Do all cancerous prostates need to be removed?

Usually found in the outer zone of the prostate, prostate cancer tends to be thought of as an all-or-nothing situation. Either you remove the prostate, or you die. However, not all prostate cancer needs to be treated aggressively with surgery (the side effects of removal can be urinary incontinence and sexual dysfunction, because the nerves that control erections are next to the prostate).

Certainly, prostate cancer needs to be followed more closely than a high-speed fugitive, but you should make treatment decisions taking into consideration such things as life expectancy, quality of life, potential side effects of treatment, and the aggressiveness of the cancer. Docs will use what's called the Gleason score to determine how aggressive the cells of the cancer are. About 90 percent of men have prostate cancer by age 90, and their life expectancy is generally not limited by this disease if they are older when diagnosed because the tumor is so slow growing—making it different from many other cancers.