mCRPC: Advice for Treatment During COVID-19

Daniel Petrylak, MD: We’ve seen everything go full circle. I remember that there was a warning out that ACE inhibitors shouldn’t be used on patients with COVID-19, then that got pulled back, and now they’re saying that patients on ACE inhibitors do better. Same idea with chemotherapy. There doesn’t seem to be any major difference in patients treated with chemotherapy versus not in terms of susceptibility. The question is, if you have a patient who is positive for COVID-19, are you at more risk? We know that in surgery you are, but in terms of chemotherapy, I can’t remember what the data was on that, so we may just want to go with a small portion of this. You’re blocked up.

The only recommendation I can give is to remember that there are long-term consequences to not treating patients with standard-of-care treatments. We must remember, we have to balance out what the effect of COVID is going to be on our patients, versus the effect of lack of treatment or delay in definitive surgical procedures for prostate and bladder cancer, also the delay of chemotherapy or hormone therapy. Those will impact on survival if we don’t do them in a timely fashion.