I am somewhat confused as when to take action when on ADT vacation. To set the stage, I am on Lupron and Keytruda and psa has been undetectable for 17 months. Initial scans showed lymph nodes and bladder neck invaded with pc two months after prostatectomy done two years ago. Gleason score of 10.
I plan to have my last Lupron shot next week (completes two year treatment), but Keytruda to continue till April, 2022. First of all, after treatment stops, how often should I get psa checked? Three months seems like a long time with Gleason score of 10. Also, should I be getting the super sensitive psa test which I assume goes to three decimal points? Based on some previous posts, it seems that no action is warranted until psa rises to a certain point (0.2). Is that correct or is the rate of rise also relevant? Although there will be not be an absolute correct answer, how much of a gamble is it for me to take an ADT vacation? By then, I should have (hopefully) psa undetectable for 22 months.