This is just my experience so you can make your own decision, but I wish my urologist had done a biopsy on me when I was being treated for what he assumed was bladder cancer. Turns out the cancer was primary prostate. I was 62 at the time. My brother had a prostatectomy at age 58 and is now 86. I on the other hand have mcrpc and have recently failed my second chemo drug. That was after bracytherapy and 18 months of Lupron. Also failed on Casodex and abiraterone. Not a candidate for Pluvitco. I recently had another prostate biopsy 5 + 5 and the cancer has spread to the left side which was clear 4 years ago. I had the biopsy in the doctor's office. Prostate cancer has ruined my life. Take early action. Good luck to you.