Task: Question Answering
Input (English): Question: Before a 49-year-old man, asymptomatic, with a family history of a father who died of prostate cancer, a PSA (Specific Prostate Antigen) of 5.9 ng / ml was identified in a routine company control, with a PSA ratio free / Total PSA of 11% and that in a digital rectal examination there is an increase in consistency in the right prostatic lobe, what is the following clinical indication? 
 Options:  <1> Ask the patient to perform a transrectal ultrasound and prostate biopsy. <2> Perform a abdominopelvic CT scan. <3> Start treatment with 5 alpha reductase inhibitors to halve PSA levels. <4> Start combined treatment of LHRH analogues and antiandrogens. <5> Perform a bone scan.
Output (English): 1