@chippydoo "You can always go back on if numbers start climbing."

Very true. The risk is that the any cancer that was castrate-sensitive comes back as castrate-resistant after the pause, as it learns to grow in the partial-T environment while your testosterone slowly returns. That's why these studies and trials exist, trying to balance the risk of that vs the risk of the side-effects.

But agreed with your main point: if the cancer hasn't metastasised yet, studies and trials have shown that the benefits of ADT pauses/holidays outweigh the risks (obviously that risk assessment could change for individuals, e.g. with genetic predispositions or NEPC).