September is Prostate Cancer Awareness Month, and a Syracuse urologist is worried there could be an uptick in patients with prostate cancer because men, or their doctors, are putting off regular screenings. Under normal circumstances, prostate cancer can sometimes get missed if symptoms are not noticed. Dr. Christopher Pieczonka says COVID-19 fears mean patients who could have been treated are potentially allowing their prostate cancer to go undiagnosed until it’s too late.
“Our screening for prostate cancer is down significantly. My bias is that it will come back, but I’m fearful, as someone who deals with Stage 4 cancer all the time, that the people who I’m going to be seeing next year are the ones who are missing opportunities to get treated this year.”
While that can lead to worse outcomes, there is reason for optimism. Pieczonka’s patients were the first to be treated with an immunotherapy for metastatic prostate cancer. He says while men who received the therapy fared better than those who did not, the study also found a difference in race.
“The men who are African American, who got the immunotherapy, did fantastically better. The signal was so striking, that I think those of us who do this type of work are trying to literally get the word out.”
Meanwhile, the doctor says men should get screened. For those without a family history or symptoms, that should start at age 50 with both a digital exam and bloodwork. Pieczonka says Black men seem to be more reluctant to get the physical exam, which is yet another tool to catch the disease early. But he worries that patients aren’t being offered testing at all.
“The primary care physicians are focusing on the cholesterol that’s out of whack, losing weight, so the screening part of things often gets left by the wayside. Then you factor into the equation that men are terrible advocates for themselves, and some of our patients don’t even go to the doctor.”
The doctor says that means as many as 30,000 men get diagnosed too late and don’t survive, including African American men who are disproportionately affected by the most aggressive forms of prostate cancer.