Facing-Off with Prostate Cancer During the Coronavirus Pandemic

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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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

PSA—to test or not

How should a man decide whether to have a PSA test? In the UK, routine testing isn’t offered, but men over 50 years old can request the test from their GP. Digital decision aids abound, but do they help men to reach a decision compared with usual care (discussing the pros and cons with a doctor)?

This systematic review and meta-analysis of 19 randomised clinical trials comparing decision aids for prostate cancer screening in 12 781 men found that decision aids are probably associated with a small reduction in “decisional conflict,” possibly associated with an increase in knowledge and possibly not associated with whether physicians and patients discuss prostate cancer screening or what screening decision the man makes.

PSA is an imperfect test, and no amount of shared decision making can get round that.

From https://blogs.bmj.com/bmj/2019/07/03/ann-robinsons-journal-review-3-july-2019/

National Cancer Survivor’s Day

 

 

Observed annually on the first Sunday in June, National Cancer Survivor’s Day has been set aside to “demonstrate that life after a cancer diagnosis can be a reality.”

Each year on National Cancer Survivor’s Day, events and celebrations are held and hosted around the United States by local communities, hospitals and support groups honoring cancer survivors.  Events may include parades, carnivals, art exhibits, contests and testimonies. President George W. Bush and the National Cancer Institute director each included a commencement at the 2008 celebration.

 

So today is my day and my mom’s day and countless other people’s day.  I’m a kidney cancer survivor – 13 years now!

My mom survived colon cancer TWICE

My sister-in-law survived breast cancer TWICE

My DH survived melanoma and is working hard at surviving prostate cancer.

It hasn’t been all good though.  There have been many more in my extended family who did not survive, including my dad and my aunt. 

 

Congratulations to the survivors on this special “Who Knew” holiday, National Cancer Survivor’s Day

 

 

New treatment lowers risk for death from aggressive prostate cancer by over 70 percent

Some of the 165,000 U.S. men who are estimated to receive a new diagnosis of prostate cancer this year will develop resistance to hormonal therapies for the disease, but a new study by a doctor now at Northwestern Memorial Hospital points to use of an existing drug to help treat them.This kind of aggressive cancer has challenged doctors, as effective treatment to improve outcomes for these men hadn’t existed previously.

But a clinical trial led by Dr. Maha Hussain, now an oncologist at Northwestern Memorial, showed that taking a drug, enzalutamide, resulted in a 71 percent lower risk of cancer spread or death, compared to those taking a placebo during the three-year trial. The patients involved all had prostate cancer that hadn’t spread but that also had not responded to hormone treatment.

Men taking the drug also had delayed cancer reappearance for almost two years.

Read the entire article at New treatment lowers risk for death from aggressive prostate cancer by over 70 percent, study finds – Chicago Tribune

Doctor Offers Cutting-Edge Treatment

EUGENE, Ore. — The Willamette Valley Cancer Institute and Research Center offers a cutting-edge treatment to help patients with prostate cancer improve their quality of life.

When William Marshall was first diagnosed with prostate cancer in 2016 he said he was concerned about how traditional treatments could impact his life. He said he went to a support group and saw people wearing diapers and colonoscopy bags and worried he wouldn’t be able to do many of the things he enjoys like hiking, hunting, and fishing.

Then he saw a commercial about a new treatment the Cancer Center was offering.

The treatment is called SpaceOAR which is essentially a gel that is put between the prostate and rectum that separates the organs. Its designed for patients who use radiation to treat their prostate cancer. By separating the organs, the gel helps reduce the amount of radiation to organs surrounding the prostate. The gel is temporary and will only stay in the body for about three months before it dissolves.

Dr. Thomas Sroka, a radiation oncologist with the Cancer Center, said inserting the gel is a minimally invasive procedure that can reduce long-term side effects like chronic pain, irritation, diarrhea, and bleeding.

“Radiation treatments are already effective at curing prostate cancer, but this is really something now that is focused on just improving the patients quality of life during treatment and after treatment,” Sroka said.

Sroka said patients getting the treatment done are often able to avoid the negative side effects.

Marshall said the treatment changed his life and helped him manage his cancer.

“I’ve been able to do exactly what I have my whole life without any second thoughts about that cancer that I have that I now believe is gone,” Marshall said.

Marshall said now he wants to make sure other people dealing with similar circumstances know the treatment is an option.

Currently, Sroka is the only doctor in Oregon who can perform the procedure. However, he said Medicare has now recognized the treatment and he expects more doctors to become certified.

From http://www.kezi.com/content/news/Willamette-Valley-Cancer-Institute-and-Research-center-offers-innovative-treatment-for-prostate-cancer-patients-478918853.html