I would like to add that after the DRE suggested an anomaly (along with the PSA of 18), it was straight to the biopsy. Here's what I would like to add, I was offered no choices of which type of biopsy I was about to receive or which one my insurance would cover(Anthem Blue Cross). My biopsy was painfully barbaric. I would have asked to have anesthesia if I had known I could have. If there is a painless MRI out there, take it or at least ask about your options.