PSA Testing Frequency Post Treatment and Anxiety

This subject has been covered a number of times but it seems that some change has been occurring. When I had surgery in 2018, the urologist group had a standard post-op schedule that stated 3 month PSA testing for 2 years, 6 month PSA testing for next 3 years, annual testing after 5 years. Testing was typically done with the < 0.10 testing sensitivity which was common at Mayo and others around here.

I had my 4 year annual visit a few months ago and my Uro said I could go to annual PSA testing if I wanted and no need to see him anymore unless I had issues which surprised me a little. A person I know had surgery at Mayo (Rochester MN) last year. Their current care plan is for testing every 6 months in second year and annually in year 3 and after.

I have had discussions with my Uro in the past regarding test sensitivity and testing schedule and the one thing in common is his concern over patient anxiety. This is what I have heard from some that went to Mayo as well.

Being a member of HW and conversing with a few people locally who have had PCa after me, it is clear that anxiety is a big problem. I have witnessed the extremes here from those with a very casual attitude about everything to those who obsess about all things real and imaginary with the PCa.

My question - Are urologists and RO's (MO's are typically a different situation) tending to more concerned about patient anxiety with their followup testing recommendations or is there some new study that says it is a waste of time and money post-treatment at previous levels that they are following? or something else?

A fewwwww years ago, my Cardio, URO and Dermatologist all wanted to see me twice a year.... Even my darn dentist said I needed to have my teeth cleaned FOUR times a year.... I talked to all of them and they all agreed we could slow it down.

I was seeing my URO so much due to taking T Meds... But we worked out that on the first blood draw I won't see him unless the test indicated that I needed to see him.

lapilot - Your situation is what I am talking about. I recall you having surgery and radiation, correct? What would be the point of ultra sensitive testing every 6 months other than to keep you guessing? Will it change your treatment plan and potential success if your PSA rises?

What I noted is that doctors are seeming to release surgery patients from PSA testing at short intervals sooner. My guess is that they are concerned about the anxiety it causes for little gain for many patients. I was a G9 when the smoke cleared with a small positive margin which should be pretty high risk (had ART) yet my urologist said I could go on annual testing if I wanted. Others I noted have seen some relaxation as well.

One fellow told me that his doctor suggested initial 4 month testing which seem so obvious to me as what is the real difference, nothing. Yet you save one testing moment of anxiety per year. Going to 6 month testing was a huge benefit, now annually is the next jump that I am thinking about. I wait a year, get tested, if there is a problem, get told I have to wait until my PSA is higher to run scans? Just thinking out loud but constant testing after a point seems to provide little value.

I had surgery in 2015 and yes, it was every 3 months for 2 years, then the plan was at the two year mark i would go to every 6 months. However at the 2 year mark, i lost the < sign. So back to every 3 months.

Subsequently a year later, i had radiation, and i was asked to test every 3 months for a year, then every 6 months after that. After 2 years post radiation/SRT i was told i could go to 1 year testing but it was up to me, and decided not to do that, after the last test, in May, i decided to go to every 9 monhts.

The doctors never mentioned anxiety as an issue, although it was pretty apparent that i was quite anxious (and still am, its ust how i am built). Not sure that this adds to the conversation, Mumbo, but figured I'd share my experience