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1.
Health Expect ; 25(4): 1319-1331, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1961572

ABSTRACT

INTRODUCTION: The supportive care needs of men with prostate cancer (PCa) have been well documented, but little is known about how an online portal may address these. This study sought to determine priority issues facing men with PCa, barriers and enablers to accessing care and whether health professionals (HPs) and men would support the inclusion of a patient-reported outcome (PRO) comparator tool. METHODS: We conducted four online focus groups with HPs recruited from healthcare services in Victoria, followed by seven online codesign workshops with men with PCa, recruited through the Victorian Prostate Cancer Outcomes Registry, Prostate Cancer Foundation Australia and the Cancer Council Victoria. Men were eligible to participate if they had lived experience of PCa and access to the internet. We analysed focus groups thematically. Workshops were analysed using descriptive-content analysis. RESULTS: HPs (n = 39) highlighted that men had shifting priorities over time, but noted the importance of providing information to men in lay terms to assist in treatment decision-making and side-effect management. HPs identified key enablers to men accessing support services such as practice nurses, partners and having men share their stories with each other. HPs raised financial, cultural, geographic and emotional barriers to accessing supportive care. Inclusion of a PRO comparator tool received mixed support from HPs, with 41% (n = 16) supportive, 49% (n = 19) unsure and 10% (n = 4) not supportive. Men involved in workshops (n = 28) identified informational needs to assist in treatment decision-making and side-effect management as the top priority throughout care. Men described support groups and practice nurses as key enablers. Short consultation times and complex information were described as barriers. Unlike HPs, all men supported the inclusion of a PRO comparator tool in a portal. CONCLUSIONS: Our findings suggest that a patient support portal should provide information in lay terms that address the shifting priorities of men with PCa. Men with PCa would welcome the development of a portal to centralize support information and a PRO comparator tool to prompt health-seeking behaviour. Future research will implement these findings in the development of a portal, and pilot and evaluate the portal within a population-based sample. PATIENT OR PUBLIC CONTRIBUTION: This project adopted a codesign approach including both men with PCa and HPs involved in PCa care. Men with PCa also formed part of the study's steering committee and consumer advisory groups. HPs were consulted in a serious of online focus groups. Subsequently, men with PCa and their support persons participated in workshops. Men with PCa were also involved in the preparation of this manuscript.


Subject(s)
Health Personnel , Prostatic Neoplasms , Focus Groups , Health Services Research , Humans , Male , Prostatic Neoplasms/psychology , Prostatic Neoplasms/therapy , Victoria
3.
Front Endocrinol (Lausanne) ; 13: 872411, 2022.
Article in English | MEDLINE | ID: covidwho-1809372

ABSTRACT

Since 2019, coronavirus disease 2019 (COVID-19) has swept the world and become a new virus threatening the health of all mankind. The survey found that prostate cancer accounts for one in three male cancer patients infected with COVID-19. This undoubtedly makes prostate cancer patients face a more difficult situation. Prostate cancer is the second most harmful malignant tumor in men because of its insidious onset, easy metastasis, and easy development into castration-resistant prostate cancer even after treatment. Due to its high immunogenicity and a small number of specific infiltrating T cells with tumor-associated antigens in the tissue, it is difficult to obtain a good therapeutic effect with immune checkpoint blocking therapy alone. Therefore, in the current study, we developed a platform carrying Doxorubicin (DOX)-loaded black phosphate nanometer combined with photothermal therapy (PTT) and found this drug combination stimulated the immungentic cell death (ICD) process in PC-3 cells and DC maturation. More importantly, zinc ions have a good immunomodulatory function against infectious diseases, and can improve the killing ability of the nanosystem against prostate cancer cells. The introduction of Aptamer (Apt) enhances the targeting of the entire nanomedicine. We hope that this excellent combination will lead to effective treatment strategies for prostate cancer patients infected with COVID-19.


