6 months or 1 year

In November 2020, urologist recommended 1 year appointment and PSA test. I agreed to the 1 year appointment but asked that we test PSA at 6 months. Tested today .02

At what point do I test PSA once a year?

I was surgery guy, but our bottom lines may be the same. I was G9 (4+5) after my RP, but with an otherwise excellent outcome, with no adverse features and a low PSA on an ultrasensitive test.

After 2 years of 3-month testing, my uro said he was OK with going to 6-month testing, but I should pick an interval that made me comfortable: 3, 4, or 6 months. I chose 4 months, planning to do a year of 4-month testing and then go to 6. (For my case my uro does not want anything greater than 6 months).

After one test at 4 months, Covid pushed the next to 6-months, which came back fine, so we kept it at 6. However, after a slightly elevated reading, my uro (and I) wanted the following test (my last) at 3 months, when my PSA came down. My next will be at 3 months again. I'll probably do 3-months another few times, and if all is good, go back to 6.

I suggest you choose a testing interval that is (1) no greater than what your uro recommends, but also (2) frequent enough to make you comfortable. Of course you can always increase the frequency if your PSA looks like it's climbing, as we did. Your uro is in charge of making sure the interval he/she suggests is short enough that any unexpected PSA increase will still give you plenty of lead time to monitor before any salvage treatment is needed.

Some men suffer anxiety at testing time and like the minimum recommended; some become anxious if they go too long without a test. For RT guys calculating lead time until any treatment would be needed, I would take into account that BCR is usually defined as 2.0 over your PSA nadir. This is quite different than the post-op dynamics and guidelines for RP guys.

Djin

Hi Manfred. My RO will keep me at 6 month intervals until, i believe he said, 5 years. My Radiation was salvage, i believe yours was primary treatment from looking back at your past posts (would be great if you could put in a signature).
I would think 5 years staying at nadir would be good enough, but as Djin said, how comfortable you are plays into it as well. I'm not sure what i will do if i get to 5 years with undetectable.

For me, life in 3 month increments for the rest of my life. 😉

"At what point do I test PSA once a year?"

it's your call

After RALP I did every 3 months for the first year. With an undetectable PSA I went to annual for the next 2 years. After that, and this was recently, my uro said "Good luck" and told me to just have my regular doctor check the PSA during my annual physical.