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Prostate Cancer and COVID-19

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COVID-19 delayed prostate cancer tests and care. Many patients had to wait for treatment. This article discusses COVID-19 in prostate cancer patients.

Written byDr. Anuthanyaa. R

Medically reviewed byDr. Madhan Kumar Madathupalayam Velusamy

Published At July 21, 2021
Reviewed AtFebruary 12, 2026

COVID-19 is not a cause of prostate cancer, but it has led to a change in when, where, and how it is diagnosed. Because of the fear of contracting COVID-19, men postponed visiting health facilities. Procedures such as PSA blood tests and digital rectal examinations, among others, were postponed.

Biopsies, surgeries, and radiation sessions at health facilities were also postponed due to congestion. As a result, some cases of prostate cancer may not have been diagnosed at an early stage. When it comes to cancer, late detection translates to advanced cancer because it was not diagnosed in its earlier stages.

Handling a Patient with Urinary Issues in the COVID-19 Setting

Urinary problems are quite common in men aged 50 years and above. One of the early signs of prostate cancer is urinary issues. Chances are that these problems are not due to prostate cancer but to an enlarged prostate. Even if you have prostate cancer, it is not aggressive. There is no need to panic.

In the case of COVID-19, care was required only in the event of severe symptoms, including obstructed urine flow or red urine.

Preferred treatments were:

Surgery or radiation therapy only when absolutely needed. Visits to emergencies in hospitals were avoided as much as possible.

Can a Prostate Biopsy Be Delayed During COVID-19?

In most patients, prostate biopsy could be safely delayed. Routine screening was also postponed during the pandemic. Tests that could be delayed included:

A wait of up to six months did not normally do any harm. A biopsy was undertaken urgently only if there were severe symptoms, for example:

  • Urinary retention.

  • Severe bone pain.

  • Spinal cord compression.

  • Extremely high PSA levels.

How Long Can Localized Prostate Cancer Treatment Be Delayed?

In most patients, treatment can be postponed for 3 to 6 months without harm. This was even more preferable than the risks of COVID-19 transmission.

The treatment may be deferred in cases where:

  • Very low-risk prostate cancer.

  • Prostate cancer, low risk.

  • Favorable intermediate-risk prostate cancer.

Also, patients with higher-risk cancer who were asymptomatic could wait under close medical supervision. The uro-oncologist had to decide the cases of these patients.

Treatment could be delayed for:

  • Very low-risk prostate cancer.

  • Low-risk prostate cancer.

  • Favorable intermediate-risk prostate cancer.

Treatment Plan for High-Risk Early Prostate Cancer During COVID-19

Prostate cancer usually grows slowly, even in higher-risk cases. Hormone therapy could be started first. Radiation therapy could be delayed for months. Surgery could be postponed for up to six months. This approach was safe for many patients during the pandemic. Prostate cancer usually grows slowly, even in higher-risk cases. This approach was safe for many patients during the pandemic.

Can Chemotherapy Continue During COVID-19?

Chemotherapy could be given, but only with careful monitoring. Doctors usually choose medicines that are less likely to weaken the immune system. In many cases, injections to support white blood cell counts were given on the same day. Patients were encouraged to talk through the benefits and risks in detail with their oncologist before continuing treatment.

Are Prostate Cancer Patients at Higher Risk of COVID-19?

Risk depends on the treatment being used:

  • Chemotherapy: Higher risk of severe COVID-19.

  • Advanced Cancer with Lung Spread: Higher risk.

  • Past Surgery (radical prostatectomy): Same risk as the general population.

  • Radiation Therapy: No increased risk.

  • Hormone Therapy: No increased risk.

  • Abiraterone: Slight risk due to low-dose steroids.

  • Enzalutamide: Increased infection risk.

  • Patients on chemotherapy were advised to stay home as much as possible.

Conclusion:

Considering the COVID-19 disease, switch to the treatment recommendations for prostate cancer and follow the COVID-19 safety precautions to avoid community spread and prevent complications. Get the vaccination and the booster dose. Also, patients should seek immediate medical attention if they experience any unusual symptoms and avoid frequent clinic visits unless the treatment cannot be managed through telemedicine. Talk to a cancer specialist for more clarity.

Key Takeaways:

  • COVID-19 caused delays in prostate cancer tests and treatments for many patients.

  • Most urine-related problems were not emergencies and could be managed with a doctor’s guidance.

  • Early and low-risk prostate cancer treatment could often be safely delayed for a few months.

  • Higher-risk prostate cancer was often treated first with hormone therapy, while surgery or radiation was delayed.

  • COVID-19 vaccination helps protect people with prostate cancer and is generally safe, especially for those at higher risk.

