Most prostate cancer progresses very slowly and is unlikely to metastasize.
It does usually progress slowly, until it doesn't, then it kills you (often painfully because it's metastasised to bone).
Very often, men with prostate cancer die of something completely unrelated.
This is what I was taught at medical school, it's also just what my dad was told 15 years ago, but the "you'll probably die of something else first" argument is just plain retarded. It's the same excuse idiots give for poor health behaviour like smoking. Medicine is getting better all the time, people aren't dying of other things so much as they used to, they are living longer and allowing these conditions to come into play. My dad was still in excellent health otherwise, in his 80s, when hormone treatment inevitably stopped working 14 years later. Treatment for prostate cancer needs to improve too, rather than just ignoring the condition.
On the other hand, operating on it can cause impotence and incontinence. If I ever get diagnosed with it, my first question to the doctor will be, "does it matter?", not a panicked question about how soon I can be scheduled for surgery
I can tell you, as a doctor, if I get diagnosed I will have surgery in the first available theatre slot. Yes there are potential side effects, significant ones (see my previous point about the need for treatment to get better), but I'm not (literally) going to sit on cancer that *will* go on kill me kill me unless I'm "lucky" enough to die of something else first.
The reason for similar outcomes in the UK of surgery or not, is likely the fact we don't have screening, something held off due to the fallacy that it's not harmful and we overtreatment. With proper screening and earlier intervention I am confident (though clearly can't prove it) that more radical treatment will be more effective when used earlier, than when it's currently identified and there are already micromets or local spread that surgery can't remove and will only be held in check for so long with hormone treatment.