Four years ago, a 67-year-old man had a serum prostate-specific antigen (PSA) level of 16 ng/mL. Biopsy specimen showed adenocarcinoma of the prostate gland. His Gleason score was 7. He was treated with external-beam radiation therapy. One month ago, the patient noted fatigue and rib pain. His PSA was found to be 87 ng/mL, and bone scan revealed diffuse metastatic disease. What is the best treatment for this patient?

Radiation therapy with strontium-89

Chemotherapy with mitoxantrone and prednisone

Androgen ablation (medical or surgical)

Four years ago, a 67-year-old man had a serum prostate-specific antige

1.	Four years ago, a 67-year-old man had a serum prostate-specific antigen (PSA) level of 16 ng/mL. Biopsy specimen showed adenocarcinoma of the prostate gland. His Gleason score was 7. He was treated with external-beam radiation therapy. One month ago, the patient noted fatigue and rib pain. His PSA was found to be 87 ng/mL, and bone scan revealed diffuse metastatic disease. What is the best treatment for this patient?
A.	Chemotherapy with docetaxel
B.	Chemotherapy with mitoxantrone and prednisone
C.	Androgen ablation (medical or surgical)
D.	Radiation therapy with strontium-89
Answer» D. Radiation therapy with strontium-89

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