Prostate cancer has earned its reputation as a silent killer, often showing no early symptoms and going undetected until it reaches advanced stages.

Without regular screening, many men may never know it’s there until it is too late.

Currently the most common cancer among South African men and the second deadliest, prostate cancer is on a worrying upward trend, particularly among younger men. This is according to Vanessa Snow, Head of Medical Affairs at Johnson & Johnson, who warns that prostate, colorectal and lung cancer top the list of male cancers in the country.

“Early-onset prostate cancer tends to be more aggressive,” said Snow, adding that men of African descent are at even greater risk.

Research shows that one in six black African men will develop prostate cancer, compared with one in eight white men. More alarmingly, men in this demographic are also more likely to be diagnosed at Stage 3 or 4 of the disease, when treatment options become more limited.

While access to healthcare in developing regions remains a barrier, Snow said the lack of knowledge and screening cuts across all groups.

“The earlier the disease is diagnosed, the better the chances of entering an effective treatment pathway,” she said, recommending routine Prostate-Specific Antigen (PSA) blood testing for all men.

Scientific advances are also changing the game. Genetic testing, once the domain of high-cost research labs, is now more accessible and could revolutionise prostate cancer screening and treatment.

Andrew Oberholzer, CEO of the Prostate Cancer Foundation of South Africa, said inherited mutations, particularly in the BRCA2 gene, significantly raise the risk of developing prostate cancer, often at a younger age and in a more aggressive form.

“There are two kinds of genetic mutations, germline, which are inherited, and somatic, which develop over time,” he said.

“Testing for somatic mutations can help identify men who may benefit from targeted treatments like PARP inhibitors.”

These therapies block the PARP enzyme, which cancer cells use to repair DNA damage and are proving effective in specific prostate cancer cases.

Oberholzer emphasised the broader impact of genetic testing within families.

“If a man carries a mutation, his siblings or children might, too. Early knowledge means earlier screening and potentially, a lifesaving difference.”

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