Common questions about 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. Depending on where you live, you may have a phone or video appointment to discuss your concerns. Your GP may then ask you to book another appointment if they want to see you in person.

Some GP surgeries have fewer appointments available than usual. However, they are being asked to prioritise anyone who might have cancer, as well as patients who've already been diagnosed with cancer. So you shouldn’t have to wait very long for an appointment.

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.

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.

What will happen if my GP thinks I might have prostate cancer?

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. Your GP surgery will have made changes to help prevent the spread of coronavirus – call them if you’re worried or want more information on this.

If you have coronavirus symptoms or if test results show you have coronavirus, you’ll need to delay your PSA test while you follow the latest guidance on self-isolating at home.

Depending on your PSA level, the GP might suggest having another PSA test in the future to see if your PSA level changes. Or they may refer you to see a specialist at the hospital.

If you’re given a hospital appointment, you will be asked to follow the hospital's guidance to reduce the risk of you catching and spreading coronavirus to other people at the hospital. The hospital will give you more information about this, as the advice can vary from hospital to hospital.

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

The effects of coronavirus infection could be particularly severe for certain people with prostate cancer (those who were previously considered as ‘clinically extremely vulnerable’ and advised to shield). These include men having:

• 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 and speak to your medical team about any concerns you have.

The following steps will all help to reduce your risk:

• wash your hands well and often
• avoid touching your face and wear a face mask where required 
• if you go to shops or other indoor public places, try to go at quieter times and limit the amount of time you’re there
• limit travel on public transport and try to travel at quieter times

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.

For more detailed advice about staying safe where you live, read the government’s information for people in England, Wales, Scotland or Northern Ireland.

Do I need to follow this guidance after I've had the coronavirus vaccine?

Yes, you should continue following the guidance above, even after you’ve had the vaccine. 

To find out more, read our information about COVID-19 vaccines for people with prostate cancer.

For other men with prostate cancer

Even if you aren't having one of the treatments listed above, it's very important to follow the government guidelines for your area. This will help to reduce your risk of catching or spreading coronavirus.

Going to your appointments

Depending on where you live and the type of care you need, your doctor or nurse may suggest you have phone or video call appointments, instead of visiting the hospital or GP surgery. It might also be possible to have blood tests done at home. Speak to your doctor or nurse if you’re concerned about your appointments.

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. Everyone needs to be careful, and particularly 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.

It’s very important to go to any hospital appointments that are arranged for you, including radiotherapy sessions. Hospitals are taking extra measures to lower the risk of staff or patients catching coronavirus, but talk to your doctor, radiographer or nurse if you’re worried.

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. 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. 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. It’s very important to follow the government's guidance and the advice of your medical team to reduce your risk of catching coronavirus.

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.

I’m on chemotherapy and have a cough or high temperature – what should I do?

If you’re having chemotherapy, you should have 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. Read about the possible signs of an infection and what to do.

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.

But some men and their doctors may still have to decide whether to delay or change their prostate cancer treatment. Your safety will always be a priority in these decisions, and you can discuss any concerns with your doctor.

Prostate cancer often grows slowly, so for many men a delay or change to their treatment shouldn’t affect how well their treatment works in the long term. If tests show your cancer is more likely to grow quickly or spread, your doctor should make your treatment a priority so that you get the treatment you need without unnecessary delays.

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.

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

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.

Will I be offered surgery?

You should be offered surgery for prostate cancer (radical prostatectomy), if your doctor thinks it is suitable for you. But you may have to wait a little longer than usual for your operation. 

Your doctor may talk to you about having hormone therapy to control your cancer before your surgery. All types of radical prostatectomy (including robot-assisted keyhole surgery, keyhole surgery by hand, and open surgery) are still possible after being on hormone therapy.

Your doctor will talk to you to make sure you understand your options and help you decide what to do next. Most localised prostate cancer grows slowly. For many men with localised prostate cancer, having hormone therapy for a while first won’t affect how well the surgery works in the long term.

You will probably need to have a coronavirus test 2-3 days before your operation, to make sure you don’t have coronavirus. Once you’ve had the test, you’ll need to self-isolate until you go into hospital for your surgery. The hospital will give you more information about what you need to do, and for how long.

