I think I figured it out.
You can calculate rho by considering a triangle:
The central angle would be 180 - theta and the two sides would have length of radius of the earth and radius of the earth + altitude. The third side can be figured out with the law of sines.
Once you have rho, you can calculate x, y, z based on how the the spherical coordinate system is specified (directions of +x, +y, +z).