As Prostate Cancer Awareness Month opens with new data on late diagnoses, an Atlanta urologist explains how risk-based screening, precision imaging, and coordinated treatment are changing what happens after a PSA test.
The American Cancer Society opened Prostate Cancer Awareness Month on Sept. 1 with a figure that urologists have been watching closely. New prostate cancer cases rose about 3% a year from 2014 through 2022, and the steepest climb came in cancers found at an advanced stage. The Atlanta-based organization projects 333,830 new diagnoses and 36,320 deaths from the disease in the United States this year.
Part of that increase is good news: more men are being screened. The harder part is the timing. The society’s chief scientific officer, Dr. William Dahut, described the data as evidence that screening conversations are still happening too late for too many men, especially those at high risk.
For Dr. Jitesh Patel, the board-certified urologist who founded and serves as President of Advanced Urology, that gap between when men should start the conversation and when they actually do shapes much of his daily work. A Temple University School of Medicine graduate who completed his residency at Thomas Jefferson University Hospitals, where he served as chief resident, Dr. Patel has spent roughly two decades treating urologic disease. The practice he built now spans 14 clinic locations and six AAAHC-accredited ambulatory surgery centers across metro Atlanta, and prostate cancer sits at the center of its work.
Common, treatable, and still found too late
Prostate cancer is the most frequently diagnosed cancer in American men. According to the American Cancer Society, about 1 in 8 men will be diagnosed during his lifetime. Roughly 6 in 10 cases are found in men 65 or older, and the average age at diagnosis is about 67.
The long-term trend has been encouraging. The prostate cancer death rate fell by about half between 1993 and 2022, a decline the society attributes largely to earlier detection and better treatment. More than 3.5 million American men who have been diagnosed with the disease are alive today. That progress, however, has slowed in recent years, and the society links the slowdown to the growing share of cancers discovered after they have already spread.
“Most of the men who walk into our clinics with prostate cancer feel perfectly fine. That is exactly why the screening conversation has to happen before symptoms appear. When we find this disease early, a man has far more options, and those options are generally easier to live with.” Dr. JITESH PATEL, PRESIDENT AND FOUNDER, ADVANCED UROLOGY
Screening is a conversation, and the right age depends on the man
Current guidance treats prostate cancer screening as an individual decision rather than a universal rule. The American Cancer Society recommends that men at average risk talk with a doctor about screening at age 50. Men at higher risk, including African American men and those with a family history of the disease, should have that discussion at 45. Men with multiple close relatives diagnosed at an early age should start at 40.
The disparity behind those recommendations is significant. Compared with white men, Black men are nearly 70% more likely to be diagnosed with prostate cancer and twice as likely to die from it, and they tend to be diagnosed younger. For a practice serving a region as diverse as metro Atlanta, that gap is part of everyday clinical reality, and it is one reason Dr. Patel’s team encourages men to understand their personal risk well before 50. The American Cancer Society offers a free online tool, CancerRisk360, that helps men assess their risk factors before that first appointment.
From a PSA number to a precise picture
For most men, the path begins with a prostate-specific antigen blood test. An elevated result is a signal, not a diagnosis. PSA can rise for many reasons, including benign enlargement and inflammation, a point Dr. Patel has explained in detail.
What has changed over the past decade is how much urologists can learn between that first abnormal result and a treatment decision. Multiparametric MRI now helps identify and characterize suspicious areas inside the prostate, guiding where a biopsy should be taken and informing risk assessment. The joint guideline from the American Urological Association and the American Society for Radiation Oncology calls for MRI in men on active surveillance whose original biopsy was performed without MRI guidance.
Imaging has also transformed staging, the step that determines whether cancer has spread beyond the prostate. PSMA PET, which uses a tracer that binds to a protein found on most prostate cancer cells, has sharply outperformed the CT and bone scans that were standard for decades. In the randomized proPSMA trial of 300 men with high-risk disease, PSMA PET/CT reached 92% accuracy compared with 65% for conventional imaging, with higher sensitivity, higher specificity, fewer equivocal findings, and less than half the radiation exposure. Advanced Urology offers PET/CT imaging as part of its prostate cancer program, allowing staging to happen within the same system that manages the patient’s care.
