A 60-year-old male with known metastatic prostate cancer presents with new-onset severe back pain, bilateral lower extremity weakness, and urinary retention. Physical examination reveals decreased rectal tone and a sensory level at T10. What is the most appropriate initial management step?

✓ Correct Answer: Option A

The patient presents with classic signs of malignant spinal cord compression. Administering high-dose corticosteroids (e.g., dexamethasone) is the most appropriate initial management step to reduce edema around the spinal cord and prevent further neurological deterioration while awaiting definitive diagnostic imaging (MRI) and treatment.