Does it matter if I can’t have scheduled surgery for prostate cancer due to the new crown epidemic?

The year 2020 was an extraordinary year. The new coronavirus broke out around the Spring Festival and the whole country actively fought against the epidemic, people all over the country responded to the call to go out as little as possible, many cities took “city closure” and most units extended their holidays to cut off the spread of the virus. More importantly, because of the large number of patients in hospitals, especially large hospitals, the possibility of cross-infection is greater than in other places due to the large flow of people and mixed personnel, hospitals may be the most dangerous place under the current epidemic. It may be a good choice to avoid hospitals if it is not an emergency or urgent medical condition, for the sake of your health and your family, and not to add to the country. Despite the great enemy, it is hard for oncology patients to avoid dealing with hospitals. Some of my friends had screening tests and further puncture biopsies to confirm the diagnosis of prostate cancer during their visits a year ago. After a period of preparation for neoadjuvant endocrine therapy further admission for surgery is needed, however, in the current epidemic environment making admission for surgery difficult, it seems less safe to visit and stay in the hospital at the moment. On the one hand, I am worried about the progression and spread of the tumor, and on the other hand, I am worried about going to the hospital and contracting the neo-coronavirus, so what should I do? Does it matter if I can’t have surgery as scheduled? Prostate cancer is a malignant tumor that is often detected in the early stages through blood sampling for prostate-specific antigen screening (PSA), further prostate MR scan + dynamic enhancement and ultrasound-guided prostate puncture biopsy. Prostate cancer is a relatively “inert” tumor that grows at a relatively slow rate. Worldwide, prostate cancer accounts for less than 1% of male deaths and about 7% of tumor-related deaths. With the widespread use of PSA screening and multi-point biopsy, the proportion of low-risk limited prostate cancer is increasing. The risk of progression of this group of prostate cancer 10-15 years after diagnosis is very small, and for this group of patients even close follow-up review can be considered instead of immediate curative treatment, and curative treatment measures may be taken when progression is detected during surveillance. In addition, most prostate cancers are treated with relatively good outcomes. Most patients have now undergone neoadjuvant endocrine therapy prior to radical surgery, which can effectively reduce tumor cells, shrink tumor volume, improve local blood flow, reduce necrotic tissue or improve tissue oxygenation, which in turn reduces intraoperative bleeding and makes prostatectomy easier to perform, while reducing clinical staging, lowering the rate of positive prostate margin tumors, and ultimately improving patient survival. To maximize prostate volume reduction, neoadjuvant therapy is recommended to last for 3 months in most patients, and can be extended to 6 months in larger prostates. Therefore, patients who are currently on neoadjuvant therapy have even less need to worry about tumor progression and spread in the near future and do not need to rush surgery and can wait for the end of this epidemic at home with peace of mind. In the current situation, the risk of neo-coronavirus is much greater than that of prostate tumors, and thus immediate hospital surgery is not recommended. The actual fact is that you will be able to get to the hospital as soon as possible after the epidemic has been effectively controlled and then arrange for surgery. After all, with the passage of time, the tumor will slowly grow after the tumor becomes resistant to drugs, the probability of complete surgical removal of the tumor becomes lower, the difficulty of performing surgeries to preserve erectile and urinary control functions will also increase accordingly, the complication rate may increase, and some may even lose the chance of surgery. We believe that with the joint efforts of all of us, we will definitely win this “war epidemic” with the fastest speed.