@quaddick Big grey zone for me too. I will add that a major health priority for me is avoiding anything that increases the risk of cognitive decline (i.e, dementia and Alzheimer’s). A few recent studies have shown an association between ADT and increased risk of cognitive decline (one abstract attached). Given that adding ADT to my RT seemed marginally beneficial based on all my readings, the risks outweighed the benefits in my final analysis. Again, someone may have decided differently based on their risk tolerance and life/health priorities. Tough decisions with no one-size-fits-all answers, that is for sure.