I did 18 months, the attached chart shows my clinical history. The side affects were mild fatigue, hot flashes, muscle and joint stiffness and genitalia shrinkage. I did not lose my libido. Throughout those 18 months I maintained my "normal" life, exercised, travelled, worked in the garden, walked my dog....I did keep an eye on my weight which rose about 10 pounds despite watching my diet.

There are various studies you can look for, some will say six months when you are ding it in conjunction with SRT, others will say 18 months is just as effective as 24-36. There is intermittent ADT and of course, "lifetime" ADT or at least until you become castrate resistant...

If you decide to stop AFT, consider basing it on response to treatment, as an example, in my case, PSA had dropped to undetectable and stayed there for the 18 months, then, if you do sop, have a plan to actively monitor your PCa and decision criteria about if and when to go back on treatment based on imaging, labs such as PSA which could provide doubling and velocity ties, any other clinical data such as cardiovascular health. I see my urologist every 2-4 months for labs and a quick consult.

You will find a wide variety of decision "triggers" for resuming treatment. Some will say when PSA hits 4, I've seen 10. As always the questions is, if advanced PCa is not curable, what do I gain if I start treatment back up "early? Does it increase my overall survival...again, you'll find studies all over the map. For me, I would want hard clinical data, imaging when PSA hits .5 to 1.0, labs spaced 2-3 months apart showing PSADT and PSAV, then treatment for a specified period, if the results are "favorable," go back off treatment and actively monitor, repeat.

One has to balance quality of life versus quantity, how one reacts to treatment (some experience horrendous SEs from ADT to include depression), the financial toxicity, life expectancy...It may be that we are entering a phase where we can "live" with PCa, like people who have AIDS and Diabetes then die from something else...That decision is yours as to treatment, what, when, for how long.

I chose to be aggressive in the face of aggressive clinical history and data, it has worked, almost four years of no treatment. I am not saying that I'm cured but the time off treatment has been great!

There is no one "right" decision. We must each make our own based on our specific clinical history and personal preferences.