Frequency of PSA tests after RALP

I don't know what's medically indicated, but there's no real downside to more-frequent testing (except your extra travel time back-and-forth to the clinic), so it's OK to ask to stay on the 3-month interval for a while if it would make you more comfortable.

I agree with @northoftheborder that more frequent testing than the guidelines really comes down to what makes you the most comfortable. For 20 years before my PC diagnosis I maintained the annual psa testing back when it wasn't generally recommended. I did that primarily due to a bad family history with prostate/breast cancer. Since my RP in June 2024, I've also been undetectable. Emotionally, I was comfortable with switching to every 6 months psa testing at 1 year (as recommended by my care team at a CCOE). But if I wasn't comfortable with that interval, I wouldn't hesitate to stay on a more frequent schedule. Whatever gives you the most peace of mind is, in my humble opinion, probably the best answer. In this context I think the only "wrong" decision would be if someone neglected to get the recommended periodic psa testing after RP. Of course, that isn't what you asked about but I thought I'd mention it so no other reader misunderstands my comment. Best wishes.

Yesterday had my first PSA post-op (undetectable - yipee!!) and they said every 3 months for the first year and then less frequently after that (assuming I remain undetectable). This was at Mayo Jax. So consistent with what you were told.

Every three months may be just fine, but it depends on what your initial diagnosis was. If you had aggressive issues in your biopsy Following the prostatectomy, then you may want to have three month tests for a longer period of time.

In my case, my cancer came back 3 1/2 years after the prostatectomy. I got three months test for the first year and six month test after that, but I was a Gleason seven which is less aggressive. If I were a Gleason eight or Gleason nine I would want to have PSA tests at three months for a longer period of time.

Typical is every 3 months for first 1-2 years; than every 6 months for the next 3-4 years; than annual; if there is a BCR than it resets after the new treatment. Can always have more.

Yes, after one year my RO at Sloan did the same thing.
Phil

Post-RP PSA testing is every three months for the first year. If the PSA is, and remains, undetectable that first year, then standard protocol seems to be test every six months until if there is a detected increase. When that happens, I assume testing reverts to every three months while you are monitored, to perhaps include starting radiation therapy if that is what your urologist decided you need. There is nothing wrong with testing every three months, but you need two things: 1) Urologist willing to do it because they find it valuable, if not for themselves, for your peace of mind; 2) Your insurance company's willingness to pay for the two extra tests per year. I imagine that some men will read this and offer their experiences with their insurance company easily approving it, or hassling them and denying it.
Something to consider too: If your surgical pathology report revealed "Extraprostatic Extension" (EPE) of the tumor, to perhaps also include "Surgical margins" (cancerous tissue left behind in your body), and spread of the cancer to one or both seminal vesicles, your doctor will likely be more willing to write the order for the extra PSA testing, and your insurance company will likely be more willing to approve it, since all of those features indicate a 25-50% chance of the cancer recurring "within" the first five years post-op.
Good luck to you.

@rlpostrp If more PSA tests are desired get self-ordered tests. DrSays.com is the lowest cost I have found ($61 for LabCorp ultrasensitive PSA for RP; $20 for std PSA if radiation or AS). All cash pay. Many others out there for a few dollars more and most are less than LabCorp or Quest direct. Do not let your insurance or doctor dictate your health care. To date my GP has ordered and insurance has paid (less than above with their discount) but these sites are my backup.

If are intermediate risk your post RARP pathology did not show any adverse features, I believe it is standard to move to every six months after the first year. But as has been said, you may just want to continue every three months for another year or so to be on the safe side.

I just had this exact discussion with my Cleveland Clinic urologist yesterday having now gone one year undetectable after RARP. When the urologist advised that future testing would be extended to six-month intervals, I gently pushed back noting my high pre-surgical Decipher and family history. The urologist then noted that with very encouraging post-surgical pathology, going to six months was appropriate. Am still processing but will probably go with the push to six months. Continuing with three month testing for those with post-surgical biopsy concerns as others have suggested certainly makes sense.