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Key Points Androgen deprivation therapy remains a critical component of treatment in men with advanced prostate cancer, and data supports its use in metastatic disease and in conjunction with surgery or radiation therapy in specific settings Alternatives to standard androgen deprivation therapy, such as intermittent androgen suppression and estrogen therapy, hold the potential to improve toxicity profiles while maintaining clinical benefit Current androgen deprivation strategies seem to incompletely suppress androgen levels and AR-mediated effects at the tissue level Multiple mechanisms are implicated in the development of castration resistance, but the majority involve continued activation of the AR, which might be targeted by novel therapeutic agents This is a preview of subscription content, access via your institution Access options Subscribe to this journal Receive 12 print issues and online access $189.00 per year only $15.75 per issue Buy this article Purchase on SpringerLink Instant access to the full article PDF