To confirm the presence of prostate cancer which is the most incident visceral cancer in men, prostate biopsies are acquired using the magnetic resonance imaging fusion-guided prostate biopsy protocol. For this approach annotated magnetic resonance imaging is overlaid onto real-time ultrasound imaging to guide sampling of suspicious regions marked by uroradiologists. Additional biopsy samples are acquired via the previous clinical gold standard, i.e. the templated 12-core transrectal ultrasound-guided prostate biopsy protocol. While this approach improves the sensitivity of the prostate biopsy, a real-time, multiparametric imaging method of identifying biopsy targets could help overcome some of the inherent pitfalls of the magnetic resonance imaging fusion-guided prostate biopsy. Since ultrasound is used during the prostate biopsy, photoacoustic tomography, e.g. a hybrid imaging modality in which clinical ultrasound probes can be used to detect centimeters deep chemical alterations, has the potential to provide real-time targeting during biopsy. The translation of photoacoustic tomography to the clinic for prostate biopsy has been prevented by engineering challenges, which include identification of a biomarker for detecting suspicious regions of tissue and light delivery to the prostate for photoacoustic signal generation. Here, we present a vascular texture analysis method that identified 100% of primary and 67% of secondary tumors in the testing data set of ex vivo human prostate specimens. This method can be applied to future in vivo photoacoustic and ultrasound tomography of human prostates after further optimization of light delivery for photoacoustic tomography. To progress towards achieving this aim, we developed a transurethral light delivery device with angular light coupling method. By controlling the launch angle of the light into the fiber, the conversion of forward to side propagating energy can be improved from 27% to 98%, and the longitudinal emission profile can be controlled in order to illuminate the whole prostate simultaneously.<br>