For intermediate risk prostate cancer, as this interview (https://youtu.be/cyY0nHXvzGc?si=En9UL6H_Bb27FVE9) and this study they’re talking about (https://pubmed.ncbi.nlm.nih.gov/37104748/) point out, as far as overall survival (OS), the benefit of using ADT is minimal. It might lead you to believe that such a small % improvement in OS might not be worth it.

However, as the study concludes, though there was only small improvement in OS using ADT, there were improvements using ADT in metastases rates, prostate cancer deaths, and PSA failures.

So, one probably should not only weigh the risk of OS, but the risk of all adverse events against the impact of ADT on quality of life.

Also (unless I missed it), neither that interview nor the paper indicated whether by “intermediate” they meant “intermediate favorable” or “intermediate unfavorable”?

If they only meant “intermediate favorable,” ADT isn’t usually used in those cases anyway so, the study simply substantiated current practice. However, if they meant “intermediate unfavorable,” then the study conclusion may be significant.

And if the study involved a mix of intermediate favorable/unfavorable, the % mix would be of interest.

Remember too that many QoL side-effects of hormone therapy can be minimized in various ways.