Prostate Cancer and Covid-19: Widening Impact and Stronger Voices

Prostate Cancer and Covid-19: Widening Impact and Stronger VoicesOver the last few weeks, a double whammy of anxiety has hit the NHS as fears of a Covid second wave build and more evidence of the delays to cancer patients were revealed. This has generated a surge in influential voices advocating for cancer patients and putting forward demands that cancer patients are not forgotten as Covid restrictions continue and, in many areas, deepen.

The Daily Mail reported in September that prostate cancer referrals from GPs to specialists had dropped by half during lockdown, and that they were at their lowest in ten years. In total 27,000 fewer men have been referred to a specialist with suspected cases compared to the same period last year, according to analysis of official NHS data by Prostate Cancer UK.

Prostate Cancer UK pointed out that “there is significant variation across the country in terms of delays to treatment, with many men contacting us concerned that they have been ‘forgotten about’”.

This week the Express reported on severe hit in funding to cancer research charities, citing a likely 46% cut to cancer research. It referenced an analysis by the National Cancer Research Institute (NCRI) which found that in 2018-2019 charities accounted for more than half of publicly funded cancer research, pumping in £362million. The predicted fall in provision would see overall public investment in cancer research drop by a quarter. The greatest impact would be on research focused on tackling specific cancers, for which charities provide 70 percent of the funding, the NCRI said.

Covid 19 has revealed deep health inequalities in the UK, and has made many in the medical, media and political community more aware of differences in disease impact based on race, age, socioeconomic status and geographic location. This week Cancer Research UK highlighted how these inequalities manifest in the incidence of cancer.

The good news is that some powerful voices in government, medicine and media have begun to cut through the negative news stories and advocate for action in addressing the growing, widespread and urgent needs of cancer patients. These voices have been getting louder each week, and we will continue to join them.

In Parliament, the Health Select Committee delivered its report on the impact of Covid19 on essential NHS services, stating:

“We’ve heard of severe disruption to services, especially cancer, and here we could be looking at tens of thousands avoidable deaths within a year. If we’re to avoid this going forward it is time to give as much priority to avoiding harm and death caused by the interruption of normal NHS services and introduce mass testing for all NHS staff. Today we set out these and other steps the government and NHS leaders must take to manage services through a second wave.”

On Monday, The Labour Party demanded that government ministers outline a plan to tackle the growing backlog of non Covid care, especially for cancer treatment, and provide enhanced cancer screening, citing the number of people getting treatment for cancer following a national screening programme is at an all time low, with just 319 people getting treatment in July 2020. The number of people starting treatment following screening has dropped by two-thirds, compared to the same time last year.

And in the medical community, cancer patients have a champion in the form of Professor Karol Sikora, former head of Cancer programmes at the WHO, and a powerful voice in mainstream and social media on the need to give cancer patients care during the pandemic.

“We must do everything within our power to reduce the overall waiting list. We cannot afford to see a secondary backlog of cancer cases accumulate over this winter. That would be a disaster that will take many years to recover from, and potentially costing thousands of lives.”, he said this week.

Here at The Focal Therapy Clinic, we are picking up three key trends that have developed in the Covid era from our conversations with prospective patients.

First is a significant increase in the use of Hormone therapy for men with relatively low-risk prostate cancer. As a Consultant Urologist Raj Nigam pointed out in a recent OnFocus interview, this is happening with astonishing frequency and compromising the quality of life for too many men.

Second is what is becoming known as “age apartheid”, where men 70 and over are not given access to innovative treatments that can maintain their (often very high) quality of life.

Third is the number of men on Active Surveillance who are struggling to sustain regular monitoring as appointments are cancelled and diagnostic procedures delayed.

We are advocating for our patients and actively joining the voices that are calling on government and the NHS to provide the services that they deserve.

If you have a concern about your prostate cancer diagnosis, get in touch — we’re here to help.

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