Probably not insane other docs say similar things about resuming hormone therapies after being on them a while. Dr. Strum and others say such things when in proper context. Here is what my radiologist mentioned and he 'says' he has published some things on hormone therapy at PubMed I need to find out the links.
'Psa levels to resume drug therapies in Canada 20.0 or greater (restart)
Psa (USA) pick an arbitrary number between 1 to 10 (restart) 5-10 is ok too
Level of 15 still is considered by many as still sane territory' (may not look sane to us)
Nobody has certainty in this area as to what the biology is exactly like and therefore no real definitive answers to this question. Probably someone whom is non-detectable levels and when going off HT, might consider the lower thresholds for arbitrary resuming, if psa levels rise. This is the assumption from the medical world in general.
Now this is talking about patients whom have done therapies and are recently off cycle or taking a holiday from drugs, and resuming. This is not the case for newly diagnosed people as you want to try to defeat or put into remission all PCa you can and do it asap.
I decided to take a short holiday myself, no drugs thus far for about 1 month, will be getting a PSA real soon and decide. This way you can see your possible velocity and/or or if a doubling time exists...those are things to watch and make decisions upon. If I have only slight rise, then I will go perhaps much further before jumping back in.
Summary- PCa is not an exact science at this time. At psa failure levels one should consider having an oncologist whom understands more about biology of the patient.
Consider this an attempt to answer your question, 'small print' many contain S.W.A.G. information and conflict with your docs opinion, no warranty expressed or implied, results can vary, not valid in Podunk County. (LOL) I didn't stay at a Holiday Inn Express either. This is what I kind of have gathered on this important question.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35 normal, ct and bone scans appearing clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off for 1 yr., controlled so well, resumed, using intermittently, pleased with results