From my email today:
At PCF, we realize that many of you who have been affected by prostate cancer, or whose loved ones have been affected by prostate cancer, might be wondering if special precautions need to be taken with the coronavirus pandemic unfolding. We have always believed that evidence out of science and research are the best tools for solving patients’ problems, whether that’s cancer or public health emergencies. As such, we will do our best to use science to provide information and a steady hand in this tumultuous situation.
Scientists know that the coronavirus (aka COVID-19 COrona VIrus Disease 2019) can affect your immune system, although we are still learning more. Based on recent data as reported in the journal The Lancet, it appears that the virus hits the immune system early and knocks down the white blood cells that fight infections. This translates to respiratory disease for most patients who become sick with COVID-19.
The most important thing to remember, whether you have been affected by prostate cancer or not, is that if you are having symptoms as described here, such as a fever (99.1°F [37.3°C] or higher), persistent cough, or shortness of breath, you need to call your doctor.
If you are not having symptoms, it is important that you follow the guidelines to stay safe and avoid spreading the disease. It is critical that all citizens, not just those with prostate cancer, adhere to CDC and local public health guidelines (here’s an example of one source of local guidelines from the County of Los Angeles). You can view the full, trusted list of prevention tactics here, but our top three are: 1) wash your hands for 20 seconds with soap, especially after blowing your nose and before eating, 2) stay 6 feet away from people if you are out in public, and 3) keep your hands away from your face, where the virus can readily enter through your eyes, nose, and mouth.
That said, here are a few extra details for those of you in the prostate cancer journey:
- If you have been diagnosed with early-stage prostate cancer for example, you’re on active surveillance, are receiving radiation treatment, or are scheduled for surgery you are not at increased risk of severe disease with COVID-19. This is because early prostate cancer has not been shown to significantly affect your immune system and your ability to fight infection. Unlike some blood cancers, early prostate cancer does not affect your T cells’ and B cells’ (i.e., the cells that rule your immune system) ability to fight viral and bacterial infections normally.
- If you’re on a form of hormone therapy, there is no increased risk of severity. Extensive research in tens of thousands of patients on medications such as Lupron® or Zytiga® shows there is no evidence that these treatments put a prostate cancer patient at higher risk of viral infections like influenza.
- The situation is different for patients receiving chemotherapy (such as taxotere, carboplatin, or cabazitaxel) for advanced prostate cancer. Because chemotherapy affects rapidly-dividing cells in the body both cancerous and normal cells your bone marrow makes fewer infection-fighting cells, leaving you at higher risk for all types of infection. If your white blood cell count is being monitored, talk to your doctor before coming in for a clinic visit. You want to be assured that from getting out of your car to getting back into your car to go home, you are in a healthcare environment that is maximally prepared to reduce the spread of COVID-19 to cancer patients.
- Regarding the impact of COVID-19 on prostate cancer survivors, there is no data yet from China (the country where the disease has impacted the most people, and therefore where information is “leading”), but as we get it, we will share it with our community.
- Other co-existing medical conditions can increase your risk of severe disease if you are exposed to COVID-19, regardless of prostate cancer diagnosis. These include high blood pressure, diabetes, and heart disease. Respiratory conditions (e.g., asthma, emphysema, or former heavy smoking) and conditions that affect your immune system (e.g., inflammatory bowel disease or a history of transplant) may also increase your risk.
At PCF we are tracking any real-time data on COVID-19 in cancer patients that’s credible and peer-reviewed. PCF.org/COVID-19 lists a number of resources for patients and families, including the ones mentioned here. We will continue to update this page as more information becomes available.
With kind regards for the health of you and your family,
Jonathan W. Simons, MD
President and CEO
Prostate Cancer Foundation