After skin cancer, prostate cancer is the second most common cancer among men. Yet in South Africa, many men of African descent, a group at higher risk, are not getting screened regularly, missing opportunities for early detection and effective treatment.

Dr Steven Cornish, a urologist at Netcare Sunninghill Hospital, said international research indicates that black men are 60% more likely to develop prostate cancer. Factors contributing to this include genetics, potential environmental influences, and systemic issues, such as cultural mistrust, lower access to quality care, and lower health literacy within the community.

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“There are different types of prostate cancers,” said Cornish, “and the majority are completely silent. By the time advanced symptoms, like swollen lymph nodes, leg weakness, or weight loss, appear, it may already be too late for curative treatment.

“Prostate cancer does not have to be life-threatening, when men know their risk factors and make screening part of their healthcare routine. Considering where the prostate gland is located, men would not usually notice if prostate problems were developing. This is why blood tests, called prostate-specific antigen (PSA) tests, and a digital rectal examination by a doctor are so important.”

PSA testing is quick, and can be lifesaving, but while South Africa continues to build solid national statistics on prostate cancer, Cornish noted a lingering taboo surrounding men’s health discussions. “To improve outcomes across all communities, men need to have open conversations with their doctors about screening, particularly black men, as their incidence of prostate cancer internationally is higher than other race groups.”
Netcare Sunninghill Hospital is hosting a public awareness event on September 20. Men attending can receive free PSA blood testing, sponsored by Astellas Pharmaceuticals, and learn more about this crucial health issue. PSA levels can indicate a range of prostate-related issues, from age-related enlargement to infection or prostate cancer.

“Higher PSA levels simply mean there is something worth checking with your doctor,” added Cornish. “Even if a small biopsy is needed, and the result confirms prostate cancer, there is no need to panic. These days, prostate cancer is usually highly treatable if caught early.”

Men with a family history of prostate cancer in male blood relatives, or breast or ovarian cancer in female relatives, have an increased genetic risk and may require earlier or more frequent screening.
Screening guidelines recommend that all men start at age 45, while black men, and those with a close family history, should begin at 40. Frequency depends on individual risk factors and previous PSA results, ranging from annual testing to every five years. Screening typically continues until the last ten years of a person’s life.

“In some cases, prostate cancer may not require immediate treatment,” said Cornish. “An approach called ‘active surveillance’ may be used, as prostate cancer generally progresses more slowly than other cancers, like lung or liver cancer. This gives men time to consider their options and ask questions.

“The small percentage of prostate cancers that are more aggressive are often picked up in younger men. Regular screening from the 40s can help detect these cases early.

“As men, we never know when this common male cancer might strike, but we can improve outcomes by making screening part of our health routine and by helping to protect our loved ones. Start conversations with the men in your family about prostate health.”

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