Prostate cancer has become one of the common diseases among elderly men in China, and many patients have already developed systemic metastases when diagnosed, which is what we often call advanced tumors. Endocrine therapy is preferred for advanced prostate cancer, because the development and progression of prostate cancer depends on androgens. Surgery or drugs to bring down the level of androgens in the body to the bottom, so as to inhibit prostate cancer, is called androgen deprivation therapy, also known as depot treatment. Endocrine therapy also includes anti-androgen therapy, in which drugs are used to block the binding of androgens to the targets of tumor cells for therapeutic effect. There are some drawbacks to endocrine therapy. Prolonged androgen troughing can have adverse systemic effects, including weakness, sexual dysfunction, cognitive impairment, osteoporosis and elevated blood sugar. Even so, there is a more serious problem to face with endocrine, and that is drug resistance, also known as depot resistance. As you are familiar with, bacteria can become resistant to antibiotic treatment, and the choice of resistant antibiotics is usually not effective. The same is true for tumors, which can become resistant to chemotherapy drugs and other treatment drugs after a period of treatment. This is when adjustments to the drugs and treatment regimen are usually required. Prostate cancer that is resistant to depot treatment enters a so-called depot resistance stage, which makes subsequent treatment more difficult. How to restore or prolong the sensitivity of prostate cancer to androgens, so that denervation therapy continues to be effective, is one direction of treatment for advanced prostate cancer. In recent years, it has been found that after androgens have hit rock bottom in advanced prostate cancer patients treated with depot treatment, androgen can be restored in some prostate cancer patients by cyclically increasing androgens to more than physiological levels – reaching peak androgens – which can restore the sensitivity to androgens and inhibit tumor progression in some patients. At the same time, due to elevated androgen levels, it can restore the patient’s vitality and reduce the side effects associated with low androgen levels. However, the mechanism of action of this approach is not yet clear, and which patients are suitable for this androgen valley-peak bipolar modulation therapy needs to be further clarified.