Subject(s)
COVID-19 , Prostatic Neoplasms , COVID-19/therapy , Humans , Male , Nanoparticle Drug Delivery System , Phosphorus , Photothermal Therapy , Prostatic Neoplasms/complications , Prostatic Neoplasms/therapy , Zinc
5.
Cancer Treat Res Commun ; 31: 100553, 2022.
Article in English | MEDLINE | ID: covidwho-1768026

ABSTRACT

INTRODUCTION: The COVID-19 outbreak has affected care for non-COVID diseases like cancer. We evaluated the impact of the COVID-19 outbreak on prostate cancer care in the Netherlands. METHODS: Prostate cancer diagnoses per month in 2020-2021 versus 2018-2019 were compared based on preliminary data of the Netherlands Cancer Registry (NCR) and nationwide pathology network. Detailed data was retrieved from the NCR for the cohorts diagnosed from March-May 2020 (first COVID-19 wave) and March-May 2018-2019 (reference). Changes in number of diagnoses, age, disease stage and first-line treatment were compared. RESULTS: An initial decline of 17% in prostate cancer diagnoses during the first COVID-19 wave was observed. From May onwards the number of diagnoses started to restore to approximately 95% of the expected number by the end of 2020. Stage at diagnosis remainedstable over time. In low-risk localised prostate cancer radical prostatectomy was conducted more often in week 9-12 (21% versus 12% in the reference period; OR=1.9, 95% CI; 1.2-3.1) and less active surveillance was applied (67% versus 78%; OR=0.6, 95% CI; 0.4-0.9). In the intermediate-risk group, a similar change was observed in week 13-16. Radical prostatectomy volumes in 2020 were comparable to 2018-2019. CONCLUSION: During the first COVID-19 wave the number of prostate cancer diagnoses declined. In the second half of 2020 this largely restored although the number remained lower than expected. Changes in treatment were temporary and compliant with adapted guidelines. Although delayed diagnoses could result in a less favourable stage distribution, possibly affecting survival, this seems not very likely.


Subject(s)
COVID-19 , Prostatic Neoplasms , COVID-19/epidemiology , Disease Outbreaks , Humans , Male , Netherlands/epidemiology , Prostatectomy , Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/pathology , Prostatic Neoplasms/therapy
9.
Curr Opin Urol ; 32(3): 311-317, 2022 05 01.
Article in English | MEDLINE | ID: covidwho-1684904

ABSTRACT

PURPOSE OF REVIEW: The Coronavirus disease 2019 (COVID-19) pandemic has led to uncertainty on the optimal management for prostate cancer (PCa). This narrative review aims to shed light on the optimal diagnosis and management of patients with or suspected to have PCa. RECENT FINDINGS: Faecal-oral or aerosol transmission is possible during prostate procedures; caution must be in place when performing digital rectal examinations, transrectal ultrasound-guided prostate biopsies and prostate surgeries requiring general anaesthesia. Patients must also be triaged using preoperative polymerase chain reaction tests for COVID-19. COVID-19 has accelerated the adoption of multiparametric Magnetic Resonance Imaging (MRI), reducing the need for prostate biopsy unless when absolutely indicated, and the risk of COVID-19 spread can be reduced. Combined with prostate-specific antigen (PSA) density, amongst other factors, multiparametric MRI could reduce unnecessary biopsies in patients with little chance of clinically significant PCa. Treatment of PCa should be stratified by the risk level and preferences of the patient. COVID-19 has accelerated the development of telemedicine and clinicians should utilise safe and effective teleconsultations to protect themselves and their patients. SUMMARY: COVID-19 transmission during prostate procedures is possible. Patients with a Prostate Imaging-Reporting and Data System (PI-RADS) of <3 and PSA density <0.15 ng/ml/ml are deemed low-risk and are safe to undergo surveillance without MRI-targeted biopsy. Intermediate- or high-risk patients should be offered definitive treatment within four months or 30days of diagnosis to avoid compromising treatment outcomes; three-month courses of neoadjuvant androgen deprivation therapy can be considered when a delay of surgery is anticipated.


Subject(s)
COVID-19 , Prostatic Neoplasms , Androgen Antagonists , Humans , Image-Guided Biopsy/methods , Magnetic Resonance Imaging/methods , Male , Prostate-Specific Antigen , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/pathology , Prostatic Neoplasms/therapy , Retrospective Studies
10.
Support Care Cancer ; 30(7): 5553-5555, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1661697

ABSTRACT

Prostate cancer (PCa) affects 1 in 8 men, but exercise therapy has been shown to be a very effective intervention not only to induce physiological benefits but to also reduce the side effects of cancer treatments typically administered during PCa. The COVID19 pandemic has restricted access to exercise clinics, a problem which always existed for people living in rural and remote areas. This caused many exercise physiologists and researchers to transition their clinic-based exercise to online, home-based exercise. We would like to propose that researchers and exercise physiologists should consider the use of elastic tubes in both research and the clinical management of PCa, when exercise programs are administered remotely, as their characteristics make them an ideal exercise equipment. In this article, the characteristics, considerations, and information on quantifying exercise dosage when using elastic tubes in remote exercise delivery are discussed.


Subject(s)
COVID-19 , Prostatic Neoplasms , Telemedicine , Exercise , Exercise Therapy , Humans , Male , Prostatic Neoplasms/therapy
11.
BJU Int ; 130(2): 262-270, 2022 08.
Article in English | MEDLINE | ID: covidwho-1649592

ABSTRACT

OBJECTIVE: To determine the impact of the COVID-19 pandemic on diagnostic and treatment activity in 2020 across hospital providers of prostate cancer (PCa) care in the English National Health Service. METHODS: Diagnostic and treatment activity between 23 March (start of first national lockdown in England) and 31 December 2020 was compared with the same calendar period in 2019. Patients newly diagnosed with PCa were identified from national rapid cancer registration data linked to other electronic healthcare datasets. RESULTS: There was a 30.8% reduction (22 419 vs 32 409) in the number of men with newly diagnosed PCa in 2020 after the start of the first lockdown, compared with the corresponding period in 2019. Men diagnosed in 2020 were typically at a more advanced stage (Stage IV: 21.2% vs 17.4%) and slightly older (57.9% vs 55.9% ≥ 70 years; P < 0.001). Prostate biopsies in 2020 were more often performed using transperineal (TP) routes (64.0% vs 38.2%). The number of radical prostatectomies in 2020 was reduced by 26.9% (3896 vs 5331) and the number treated by external beam radiotherapy (EBRT) by 14.1% (9719 vs 11 309). Other changes included an increased use of EBRT with hypofractionation and reduced use of docetaxel chemotherapy in men with hormone-sensitive metastatic PCa (413 vs 1519) with related increase in the use of enzalutamide. CONCLUSION: We found substantial deficits in the number of diagnostic and treatment procedures for men with newly diagnosed PCa after the start of the first lockdown in 2020. The number of men diagnosed with PCa decreased by about one-third and those diagnosed had more advanced disease. Treatment patterns shifted towards those that limit the risk of COVID-19 exposure including increased use of TP biopsy, hypofractionated radiation, and enzalutamide. Urgent concerted action is required to address the COVID-19-related deficits in PCa services to mitigate their impact on long-term outcomes.


Subject(s)
COVID-19 , Prostatic Neoplasms , COVID-19/epidemiology , Communicable Disease Control , Humans , Male , Pandemics , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/therapy , State Medicine
12.
PLoS One ; 16(10): e0255966, 2021.
Article in English | MEDLINE | ID: covidwho-1456078

ABSTRACT

BACKGROUND: Men have a higher risk of death from COVID-19 than women and androgens facilitate entrance of the SARS-CoV-2 virus into respiratory epithelial cells. Thus, androgen deprivation therapy may reduce infection rates and improve outcomes for COVID-19. In the spring of 2020, Sweden was highly affected by COVID-19. The aim was to estimate the impact of androgen deprivation therapy on mortality from COVID-19 in men with prevalent prostate cancer by comparing all-cause mortality in the spring of 2020 to that in previous years. PATIENTS AND METHODS: Using the Prostate Cancer data Base Sweden all men with prostate cancer on March 1 each year in 2015-2020 were followed until June 30 the same year. Exposure to androgen deprivation therapy was ascertained from filled prescriptions for bicalutamide monotherapy, gonadotropin-releasing hormone agonists (GnRH), or bilateral orchidectomy. RESULTS: A total of 9,822 men died in March-June in the years 2015-2020, of whom 5,034 men were on androgen deprivation therapy. There was an excess mortality in 2020 vs previous years in all men. The crude relative mortality rate ratio for 2020 vs 2015-2019 was 0.93 (95% confidence interval (CI) 0.83 to 1.04) in men on GnRH, and 0.90 (95% CI 0.78 to 1.05) in men on bicalutamide monotherapy. After multivariable adjustment these ratios were attenuated to 1.00 (95% CI 0.89 to 1.12) and 0.97 (95% CI 0.84 to 1.12), respectively. When restricting the analysis to the regions with the highest incidence of COVID-19 or to the time period between 2 April to 10 June when mortality in 2020 was increased >30% compared to previous years, the results were similar to the main analysis. CONCLUSIONS: In this large national population-based cohort of men with prevalent prostate cancer, there was no clear evidence in support for an effect of androgen deprivation therapy on COVID-19 mortality.


Subject(s)
Androgen Antagonists/administration & dosage , COVID-19/mortality , Databases, Factual , Pandemics , Prostatic Neoplasms/mortality , Registries , SARS-CoV-2 , Aged , Aged, 80 and over , COVID-19/therapy , Disease-Free Survival , Humans , Male , Middle Aged , Prostatic Neoplasms/therapy , Survival Rate
13.
Actas Urol Esp (Engl Ed) ; 45(8): 530-536, 2021 10.
Article in English, Spanish | MEDLINE | ID: covidwho-1415156

ABSTRACT

INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic has brought about changes in the management of urology patients, especially those with prostate cancer. The aim of this work is to show the changes in the ambulatory care practices by individualized telematic care for each patient profile. MATERIALS AND METHODS: Articles published from March 2020 to January 2021 were reviewed. We selected those that provided the highest levels of evidence regarding risk in different aspects: screening, diagnosis, treatment and follow-up of prostate cancer. RESULTS: We developed a classification system based on priorities, at different stages of the disease (screening, diagnosis, treatment and follow-up) to which the type of care given, in-person or telephone visits, was adapted. We established 4 options, as follows: in priority A or low, care will be given by telephone in all cases; in priority B or intermediate, if patients are considered subsidiary of an in-person visit after telephone consultation, they will be scheduled within 3 months; in priority C or high, patients will be seen in person within a margin from 1 to 3 months and in priority D or very high, patients must always be seen in person within a margin of up to 48 h and considered very preferential. CONCLUSIONS: Telematic care in prostate cancer offers an opportunity to develop new performance and follow-up protocols, which should be thoroughly analyzed in future studies, in order to create a safe environment and guarantee oncologic outcomes for patients.


Subject(s)
Ambulatory Care/organization & administration , COVID-19/epidemiology , Delivery of Health Care/organization & administration , Pandemics , Prostatic Neoplasms/therapy , Telemedicine , Appointments and Schedules , Continuity of Patient Care , Delivery of Health Care/methods , Health Priorities/organization & administration , Humans , Male , Prostatic Neoplasms/diagnosis , SARS-CoV-2 , Time Factors
14.
Urology ; 155: 179-185, 2021 09.
Article in English | MEDLINE | ID: covidwho-1411044

ABSTRACT

OBJECTIVE: To determine the attitudes and education regarding surgical castration in men receiving androgen deprivation therapy (ADT) for metastatic prostate cancer (mCaP). METHODS: We identified 142 patients receiving ADT for mCaP at our institution without prior orchiectomy who were then sent 2 surveys via mail: (1) A questionnaire to assess knowledge and understanding of ADT treatment alternatives and (2) the functional assessment of cancer therapy - prostate (FACT-P) questionnaire which determines health-related quality of life (HRQOL). Two cohorts were created based on the answer to "would you be interested in surgical orchiectomy?" and demographic, CaP and HRQOL were compared between the surgical castration yes (SC+) and surgical castration no (SC-) cohorts. A second analysis identified predictors of worse HRQOL. RESULTS: Of 68 (47.9%) patients that responded to the survey, only 39 (59.1%) recalled a discussion regarding treatment alternatives to ADT and only 22 (33.3%) recalled a discussion regarding orchiectomy. There were 24 (40.0%) patients that stated interest in undergoing orchiectomy (SC+) as an alternative to ADT with the only independent risk factor being "…bother from the number of clinical appointments required for ADT…" Patients most bothered by side effects and cosmetic changes associated with ADT reported lower HRQOL scores on the FACT-P. CONCLUSIONS: Few men on ADT knew about surgical alternatives, implying that educational deficits may be a significant factor in the decline in the utilization of orchiectomy. Changes in healthcare economics, utilization and delivery brought on by a global pandemic should warrant a fresh look at the use of surgical castration.


Subject(s)
Health Knowledge, Attitudes, Practice , Orchiectomy/psychology , Prostatic Neoplasms/therapy , Quality of Life , Aged , Androgen Antagonists/therapeutic use , Humans , Male , Neoplasm Metastasis , Patient Acceptance of Health Care , Patient Education as Topic , Prostatic Neoplasms/pathology , Surveys and Questionnaires
15.
Prostate ; 81(15): 1107-1124, 2021 11.
Article in English | MEDLINE | ID: covidwho-1380409

ABSTRACT

BACKGROUND: The 27th Annual Prostate Cancer Foundation (PCF) Scientific Retreat was held virtually from October 20 to 23, 2020. METHODS: The Annual PCF Scientific Retreat is a global scientific research conference that highlights the most promising and cutting edge advances in prostate cancer basic, translational and clinical research, as well as research from other fields with a strong potential for advancing prostate cancer research. RESULTS: Primary areas of research discussed at the 2020 PCF Retreat included: (i) the intersection between prostate cancer and COVID-19 research; (ii) lessons from the COVID-19 pandemic that may address prostate cancer disparities; (iv) the role of the microbiome in cancer; (v) current challenges in treatment of patients with metastatic prostate cancer; (viii) prostate cancer germline genetics and evolutionary genomics; (ix) advances in circulating DNA methylation biomarkers for diagnosis, prognosis, and treatment selection; (x) advances in the development of MYC-targeting therapeutics; (xi) advances in antibody-drug conjugates for the treatment of cancer; (xii) advances for immunotherapy in prostate cancer; and (xiii) updates from other recent prostate cancer clinical trials. CONCLUSIONS: This article summarizes the research presented at the 2020 PCF Scientific Retreat. We hope that dissemination of this knowledge will help to accelerate and direct the next major advances in prostate cancer research and care.


Subject(s)
COVID-19 , Prostatic Neoplasms , SARS-CoV-2 , Androgens , Animals , Biomarkers, Tumor , Biomedical Research , DNA Methylation , Genetic Predisposition to Disease/ethnology , Genomics , Healthcare Disparities , Humans , Immunotherapy , Male , Mice , Microbiota , Mutation , Pandemics , Prognosis , Prostatic Neoplasms/genetics , Prostatic Neoplasms/microbiology , Prostatic Neoplasms/therapy
16.
Cancer Control ; 28: 10732748211024239, 2021.
Article in English | MEDLINE | ID: covidwho-1277868

ABSTRACT

INTRODUCTION: The health profile of older adults places them at risk of infirmity and death from COVID-19 which may induce anxiety or exacerbate pre-existing anxiety. We examined COVID-19 related anxiety in men undergoing treatment for prostate cancer (CaP). METHOD: This study was conducted between July and September 2020. Sixty participants from a larger prospective, longitudinal study assessing depression, anxiety and health related quality of life in men with localized prostate cancer (DAHCaP) were included. COVID-19 related anxiety was measured at a single time point using, the Corona Virus Anxiety Scale (CAS). In addition, the following, the State-Trait Anxiety Inventory (STAI-S), the Connor-Davidson Resilience (CD-RISC) scale and Multidimensional Scale of Perceived Social Support (MSPSS) that form part of the DAHCaP study were used in the analysis. We extracted pre-pandemic data for the STAI-S. RESULTS: Twenty-one percent had diabetes, 62.3% had hypertension and 24.6% had cardiac diseases, all known risk factors for severe COVID-19. Only 3% scored ≥9 on the CAS, indicating COVID 19 anxiety dysfunction. Half knew of family or friends that had contracted COVID-19 especially those scoring higher on the CAS (P = 0.042). There was a significant decrease in STAI-S scores pre-pandemic to the pandemic phase (34.7 to 29.8, P = 0.003). No correlation was observed between CAS and STAI-S (rho = 0.08), CD-RISC (rho = -0.06) or MSPSS (rho = -0.15). There was a weak positive correlation between the CAS and monthly income (rho = 0.33; P = 0.010). CONCLUSION: COVID-19 did not induce significant anxiety in men being treated for CaP nor did it place an additional psychological burden, nor was there any correlation with state anxiety, resilience or social support.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Depression/psychology , Prostatic Neoplasms/psychology , Quality of Life/psychology , Aged , Health Status , Humans , Longitudinal Studies , Male , Middle Aged , Prospective Studies , Prostatectomy , Prostatic Neoplasms/therapy , Psychometrics , Resilience, Psychological , SARS-CoV-2 , Social Support , South Africa , Surveys and Questionnaires , Tertiary Care Centers
17.
Anticancer Res ; 41(6): 3127-3130, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1259822

ABSTRACT

BACKGROUND/AIM: To evaluate the diagnosis and treatment of prostate cancer (PCa) during 1 year of the COVID-19 pandemic. PATIENTS AND METHODS: The management of men with PCa during COVID-19 pandemic (March 2020-2021) was compared with the clinical activity of the 12 months before the COVID-19 pandemic (March 2019-2020). RESULTS: The number of clinical visits, prostate biopsy, and men enrolled in active surveillance was significantly lower during the COVID-19 pandemic (p<0.05); on the contrary, the number of cases with advanced (pT3b: 11.2 vs. 25.6%; nodal positive: 14.8 vs. 46.1%) and metastatic (5.9 vs. 9.3%) PCa increased. The number of open radical prostatectomies increased compared with the ones using a laparoscopic approach; moreover, more men were treated with external radiotherapy (25.1 vs. 54.2%). CONCLUSION: The guideline recommendations in the management of PCa should constantly adapt to the epidemiological evolution, but the overall cost of delayed diagnosis will increase in the near future.


Subject(s)
COVID-19/epidemiology , Pandemics , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/therapy , COVID-19/virology , Humans , Male , Prostatic Neoplasms/pathology , SARS-CoV-2/isolation & purification
18.
Scand J Urol ; 55(3): 184-191, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1207211

ABSTRACT

INTRODUCTION: The first case of COVID-19 in Sweden was diagnosed in late January 2020, the first recommendations against the spread of the virus were released in mid-March, and the peak of the first wave of the pandemic was reached in March-June. The aim of this cross-sectional study was to assess the short-term effects of the first wave of the COVID-19 pandemic on prostate cancer (PCa) diagnosis, staging, and treatment. MATERIALS AND METHODS: Data in the National Prostate Cancer Register (NPCR) of Sweden on newly diagnosed PCa cases and on the number of diagnostic and therapeutic procedures performed between 18 March 2020 and 2 June 2020 were compared with those in the corresponding time periods in 2017-2019, as reported until January 31 of the year after each study period. RESULTS: During the study period in 2020, 36% fewer PCa cases were registered in NPCR compared with the corresponding time period in previous years: 1458 cases in 2020 vs a mean of 2285 cases in 2017-2019. The decrease in new PCa registrations was more pronounced in men above age 75 years, down 51%, than in men aged 70-75, down 37%, and in men below age 70, down 28%. There was no decrease in the number of radical prostatectomies and number of radical radiotherapy courses increased by 32%. CONCLUSIONS: During the peak of the first phase of the COVID-19 pandemic, the number of men diagnosed with PCa in Sweden decreased by one third compared with previous years, whereas there was no decrease in the number of curative treatments.


Subject(s)
COVID-19/mortality , Delivery of Health Care/statistics & numerical data , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/therapy , Age Factors , Aged , Catchment Area, Health/statistics & numerical data , Cross-Sectional Studies , Humans , Male , Prostatectomy/statistics & numerical data , Prostatic Neoplasms/pathology , Radiotherapy/statistics & numerical data , Registries , SARS-CoV-2 , Sweden/epidemiology
20.
Asia Pac J Clin Oncol ; 17 Suppl 3: 48-54, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1186124

ABSTRACT

AIM: In response to the fast-developing coronavirus disease 2019 (COVID-19) pandemic, special arrangement and coordination are urgently required in the interdisciplinary care of patients across different medical specialties. This article provides recommendations on the management of different stages of localized or metastatic prostate cancer (PC) amid this pandemic. METHODS: The Hong Kong Urological Association and Hong Kong Society of Uro-oncology formed a joint discussion panel, which consisted of six urologists and six clinical oncologists with extensive experience in the public and private sectors. Following an evidence-based approach, the latest relevant publications were searched and reviewed, before proceeding to a structured discussion of relevant clinical issues. RESULTS: The joint panel provided recommendations for PC management during the pandemic, in terms of general considerations, diagnostic procedures, different disease stages, treatment modules, patient support, and interdisciplinary collaboration. The overall goal was to minimize the risk of infection while avoiding unnecessary delays and compromises in management outcomes. Practical issues during the pandemic were addressed such as the use of invasive diagnostic procedures, robotic-assisted laparoscopic prostatectomy, hypofractionated radiotherapy, and prolonged androgen deprivation therapy. The recommendations were explicated in the context of Hong Kong, a highly populated international city, in relation to the latest international guidelines and evidence. CONCLUSION: A range of recommendations on the management of PC patients during the COVID-19 pandemic was developed. Urologists, oncologists, and physicians treating PC patients may refer to them as practical guidance.


Subject(s)
COVID-19/epidemiology , Prostatic Neoplasms/therapy , SARS-CoV-2 , Androgen Antagonists/therapeutic use , Hong Kong/epidemiology , Humans , Male , Medical Oncology , Prostatectomy , Prostatic Neoplasms/pathology , Societies, Medical
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