Intermittent hormone therapy

Updated: Apr 16

also called intermittent Androgen Deprivation Therapy

also called intermittent ADT


Definition

Taking breaks in hormone therapy

Alternative

Continuous hormone therapy


Summary

It was hoped intermittent hormone therapy would make you last longer.

  • It doesn't.

It was hoped intermittent hormone therapy would be better for your bones, for the glands that produce hormones to regulate your metabolism, to help with your thinking.

  • It doesn't.

It does

  • produce more thrombotic events (blood clots that can move to the brain or lungs).

  • produce more ischemic events (slowing of blood flow, worst if it slows blood flow to the heart).

Despite these risks, if your side effects from continuous hormone therapy are too bad, your doctor may recommend, or you may elect to take, intermittent hormone therapy.


The study that showed that intermittent hormone therapy was no better than continuous hormone therapy


Hussain, M., Tangen, C. M., Berry, D. L., Higano, C. S., Crawford, E. D., Liu, G., Wilding, G., Prescott, S., Kanaga Sundaram, S., Small, E. J., Dawson, N. A., Donnelly, B. J., Venner, P. M., Vaishampayan, U. N., Schellhammer, P. F., Quinn, D. I., Raghavan, D., Ely, B., Moinpour, C. M., Vogelzang, N. J., … Thompson, I. M., Jr (2013). Intermittent versus continuous androgen deprivation in prostate cancer. The New England journal of medicine, 368(14), 1314–1325. https://doi.org/10.1056/NEJMoa1212299 

[There were not enough advanced men in the study to determine that continuous was definitely better than intermittent for advanced men. But, in this group of advanced men, those on continuous hormone therapy lived an average of 14 months longer than those on intermittent hormone therapy.]


The study that identified the problems that intermittent hormone therapy added


Conclusion

Contrary to our hypothesis that intermittent ADT would reduce long-term health-related events compared with continuous ADT, we found that older men assigned to intermittent ADT had no apparent reduction in bone, endocrine, or cognitive events and an increased incidence of ischemic and thrombotic events.


Hershman, D. L., Unger, J. M., Wright, J. D., Ramsey, S., Till, C., Tangen, C. M., Barlow, W. E., Blanke, C., Thompson, I. M., & Hussain, M. (2016). Adverse Health Events Following Intermittent and Continuous Androgen Deprivation in Patients With Metastatic Prostate Cancer. JAMA oncology, 2(4), 453–461. https://doi.org/10.1001/jamaoncol.2015.4655 

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