COVID-19 guidance for prostate cancer examinations, diagnosis and treatment

Examinations and treatment for prostate cancer, among other prostate conditions, have had to be adjusted during the coronavirus (COVID-19) pandemic. Mr Ballaro, a senior consultant urologist, is working through the pandemic assisting new and existing patients with their prostate health. Read on to learn about how you can have a consultation and, if needed, a physical examination to address your concerns.

I'm having prostate cancer treatment, could I get very ill if I contract coronavirus?

The answer to that is yes, there’s a possibility to get very ill if you contract coronavirus while undergoing cancer treatment, although the instance of this continues to fall rapidly.

In my opinion, there is clearly a risk of a second wave and whether you’re undergoing  prostate cancer treatment or not, the coronavirus pandemic is severe. If you’ve been advised to have an exam or treatment, it’s highly important that you go to your clinic no matter the scenario.

However, there are various types of prostate cancer and varying severities: Patients with low or intermediate-risk disease arguably don’t need very urgent treatment.

If I need urgent cancer treatment, will I be safe during my visit to the hospital?

Yes, hospitals have made very widespread and high-level changes based on the best science available and are very careful to protect patients. Both the NHS and private healthcare institutions are doing everything possible to ensure the maximum level of safety.

I have prostate-related symptoms; does this mean I have prostate cancer?

The first thing to say is that prostate cancer may not cause symptoms at all - it’s generally picked up through routine testing and then diagnosed using prostate MRI (magnetic resonance imaging) scans.

If prostate cancer causes symptoms, it’s most often because the cancer is in an advanced stage. However, prostate symptoms are very commonly caused by benign (non-cancerous) prostatic problems such as benign prostatic enlargement (benign prostatic hyperplasia). Furthermore, it’s important to understand that both prostate cancer and prostatic enlargements grow more common as men get older and are not mutually exclusive.

When should I get my prostate tested?

All patients with prostate symptoms should undergo a rectal examination of the prostate by an experienced clinician (such as a urologist) to exclude advanced prostate cancer and to have a discussion regarding the pros and cons of PSA testing.

The debate surrounding PSA (prostate-specific antigen) tests as a screening tool for prostate cancer continues and there is no UK national prostate screening programme. Men are informed of the risks and benefits of a PSA test with their urologist and they can make an informed decision.

How can symptoms be managed during the pandemic?

The majority of mild prostate symptoms can be managed by modifying fluid intake. However, if prostate symptoms become bothersome, patients should discuss them with their GP or urologist as there are a number of additional measures that can be employed to improve these symptoms, including medications and surgical procedures.

In the current COVID environment, each patient should weigh up the risks of seeking medical treatment at hospital (which has been greatly reduced due to hygiene measures) and the severity of their symptoms. Despite surgical procedures for benign prostate enlargement generally being delayed because they’re not as clinically urgent as cancer operations, there is still a lot we (urologists) can do to help in terms of advice and medications.

Can I get a physical exam during the pandemic?

Before COVID, we didn’t do video consultations. Since the beginning of the pandemic, we’ve been doing most of our patient-doctor interactions online.

This has many benefits but it does have downsides in that a physical examination can’t take place. In my practice at the Hospital of Saint John and Saint Elizabeth, I have two consultations a week where any patient can come in and be seen by myself. Many private hospitals are not allowing face-to-face consultations or are only allowing them on a named patient basis for certain conditions. Having the ability to see patients without prior consultations, unlike other private practices, has been very helpful.

Whether you’re a new patient or an existing one, I’m available to have a video call with your through e-Consultation (the video consultation service by Top Doctors) and if you need a physical examination, we can arrange for you to come to whichever of my clinics is most convenient for you.

If you’re worried about your prostate health, Mr Ballaro is readily available to help you resolve your concerns via video consultation and if necessary, receive further examination or treatment – book your consultation via his profile.