Prostate cancer is closely related to male androgen level, whether it is surgery or injection depot, if androgen is lowered to depot level, it can inhibit the development of tumor, i.e. androgen blocking therapy, or become endocrine therapy. I usually ask patients to do endocrine therapy only when they have advanced cancer with metastases. For early and middle stage patients, the first choice is still radical surgery or radical radiotherapy, and now even in the case of oligometastases, such as pelvic lymph node metastases or a small amount of bone metastases, surgery can be considered to remove the primary lesion, which may be beneficial to the treatment of metastases in the next step. For patients after radical surgery, if PSA is high and does not decrease or re-elevates to above 0.2 after lowering, a comprehensive examination should be done to determine whether distant metastases or local recurrence has occurred, and local and systemic treatment should be performed according to the situation. There are two types of debulking, surgical debulking and pharmacological debulking. Surgical debulking is the removal of the testicles, which is irreversible, completely loses sexual ability, and is very psychologically devastating to the patient; therefore, more and more patients are now doing drug injection therapy, androgen levels can be restored after stopping the drug, and the testicles are still there, preserving the integrity of the organ, and the patient is more psychologically tolerant. However, depot treatment cannot eradicate the root of the disease. Generally, the effective time is 18-20 months, during which the hormone-sensitive tumor will gradually shrink and the metastases may reduce or disappear, but after this period, it is likely that the tumor will gradually lose sensitivity to the drug, PSA will rise again, and the disease will start to progress again and become depot-resistant prostate cancer. However, at this time, the drug injections do not stop and continue to be used to maintain the androgen at the destructive level. Some patients can be treated with endocrine therapy by intermittent medication, such as those with high drug side effects, while PSA is reduced to lower levels, can be temporarily discontinued. During discontinuation, the side effects caused by the drug will gradually improve, sexual function may also be restored to some extent, and the patient can get a better quality of life. However, it has also been reported in the literature that this approach does not prolong the patient’s life compared to continuous medication, so patients should weigh the pros and cons according to their situation and their doctor’s guidance. If one chooses medication depot, injections become part of the patient’s life, usually once a month – 1,300 to 1,400 yuan for domestic drugs and about 2,000 yuan for imported drugs – and the patient also has to budget financially, so it is good to know that health insurance will cover it. Since depot treatment causes a significant drop in androgens, patients are prone to secondary metabolic problems, such as calcium loss and osteoporosis, so it is more important to pay attention to daily safety by using drugs that supplement vitamin D and calcium, or drugs that repair bones such as zoledronic acid, to avoid fractures; also, to prevent drug side effects, patients should have their liver and kidney functions checked regularly.