Patient description: The patient is a 53-year-old man complaining of frequent headaches, generalized bone pain and difficulty chewing that started 6 years ago and is getting worse. Examination shows bilateral swellings around the molars. The swellings have increased since his last examination. Several extraoral lesions of the head and face are detected. The swellings are non-tender and attached to the underlying bone. Further evaluation shows increased uptake of radioactive substance as well as an increase in urinary pyridinoline. The serum alkaline phosphatase is 300 IU/L (the normal range is 44- 147 IU/L). The patient's sister had the same problems. She was diagnosed with Paget's disease of bone when she was 52 years old. The diagnosis of Paget's Disease of Bone is confirmed and Bisphosphonate will be started as first-line therapy.

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Adenocarcinoma of the Prostate Bone Metastases Hormone-resistant Prostate Cancer Recurrent Prostate Cancer Soft Tissue Metastases Stage IV Prostate Cancer Histologically documented adenocarcinoma of the prostate Life expectancy of >= 6 months, Eastern Cooperative Oncology Group (ECOG) performance status =< 2 Metastatic disease as evidenced by soft tissue and/or bony metastases on baseline bone scan and/or computed tomography (CT) scan or magnetic resonance imaging (MRI) of the abdomen or pelvis Castration resistant prostatic adenocarcinoma; subjects must have current or historical evidence of disease progression despite castrated level of testosterone (< 50 ng/dL) achieved by orchiectomy or luteinizing hormone-releasing hormone (LHRH) agonist or antagonist therapy; disease progression has to be demonstrated by PSA progression OR progression of measurable disease OR progression of non-measurable disease as defined below PSA: Two consecutive rising PSA values, at least 7 days apart Measurable disease: >= 20% increase in the sum of the longest diameters of all measurable lesions or the development of any new lesions; the change will be measured against the best response to castration therapy or against the pre-castration measurements if there was no response Non-measurable disease Soft tissue disease: The appearance of 1 or more lesions, and/or unequivocal worsening of non-measurable disease when compared to imaging studies acquired during castration therapy or against the pre-castration studies if there was no response Bone disease: Appearance of 2 or more new areas of abnormal uptake on bone scan when compared to imaging studies acquired during castration therapy or against the pre-castration studies if there was no response; increased uptake of pre-existing lesions on bone scan does not constitute progression White blood cell (WBC) >= 2,500 cells/uL  The presence of liver, or known brain metastases, malignant pleural effusions, or malignant ascites Moderate or severe symptomatic metastatic disease, defined as a requirement for treatment with opioid analgesics for cancer-related pain within 21 days prior to registration Eastern Cooperative Oncology Group (ECOG) performance status > 2 Treatment with chemotherapy within 3 months of registration Treatment with any of the following medications or interventions within 28 days of registration Systematic corticosteroids; use of inhaled, intranasal, and topical steroids is acceptable Any other systemic therapy for prostate cancer (except for medical castration) History of external beam radiation therapy to metastatic sites within 1 year of enrollment to the study Participation in any previous study involving sipuleucel-T Pathologic long-bone fractures, imminent pathologic long-bone fracture (cortical erosion on radiography > 50%) or spinal cord compression