Hi David...See my responses within your post...Best wishes and good
health, Ron

Just like treatment selection, many aspects of detection come down to
personal choice.  Both in the literature, as well as on lists like
this, I've read of men who had multiple biopsies (I think about 6 is
the most I've seen),with no evidence of cancer, but a continually
rising PSA.  Typically on the 3rd or 4th biopsy, PCa is Dx'd.  Such
cancers typically start in the transition zone and won't be detected by
standard TRUS biopsy until they grow large enough to have tumors in the
region sampled by the standard TRUS biopsy.  While TZ PCa is often less
aggresive and slow-growing, why give the bastard a head-start, why let
it grow in volume and mutate to a more aggresive form (higher GS)?  But
again, I recognize and respect the element of personal choice here.

Well, as many PCa-focused docs have pointed out, it gives you a heads
up that something may be happening.  Consequently, you have more time
to overcome the initial shock of recurrence and start planning.
Personally, for me, if I were to recur, I'd rather have a string of PSa
increases from 0.01 to 0.10 where I can 1) confirm the rising pattern,
2) get past the initial emotional trauma, 3) have enough measurements
to estimate a doubling time and 3) plan a course of action, so that I
could initiate action around PSA=0.2, rather than begin doing all of
that around PSA=0.1 and have to wait longer to start the fight; earlier
is always better.  Finally, there have been studies that suggest that
if your PSA remains below 0.01 for 3 years or so, you're less likely to
recur (hope they're true).  So, at least for me, there is also the
element of the test serving as a prognostic indicator (best case) or an
emotional crutch (worst case).  But again, I recognize the element of
personal choice here too..  

   Your argument would be more compelling if the cancer would go away, like
a small virus. Some want to know as early as possible, since early detection
and removal would put you on a better course for a cure.