A 64-year-old man presents with complaints of nocturia, urinary urgency, and hesitancy, with a weak stream. He also reports hematuria in the past few weeks. In addition to his urologic symptoms, the patient complains of low-grade, constant back pain. He also complains of shortness of breath and persistent cough. His past medical history is unremarkable. His mother died of breast cancer at age 69 and his father died of prostate cancer at age 82. A digital rectal examination (DRE) reveals an enlarged prostate gland with several palpably discrete, hard, diffuse nodules. The patient's prostate-specific antigen (PSA) level is 110 ng/mL. A needle biopsy is ordered.