As the title conveys, All three are a different form of ADT... merely because a person has circulating testosterone in their blood when taking bicalutamide doesn't mean bicalutamide is not a form of ADT or that they are able to use the testosterone even though they have it.
My understanding is -- the way it was explained to me:
bicalutamide blocks you from being able to use testosterone. When a patient is being switched back and forth from lets say 6 months of lupron to 6 months of bicalutamide --there is no off period of ADT -- they are still on ADT either way -- just a different form of ADT.. (a different way of denying your body testosterone) Lupron stops you from being able to make testosterone -- whereas bicalutamide doesn't stop you from making testosterone but -- blocks the cells from being able to use it ... in effect resulting in the same thing ( ADT)
--- lupron -- no ability to make testosterone -- therefore no testosterone to use. ----bicalutamide blocks ability to use testosterone. even though you can still make testosterone and have testosterone circulating in the blood..
Testosterone circulating in the blood while on bicalutamide means virtually nothing --- you might as well not have it -- you cant use it.
bi-polar treatment can be done on lupron but not on bicalutamide. While on bicalutamide you can inject all the testosterone you want -- but the body is blocked from using it --