Haematology and Oncologycommon
A 67-year-old man with prostate cancer on androgen deprivation therapy presents with two weeks of mid-back pain that is worse lying flat and wakes him at night. Over the past 24 hours his legs have felt heavy climbing stairs and he has had difficulty starting his urine stream. On examination, power in both legs is 4/5, knee and ankle reflexes are brisk, both plantar responses are upgoing, and light-touch sensation is reduced from the level of the umbilicus downwards. His prostate-specific antigen was rising at his last review.
Which one of the following is the most appropriate immediate management?