Androgen Deprivation Therapy (ADT) is a cornerstone of treatment for high-risk prostate cancer and is almost always used in combination with radiation therapy. ADT works by lowering testosterone levels, which prostate cancer cells rely on to grow and survive.

In high-risk cases, ADT is typically given for a long duration—18 to 36 months—based on strong clinical evidence showing improved survival and reduced recurrence when combined with radiation. Common ADT agents include leuprolide, goserelin, degarelix, and relugolix. While effective, long-term ADT can cause side effects such as hot flashes, fatigue, sexual dysfunction, bone loss, and metabolic changes, so risks and benefits must be carefully considered.