I've seen occasional references in some studies that suggest while intermittent ADT is ok for intermediate risk, that the G9 cases may warrant continuous. They may be the only ones that do. Unfortunately, the studies rarely include enough G9 cases to draw statistical conclusions. We all hate ADT. Some hate ADT so much they'd rather give up treatment, live a better quality of life and give up some potential length of life.
Some studies leaned on doubling rate to suggest continuous would be better. Short doubling times (like 6 months or less) in recurrence suggest rapid advancement to a serious outcome.
I've considered it. However, I also lived 3 years on ADT2 already. If my case begins advancing, I'm planning on early initiation and continuous treatment. My personality wouldn't let me sleep if I tried the intermittent approach. I didn't have any joint pain, and that sounds like it would be very unpleasant. Hot flashes for sure, though Megace helped. Have you tried estrogen patches for it (with tamoxifen to protect against gynecomastia)? Those help some people. Fatigue was tough, very tough to fight, but some light exercise and daily half-hour naps helped a lot.
The no sex part is rough on guys. In my case, my post-menopausal wife has zero interest anyway, so for me it was kind of a relief. Couldn't do it, but didn't want to so it didn't matter.
A 5+4 case is almost as serious as it gets. With nodes already positive? I personally wouldn't even consider intermittent ADT. But that's just my perspective, worth what you paid for it....
