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In an October 14, 2026, MedPage Today interview, Cleveland Clinic oncologist Christopher Wee discussed balancing treatment goals with side effects for metastatic castration-sensitive prostate cancer. He described common effects of androgen deprivation therapy and said continuous therapy remains the standard for metastatic disease, while treatment decisions should account for a patient’s health and preferences.
Cleveland Clinic oncologist Christopher Wee said clinicians treating metastatic castration-sensitive prostate cancer must weigh the benefits of disease control against the effects of androgen deprivation therapy (ADT), while tailoring discussions to patients’ health and priorities. In an interview published by MedPage Today on October 14, 2026, Wee described common side effects and said continuous ADT remains the standard approach for metastatic disease.
Wee discussed the subject in the third episode of MedPage Today’s “Beyond Diagnosis” series, hosted by John Mangels. The conversation focused on treatment decisions after a metastatic diagnosis, including how clinicians discuss adverse effects, quality of life and the intensity of treatment. The source is an interview transcript, not a new clinical trial or treatment guideline.
Wee said ADT contributes much of the side-effect burden in systemic treatment for this disease. Effects can include hot flashes, fatigue, muscle loss, reduced bone density, sexual dysfunction, mood changes and weight gain. He also cited a slight increase in heart attack risk. He said many patients manage treatment without major disruption to daily life, but the severity can vary and is difficult to predict; some effects can be serious and should be discussed with a clinician.
Wee said treatment conversations should cover both harms and potential benefits that may not be immediately visible to patients who feel well. In his account, treatment may help delay complications such as fractures, other skeletal events or pain from disease progression. He described trying treatment and monitoring how a patient responds as one way to approach concerns, while acknowledging that side effects can affect quality of life.
Balancing Disease Control and Daily Life
The discussion addresses a decision many patients face: treatment can cause symptoms before they feel an immediate benefit, while clinicians are also trying to control cancer and reduce the chance of future complications. Clear conversations about expected effects, individual priorities and how symptoms will be monitored can help patients make informed decisions and raise problems early.
Wee emphasized that treatment intensity should reflect a patient’s overall health, frailty and preferences, rather than treating every patient as if their circumstances were identical. The interview does not provide new comparative evidence about which regimen is best; it offers one oncologist’s account of how he discusses treatment and side effects with patients.
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ADT Choices in Metastatic Disease
ADT lowers testosterone, which can help treat prostate cancer. Wee said it is a central part of systemic therapy for metastatic castration-sensitive disease. He noted that patients may receive ADT through injections, including the GnRH agonist leuprolide, or through the oral drug relugolix. He said some patients value relugolix because it can be stopped more quickly than an injection that remains active over time, though individual treatment choices require medical guidance.
Wee said that, for metastatic disease, continuous ADT is the standard of care. He referred to a trial comparing intermittent and continuous ADT, saying it did not establish that intermittent treatment was non-inferior. He added that patients experiencing substantial difficulty may still make informed decisions with their clinicians after discussing risks and benefits. The interview does not identify the trial or provide its data, so it does not allow readers to assess the evidence independently.
“These can be serious.”
— Christopher Wee, MD
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Individual Side Effects and Treatment Response
The interview does not quantify how often each side effect occurs, identify which patients face the greatest risks, or provide detailed comparisons among ADT medicines and other treatment combinations. Wee said side-effect severity is hard to predict. His comments also do not establish that a particular drug or strategy will prevent or resolve symptoms for an individual patient.
Although Wee referred to a trial of intermittent versus continuous ADT, the transcript does not name the study or give its results in detail. It also does not specify how often treatment should be adjusted or paused for patients with severe effects. Those decisions depend on individual circumstances and should be discussed with the treating oncology team; patients should not change or stop prescribed therapy based on the interview alone.
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Discussing Side Effects During Care
Wee’s interview points to ongoing conversations between patients and clinicians as treatment proceeds: patients can report symptoms, discuss how treatment affects daily activities and review options in light of their health and goals. The transcript does not announce a new guideline, trial result or formal follow-up milestone. For now, it presents clinical advice about weighing treatment benefits and adverse effects while maintaining continuous ADT as the usual standard for metastatic disease.
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Key Questions
What side effects of ADT did Christopher Wee describe?
Wee listed hot flashes, fatigue, muscle loss, bone-density loss, sexual dysfunction, mood changes and weight gain, as well as a slight increase in heart attack risk. Effects differ among patients, and he said their severity is difficult to predict.
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 therapy was non-inferior, but the interview does not provide the study’s name or detailed findings.
Did the interview recommend stopping treatment when side effects occur?
No general recommendation to stop treatment was made. Wee said patients facing significant difficulties can discuss risks and benefits with their clinician. Patients should consult their care team before changing or stopping prescribed therapy.
What is relugolix, according to the interview?
Relugolix is an oral option for ADT. Wee said some patients value that testosterone suppression can wear off more quickly after stopping it than after an injection. Whether it is suitable depends on the patient’s circumstances and a clinician’s advice.
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