<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 62-year-old man presents to the physician because of difficulty initiating urination, terminal dribbling of urine, and bone pain for 3 months. He has no medical history of serious illness, and he currently takes no medications. His father had prostate cancer at age 58. His vital signs are within normal limits. The physical examination shows tenderness over the lower lumbar vertebrae and the right pelvis. The digital rectal exam DRE shows a prostate size equivalent to 2 finger pads with a hard nodule. The laboratory tests show the following results:SerumProstate-specific antigen PSA 15 ngmLTestosterone 350 ngmL N2701070 ngmLThe prostate biopsy confirms the presence of prostate cancer with aggressive histologic features. The MRI shows local extension of the tumor. The radionuclide bone scan shows multiple metastatic sites. Which of the following is the most appropriate next step in management?? A: Active surveillance, B: Androgen deprivation therapy, C: Chemotherapy, D: Radiation therapy, E: Radical prostatectomy,  <response>: This is a question about managing prostate cancer in a 62-year-old man. Key findings include an elevated PSA, hard prostate nodule on DRE, biopsy confirming aggressive prostate cancer, MRI showing local extension, and bone scan showing metastases. The choices include active surveillance, androgen deprivation therapy, chemotherapy, radiation therapy, and radical prostatectomy.Given the patients age, biopsy results, extension beyond the prostate, and metastases, active surveillance would not be appropriate. Chemotherapy may play a role but is not the most appropriate next step. Radical prostatectomy is also not indicated given the local extension and metastases. The most appropriate initial management would be androgen deprivation therapy to treat the metastatic disease, along with consideration of radiation therapy for local control.B: Androgen deprivation therapy 