Prostate cancer is now the commonest cancer diagnosed in Australia. In 2005 there were 5913 men diagnosed with prostate cancer in New South Wales alone (31% of male cancers; 17% of all cancers). However, that year there were only 980 deaths from prostate cancer in NSW, and so prostate cancer dropped to be the fourth commonest cause of cancer death, ahead of breast cancer with 877 deaths. This discrepancy is a major cause of the angst experienced in the detection and management of prostate cancer. What is needed is a way to separate the significant prostate cancers from the insignificant ones, and accept that identifying them is a very different issue to managing them aggressively.