Coronavirus and prostate cancer

I’m worried about prostate cancer – can I see a GP?

Yes – your GP surgery is open and it’s important to contact them if you have any unusual symptoms or are worried about your risk of prostate cancer. If you’ve noticed changes in the way you urinate (wee), this is likely to be caused by a non-cancerous problem, rather than prostate cancer. But it’s important to get any symptoms checked out, so that your GP can help find out what is causing them.

Your GP may offer you a phone or video appointment to discuss your concerns. Then they might ask you to book another appointment if they want to see you in person. At this appointment, if your GP thinks you may have prostate cancer or a prostate problem, they may do a digital rectal examination (DRE) and a urine test to rule out infection. They may also offer you a PSA blood test and discuss its pros and cons.

Find out more information about these tests.

If you do struggle to get an appointment, contact our Specialist Nurses. They can listen to your concerns and help you prepare to speak to your GP surgery.

How do I make the most of my phone appointments?

Since the pandemic began, you may have started having telephone or video appointments with your GP, hospital doctor or specialist nurse.

When you’re talking to your doctor or nurse, you might find it difficult to take everything in. It can be particularly difficult having these discussions over the phone, rather than in-person with a health professional.

You may have a lot of questions, such as how coronavirus could affect your diagnosis, treatment or monitoring. You may also feel anxious about the future and how having prostate cancer will affect your life and your loved ones. It’s completely normal to feel like this. Everyone reacts differently when they have prostate cancer – there’s no right or wrong way.

It may help to think about some of the questions you want to ask your doctor or nurse. Write down your questions, as well as any concerns, thoughts or feelings, so that you remember to discuss them. You might find writing in a diary or a journal helpful.

If you’re planning a phone or video appointment, remember that calls from your GP surgery or hospital may come from a withheld number, or you may not recognise the number. It may be worth answering any calls from withheld numbers or numbers you don't recognise at this time; in case your doctor or nurse is trying to contact you.

When your doctor or nurse calls, find a quiet or private room in your home. You may want to put the phone on speakerphone so that your partner or a family member can also listen to the call. If your loved one doesn’t live with you, you could ask if it’s possible to include them in the phone call as well.

It can also help to write down or record what’s said to help you remember or to listen again in your own time. You have the right to record what is said because it’s your personal data, but you should always let your doctor or nurse know that you are recording the conversation.

It might also help to keep a note of the names and contact details of the health professionals you speak to. This will help you remember who is involved in your care, and who to contact if you have any questions.

Make sure you take all the time you need to ask the questions you want. Just because you’re speaking on the phone doesn’t mean you have to rush the conversation. Your doctor or nurse will want to be sure you have all the information you need.

I’m having prostate cancer treatment – could coronavirus make me very ill?

The effects of coronavirus infection could be particularly severe for certain people with prostate cancer. In particular men having the following treatments:

• chemotherapy
• clinical trial drugs that affect the immune system, such as olaparib (Lynparza^®) or pembrolizumab (Keytruda^®).

If you're having one of these treatments, or have stopped having one of them in the last three months, you should continue to take the precautions you are comfortable with to protect yourself.

Although most coronavirus related restrictions have now been removed, it’s really important that you follow the advice of your medical team. They may suggest you take other steps to protect yourself, depending on your own situation.

Does my cancer treatment make me more likely to catch coronavirus?

Surgery (radical prostatectomy)

If you’ve had prostate surgery in the last 6 weeks and are still recovering from the operation, it’s very important to follow the advice of your medical team. This will limit your contact with other people and reduce your risk of catching coronavirus.

If you’ve had surgery to treat prostate cancer in the past and have recovered from the operation, this won’t increase your risk of catching coronavirus. It also won’t increase your risk of severe illness if you do catch coronavirus.

Your risk should be the same as other people in general. You may need to be particularly careful if:

• you are 70 or over
• you have a long-term health problem, for example with your lungs or heart, or a weak immune system
• you’re having a treatment that puts you at increased risk of infections.

Some men have lymph nodes near the prostate removed during surgery – this is known as a pelvic lymph node dissection. Lymph nodes are part of your immune system. However, having the lymph nodes near your prostate removed shouldn’t affect your risk of getting coronavirus.

Radiotherapy

External beam radiotherapy to the prostate shouldn’t affect your immune system. So if you’ve had – or are currently having – radiotherapy to treat cancer inside your prostate, this won’t affect your risk of catching coronavirus. It also won’t increase your risk of severe illness if you do catch coronavirus.

Some men have radiotherapy to a wider area, including the nearby lymph nodes. Lymph nodes are part of your immune system. However, having radiotherapy to the lymph nodes near your prostate shouldn’t affect your risk of getting coronavirus.

