I recently switched from my urologist to a medical oncologist and had my introductory meeting with him. I laid out my hopes and dreams (live long enough for a cure) and he politely dashed them with the "goal is to remain as comfortable as possible" line. I am just at the point where my PSA is rising after being on Lupron for 18 months, and as of June there was no evidence of metastasis yet. Dr. J suggested the my next course of action, if my PSA rises to 1.5 or 2.0 would be to start bicalutamide. It seems that his theory is to try to milk each treatment for as much time as we can get out of it. Honestly, I don't really hear of anyone being prescribed bicalutamide any more. Thoughts? I am thinking that if my PSA does rise, I might want to get a second opinion. His philosophy seems pretty old school.