increases with age:
40-49 years: 2.5 ng/mL
50-59 years: 3.5 ng/mL
60-69 years: 4.5 ng/mL
70-79 years: 6.5 ng/mL

If you’re concerned about the rate of increase of your PSA, you should consider taking a look at your:
> PSA Doubling Time
> PSA Density
> % Free PSA

Also, consider other biomarker (genomic) and genetic (germline) test results.

If you’re still concerned, consider getting an MRI and see where that takes you. With all that information, you’ll have enough information to decide what to do next.

Many thanks!

Just wondering if it's "necessary" to continue considering my age and slightly elevated score of 5.1. Would it be appropriate just to undergo a biopsy now and see what the results are or should I wait to see if there is a future increase in PSA?

“Necessary” is a word-and-a-half. It’s always hard to say what’s “necessary.” The question is “What do the data indicate is appropriate to do?”

If it were me with these concerns, before jumping directly to a biopsy, (besides doing those other tests that I mentioned earlier) I would first request a 3T MRI of my prostate. Then, if the results of the MRI showed something suspicious, only then would I go to that next step of a tissue biopsy. Then, from there do whatever the data show is appropriate.

My oldest brother is going through that right now. At 78y, he had an elevated PSA (5.1, 5.5, 5.7) with no apparent reason for those increases. His 3T MRI showed two PIRADS 4 lesions; his biopsy showed those to be 3+3=6 and 4+3=7, respectively. He’s now getting more tests (PSMA PET, genetic, genomic, etc), getting referrals to specialists, and collecting more information so that he can eventually make a decision on treatment or watchful waiting.

Ultimately, it will be his call, just like yours will be your call once you have full information on your status.

I agree with @jeffmarc, Get the PSE test as part of your next blood test. It will show you whether you are less likely or more likely to have prostate cancer. Then decide on a biopsy.

I also agree with the others, keep testing as part of your normal blood panel.