Very interesting and has a lot of data over time. In a nutshell, once your PSA is less than .2, the author says you can try intermittent ADT, but only if you have no metastases.
You can do this cycle several times, but some cases become castrate resistant because of IADT so there is that risk.
I guess you would have to go off ADT and then see how long it takes for your PSA to rise. Rise to WHAT is the real issue. The author mentions a PSA of 3 (as opposed to the original level of 6) but I would personally be freaked out if my PSA went from .2 to 3 in less than 18 months. Don’t even ask me where I got that number - it just seems like a reasonable amount of time to watch your PSA go up by an order of FIFTEEN times from its lowest value before you go back on ADT. That scenario would not bode well for future cycling. However, if it took 5 YEARS to reach 3, that would indicate a fairly low aggressive PCa cell and a more favorable environment to repeat the cycle. It’s a process, that’s for sure….Just my two cents!