In the last decade, PSA was all we had. Fortunately, in 2014, that's not the case anymore. The following are tests which can complement the PSA in decision making about whether a prostate biopsy is really needed:
1) PHI (prostate health index) - blood test
2) 4Kscore - blood test
3) PCA3 - urine test
There are also various calculators based on PSA, physical exam results, and age which assess the risk of cancer. These include: