Watchful waiting is a euphamism for a decision to die, and gambling that you will get a few years, or that you will die of something else.
Something for gambling fans.
Prostate Cancer feeds on testotserone, and Hormone injections kill the testosterone throughout the body, and would have been used in my case if the cancer had escapes from the prostate, which they suspected, but the side effects are huge, you finish up with bleeding and you only get a few years.
I have a friend who has had Brachytherapy (internal radiotherapy by inserting "seeds" into the tumor, which is usually associated with an early stage tumor, but this is a pathway of no return. If the cancer escapes, they can't take the prostate out.
My thinking is if you don't have a prostate the main source of the cancer production is gone.
Once you get into the cancer system you realise there are many forms and stages of the disease, and a big variety of effects on erectile and incontinence levels from zero effect on.
The PSA test does not exclusively report cancer, there are several other causes if high PSA, such as an infection, so of course no one relies on it alone, but I would have just a few months to live if I hadn't had one. That's why I recommended both tests. A high PSA reading may decide the specialist to do a biopsy, then there is no doubt.
Disclaimer. This has been a bush amateur's summary, but you are better off by far getting to a specialist in prostate cancer fast, having the diagnostics, and taking charge of your life. Do it early and most of you will get good news.