"....per rectal biopsies are substandard care in the UK"
1) 3-4% hospitalization from infections'2) The anterior lobe cancer though infrequent cannot be accessed.
3) Targeting the main lesion(s) with ultrasonic MRI fused guidance is better than random 12 pokes.
4) General anesthesia may be needed for the short procedure.

Go to a center of cancer excellence (CCOE) and get state of art techniques.

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C) get the DECIPHER genomics tissue test
D) ARTERRA artificial intelligence look at biopsy slides to compare with thousands of others