If your practitioner is trained correctly "Mr. Dr finger" is still the best available, unfortunatly...
I would say, as anything concerning medicine : a good clinical exam (a doc putting his hands on your various body parts) and a good interview is still the best available way to diagnose something. Everything else is useful to confirm it and find the best treatment
PSA brings a lot of "false positive" inducing invasive surgical or radio therapy with too many side effects to be bearable.
And first of all, it depends of your age : before 50 a prostate cancer is generally a killer, after 70 it evolves so slowly that patients finally die from something else, just like my dad.
My dad was an urological surgeon and I learned a lot from him even if I'm a psychiatrist !! A clinical exam is always safer and more reliable than many blood samples, Pet scans or MRI.
He died from an pancreatic cancer with carcinogenic lungs he treated like a flu for 6 month. From the first lungs Xray he accepted to pass through to his death it took less than 3 month. He was 86 years old.
Myself I suffered from a pudendal nerve compression due to a traumatic jump on a bike. the saddle exploded when I landed and the only person who was able to diagnose it was a particularly well trained urologist with his very flexible and invading finger... All the other doctors I saw were absolutely unable to find anything and all blood exams and MRI were of no help at all.