I discussed an ADT/ARSI break with my new radiation oncologist at my last appointment, but given that my PSA is still undetectable after almost three years (stage 4b oligometastatic), I decided not to mess with what's working; my concern is that if I took an ADT holiday, any dormant cancer cells hiding in my bones might come back castrate-resistant.

It's a tough decision (either way), and I wish you luck. Research so far — which is sparse — shows a slight increase in overall survival from ADT holidays for earlier-stage PCa, but not (yet) for advanced stages, so we're the guinea pigs. We have to keep in mind that ADT also comes with an elevated risk of heart disease and other issues, so it's not about the PCa alone.