In a recently published commentary about the optimal type of multi-modal hormone therapy for Gleason grade 4 and 5 prostate cancer the author addressed the discordance between results of several randomized trials evaluating survival benefit of continuous androgen deprivation therapy in men with high-risk disease.

The study found that after combining data from multiple trials, it was suggested that long-term vs short-term androgen deprivation therapy in prostate cancer may be most effective in men with Gleason grade 4 and less effective in men with Gleason grade 5 disease, dspite their cancer being more aggressive.

This is a little surprising, but it should be considered if you do have a Gleason grade 5 prostate cancer. Since long-term androgen deprivation has more toxicity than short-term therapy and you might not experience any survival benefit you might want to consider only short-term androgen therapy.