A 71-Year-Old Man Diagnosed with a Stage T2 Prostate Tumor

Multiple Choice

A 71-year-old man diagnosed with a stage T2 prostate tumor 2 years ago has elected watchful waiting, based upon an underlying heart condition that renders surgery potentially fatal. Recently, his PSA has jumped considerably, as have his levels of serum acid phosphatase. Which course of action would be least appropriate at this stage?

A) Combination treatment with an antiandrogen and a GnRH agonist
B) Treatment with bisphosphonates
C) Treatment with GnRH agonists alone
D) Treatment with ketoconazole