Some men with advanced prostate cancer have radiotherapy to relieve bone pain in parts of the body where the cancer has spread. Depending on the bone being treated and the dose of radiotherapy, this might affect the bone marrow, which can cause a temporary drop in the number of blood cells that help fight infection. If this happens, it might mean you’re more likely to get infections. Speak to your doctor, radiographer or nurse if you’re having radiotherapy to treat symptoms of advanced prostate cancer and are worried that you might be at increased risk.

If you’re having radium-223 (Xofigo®) to treat bone pain caused by advanced prostate cancer, this can occasionally affect the bone marrow and increase your risk of getting infections. Speak to your doctor or nurse if you’re worried.

Hormone therapy

LHRH agonists, GnRH antagonists and anti-androgens

Standard hormone therapy treatments, including LHRH agonists, GnRH antagonists and anti-androgen tablets, don’t affect your immune system. This means that being on standard hormone therapy won’t increase your risk of catching coronavirus, or of severe illness if you do catch coronavirus. However, remember to think about any other treatments you might be taking, and whether those might increase your risk.

Abiraterone

If you’re taking abiraterone (Zytiga^®) tablets, you will also be taking a steroid called prednisolone or prednisone. Steroids cause some people to have a slightly higher risk of getting infections, but this will depend on the amount you are taking.

If you’re taking a steroid with abiraterone, you’ll only be having a low-dose steroid. This means the effect on your risk of getting infections should be small. See below to read about steroids and coronavirus risk.

Enzalutamide

If you’re taking enzalutamide (Xtandi^®), this could affect the number of white blood cells in your blood. If this happens, you may be more likely to get infections, including coronavirus. Speak to your doctor or nurse if you’re concerned, and always contact your medical team at the hospital straight away if you have signs of an infection.

Steroids

Steroids can affect the cells that help your body fight infections. This means they cause some people to have a slightly higher risk of getting infections. They can also lower the body’s response to existing infections. Whether or not this happens will depend on the dose of steroids you are taking.

If you’re taking a high-dose steroid, this could increase your risk of getting infections.

Most men who take steroids as part of their prostate cancer treatment will be having a low-dose steroid. This means the effect on your risk of getting infections should be small. Check with your doctor or nurse if you’re not sure about your dose.

We don’t yet know the effect that taking a low-dose steroid for a long time could have on your body’s ability to fight infections. It’s possible that the effect on your immune system might increase over time, and you might become more likely to get infections. But we don’t know this for certain. If you’ve been taking a low-dose steroid for a long time and are worried about your risk of catching coronavirus, speak to your doctor or nurse.

Remember that if you’re taking a low-dose steroid while having chemotherapy, the chemotherapy can increase your risk of catching infections because it can make your immune system weaker. If you’re having chemotherapy, it's very important to follow the latest government guidance and the advice of your medical team. 

Always contact your medical team at the hospital straight away if you have signs of any infection, even if they are only mild. You should have been given a number to call at the hospital if you have any signs of an infection. Call this number if you’re worried you may have coronavirus or any other type of infection.

Will I have my cancer treatment as planned?

The NHS is working hard to continue providing essential and urgent cancer treatments. Across the UK, hospitals have made changes to ensure that people with cancer can be treated in places that are likely to be free from coronavirus.

If your doctor does need to delay or change your treatment at all, they will talk to you first to make sure you understand your options and why this is happening.

Some of your appointments and check-ups may happen over the phone so that you don’t have to go into the hospital or GP surgery as often. If you’re not sure whether to go to any planned appointments, contact your doctor or nurse to check.

Will my regular PSA tests still happen?

Where possible, GP surgeries and hospitals are continuing to provide routine tests as normal. If you have coronavirus symptoms, you’ll need to delay your blood test while you follow the latest government guidance on self-isolating at home.

Should I take vitamin D if I’m at high risk from coronavirus?

Your body makes most of the vitamin D it needs when your skin is exposed to sunlight. If you’re at high risk of becoming very ill from coronavirus it’s a good idea to take a daily vitamin D supplement during the winter months. But you shouldn’t need to take these in spring and summer, because your body usually makes enough during these sunnier months. 

Will taking vitamin D supplements reduce my risk of coronavirus?

There isn’t enough evidence to support taking vitamin D supplements to prevent or treat coronavirus. But vitamin D is very important for your general health, including helping to keep your bones and muscles healthy.

Are vitamin D supplements safe for men with prostate cancer?

It’s safe for most men with prostate cancer to take a daily vitamin D supplement. However, if you already have high levels of vitamin D in your blood, for example if you already take a supplement containing vitamin D, you probably don’t need extra vitamin D – and it could even be harmful. Read more about how to take vitamin D safely.

It’s important to check with your hospital doctor or nurse before taking any supplements, including vitamin D.

