Radionuclide bone scan trend and response to radium-223. A. June 2008, metastatic prostate cancer diagnosis. B. May 2010, disease progression on combined androgen blockade. C. May 2011, disease progression following sipuleucel-T immunotherapy. D. December 2011, disease progression just prior to docetaxel chemotherapy. E. June 2013, widespread disease progression associated with severe diffuse bone pain on enzalutamide (“pre-radium-223”). F. February 2014, dramatic bone scan response two months after completing six treatments of radium-223 (“post-radium-223”).