What a urologist will do varies considerably. Some will offer a PSMA pet for 3+3 or 3+4. In your case, I’m pretty sure the insurance companies would have no problem paying for that test. In Canada, there’s a completely different medical system.

As for BRCA testing, and genetic testing for other anomalies, this has been highly recommended for all doctors to do. Places like UCSF and Mayo (And many others) Have their patients checked almost all the time. If there is a history of cancer in the family, then those tests are almost always done. If there is no cancer in the family, then many doctors will not think genetic testing was necessary. Fortunately, in the US if you’ve got prostate cancer, you can get a test for free from prostatecancerpromise.org

So my dear case, do you have cancer in your family? Both of my mother sisters got breast cancer. One of them died as did her daughter from breast cancer. My grandfather died from pancreatic cancer. Having those multiple cancers made it obvious that I needed to be tested, But it wasn’t done until 11 years after I was diagnosed with prostate cancer. Things are changing, but it’s slow moving.