Apalutamide in Treating Patients With Prostate Cancer Before Radical Prostatectomy

Inclusion Criteria: * Willing and able to provide written informed consent * Histologically confirmed adenocarcinoma of the prostate * A minimum of 10 core biopsies have been performed at baseline and available. A prostate biopsy within 6 months from screening is allowed for entry requirements. Biopsies performed within 6-12 months from screening are acceptable if the treating physician would allow treatment without further biopsy. Patients must meet intermediate risk criteria from Gleason score, T stage, and prostate-specific antigen (PSA) value by National Comprehensive Cancer Network (NCCN) criteria: cT2b-T2c or Gleason 7 (3+4 or 4+3) or PSA 10-20 ng/mL. In addition, the Gleason 3+4 or 4+3 must be present * Pathology review at MD Anderson Cancer Center. The volume of disease must be high enough for the surgeon to agree to include an extended template pelvic lymph node dissection * Serum testosterone \> 200 ng/mL * Patient and urologist must agree that patient is suitable for prostatectomy * No evidence of metastases on imaging. This risk group does not require metastatic studies, but if performed they must be negative (as determined by urologist or radiologist). Suspicious lymph nodes permissible if \< 10 mm * Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 * Hemoglobin \>= 10.0 g/dL * Platelet count \>= 100,000 x 10\^9/microliter * Glomerular filtration rate (GFR) \>= 45 mL/min * Serum potassium \>= 3.5 mmol/L * Serum albumin \>= 3.0 g/dL * Able to sw…