Frequency of PSA Test

@northoftheborder Same here. If ordered by my doctor, it’s covered. A couple of times I’ve ordered one myself - just out of curiosity. I started PSA testing in 2000 (at 45y/o) after reading an article (similar to this 1992 article) a few years earlier.

What often happens here is that doctors won’t order a test unless you ask for it. That’s it! All a guy has to do is to ask for it.

I’ve asked my wife about mammograms - do they make you have one? She said no; they bring it up, but it’s totally up to her whether or not to have one. Similar with pelvic exams - do they make you have one? She said no; they bring it up, but it’s totally up to her whether or not to have one. But, women know about them (and the value), so they get them done.

On the other hand, I’ve heard guys (even some mention on this forum) say they never heard about prostate cancer or PSA tests until they started having issues. That seems impossible to believe.

Recently, I was curious as to how many celebrities and other notable figures (athletes, actors, politicians, business leaders, and others in the spotlight) over the past few decades have been in the news with a diagnosis (or death) from prostate cancer. After less than an hour of searching, this was the list I amassed: Al Roker, Andre Dawson, Andre Patterson, Andrew Lloyd Webber, Andy Grove, Andy Taylor, Arnold Palmer, Ben Stiller, Bill Bixby, Bjorn Borg, Bob Casey, Bob Dole, Brooks Robinson, Cal Ripken, Carlton Fisk, Charlton Heston, Chuck Tanner, Cliff Richard, Colin Egglesfield, Colin Powell, Dan Fogelberg, Darwin Deason, Davey Lopes, David Koch, Dennis Hopper, Derrick Hall, Dexter Scott King, Dick Sargeant, Don Ameche, Dusty Baker, Elton John, Francois Mitterrand, Frank Zappa, Gary Cooper, Glenn Thompson, Gregg Olson, Harry Belafonte, Hugh Freeze, Ian McKellen, Jake Abraham, James Michael Tyler, James Pickens, Jr., Jay Harris, Jerry Brown, Jerry Orbach, Joe Torre, John Kerry, Johnny Ramone, Ken Griffey, Sr., Langston Hughes, Linus Pauling, Lloyd Austin, Lord Cameron, Mandy Patinkin, Michael Bennet, Michael Milken, Michael Ray Richardson, Mitt Romney, Montel Jordan, Nelson Mandela, O.J. Simpson, Phil Lesh, Phil Niekro, Ram Herrera, Rick Steves, Rob Halford, Ryne Sandberg, Rob Gardenhire, Robert DeNiro, Rod Stewart, Roger Moore, Ron Wyden, Rudy Giuliani, Ryan O’Neal, Shannon Sharpe, Sidney Poitier, Sir Chris Hoy, Sir Roger Moore, Stephen Fry, Steve Garvey, Steve Ross, Stokeley Carmichael, Telly Savalas, Terrell Williams, Thom Tillis, Tim Commerford, Timothy Leary, Ty Cobb, Warren Buffet, & William Hurt.

I’m sure there are many others. All of us have heard of many (or most) of those in that list. Despite all the media
attention given to these celebrities and their diagnoses, most men say they never even
heard about prostate cancer or PSA testing; as a result, never choose to get their PSA tested. I don’t get it.

That’s an unfortunate choice.

@kenhorse Great news! I hope to become member of your club!

I too have tests done every three months yet am still early in the cycle (2 years). The six month schedule might indicate a confidence in your oncologist that things seem to be proceeding well, as I hope they are. Best to you on your continuing journey…

There's guidelines and then there's the application of those guidelines to your particular clinical data.

If you are not comfortable with going to six months and are with three, unless your medical team has has some overwhelming argument for not doing what you are asking, they should just write the darn order!

There is always the discussion about "over testing." Again, that's a discussion with one's medical team.

At the end of the day, the question may be does extending the frequency entail any risks?

That answer may be in part the risk category, GS, GG, PSADT and PSAV, genetic testing, other tests such as decipher....

This summary, to me, says the frequency is variable..,

Key Surveillance Principles
Initial Post-Surgery:

A baseline PSA is taken soon after surgery (around 4-6 weeks) to confirm the prostate is removed, with levels ideally dropping to < 0.1 ng/mL.

First Few Years (Years 1-5): Testing typically occurs every 3-6 months, or every 6-12 months as per older guidelines, to catch early recurrence.

Long-Term: After five years with no recurrence, testing often shifts to annually or even less frequently, depending on risk factors.

Goal: The primary aim is to detect a rising PSA (biochemical recurrence) which signals potential cancer regrowth, prompting further investigation (imaging, etc.).

Factors Influencing Frequency
Risk Level:

Patients with higher-risk cancer might have more frequent monitoring.

Clinical Factors: Urinary issues, infections, or recent procedures (like catheterization) can temporarily raise PSA, requiring repeat testing later.

Age & Health: Guidelines consider a patient's overall health and life expectancy, with observation for those with shorter life expectancies.

In essence, PSA testing post-surgery is a crucial part of NCCN's surveillance strategy, becoming less frequent over time if PSA remains stable and undetectable, but intensifying if it begins to rise, says the Prostate Cancer Foundation and the NIH.

Kevin

5 years?
Insufficient (to me) 6-monthly tests for 5 years?
Bugger that. I'm gonna ask for a PSA at the same time as my usual tests for cholesterol, lipids & pregnancy.

I had a prostectomy in March 2020. Psa hit .2 in
MAr. 2025. Began 6 months of ADT ( Orgovyx) in April. 5 weeks of radiation in June/July. PSA was undetectable in OCt. Just had a 3 month follow up Friday. PSA was undetectable. Testosterone was normal. The next one is scheduled in 6 months. The rationale is that since my testosterone was back and the PSA was undetectable , that is a good indicator that the radiation was effective. That was welcome news.

My surgeon said at the five year mark your odds of recurrence go down significantly and at ten years recurrence is doubtful. My scores were similar to yours. I have had undetectable< 0.01 for two years, with tests every 3 months. He wanted me to switch to every year but I requested 6 months. My next test is April. As with all prostate cancer patients, there still is not “a one size fits all” treatment. Regardless, let’s hope whatever treatment is suggested works! 🤞🙏. Best wishes.

I would go out to 6 mos. or yearly at your point. I just did my 3 month after finishing radiation 10 months ago and it was < 0.1 so ditched my appointment and reset myself it for 6 months from now. This cancer doesn't bloom overnight. Gleason 9 grade 5 diagnosis. My private practice over treats whenever they can so they can bill. Blood test followed by a $400 5 minute appointment is a ripoff. I will mostly live my life rent free of prostate cancer for the next 5 months and 3 weeks.

Hey @brianjarvis ! Hope you are healthy and well (as I do for everyone on this forum). My initial reaction regarding your list of celebrities was along the lines of "This should be a web page/reference, maybe I'll do that." But in fact that already exists on Wikipedia:
https://en.wikipedia.org/wiki/List_of_people_with_prostate_cancer
I don't actually have the time to check your list against Wikipedia, but anyone can do it. That's the whole concept behind Wikipedia. This group should make sure it's up to date imo, including Scott Adams.

@smoore4 Wish I had seen that; would’ve saved me time starting and updating the list.

Even more, it really minimizes the excuse “I never heard about PSA/prostate cancer.”