@jeffmarc

Thanks, Jeff.

What if we repeat the combination for 2 or 3 months? And add an additional variation.

Look at this

Cycle 1

2 months - ADT only (decrease testosterone)
2 months - ADT + lutamide (decrease testosterone and reduce "ignition")
3 months - lutamide only (reduce "ignition" increase testosterone)
1 month - no ADT no lutamide ( "let cancer think that wall is no exist ")

Cycle 2

2 months - ADT + lutamide (decrease testosterone and reduce "ignition")
3 months - ADT only (decrease testosterone)
1 month - no ADT no lutamide ( "let cancer think is wall no exist ")
1 month - no ADT no lutamide ( "let cancer think that wall is no exist ") 2 months - lutamide only (reduce "ignition" increase testosterone)

Cycle 3

2 months - ADT + lutamide (decrease testosterone)
1 month - no ADT no lutamide ( "let cancer think that wall is no exist ")
2 months - lutamide only (reduce "ignition" increase testosterone)
3 months - ADT only (decrease testosterone)
....

Cycle 4 (New combination)

Each line can be linked to a PSA increase. As I already mentioned, if the increase is small, the lines are swapped; if the increase is significant, we increase "protection" by using both components over a longer period.

In other words, combinations should not be repeated.

You can consider varying the duration (2-3 months) depending on the Gleason level and PSA increase, and try to find a correlation. It's clear it will be nonlinear. For example, for those with a high Gleason level, they should not go without a moderate level of protection for 3 months (level = duration and combination of ADT and lutamide).