I had a problem with gross hematuria 7 months ago. I started…

I had a problem with gross hematuria 7 months ago. I started Avodart and the symptoms stopped in approximately 30 days. I have remained on Avodart for 6.5 months. Before starting Avodart my PSA was 8. After 5mo's on Avodart my PSA dropped to 4.33, but I was told that I had to use a multiple of 2 to get my true PSA, which would make it 8.6. My urologist suggested another PSA in January just to make certain the drug had had a chance to take full effect. I had the PSA and much to my surprise it went up to 5.19. After a multiple of 2, 10.38. I was slightly shocked because I fully expected it to go down. My PSA has climbed steadily from 2.4 in 2000, to 10.38 in January of this year. I had a 6 site biospy on 7/05, and another 12 site biospy on 5/09 when my PSA was 6.30. After both biospies I was told I had mild to moderate prostatities. Today my urologist recomend another biospy. I trust my urologist a great deal, however, he only does a six site biospy. If I want a "carpet biospy" I had to travel to a larger medical center 100 miles from here and establish a relationship with another urologist. Given my history of gross hermaturia am I wise to have any more than a six site biospy? What are the odds of a 12 or 14 site biospy turning up a malignancy over a six site biospy given I've already had 18 sites biospied. I would much prefer to have this biospy locally, do you think if I had six more sites that I could rest assured that I'm cancer free at least right now? Although I'd like to have this biospy locally, I don't want to take any unnecessary chances either.