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Prostate Cancer

The most common cancer in men — and one of the most survivable when it is found early and managed wisely. Modern care is as much about avoiding over-treatment as it is about treating.

The modern picture

Most prostate cancer is slow. The skill is telling which kind you have.

Prostate cancer is common — roughly one in eight men will be diagnosed in his lifetime — but the word "cancer" hides enormous variation. A great deal of prostate cancer grows so slowly that it never threatens a man's life, while a smaller share is genuinely aggressive and needs prompt, decisive treatment.

For decades, the field treated almost everything the same way, which meant many men underwent surgery or radiation for disease that would never have harmed them — and lived with the urinary and sexual side effects that followed. The modern approach is different: identify the small number of significant cancers precisely, treat those, and safely monitor the rest.

That shift — from reflexive treatment toward risk-adapted, evidence-based decisions — is the single most important advance in prostate cancer care, and it is the philosophy that organizes how we work.

At a glance

ScreeningRisk-adapted PSA and exam
DiagnosisMRI before biopsy, targeted sampling
Low-risk diseaseOften watched, not treated
When treatment is neededTargeted, function-sparing options
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Step one

Screening that's matched to your risk.

Smart screening isn't about testing everyone the same way. It's about knowing who to watch closely, and sparing everyone else unnecessary worry and procedures.

The PSA test

A starting point, not a verdict

A PSA blood test is a useful signal, but a single number rarely tells the whole story. Trends over time, PSA density, and your age and risk factors matter far more than one reading — and an elevated PSA has many causes besides cancer.

Who needs closer attention

Family history & ancestry

Risk is higher for men with a father or brother who had prostate cancer, for men of African ancestry, and for carriers of certain inherited gene changes. For these men, screening should start earlier and be followed more closely.

Avoiding the cascade

Fewer unnecessary biopsies

Rather than sending every elevated PSA straight to biopsy, modern workups add prostate MRI and refined blood and urine markers first — so a biopsy happens only when it is genuinely warranted.

Step two

If a biopsy is needed, it should be precise.

How a prostate biopsy is performed determines how much you can trust the result. We use MRI-guided targeting rather than blind sampling.

Targeted, not blind

MRI Fusion Biopsy

A prostate MRI is fused with live ultrasound, letting suspicious areas be sampled directly. It finds significant cancers more reliably and avoids over-diagnosing disease that never needed treatment.

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In-office comfort

Done where you're seen

Imaging, assessment, and the biopsy itself are handled in the office — with a focus on comfort and a clear explanation of results, rather than a hospital referral and a long wait for answers.

Grading the risk

Understanding your Gleason score

If cancer is found, its grade (the Gleason score and grade group) tells us how it is likely to behave. That number — together with PSA and MRI findings — is what separates disease that can be watched from disease that should be treated.

Man discussing active surveillance for low-risk prostate cancer
Step three

For low-risk cancer, watching closely is the treatment.

Active surveillance means monitoring a low-risk cancer carefully — with periodic PSA tests, MRI, and occasional repeat biopsy — and treating only if it shows signs of becoming more aggressive. For the right patient, it avoids the side effects of surgery or radiation without compromising safety.

It takes confidence — in the diagnosis and in the follow-up — to recommend doing less. Accurate MRI-targeted biopsy is what makes that confidence possible, and it is why precise diagnosis matters so much.

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When treatment is needed

Targeted treatment, function in mind.

When a cancer is significant enough to treat, the goal is to control it while protecting urinary and sexual function as much as possible. The right choice depends on the cancer, your anatomy, and your priorities.

Treating the lesion, not the whole gland

Focal & targeted therapy

For carefully selected cancers, treatment can be directed at the tumor itself rather than the entire prostate — an approach aimed at preserving function while controlling disease.

Established options

Surgery & radiation

When whole-gland treatment is the right call, surgery and radiation remain highly effective. We help you understand the trade-offs of each honestly, and coordinate care with the right specialists.

A plan built around you

Shared, unhurried decisions

There is rarely a single "right" answer — only the right answer for you. We take the time to walk through the options so the decision is made with a full understanding, not under pressure.

Common questions

Frequently asked questions.

No. Many prostate cancers grow so slowly that they never threaten a man's life and are safely monitored rather than treated. A smaller share is aggressive and needs prompt treatment. The key is accurate diagnosis to tell which kind you have.
For most men, a screening conversation begins around age 50. Men at higher risk — those with a family history, of African ancestry, or carrying certain inherited gene changes — should start earlier, often around 40 to 45. The right timing is individual and decided together.
Not necessarily. PSA can rise for many reasons besides cancer, including an enlarged prostate, inflammation, or recent activity. A single elevated reading is a signal to look closer — often with MRI — not a diagnosis.
Active surveillance means carefully monitoring a low-risk prostate cancer with periodic PSA tests, MRI, and occasional repeat biopsy, and treating only if it shows signs of becoming more aggressive. For the right patient, it avoids the side effects of surgery or radiation without compromising safety.
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Begin care

A urologist who tests thoroughly and treats gently.

Whether you need a first PSA conversation, a second opinion on a recent diagnosis, or a clear plan for managing prostate cancer — start with a complete diagnostic picture and a treatment plan built around the smallest effective step.

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