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Intermittent androgen suppression
In this approach, androgen blockade is achieved chemically (using an LH-RH analog or gonadotropin-releasing hormone antagonist alone or in combination with an antiandrogen) until PSA levels fall to the castrate range. Treatment is then discontinued until PSA begins to climb again. The rationale for this approach is the belief that hormone therapy encourages the growth of androgen-insensitive cancer cells (the cells that cause the tumor to grow despite hormone therapy). Some doctors believe that cycling therapy on and off may delay the emergence of these deadly cells. In addition, intermittent androgen suppression is associated with fewer side effects, since men discontinue therapy for periods of time.
More studies are needed to determine whether intermittent androgen suppression is as effective at slowing disease progression as continuous androgen support. But many oncologists use this approach routinely.
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