The studies I've seen are a little more nuanced: it's not that prolonged ADT promotes castrate resistance, but that overall mortality can fall with ADT holidays for earlier-stage cancers, because the risk from side-effects like heart disease and diabetes are reduced.

Unfortunately, they have not found that (yet) for stage 4. Our life expectancy used to be in the low single digits (there's a good chance I'd have been dead by now); things are much better with new treatments over the past few years, but our bodies are *not* evolving any "natural resistance" to prostate cancer at stage 4. We just have to keep hitting it hard and knocking it back. ARSIs like the -lutamides are massively extending the period of castrate-sensitivity for many of us now in the 2020s, so it's no longer the old story of just ADT, either — any data collected more than a few years ago is seriously out of date

One also needs to consider age and general health — if you're very old and/or very sick, then yes, the side effects from ADT might be more dangerous to you than the cancer itself.