There are two types of endocrine treatment for prostate cancer, surgical removal of the testicles and medication. Surgical removal actually has few physiological side effects, the more common ones are some inflammation, which is not serious; however, psychological trauma is the most important side effect after surgery. Every patient knows what testicular removal means, they completely lose their sexual function, and the empty feeling down there after removal will further strengthen the patient’s psychological discomfort. Therefore, it is still recommended that patients use medication to block androgens to have a better quality of life. There are two types of androgen-blocking drugs: one is injectable depot drugs, which prevent the testes from synthesizing androgens; the other is oral anti-androgen drugs, which act to form a barrier between the androgens produced by the adrenal glands or other sources and the tumor, so that the tumor does not get androgens. The combination of these two methods not only inhibits the synthesis of androgens, but also prevents the “leaky” androgens from taking effect, i.e., maximum androgen blockade therapy, which is arguably the most powerful endocrine therapy. Drug blockade of androgens has a significant impact on the sexual function of patients, especially in combination with oral anti-androgen therapy, where androgens are significantly reduced and erectile dysfunction can be more severe. In response to this situation, it has also been noted in the literature that erectile function may be restored to some degree in younger patients if the oral anti-androgen medication is increased to three times the amount. The reason for this is that these drugs simply do not allow the androgens in the body to bind to the prostate tumor, while they can still stimulate the testes and thus maintain sexual function. With this type of treatment, the PSA does not rise. Drug injections are done every four weeks, subcutaneously, either on the upper arm or on the belly, in most cases just at a community hospital, and there is rarely any discomfort after the injection. Compared to surgical removal of the testicles, the cost of drug injections is higher, ranging from 1,000-2,000 yuan per month depending on the choice of drugs; the mechanism of action of depot drugs produced by different manufacturers is similar. One week after the drug is used, half of the PSA in the patient’s body will be metabolized. Generally speaking, in four to five weeks, PSA will be undetectable, so the first review is in about one month, and the next check will be once a month, and if PSA drops below the normal value, it can be changed to one check in three months. It should be added that the PSA test and the depot medication injection can be done on the same day, and they do not interfere with each other. If PSA is found to rise gradually, it means that the tumor may be resistant to endocrine therapy, but it is especially important to note that the depot medication cannot be stopped at this time, and the injection must be continued. If the medication is stopped, androgens will rise significantly and PSA will increase faster; however, at this time, oral anti-androgen medication is no longer effective and can be stopped. Note: PSA units in this article are all ng/ml