Exercise seems to be a tremendous help in getting through ADT. I started relugolix about 4 weeks before SBRT and am ending it after 6 months. During the 6 months I kept up my exercise routine - walking several miles 4-5 times a week, some light weight work, stretching - and at 80 I felt fine once the SEs from the radiation cleared. I've had mild hot flashes which have been annoying but not an interruption to my daily routine.

I have one question about the study mentioned above about the advantage of beginning ADT when radiation starts rather than weeks before. The study is from 2020 which precedes some of the advances in radiation treatment - MRI Linac and adaptive CT monitoring. My RO and my urologist independently told me that weakening the pc prior to treatment would make the radiation more effective. That sounds like an advantage that would be lost if ADT started at the time treatment began.