COVID-19 guidance for prostate cancer examinations, diagnosis and treatment

Written by: Mr Andrew Ballaro
Edited by: Emma McLeod

Examinations and treatment for prostate cancer, among other prostate conditions, have had to be adjusted during the coronavirus (COVID-19) pandemic. Mr Ballaro, a senior consultant urologist, is working through the pandemic assisting new and existing patients with their prostate health. Read on to learn about how you can have a consultation and, if needed, a physical examination to address your concerns.

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I'm having prostate cancer treatment, could I get very ill if I contract coronavirus?

The answer to that is yes, there’s a possibility to get very ill if you contract coronavirus while undergoing cancer treatment, although the instance of this continues to fall rapidly.


In my opinion, there is clearly a risk of a second wave and whether you’re undergoing  prostate cancer treatment or not, the coronavirus pandemic is severe. If you’ve been advised to have an exam or treatment, it’s highly important that you go to your clinic no matter the scenario.


However, there are various types of prostate cancer and varying severities: Patients with low or intermediate-risk disease arguably don’t need very urgent treatment.


If I need urgent cancer treatment, will I be safe during my visit to the hospital?

Yes, hospitals have made very widespread and high-level changes based on the best science available and are very careful to protect patients. Both the NHS and private healthcare institutions are doing everything possible to ensure the maximum level of safety.


I have prostate-related symptoms; does this mean I have prostate cancer?

The first thing to say is that prostate cancer may not cause symptoms at all - it’s generally picked up through routine testing and then diagnosed using prostate MRI (magnetic resonance imaging) scans.

If prostate cancer causes symptoms, it’s most often because the cancer is in an advanced stage. However, prostate symptoms are very commonly caused by benign (non-cancerous) prostatic problems such as benign prostatic enlargement (benign prostatic hyperplasia). Furthermore, it’s important to understand that both prostate cancer and prostatic enlargements grow more common as men get older and are not mutually exclusive.


When should I get my prostate tested?

All patients with prostate symptoms should undergo a rectal examination of the prostate by an experienced clinician (such as a urologist) to exclude advanced prostate cancer and to have a discussion regarding the pros and cons of PSA testing.


The debate surrounding PSA (prostate-specific antigen) tests as a screening tool for prostate cancer continues and there is no UK national prostate screening programme. Men are informed of the risks and benefits of a PSA test with their urologist and they can make an informed decision.


How can symptoms be managed during the pandemic?

The majority of mild prostate symptoms can be managed by modifying fluid intake. However, if prostate symptoms become bothersome, patients should discuss them with their GP or urologist as there are a number of additional measures that can be employed to improve these symptoms, including medications and surgical procedures.


In the current COVID environment, each patient should weigh up the risks of seeking medical treatment at hospital (which has been greatly reduced due to hygiene measures) and the severity of their symptoms. Despite surgical procedures for benign prostate enlargement generally being delayed because they’re not as clinically urgent as cancer operations, there is still a lot we (urologists) can do to help in terms of advice and medications.


Can I get a physical exam during the pandemic?

Before COVID, we didn’t do video consultations. Since the beginning of the pandemic, we’ve been doing most of our patient-doctor interactions online.


This has many benefits but it does have downsides in that a physical examination can’t take place. In my practice at the Hospital of Saint John and Saint Elizabeth, I have two consultations a week where any patient can come in and be seen by myself. Many private hospitals are not allowing face-to-face consultations or are only allowing them on a named patient basis for certain conditions. Having the ability to see patients without prior consultations, unlike other private practices, has been very helpful.


Whether you’re a new patient or an existing one, I’m available to have a video call with your through e-Consultation (the video consultation service by Top Doctors) and if you need a physical examination, we can arrange for you to come to whichever of my clinics is most convenient for you.


If you’re worried about your prostate health, Mr Ballaro is readily available to help you resolve your concerns via video consultation and if necessary, receive further examination or treatment – book your consultation via his profile.

By Mr Andrew Ballaro

Mr Andrew Ballaro is a highly regarded consultant urologist in North London and Essex with over 15 years of experience. He specialises in the management of all urological problems including blood in urine, urinary infections, prostate pain syndromes, general prostate and bladder disease, and the diagnosis of urological cancers including the investigation of raised PSA with MRI Fusion prostate biopsy.

He has specialist surgical expertise in the management of kidney stone disease and benign prostate enlargement (BPE), and consistently publishes UK leading surgical outcomes for complex stone operations. He offers a choice of surgical procedures for benign prostatic enlargement tailored to the patient’s requirements including Holmium Laser prostatectomy (HOLEP) and is highly experienced in dealing with very large prostates and urinary retention, with every patient in a large series going home the day after surgery without a catheter.

Mr Ballaro takes satisfaction in providing second opinions, and is supported by a warm, skilled and responsive managerial team. Together they aim to provide the best possible outcome for each and every patient. Mr Ballaro's extensive training began after graduating from The Royal Free Hospital Medical School in London, and undertaking his surgical training at Oxford. He was awarded a fellowship from the Royal College of Surgeons of London and went on to complete higher urological training on the North London Training Scheme. This was followed by advanced training in complex stone surgery from national and international experts in his field.

Alongside his dedication to education, he is currently teaching trainees at the London Deanery, catering to various levels of expertise. Additionally, he has been honoured with a Hunterian Professorship from the Royal College of Surgeons of England, showcasing his commitment to scholarly pursuits. Holding a master’s degree in urology and an MD in clinical sciences from the Institute of Urology, Mr. Ballaro has extensively published research on bladder physiology and minimally invasive urological surgery. He is the co-author of the latest edition of the popular medical student textbook 'Lecture Notes in Urology'.


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