Your safety will always be a priority in decisions about your treatment and care, but speak to your doctor if you have any concerns.

Will I be offered radiotherapy?

Having external beam radiotherapy involves regular hospital appointments. In parts of the UK with higher levels of coronavirus, this could put you at risk of catching the virus. This means that other treatments that don’t involve spending time at the hospital may be safer for people in those areas until the risk has reduced.

If you’re having radiotherapy to treat localised or locally advanced prostate cancer, it’s normal to have hormone therapy for up to six months first. This helps to shrink the prostate and the cancer inside it, making the cancer easier to treat. Your hormone therapy should still be able to go ahead as usual.

If your doctor does need to delay or change your radiotherapy, they will talk to you about other treatments to help control your cancer – or relieve symptoms – until it’s safe for you to have radiotherapy. Speak to your doctor if you have any concerns.

Will I be offered chemotherapy?

Many men with advanced prostate cancer are offered chemotherapy at some point. Chemotherapy can increase your risk from catching infections, including coronavirus. This is because it can affect your immune system, which fights infections. Chemotherapy also involves regular hospital appointments, which could put you at risk of catching coronavirus during those hospital visits.

Many men are still being offered chemotherapy to treat their prostate cancer. Hospitals have made changes to ensure that people with cancer can be treated in places that are likely to be free from coronavirus. But your doctor may talk to you about other treatments to help control your cancer, instead of chemotherapy.

For example, if you’ve just been diagnosed with advanced prostate cancer, you may now be offered enzalutamide or abiraterone, which are types of hormone therapy. These medicines are usually only offered to men at a later stage in their treatment. But they’ve now been made available as a first treatment for advanced prostate cancer during the coronavirus outbreak. They are just as effective as chemotherapy for these men, but are less likely to affect your immune system.

Your safety will always be a priority in any discussions about your treatment.

I’m on hormone therapy – will it continue?

Standard hormone therapy treatments, including LHRH agonists, GnRH antagonists and anti-androgen tablets, won’t increase your risk of catching coronavirus, or of having more severe illness if you do catch coronavirus. This means it’s safe to continue having hormone therapy.

Your doctor may decide to change your hormone therapy so that you don’t have to visit your GP surgery or hospital as often. For example, if you usually have an injection every month, you may start having one every three or six months instead. This won’t affect how well your treatment works – three and six-monthly injections release the drug slowly over time and are just as effective as monthly injections.

If you’re worried about your hormone therapy being changed, speak to your doctor. They should be able to explain why they are changing it and reassure you that it is safe.

If your doctor suggests stopping your hormone therapy and you’re not sure why, get in touch with our Specialist Nurses.

Will my regular PSA tests still happen?

Where possible, GP surgeries and hospitals are continuing to provide routine tests as normal. If you usually have blood tests at your GP surgery, you may be asked to wait outside (for example, in your car if you have one). This is so that you don’t have to wait with other patients or spend very long inside the building. 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.

In some areas, a nurse may be able to visit you at home to do blood tests – if you are concerned, ask your GP surgery if this is an option. If you usually have regular blood tests at the hospital, you may be able to have these at your GP surgery or at home instead.

One small study of 91 men with Benign Prostatic Hyperplasia (BPH) has suggested that PSA levels can increase at the point of testing positive for coronavirus infection. PSA may also continue to be raised during the early period after infection. However more research is needed to understand the importance of these changes. If you have concerns about how this might affect your treatment decisions, please talk to your medical team.   

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.

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 will 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.

Questions to ask your doctor or nurse might include:

• Will coronavirus affect which treatment I can have?
• Which treatments are currently available to me, and what are the side effects?
• Will there be a delay in starting my treatment?
• Will any delay affect how well my treatment works in the long term?
• Will I need regular blood tests and, if so, where and how often?
• Am I safe to go to hospital for my appointments?
• Can you reassure me that I’ll still get the monitoring and tests I need?
• Who can I contact if I have questions or concerns, and will they have time to talk to me?
• Where can I get support?

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.

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 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.

I’m worried about going back to work – 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. 

Help us to support you

We want to know from you how we can best support people affected by prostate cancer as we continue to live with the effects of the coronavirus pandemic. Please email our Health Information team with any suggestions or comments about the information on this page.