When should Casodex be stopped?

Was he metastatic? The Casodex is to stop a "testosterone flare" from the Lupron, which can aggravate tumors if they exist.

For non-metastatic folks, it's less clear. My uro didn't want to use it at all, nor did my RO nor my MO. But, after about 7+ weeks on Lupron, my PSA hadn't come down as far as they wanted to see before radiation started. So, suddenly with no more resistance we started Casodex too. He thought since the immediate response to Lupron was a bit less than hoped, and my quite aggressive case, we'd just stay on Casodex. That has been done in the past, as "ADT2", and you'll find it in some studies. More recently, you'll probably find most uros don't do the ADT2 approach. Of course, my G9 5+4 is also not common, fortunately.

Whether it's necessary to stay on it or not is very unclear. It's expensive, about $500/month if you don't have prescription coverage, so if I was directly paying for it I may not have stayed on it.

My plan is to take it as long as I'm on Lupron therapy, which will be 4 more months from my next (and last!) shot Monday.

If you have not consulted with a Medical Oncologist, now would be a good time to do so...I think, for the time being, the Bicalutamide (casodex) has done its job..Hopefully, his RT will be successful and that will be that..Continuing the casodex now is probably not necessary..It's a powerful drug that can have significant side-effects so you don't take it without good reason...

Thank you all for your responses. Husband is G9 4+5, SV+ and LN+. Bone scan clean. His PSA prior to Lupron was 9.1. So it sounds like high risk guys usually stay on it longer? Is that right?

I have just started Casodex, been on it a week, my Oncologist told me to take it for 4 weeks, I am also having a Zoladex implant on Monday.

Regards Mal.