yeah, it does seem given those levels and velocity the chances seem slim for cancer, however there are alot of agressive cancers with a PSA < 4. Remember, urologists do biopsies and surgery. Its how they get paid, however you have a right to seek other avenues. What would he recommend if he did the biopsy and the Gleason was normal or inconclusive? A free PSA, PCA3 or repeat PSA's over several months are all options to avoid a biopsy. I would definately ask about them.