For men with localized prostate cancer, surgery does not save lives and it has a much higher rate of complications such as impotence and incontenance. However, once a man knows he has prostate cancer, he has a powerful drive to get it out even if the data does not support this approach. The word, "cancer" scares us.
We need much better and affordable screening tests so we can identify the three percent of men who will die from localized prostate cancer. Unfortunately, far too many of the 97% who do not benefit from surgery will still have it because of fear.
We now know that the PSA test is good to follow people with prostate cancer, but it often leads to unnecessary treatment. The MRI is too expensive as a screening tool, and 3D-4D sonograms, while much less expensive is helpful to follow people with localized prostate cancer.