A very small number of men with advanced prostate cancer develop a condition called hypercalcaemia. High levels of vitamin D can make this worse. Speak to your doctor if you have hypercalcaemia, as vitamin D supplements may not be suitable for you.

I’m worried about going back to work after treatment – what support is there?

UK governments are no longer asking people to work from when possible and have recommended a gradual return to work. If you’re worried about going back to work, you might want to take some of the following steps.

• Talk to your employer about the steps they’re taking to keep you safe. There are different guidelines about this in England, Wales, Scotland and Northern Ireland.
• If you still have concerns, ask your employer if you can move into a different role or change your working patterns, so that you can work from home for longer.
• If you struggle to find a solution, contact Citizens Advice or Acas for advice.
• You may also find Macmillan's information on work and cancer helpful. They talk about how cancer may affect you at work and also answer some common questions. 

Are COVID-19 vaccines safe for men with prostate cancer?

There are currently four coronavirus vaccines that have been approved for use in the UK – the Pfizer/BioNTech vaccine, the Oxford-AstraZeneca vaccine, the Moderna vaccine, and the Janssen vaccine which is given as a single dose. Clinical studies involving tens of thousands of people have shown that all vaccines are safe for the overwhelming majority of people.

A small number of people with a history of serious allergies have had a severe reaction, called ‘anaphylaxis’, immediately after receiving the Pfizer/BioNTech or the Moderna COVID-19 vaccines. Anaphylaxis can be a rare side effect of any vaccine, and all health professionals who give vaccines have been trained to treat it. However, because of this risk, these vaccines may not be suitable for people with a history of anaphylaxis caused by a food or medicine allergy.

If you’ve had a severe allergic reaction in the past, it’s very important to discuss this with your GP before having a COVID-19 vaccine.

Are the COVID-19 vaccines safe for men having chemotherapy?

The Pfizer/BioNTech vaccine and the Moderna vaccine do not contain a live virus, so you can’t catch COVID-19 from these vaccines. They are safe for men having treatment for prostate cancer, including chemotherapy.

The Oxford-AstraZeneca and Janssen vaccines are made by changing different viruses that are both harmless in humans. The viruses have been changed so that they can't multiply inside people. This means they can't cause illness and are safe for people having treatments that weaken the immune system, such as chemotherapy. 

However, you should still talk to your medical team about whether to have the vaccine if you’re having chemotherapy.

Will it work if I’m having chemotherapy?

We don’t yet know how well the vaccines work in people with a weak immune system, including men having chemotherapy to treat prostate cancer. This is because long term data on the effectiveness of these vaccines in people having chemotherapy or other medicines that weaken the immune system is unavailable.

Some early studies suggest these vaccines may not give cancer patients as much protection against coronavirus as they do in healthy people. This includes people with cancer who aren't having chemotherapy.

But it's important to remember that research is happening continuously to improve our understanding of how effective these vaccines are for people with cancer. Even if the vaccine doesn’t give full protection in some people, it may still be better than not having it at all.

Should I have the COVID-19 vaccine?

This is a personal decision, and only you can decide whether to have the vaccine. But it is the best way to protect yourself against severe COVID-19 illness.

There is a lot of information on the internet about vaccines and it’s hard to know which information to trust. You can find the most up-to-date information about COVID-19 vaccines on the NHS website.

It may help to talk to your family or friends if you’re not sure what to do. Your doctor or nurse can also talk to you about the vaccine and help you decide what’s right for you.

I’ve already had a flu jab – do I still need the COVID-19 vaccine?

The flu jab doesn’t protect against coronavirus. To protect yourself against the flu and coronavirus, you need to have both the flu vaccine and the COVID-19 vaccine.

You won’t be able to have the flu and COVID-19 vaccines at the same appointment – you’ll need to leave at least a week in-between, to ensure they both work properly.

Do I still need to be careful after my COVID-19 vaccine?

Yes. You should continue to follow government guidance and the advice of your medical team, even after you’ve had the vaccine.

There are a couple of reasons for this. Firstly, we don’t know for certain how well the vaccines work in people with a weak immune system (for example, men having chemotherapy to treat prostate cancer).

We also don’t fully understand whether the vaccines stop people carrying and passing on the virus to other people. So it’s important to continue following government guidance, even after you’ve had the vaccine.

Where can I get further support and information?

Remember, there’s always someone you can talk to for information and support. You could contact our Specialist Nurses on 0800 074 8383, or chat to them online. They can help if you’re confused by anything you’re told in your appointments. They can also help you understand your diagnosis and treatment options. You can ask them questions and talk through any concerns or worries you may have.

You might also find it helpful to order or download our free publications or read more online. Or you can join our free online community to chat to others with similar experiences.

Many prostate cancer support groups are holding meetings in person and online at the moment. You may want to look up your nearest support group and ask them about this. They should be able to help if you’re not sure how online meetings work.