“A PSA result tells you something deserves a closer look. It does not tell you what is actually happening. Our job is to turn that number into an accurate picture, with the right imaging at the right time, so every recommendation we make rests on real information about that patient’s cancer.” DR. JITESH PATEL
Matching treatment to risk
Prostate cancer is not one disease in practical terms. A slow-growing, low-risk tumor and an aggressive cancer that has reached the lymph nodes call for entirely different plans, and modern guidelines are built around that distinction.
The AUA and ASTRO guideline directs clinicians to explain that every prostate cancer treatment carries some risk to urinary, sexual, or bowel function, and to weigh those risks against the threat posed by the cancer, the patient’s health, and his own priorities through shared decision-making. For men with low-risk disease, the guideline gives its strongest recommendation to active surveillance as the preferred approach. Active surveillance can help avoid or delay treatment while maintaining careful clinical monitoring through regular PSA testing, imaging, and follow-up, with the ability to move to curative treatment if the cancer changes.
For men with intermediate-risk disease, the range of options has widened. Robotic surgery and radiation therapy remain established curative approaches. Newer ablation technologies are also emerging for carefully selected patients. In December 2025, the FDA granted 510(k) clearance to the Vanquish Water Vapor System, which delivers targeted thermal energy through the urethra to ablate prostate tissue in men with intermediate-risk cancer. In the VAPOR 2 study, six-month biopsies in the first 110 patients showed no targeted, MRI-visible intermediate-risk disease in 91% of men after a single procedure, with low reported rates of incontinence and erectile dysfunction. Investigators continue to follow those patients for longer-term outcomes, and the AUA panel has noted that comparative long-term data on ablation are still limited, which makes careful patient selection essential. Advanced Urology offers Vanquish alongside focal therapy options for genitourinary cancers.
For men whose cancer has advanced, treatment increasingly involves systemic therapy managed over months or years. Advanced Urology’s Advanced Cancer Care Center includes an in-office dispensary, so patients can receive prescribed therapies within the practice rather than coordinating separately with outside pharmacies.
“There is no single right treatment for prostate cancer. A man with low-risk disease, a man with intermediate-risk disease, and a man whose cancer has spread are facing three very different situations. We offer the full range of prostate cancer evaluation and treatment options so the plan fits both the cancer and the person, and we monitor every patient closely whatever path he chooses.” DR. JITESH PATEL
Why coordination matters as much as technology
The technical advances in prostate cancer care arrive with a practical cost: more tests, more specialists, and more decisions. A man moving from an abnormal PSA through MRI, biopsy, PET staging, and treatment can easily face a series of separate appointments at separate facilities, each a place where delays build up.
Advanced Urology has organized its prostate cancer care to reduce those handoffs. Diagnostics, PET/CT imaging, interventional radiology, focal therapy, surgery at its accredited ambulatory surgery centers, the Advanced Cancer Care Center, and dedicated patient navigation operate within one coordinated program. Navigators help patients schedule, understand next steps, and stay on track through surveillance or treatment.
“When a man hears the word cancer, the last thing he should have to do is manage the logistics himself. Keeping imaging, procedures, medication, and navigation inside one program means fewer handoffs and fewer chances for something important to slip.” DR. JITESH PATEL
What men can do this September
The message of this year’s awareness month is less about a single test and more about timing. Men should know their family history, understand whether their race or genetics place them at higher risk, and start the screening conversation at the age that fits their risk rather than waiting for symptoms. For men who have already been diagnosed, the most useful step is a clear, individualized discussion of what their specific cancer looks like and which options fit it.
The science of prostate cancer care has advanced quickly over the past decade, from sharper imaging to a wider range of treatment options. The new data from the American Cancer Society suggest the next gains depend on something simpler: getting more men into the conversation early enough for those advances to make a difference.
