The prognosis for this patient is poor due to the extensive degree of metastatic bone involvement.13 Data derived from large prospective randomized trials indicate that the median time to progression with conventional forms of androgen ablation approaches ranges between 12 to 18 months and the median survival is around 30 to 36 months.13,15 The main issue centers around the development of hormone resistance. Evolving data with new chemotherapeutic approaches suggest that nonhormonal treatment plays a significant role in the treatment of patients with hormone-resistant prostate cancer and may be a major addition to hormonal treatment in the initial management of patients with metastatic disease.