In a patient with hormone-refractory metastatic prostate cancer after hormonal therapy, which treatment could be expected?

• A. Colony-stimulating factors
• B. Alpha-Interferon
• C. Monoclonal antibodies
• D. Endocrine surgery

Answer: (D)

The main point here is that even after progression on hormonal therapy, prostate cancer growth is still driven by androgens, so continuing to suppress testicular testosterone can be beneficial. An endocrine approach that achieves permanent testosterone suppression is surgical castration (orchiectomy). Removing the testes eliminates the major source of testosterone, delivering a lasting, low testosterone environment without ongoing drugs, which can help palliate symptoms and may slow progression in some patients.

The other options don’t fit this specific scenario well. Colony-stimulating factors are supportive care used to treat chemotherapy-related bone marrow suppression, not to control hormone-driven cancer. Alpha-interferon and monoclonal antibodies have not shown clear, consistent benefit in this setting. Endocrine surgery stands out as the method that directly targets the hormonal axis in a durable way, making it the expected choice among the options listed.