Abiraterone Acetate in Treating Patients With Metastatic Hormone-Resistant Prostate Cancer

Inclusion Criteria:

* Have signed an informed consent document indicating that the subjects understands the purpose of and procedures required for the study and are willing to participate in the study
* Written authorization for use and release of health and research study information has been obtained
* Be willing/able to adhere to the prohibitions and restrictions specified in this protocol
* Able to swallow the study drug whole as a tablet
* Willing to take abiraterone acetate on an empty stomach; no food should be consumed at least two hours before and for at least one hour after the dose of abiraterone acetate is taken
* Patients who have partners of childbearing potential must be willing to use a method of birth control with adequate barrier protection as determined to be acceptable by the principal investigator and sponsor during the study and for 1 week after last dose of abiraterone acetate
* Histologically proven adenocarcinoma of the prostate
* Eastern Cooperative Oncology Group (ECOG) performance status =\< 2
* Metastatic castration resistant prostate cancer as defined by serum testosterone \< 50 ng/ml and one of the following:

  * Prostate specific antigen (PSA) level of at least 2 ng/ml that has risen on at least 2 successive occasions at least 1 week apart
  * Evaluable disease progression by modified RECIST (Response Evaluation Criteria in Solid Tumors)
  * Progression of metastatic bone disease on bone scan with \> 2 new lesions
* Maintenance of Lupron or antagonist unless previously treated with orchiectomy
* The presence of metastatic disease amenable to computed tomography (CT) or ultrasound guided biopsy; this may include thoracolumbar vertebral bodies, pelvis, femur or humerus, or soft tissue or nodal metastasis amenable to biopsy (excluding lung or pleural lesions)
* Patients may have received secondary hormonal manipulations (excluding prior abiraterone acetate, MDV3100 or TAK700) or up to two lines of chemotherapy; all prior therapy except Lupron must have been discontinued for more than 4 weeks before enrollment
* Serum potassium of \>= 3.5 mEq/L
* Aspartate aminotransferase (AST), alanine aminotransferase (ALT) \< 1.5 x upper limit of normal (ULN)
* Bilirubin levels \< 1.5 x ULN
* Serum albumin of \>= 3.0 g/dL
* Total bilirubin =\< 1.5 x ULN
* Calculated creatinine clearance \>= 60 mL/min
* Platelet count of \>= 100,000/uL
* Absolute neutrophil count of \> 1,500 cell/mm\^3
* Hemoglobin \>= 9.0 g/dL

Exclusion Criteria:

* Active infection or other medical condition that would make prednisone/prednisolone (corticosteroid) use contraindicated
* Patients who are currently receiving active therapy for other neoplastic disorders will not be eligible
* Patients with histologic evidence of small cell carcinoma of the prostate will not be eligible
* Known brain metastasis
* Uncontrolled hypertension (systolic blood pressure \[BP\] \>= 160 mmHg or diastolic BP \>= 95 mmHg); patients with a history of hypertension are allowed provided blood pressure is controlled by anti-hypertensive treatment
* Active or symptomatic viral hepatitis or chronic liver disease
* History of pituitary or adrenal dysfunction
* Clinically significant heart disease as evidenced by myocardial infarction, or arterial thrombotic events in the past 6 months, severe or unstable angina, or New York Heart Association (NYHA) class II-IV heart disease or cardiac ejection fraction measurement of \< 50 % at baseline
* Atrial fibrillation, or other cardiac arrhythmia requiring medical therapy
* Administration of an investigational therapeutic within 30 days of screening
* Patients with dementia/psychiatric illness/social situations that would limit compliance with study requirements or would prohibit the understanding and/or giving of informed consent will not be eligible
* Patients with any condition that, in the opinion of the investigator, would compromise the well-being of the subject or the study or prevent the subject from meeting or performing study requirements
* Patients requiring therapeutic anticoagulation (e.g., warfarin, dabigatran, heparin, or low molecular weight heparins \[Lovenox, dalteparin\])
* Patients with poorly controlled diabetes
* Patients with a history of gastrointestinal disorders (medical disorders or extensive surgery) that may interfere with the absorption of the study agents
* Patients with a pre-existing condition that warrants long-term corticosteroid use in excess of study dose
* Patients with known allergies, hypersensitivity, or intolerance to abiraterone acetate or prednisone or their excipients
* Child-Pugh class B or C hepatic impairment