Radical prostatectomy (RP) and radiation treatment (RT) for localized prostate cancer was performed with reasonable safety at a New York City cancer center during the first wave of the COVID-19 pandemic in the United States, investigators reported during the virtual 2021 Genitourinary Cancers Symposium.
“At the onset of the pandemic in March 2020, our cancer center underwent a coordinated 7 week pause in both prostate cancer surgery and new radiation treatments in accordance with the executive order in New York state,” Ariel Schulman, MD, and Andrew Wood, MD, of Maimonides Medical Center in Brooklyn, New York, explained in a joint statement to Renal & Urology News. Their multi-disciplinary team quickly converted to virtual meetings and continued to discuss patients prospectively. They also developed collaborative protocols to prioritize treatments for the highest-risk patients when it was safe to restart treatments. Strict hand washing, mask wearing, and social distancing policies were instituted.
Of 75 patients at their cancer center, 20% had low-risk, 53.4% had intermediate-risk, and 26.7% had high-risk prostate cancer. Eleven patients continued previous RT once services resumed, including 1 who developed a symptomatic COVID-19 infection and required a 2-week pause in treatment.
Once the operating room reopened, 11 patients underwent RP, including 8 with unfavorable intermediate-risk or high-risk disease. A negative COVID-19 PCR test was required within 72 hours of the procedure. When feasible, the team used same-day discharge to reduce patients’ postoperative exposures. The change did not increase complications or hospital readmissions.
“There were no severe COVID-19 infections among patients finishing RT or among the first cohort of men having surgery during the restart of treatments, suggesting that localized prostate cancer treatments can be safely delivered in the event of a second wave,” Dr Schulman and Dr Wood said.
The only significant differences in management during January through June 2020 compared with the prepandemic period July through December 2019 was the COVID-19 cohort had a longer time from initial visit to treatment (92.1 vs 71.0 days) and a greater proportion of patients who were seen but did not return for management (25.3% vs 14%).
“Patient fears, reallocated healthcare resources and a societal focus on social distancing has made cancer care more challenging,” Dr Schulman and Dr Wood said. “To reintegrate patients, we have emphasized the strict safeguards in place to prevent infection, the extremely low rates of nosocomial COVID-19 transmission, and the importance of timely treatment of prostate cancer for better outcomes.”
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Wood A, Shpeen B, Lee J, et al. Management of localized prostate cancer during the Covid-19 pandemic at a multidisciplinary cancer center in New York City, New York. Paper presented at: 2021 Genitourinary (GU) Cancers Symposium; February 2021. Abstract 213.