@pesquallie wrote ❝I especially liked your comment that "studies have shown that the increase in all causes of death from the ADT side effects out weights any population benefit from decreased prostate cancer death." Doctors seem to want these studies to remain a secret because ADT shots are about all they have to offer you once surgery or radiation are finished.❞

There's no secret — note that @jim18 wrote "_more_ ADT". Doctors base the length of ADT on just those studies. That's why they might recommend (e.g.) only 6 months ADT after surgery for for someone with early-stage prostate cancer and no extra risk factors, because that's a length of treatment where the studies still show overall significant survival benefits for a patient in that specific situation.

For people with high-risk but still localised cancer, studies have shown that "ADT holidays" are effective at improving overall survival: once PSA is down, pause ADT unless/until PSA rises back above a certain level. Again, this is standard of care, not a deeply-concealed secret the the oncology community doesn't want us to find out.

For advanced-stage with distant metastases, unfortunately, research so far shows that ADT holidays reduce overall survival, but there's new research to see if continuing ARSI (like a -lutamide) changes the equation (see the LIBERTAS trial currently underway, for example).