The impact of COVID-19 continues to be felt across the UK. As Specialist Nurses at Prostate Cancer UK, we have heard many stories of the amazing measures that have been put in place by health professionals to ensure appropriate access to treatment has continued. We’ve also been hearing about the difficult decisions men and their medical teams have had to make around changes or delays to treatment by weighing up the risk of COVID-19 infection and the risk of their disease progression. 

THOUSANDS OF MISSING PROSTATE CANCER DIAGNOSES  


During the peak of the pandemic, data from April 2020 – March 2021 shows that there were around 55,000 fewer referrals for prostate cancer compared to the same time the previous year (April 2019 – March 2020). Whilst levels of referrals for prostate cancer are slowly returning to normal, there is still a large group of men who haven’t been referred and are potentially missing out on vital treatment (NHS England, 2020).  

SUPPORTING MEN TO UNDERSTAND THEIR RISK  


This big drop in referrals means there are likely to be many men who are unaware they may be at higher risk of prostate cancer due to lack of understanding about risk factors for the disease. Prostate cancer mainly affects men over the age of 50 and risk increases with age. Risk is even higher for black men, and men with a family history of prostate cancer (Public Health England [PHE], 2016).  

We need to communicate to these men that, for some, the risk of delaying investigations may be higher than the risk of attending appointments.  

Although there is no single test to diagnose prostate cancer, there are tests the GP can do to find out if a man may have a prostate problem, such as a prostate-specific antigen (PSA) blood test. It is vital that a conversation about the advantages and disadvantages of such tests takes place, to help the patient make an informed decision on whether to have the test. 

For most men with early stage prostate cancer, there will not be any symptoms, meaning that cancer awareness campaigns, such as Be Clear on Cancer, which focus on signs and/or symptoms are not as useful to this group of men. 

In recent years, we have made great strides as more men are having their prostate cancer diagnosed at an earlier stage. We do not want that to be reversed and find, further down the line, a swell of advanced disease diagnosis. This would leave men left with just trying to control the disease, rather than aiming to cure the prostate cancer. 

EMPOWERING MEN TO HAVE CONVERSATIONS WITH THEIR GP/GENERAL PRACTICE NURSE  

 

“We need to reach men at increased prostate  
cancer risk and empower them to speak to their GP or general practice nurse (GPN).” 

 

With many men still feeling reluctant to contact their GPs now, my fear for the future is about the number of diagnoses that have been missed these past few months. We need to reach men at increased prostate cancer risk and empower them to speak to their GP or general practice nurse (GPN). We want to help men understand that it is safe and easy to have the first conversation over the phone to weigh up the pros and cons of the PSA blood test and make a decision that is right for them. That is why we are sharing an online risk checker (https://prostatecanceruk.org/risk-checker?utm_source=journal&utm_medium=email&utm_campaign=risk-checker-ucct&utm_content=organic-link), which we hope will lead to conversations between GPs and men at high risk of prostate cancer. 

SUPPORTING YOU TO SUPPORT MEN  


Primary care health professionals are vital in ensuring that as many men as possible are diagnosed before their cancer becomes incurable. Most GP surgeries and primary healthcare services are up and running, although this may be in a different form to what a lot of patients are used to, such as via telephone appointments. We understand that those in primary care do not want their patients to wait with any concerns which they may have. New referrals for prostate cancer are dramatically down across the country and hospitals want patients that need to be referred to them for further tests and investigations. Here at Prostate Cancer UK, we’re continuing our work to support health professionals and have been developing resources for those who are managing prostate disease during COVID-19 which you are welcome to share with your patients. For more information, visit: www.prostatecanceruk.org/for-health-professionals/guidelines/covid-19-information-and-resources.  

References

NHS England (2020) NHS England Cancer Waiting Times Data. Available online: www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times   
 

Public Health England (2016) Guidance: Prostate cancer risk management programme (PCRMP): benefits and risks of PSA testing. Available online: www.gov.uk/government/publications/prostate-cancer-risk-management-programme-psa-test-benefits-and-risks/prostate-cancer-risk-management-programme-pcrmp-benefits-and-risks-of-psa-testing   
 

This piece was first published in the Journal of General Practice Nursing. To cite this article use: James L (2020) Thousands of missing prostate cancer diagnoses due to Covid-19 pandemic. J Gen Pract Nurs 6(3): 10, 12 


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