How would you manage a patient with intact prostate cancer with metastases to a para-aortic node and single bone?  

I would consider treating the primary site per STAMPEDE as well as possible SABR the other lesions, so long as he understands this is an evolving area and the benefit has not been conclusively demonstrated. Would recommend confirming the bone lesion by biopsy as well.

I would manage like the STAMPEDE trial, with systemic treatment with second generation antiandrogen therapy, and local RT to prostate.