Prostate cancer care decreases in the pandemic, survey shows

Diagnoses, hospitalizations and surgeries for prostate cancer have decreased since 2020, research points out. Urologist consultations also registered a lower rate than expected — until July this year, 1,812,982 were carried out, while in 2019 this number exceeded 4 million.

The data are from the Ministry of Health and obtained by the SBU (Brazilian Society of Urology).

Other research already indicated that attention to prostate cancer was decreasing. A January survey by the SBU of São Paulo estimated that approximately 4,560 patients were no longer diagnosed in the state in 2020.

Experts cite the pandemic as an explanation for this scenario. “Covid-19 greatly impacted patients’ demand for health services, resulting in a decrease in diagnosed cases”, says Geraldo Faria, president of the SBU of São Paulo.

The urologist says that there was fear of going to health institutions because of the risk of infection, but it was also necessary to reorganize the medical teams to meet the high demand in the pandemic, reducing attention to other diseases.

According to him, normally there is already underreporting of cases of prostate cancer in Brazil, resulting in a situation “of many people with the disease, but without a diagnosis”. The pandemic, however, made the situation even worse.

For Franz Campos, coordinator of the Inca Prostate Cancer Diagnosis Center (National Cancer Institute), the advance of vaccination and the control of Sars-CoV-2 are already showing results in the resumption of diagnosis.

According to him, data from Inca showed that prostate biopsy exams, essential in the diagnosis of the disease, decreased during the first year of the pandemic, but when comparing 2021 with last year, the demand for the exam rose approximately 27%.

Even so, Faria believes that it is necessary to take other measures to make the population aware of the importance of early diagnosis. For the doctor, the fact that consultations with urologists are still low shows that people have not returned to worrying completely about the disease.

He mentions the need for health associations, such as the SBU itself, to carry out campaigns that make people aware of medical evaluations. In addition, the government needs to take action to inform the population about the importance of going to the doctor, he says.

An early diagnosis of prostate cancer results in a 90% chance of a cure. It is also important because the disease has no symptoms in the early stages. When the patient notices the presence of signs, such as bleeding in the urine, it is already an indication of an advanced stage.

“The annual exam investigates the possibility of having a cancer that is silent there, so you shouldn’t wait for symptoms to know if you have the disease or not,” he says.

The importance of identifying the disease early is also highlighted by Campos, mainly because, on average, half of the patients diagnosed in Inca centers are at high risk, says the doctor.

Treatment against the disease has evolved in recent years and depends on the stage it is at. The main methods are surgery on the prostate gland to remove the tumor or radiation therapy.

“This surgery has gained a great deal of progress with the incorporation of minimally invasive techniques, such as robotic surgery, which has a small degree of aggressiveness”, explains Faria. In radiotherapy, it is now possible to apply radiation only in the region of cancer, without affecting nearby tissues and organs.

For more severe cases, there is an indication to incorporate “new oral drugs, [como a abiraterona e a enzalutamida], which greatly facilitate treatment in patients who have advanced disease,” says Faria.

Even with the advances in medicine, the urologist still emphasizes that “the cure of the patient will be done with an early diagnosis”.

“When cancer extrapolates [a próstata], leaves there, enters the bloodstream and will be located in other organs, this patient will probably die”, he says.