Inclusion Criteria:

Group-I (hormone-naïve) inclusion criteria:

• Age > 21 years, men of all ethnic backgrounds
• Patient must have had a histological diagnosis of adenocarcinoma of prostate and currently must have metastatic disease (stage TxNxM1) that is hormone-naïve.
• Patients must have conventional imaging evidence for metastatic disease as determined by CT, bone scintigraphy, or both.
• Patients must have rising serum PSA level - defined as at least 2 consecutive rises in PSA documented over a reference value (1st measure within 28 days prior to recruitment). The first rising PSA (2nd measure) should be taken at least 14 days after the reference value. A confirmatory PSA measure (3rd measure) obtained at least 14 days after the 2nd measure is required and must be greater than the 2nd measure. Additionally, patient must have a serum PSA concentration of at least 2 ng/mL in addition to increasing PSA to be eligible.

Group-II (hormone-refractory) inclusion criteria:

• Age > 21 years, men of all ethnic backgrounds
• Patient must have had a histological diagnosis of adenocarcinoma of prostate and currently must have metastatic disease (stage TxNxM1) that is unresponsive or refractory to hormonal therapy.
• Progression of measurable disease assessed with CT or bone scan within 28 days prior to recruitment
• Patients must have rising serum PSA level - defined as at least 2 consecutive rises in PSA documented over a reference value (1st measure within 28 days prior to recruitment). The first rising PSA (2nd measure) should be taken at least 14 days after the reference value. A confirmatory PSA measure (3rd measure) obtained at least 14 days after the 2nd measure is required and must be greater than the 2nd measure. Additionally, patient must have a serum PSA concentration of at least 2 ng/mL in addition to increasing PSA to be eligible. No minimum PSA level is required for clinically symptomatic patients (e.g. metastasis-related bone pain).
• Patients must have received prior hormonal therapy and have a castrate level of testosterone. Patients treated with orchiectomy are eligible.

Other general inclusion criteria for both groups:

• May have received prior surgery (14 days must have elapsed since completion of surgery with recovery from side effects)
• Creatinine ≤ 2.5 x the institutional upper limit of normal (within 28 days prior to enrollment)
• Men of childbearing potential must be willing to consent to use effective contraception.
• Must be competent to consent to study requirements
• OPTIONAL: Completed baseline McGill Pain Questionnaire and analgesic pain survey. If unable to complete questionnaires in English or Spanish, patient can still participate in this study.

Exclusion Criteria:

• History of cancer other than prostate cancer (except squamous cell carcinoma of the skin that has been treated with curative intent)
• Active infection (except mild upper respiratory infections)
• History of poorly-controlled diabetes mellitus (with Fasting Blood Glucose greater than 200 mg/dL) - in order to avoid false negative results due to glucose competition with [F-18]-Fluorodeoxyglucose in cellular uptake
• Active inflammatory conditions (e.g. rheumatoid arthritis, sarcoid)
• History of complicated non-healing fracture
• Not competent to consent