TL;DR
In an October 14, 2026, MedPage Today interview, Cleveland Clinic oncologist Christopher Wee discussed balancing treatment effectiveness with quality of life for metastatic castration-sensitive prostate cancer. He described common side effects of androgen deprivation therapy and said continuous treatment remains the standard, while patients experiencing serious difficulties can discuss their options with their clinicians.
A MedPage Today interview published October 14 examined how clinicians and patients can balance treatment goals with quality of life in metastatic castration-sensitive prostate cancer. Cleveland Clinic oncologist Christopher Wee said androgen deprivation therapy (ADT) can cause a range of side effects, while emphasizing that continuous ADT remains the standard approach for metastatic disease.
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Wee told host John Mangels that many patients want to extend survival while maintaining quality of life. Treatment discussions, he said, should address both the burdens of side effects and the potential aim of delaying disease-related problems, including pain, fractures or other skeletal events. These benefits are treatment goals, not guarantees for an individual patient.
Wee said ADT contributes much of the side-effect burden in systemic treatment. Effects can include hot flashes, fatigue, muscle and bone-density loss, sexual dysfunction, mood changes and weight gain. He also cited a slight increase in heart-attack risk. Patients vary in how strongly they experience these effects, and Wee said it can be difficult to predict who will have more trouble.
The interview discussed relugolix, an oral ADT option, as an alternative to injections such as leuprolide. Wee said some patients value its relatively quick onset and offset of testosterone suppression. However, the interview did not present stopping or taking breaks from therapy as the routine approach: Wee said continuous therapy is the standard for metastatic disease, while treatment decisions should account for individual circumstances and informed patient preferences.
Balancing Cancer Control and Daily Life
ADT-related effects can shape a patient’s daily life and willingness to continue treatment. Discussing symptoms early can help patients and clinicians weigh the intended disease-control benefits against the practical and physical burdens. Wee’s remarks also emphasize that quality of life discussions need to include the risks of disease progression, not just the effects of medication.
The interview is a clinical discussion, not a new study or treatment guideline. Its relevance is practical: patients weighing therapy can use these issues to prepare questions for their oncology team. The right approach depends on the individual’s health, symptom severity and priorities; the interview does not establish that one drug or schedule is best for everyone.
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Continuous Therapy Remains the Standard
The report focuses on metastatic castration-sensitive prostate cancer, a setting in which treatment options have expanded, according to Mangels. It is the third installment in MedPage Today’s “Beyond Diagnosis” series, which explores decision-making and communication in care. The episode centers on treatment intensity, adverse effects and how to align care with a patient’s overall health and goals.
Wee said that intermittent ADT is not the preferred approach for metastatic disease. He referred to a trial comparing intermittent and continuous treatment in which researchers could not establish that intermittent therapy was non-inferior. He said this is why continuous ADT remains the standard of care. He added that a patient struggling substantially with treatment may still make an informed decision with their clinician after discussing the risks and benefits.
“Most patients’ top priority in treating this disease is to extend overall survival as long as possible while maintaining their quality of life.”
— Christopher Wee, Cleveland Clinic oncologist
Individual Side-Effect Risks Vary
The interview does not quantify how often patients experience each side effect or identify which patients are most likely to have severe symptoms. Wee said the severity is hard to predict. It also does not provide detailed management protocols for particular effects, or evidence that relugolix is preferable for all patients.
The source describes one trial’s failure to establish non-inferiority for intermittent therapy but does not provide the trial name, patient numbers or numerical results. The interview also does not set out specific exceptions to continuous treatment. Patients should not interpret the discussion as advice to stop or change a prescribed regimen without speaking with their care team.
Discuss Symptoms With the Care Team
For patients receiving treatment, the next step is an ongoing conversation with their oncology team about symptoms, overall health and personal priorities. Patients can ask which effects need prompt attention, what support is available, and how their clinician will monitor risks such as bone loss and cardiovascular effects. Any decision to adjust treatment should be made with the clinician, particularly because continuous therapy remains the stated standard for metastatic disease.
The source material is an interview transcript and does not announce a new trial, policy change or follow-up research milestone. The next development for an individual patient will depend on their response to treatment and the discussions they have with their care team.
Key Questions
What side effects of ADT did the interview describe?
Wee listed hot flashes, fatigue, muscle loss, reduced bone density, sexual dysfunction, mood changes and weight gain. He also mentioned a slight increase in heart-attack risk. Individual experiences vary.
Is intermittent ADT the standard for metastatic prostate cancer?
No. Wee said continuous ADT remains the standard for metastatic disease. He said a trial did not prove intermittent treatment non-inferior, though patients with significant difficulties can discuss their options and the risks with their clinicians.
What is relugolix?
Relugolix is an oral ADT medicine discussed in the interview as an alternative to injections such as leuprolide. Wee said its testosterone-suppression effect can start and wear off relatively quickly, a feature some patients value.
Should a patient stop treatment if side effects become difficult?
The interview does not advise patients to stop on their own. Anyone experiencing difficult effects should contact their oncology team to discuss symptoms, risks and possible treatment decisions before changing a prescribed regimen.
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