@geneva26 So you are going for the 1% risk with ADT. The length of ADT with the NCCN 2026 guidelines depends on the severity indicated by Gleason scores (and a few other factors such as cribriform detected, ECE, etc.). A standard 3+4 is usually 0-6 months of ADT; 4+3 at 6-12 months; and 4+4 local is where you get more than a year. Discuss this with your doctor and go for a second opinion if necessary. The length of ADT has been lowered in recent revisions of the guidelines.

Longer is better for prostate cancer control but may not be better for you factoring in lifestyle impacts and other health risks from ADT. I do not know what side effects, relationship issues, health changes (bone loss, heart etc.) are impacting your life from the ADT and neither does your doctor. What is the sense of a little better control of prostate cancer if it wrecks your life.