The Journal of Clinical Oncology, published an article by Niraula et al. that searched the general literature published through August 2012. They searched MEDLINE, EMBASE, the Cochrane Library, as well as most major conference proceedings. Their criteria for inclusion included randomized, controlled trials of intermittent hormone therapy (IADT) as compared to continuous hormone therapy (CADT) that reported either overall survival (OS) or biochemical/radiologic time to disease progression.

They found that:
1- There was no difference between the two groups for the time to event occurrence.
2- Men on IADT had a better profile with their sexual function, physical activity, and general well being.
3- IADT provided a cost savings of an estimated 48 percent.

They concluded that, “There is fair evidence to recommend use of

[intermittent] instead of [continuous androgen deprivation] for the treatment of men with relapsing, locally advanced, or metastatic prostate cancer who achieve a good initial response to androgen deprivation.”

The authors did say that IADT is recommendable for men “who achieve a good initial response to androgen deprivation.” They did not define what they meant by a good initial response. Clearly, a serious conversation with your doctor about this issue should be a priority prior to your deciding that IADT is appropriate for you.

Joel T Nowak, M.A., M.S.W.