The role of nuclear medicine diagnostic bone scanning is well established in prostate cancer. This case provides an insight into the specific role that bone scanning plays in monitoring response to hormone therapy and an example of significant global skeletal response. The case highlights the remarkable efficacy of timely hormone therapy in high-grade prostate cancer with widespread bony metastasis. In addition, the range of hormone therapy currently available for clinical application in the management of metastatic prostate cancer is detailed. Finally, the case represents an incidental diagnosis of prostate cancer after evaluation of nonspecific symptoms.