Intermittent Androgen Deprivation Therapy for Metastatic Prostate Cancer?

Androgen deprivation therapy (ADT) for initial management of patients with metastatic prostate cancer has been the standard of care for more than 70 years. The dramatic rise in patients diagnosed with prostate cancer, following the advent of prostate-specific antigen (PSA) testing in the late 1980s, increased the ranks of those who underwent prostate surgery and radiotherapy and those who were ultimately found to have biochemical PSA failure. Many patients subsequently received ADT, often in the nonmetastatic setting, and were exposed to prolonged testosterone suppression, which unmasked such issues as increased risks for osteoporosis and metabolic syndrome. Thus, the intermittent use of ADT, to allow recovery of sexual function and to decr…