Prostate size 48cc with nodule and psa 7.2, psa ratio21 what to do other than biopsy cause im afraid of biopsy complications , could be bph or infectn?

Consider 4K Score : If concerned about complications, or just want to avoid biopsy, there is a blood test called the 4K Score Test which determines the probability or likelihood that a biopsy would find a life threatening prostate cancer (Gleason Score 7 or greater). However, the presence of a nodule with a significantly elevated PSA would usually warrant a biopsy. Without nodule and favorable ratio, 4K s good idea.