Two ways to go. 1) Poke and hope biopsies. Sometimes they identify cancer and sometimes they miss it altogether. 2) MRI, with a URONAV biopsy. MRI images overlaid with URONAV software rendering 3D magnified imaging. The prostate is mapped and there is a zero chance of missing cancer cells with this type of biopsy. Nothing is perfect but it is almost with an experienced urologist. Then you can determine your plan after discussions with your urologist and oncologist. PSA tests are huge factor and also the position of the tumor. Tumors close to the colon wall are extremely dangerous regardless of size. PET scans are not that accurate and sometimes ordered and are expensive.