What is the best medicine for stage 4 prostate cancer?

Stage IV means: Cancer usually infesting bones. This usually warrants anti-hormone treatment: leuprolide/goseralin, or bicalutamide, and sometimes both. Orchiectomy works: rarely offered, even rarer to accept, cheaper too. There are 'salvage' treatments should these not do the trick., .

Varies: Often times an orchiectomy is a very good option and sometimes androgen blockade is. It all depends on the age and the health condition of the patient.

And others: In addition to hormonal blockade with anti androgens or androgen blockers , there are forms of chemotherapy that have some benefit as well as immune therapy, called provenge (sipuleucel-t). Focal radiation for pain or tumor control can be offered. Additional systemic radio nucleotides such as strontium or samarium can be offered.