Skip to Main Content
It looks like you're using Internet Explorer 11 or older. This website works best with modern browsers such as the latest versions of Chrome, Firefox, Safari, and Edge. If you continue with this browser, you may see unexpected results.

TEST SITE

THIS IS A TEST AREA

Cancer Care - Prostate - Navigation Menu

Prostate

NCCP guidance for Medical Professionals on the management of patients with Prostate Cancer in response to the current novel coronavirus (COVID-19) pandemic (CD19-065 2.1 / 14.04.20)


  • This document relates to patients who do not have COVID-19 or are not suspected of having COVID-19.
  • Current events surrounding the COVID-19 pandemic are challenging and all public health bodies are placing the safety of patients, staff and communities first in all decisions.
  • This is an evolving situation. This advice is based on current information, it is additional to the advice of the NPHET, the HSE and the DoH, and will be updated as necessary.
  • The NCCP acknowledges that each hospital is working under individual constraints, including staff and infrastructure, and as a result will implement this advice based on their own unique circumstances.
  • The purpose of this advice is to maximise the safety of patients and make the best use of HSE resources, while protecting staff from infection. It will also enable services to match the capacity for cancer care to patient needs if services become limited due to the COVID-19 pandemic.
  • Any clinician seeking to apply or consult these documents is expected to use independent medical judgement in the context of individual clinical circumstances to determine any patient's care or treatment.
NPHET, HSE and DoH advice

Hospitals will operate under the overarching advice of the National Public Health Emergency Team (NPHET), the HSE and the DoH. Information is available at:

Purpose
  • The purpose of this guidance document is to provide guidance to medical professionals on the management of patients referred to urology clinics, patients awaiting biopsy tests and patients diagnosed with prostate cancer during the COVID-19 pandemic.
New patients referred to urology clinics with suspected prostate cancer

Patients classified as having a high clinical suspicion for prostate cancer -

  • Patients classified as having a high clinical suspicion for prostate cancer following review in the Rapid Access Prostate Clinic should be referred for an MRI.
  • High clinical suspicion for prostate cancer is defined as palpable disease, PSA >10 and symptoms related to prostate cancer. 
  • The need for MRI is at consultant discretion following review of the most urgent Rapid Access Prostate Clinic referrals following appropriate triage.
Patients awaiting biopsy test

All patients awaiting biopsy test -

  • In order to minimise the risk of sepsis the Guidance Development Group do not recommend the routine use of biopsy at this time. If a biopsy is performed based on urgent clinical need, informed consent must be obtained.
Risk stratification of prostate cancer patients

undefined

Patients diagnosed with prostate cancer

Recommendation for treatment of patients with low risk prostate cancer

  • Patients diagnosed with low risk prostate cancer should be placed on active surveillance and PSA should be reviewed in 3 months.

Recommendation for treatment of patients with favourable intermediate risk prostate cancer

  • Patients diagnosed with favourable intermediate risk prostate cancer should be placed on active surveillance and PSA should be reviewed in 3 months.

Recommendation for treatment of patients with unfavourable intermediate risk and high risk non metastatic prostate cancer

  • Patients with unfavourable intermediate risk and high risk non metastatic prostate cancer that are awaiting definitive treatment should be offered endocrine therapy and offered curative therapy (radical prostatectomy/ radical radiotherapy) as soon as a date is available. Staging scans will be offered to high risk patients based on availability.

Recommendation for treatment of patients with metastatic prostate cancer

  • Patients with metastatic prostate cancer should be discussed at a multidisciplinary team meeting and referred for treatment to medical oncology.

National Health Library & Knowledge Service. Health Service Executive. Dr. Steevens' Hospital, Dublin 8. Tel: 01-6352555/8. Email: hselibrary@hse.ie

Disclaimer