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Frequently Asked Questions

Due to the compromised immune systems caused by cancer therapy, Covid-19 can significantly influence cancer patients, increasing their risk of severe disease. Cancer therapies may sometimes need to be postponed or adjusted, which might impact the patient's prognosis. Cancer clinics and hospitals may also be understaffed or closed, making it difficult for patients to obtain the necessary care. Furthermore, the emotional and mental stress induced by the epidemic might impact cancer patients.
PSA (Prostate-Specific Antigen) levels can be raised by drugs such as androgens, 5-alpha-reductase inhibitors, anti-androgens, and progestins. It is essential to consult with a healthcare provider to establish the cause of a high PSA level and ensure appropriate therapy.
Certain viral infections, such as prostate cancer-related viruses and urinary tract infections, might temporarily elevate PSA levels, resulting in false-positive findings. It is essential to discuss any recent viral infections or other relevant variables that may alter PSA test results with the healthcare professional. It is also recommended to wait until an active viral illness has resolved before performing the test.
The survival rate for prostate cancer varies depending on the cancer stage when it is found. According to the American Cancer Society, the five-year survival rate for males with localized prostate cancer that has not spread outside the prostate is approximately 100%. The five-year survival percentage for males with regional prostate cancer (cancer that has spread to surrounding tissues or lymph nodes is around 96%. The five-year survival rate for males with distant prostate cancer that has spread to distant organs or bones is approximately 30%.
It is unclear if cancer survivors are more prone to get COVID-19. Cancer survivors could be at higher risk of serious illness if they contract the virus due to their weakened immune systems due to cancer treatment. To avoid infection, cancer survivors must take measures.
Cancer can, indeed, damage the immune system. Immunosuppression can develop as a result of cancer, cancer therapies such as chemotherapy (a medication that employs strong chemicals to destroy rapidly growing cells in the body), and radiation therapy (a cancer therapy in which substantial doses of radiation are used to kill cancer cells and reduce tumors), or a combination of the two.
One should not ejaculate or have prostate stimulation, such as a digital rectal exam, for at least 48 hours before a PSA test since it can temporarily raise PSA levels. Furthermore, some drugs may affect PSA results and should be discussed with a healthcare physician before the test.
No scientific evidence supports using any specific supplements to help with PSA levels. Although several accessories, such as Saw palmetto, Beta-sitosterol, and Pygeum africanum, are used for prostate health, scientific evidence does not support their usage for PSA levels. Before using any supplements, please speak with a healthcare practitioner.
A high PSA level is usually defined as a number more than the upper limit of normal for the assay employed. The laboratory's normal range for PSA levels varies; however, a 4 ng/mL reading or less is considered normal. Some laboratories may use a slightly higher cut-off, such as 4.5 ng/mL or five ng/mL. Various variables, including age, race, and prostate size, can impact PSA levels, and they can change over time. As a result, a single high PSA level only sometimes signals a problem. When interpreting the findings, assessing the patient's whole clinical picture, including symptoms and risk factors, is essential.
PSA levels can rise due to prostatitis (prostate inflammation) and urinary tract infections. These infections can raise PSA levels because they promote inflammation in the prostate, which increases PSA levels. Other illnesses that might increase PSA values include benign prostatic hyperplasia (BPH) and prostate cancer. It should be noted that a raised PSA level does not always indicate prostate cancer and more testing is typically required to make a diagnosis.
A dangerously high PSA level is defined as one that is considerably over the usual range. The laboratory's normal range for PSA levels varies; however, a 4 ng/mL reading or less is considered normal. Some laboratories may employ a slightly higher cut-off, such as 4.5 ng/mL or five ng/mL. Some clinicians may consider a PSA level exceeding ten ng/mL possibly diagnostic of prostate cancer; however, when interpreting the results, taking the patient's entire clinical picture and other risk factors is essential.
It is not known if stress causes a rise in PSA levels. PSA (Prostate-Specific Antigen) is a protein the prostate gland generates that can be increased in situations such as prostate cancer, BPH, and prostatitis (prostate inflammation). These disorders can result in a rise in PSA values owing to inflammation or an increase in prostate size. Stress, however, is not a direct cause of these illnesses, and there is no evidence that stress may induce a rise in PSA levels. Some studies have shown that psychological stress might influence the immune system, which may affect the prostate indirectly, but further study is needed to understand this link completely.
Keep track of how the condition is progressing. The American Cancer Society suggests that men begin discussing the benefits and drawbacks of prostate cancer screening with their doctor around 50. Men at a greater risk of prostate cancer, such as African Americans or those with a family history of the illness, should begin these conversations at 45.
If a PSA test reveals elevated levels, seeing a doctor for additional testing, such as a repeat PSA test, a digital rectal exam (DRE), and a prostate biopsy to establish if cancer is present, is critical. If the PSA test and other tests reveal the existence of prostate cancer, treatment options will be addressed. If the results show that the problems are not malignant, therapeutic alternatives will be addressed.
- Eat a balanced diet, exercise frequently, and avoid smoking to maintain a healthy lifestyle.
- Maintain a healthy weight.
- Limit alcohol consumption.
- Discuss any drugs taken with the doctor and their potential influence on PSA levels.
- Consider 5-alpha-reductase inhibitors (5-ARIs), which can limit the development of prostate cancer cells and reduce PSA levels.
- Discuss with the doctor the benefits of frequent PSA screenings and prostate examinations.
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Dr. Madhan Kumar Madathupalayam Velusamy from iCliniq
Dr. Madhan Kumar Madathupalayam Velusamy

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