by choline kinase to form phosphocholine is the fi rst step of multistep Kennedy pathway ( 1 ) that synthesizes the major membrane phospholipid, phosphatidylcholine. Increased choline phosphorylation (primarily by choline kinase ␣ , ChK ␣ ) in tumor as compared with normal tissue has been reported in lung, breast, colorectal, and prostate cancers ( 2-5 ). This has motivated evaluation of cancer therapies involving choline kinase inhibition ( 6 ) and use of cancer imaging techniques with choline phosphorylation as a diagnostic metabolic step ( 7,8 ).Metabolism of choline in cancer cells is known to be sensitive to its microenvironment. Tracer studies in the mouse atrial cardiomyocyte tumor lineage, AT-1 ( 9 ), and 9L glioma allografts ( 10 ) showed that radiolabeled choline phosphorylation and accumulation is signifi cantly diminished in hypoxia. Our previous tracer studies with two human prostate cancer cell lines, PC-3 and LNCaP, showed 15% and 28% decreases in choline accumulation, respectively, after 4 h of anoxia (0% O 2 ) ( 11 ). After 24 h of anoxia, choline accumulation continued to decrease in both cell lines without loss of cellular viability. Because low oxygen exposure is a common factor in the microenvironment of tumors, it is important to understand the mechanisms of this effect and the implications for therapeutic and diagnostic applications involving choline metabolism.The goals of the present study were to utilize PC-3 prostate cancer cells to assess the effects of hypoxia on 1 ) steady-state levels of choline metabolites, 2 ) equilibrium status of choline phosphorylation, 3 ) radiolabeled choline uptake and phosphorylation, 4 ) ChK ␣ mRNA and protein levels, and 5 ) choline kinase activity. In this work, we demonstrate that choline phosphorylation is not at equilibrium In recent years, choline phospholipid metabolism has been widely studied in cancer research. Choline is an important precursor of phospholipids. Its phosphorylation