How to choose between intermittent endocrine therapy and continuous endocrine therapy?

  There is an ongoing debate, both internationally and nationally, about the advantages and disadvantages of intermittent versus continuous endocrine therapy.  Proponents of intermittent endocrine therapy argue that evidence in animal models suggests that cyclic changes in androgen levels in prostate cancer patients can prolong disease progression to androgen-refractory prostate cancer, and that intermittent therapy can significantly reduce the cost of treatment for patients and can result in fewer side effects from ADT.  Proponents of continuous endocrine therapy argue that there is no evidence in human trials that cyclic changes in androgen levels in prostate cancer patients can prolong disease progression to androgen-refractory prostate cancer, and that intermittent treatment processes have the potential to lead to tumor progression or increased resistance to drugs.  Therefore, the choice of treatment should be made with reference to the patient’s individual reality and responsiveness to medications. It is generally believed that intermittent endocrine therapy is more suitable for those with limited lesions and local recurrence after treatment.