@csbarry To cut to the chase: Regardless of all the helpful suggestions made on your behalf, there are NO ALTERNATIVES to a prostate biopsy, period.
You either get a biopsy to see IF and to what degree of cancer you have…or you DON’T and you will either die from something else if it’s low grade, or you die a horrible death if it isn’t.
I hope this answers your original question.
Phil