A new box wouldn't be necessary, but if you decide to subscribe to digital cable or HD cable, if your TV is HD, the cable companies don't charge you to use their boxes (atleast none that I have do). Usually you get a lot more channels for not a lot more money, I think it's a $10 a month bump for standard to the lowest digital package and it doubles the channels that I have for my company plus I get the HD with DVR receiver and 10 HD channels for no extra charge (Time Warner Cable is pretty all right like that) I've had Comcast in the past and they charge like $6 or $10 a month extra for the HD channels (not a good deal to me since they only carry like 17 or so channels)
And the optical from the tv won't do much for you since your tv probably doesn't upconvert the audio signal (it may do it but not too many of them do). Also you will only get surround sound from HD channels since they are the only ones, to my knowledge, broadcast in 5.1, everything else is in stereo.