First your question. My stats are similar to your father's. I took the Casodex for one month. The LHRH (lupron) was given two weeks after the Casodex. I get a lupron injection every 120 days and did not need to continue with the Casodex apparently. As John said the casodex is given to prevent tumor flare. (rapid growth of the tumor) The is a new drug degerelix (or something like that) that does not cause the tumor flare. I do not believe there is set time from the start of Casodex until the first shot other than the minimum two week delay.
Now, some unsolicited advice. Drop the bum you are talking to that is masquerading as a doctor. He has neither human compassion nor empathy. Like your Dad I am uninsured but the reception I have recieived from my doctors has been much better. I asked for and recieved a discount on the normal cost of the treatments and I pay in full cash for each treatment. The casodex is now available as a generic (bicalutimide (SP?)). Cost is around $500 for 30 50 mg pills. The lupron shot retails for around $3000 and I pay about $1100. I am lucky to have the doctors I have. I am astounded that your Dad has recieved such a response. I would complain to the AMA or the state. Sorry, I am about to rant here.
I would also question the doctor about radiation. I recieved a full pelvic dose that was intended to get at a suspected lymph node (illiac). May be that it could help with the bone mets. I eally do not know but it never hurts to ask the question. My radiation treatment was around $40,000 out of pocket.
Best of luck to you and your Dad.
Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone