Hello, I am Joel Nowak from Cancer ABCs. I want to talk with you about the best practices for treating prostate cancer in the time of COVID-19. This virus, COVID-19 has turned our entire world upside down including how you can best receive treatment for prostate cancer.
First, I want to say that just like before the COVID-19 era your best plan to treat your cancer must rely on excellent communications with your oncologists or urologists.
I just listened to an interview with Dr. Emmanuel Antonarakis from John’s Hopkins. The doctor is one of the super stars in both prostate cancer research and in prostate cancer treatment.
In the interview the doctor described how the COVID-19 virus has changed his practice, or rather I should say how he has changed his practice in light of the virus.
I am going to share some of his comments from the interview because I believe that his overall direction should merit your asking your own doctor if his experiences might be adaptable and productive for your own personal care.
Please be aware that what I am sharing with you should be carefully discussed with your own physician. In no way is Cancer ABCs suggesting that any of these descriptions of how Dr. Antonarakis has changed his practice might make sense for you and your treatment.
Overall, Dr. Antonarakis has converted as many of his patients as possible to telemedicine meetings, especially for on-going routine follow up care. Unless patients have a real need to be seen, they are not be seen face-to-face, but their meetings are either postponed or converted to a telemedicine meeting.
He cited the situation where he is treating a man on intermittent hormone therapy, or ADT, he will consider if there is any reason why this man can not simply skip one injection of his medication so that the man does not need to come into the hospital. He pointed out that hormone recovery is not immediate, but will usually take a number of months, so skipping an injection might not disrupt the treatment.
The doctor has also started using longer lasting ADT injections in order to allow a man not have to come into the hospital as often as they had in the past. For example, men who usually receive a 3-month injection might now receive a six-month injection.
For men who are still hormone sensitive, or still responding to primary ADT, and who otherwise would benefit from the early use of chemotherapy, if possible, he would now avoid the use of the chemotherapy. Instead, he would consider using an oral drug like Zytiga, Xtandi or Erleada to avoid the possibility of negatively impacting the man’s immune system as well as decreasing the patient and the staff’s exposures to each other.
Dr. Antonarakis did feel that for men who were castrate resistant, or no longer responding to primary ADT, he would still considers using chemotherapy, however he said that at Johns Hopkins the man will go into the hospital’s infusion center and deal solely with the infusion nurse. Then, afterwards the doctor would have a telemedicine call with the man instead of seeing them at the infusion center, again limiting potential interpersonal exposures.
These changes in the doctor’s clinical practice might not make sense for you or your treatment, but you might want to consider asking your own doctor if these types of changes might benefit you.
Remember, one of our goals at Cancer ABCs is to help you develop better questions for your doctor. Through better questions you too can become a cancer thriver.
This has been Joel Nowak. Remember, while the COVID-19 pandemic continues please follow the guidelines produced by the CDC.
Stay at home, if you do leave your house remember to wear a mask covering both your nose and mouth, don’t touch your hands to your face, where gloves and always wash your hands for 20 seconds using soap and water.