Latest News Archive

Please select Category, Year, and then Month to display items
Previous Archive
12 February 2024 | Story André Damons | Photo SUPPLIED
Dr Matthew Benedict
Dr Matthew Benedict, Senior Lecturer and Medical Specialist in the Department of Family Medicine, Faculty of Health Sciences at the University of the Free State.

Prostate cancer and the mortality rates associated with it, particularly among black men, are on the rise in South Africa, regardless of the existing national guidelines for prostate-specific antigen (PSA) screening. These increases represent a significant public health concern.

This is according to a recent study by Dr Matthew Benedict, Senior Lecturer and Medical Specialist in the Department of Family Medicine in the Faculty of Health Sciences at the University of the Free State (UFS). Dr Benedict graduated with a Doctor of Philosophy degree at the December 2023 graduation ceremonies. Alongside his colleague, Dr Chika Egenasi, they became the first PhD holders with a specialisation in Clinical Family Medicine at the UFS.

This study could help elevate awareness around prostate cancer and ultimately enhance screening practices aimed at black men.

Dr Benedict says prostate cancer cases increased from 29 per 100 000 men in 2007 to 68 per 100 000 men in 2018. PSA screening remains a practical method for early detection and improved outcomes, despite the risks of overdiagnosis and overtreatment. The existing approach to prostate cancer screening, however, fails to adequately address the unique challenges faced by black men.

Underrepresentation of men's health issues

Dr Benedict says his study therefore sought to identify gaps relating to the prostate cancer screening approach in the Free State by simultaneously exploring two perspectives – that of primary healthcare providers and black men (healthcare users) – and the proffered strategies to address the identified gaps.

The decision to embark on this research stemmed from the observed underrepresentation of men's health issues in South African healthcare systems and media. Dr Benedict highlighted that despite the existence of national registries for breast and cervical cancers, there is a notable absence of a similar registry for prostate cancer (PCa). 

“This lack of prioritisation and emphasis on secondary prevention strategies tailored to PCa is evident. Additionally, the racial disparities in PCa morbidity and mortality are exacerbated by inadequate representation of black men in research on this disease,” he says. 

Low screening uptake

In the Free State, which has the lowest life expectancy compared to the national average, the black population faces disproportionate challenges related to lower socioeconomic status and poorer health outcomes. Prioritising equitable access to essential primary healthcare services, including screening, is crucial in this context. 

Dr Benedict explained that the findings of his research revealed that aggressive prostate cancer is prevalent among black men in the study setting, with poor knowledge and awareness of the disease and low screening uptake being observed. “Factors such as dietary habits, lifestyle, and presentation time were associated with aggressive disease at diagnosis, and cultural beliefs influenced screening uptake among men.

“Factors associated with a higher intention to screen included reduced fear, perceived benefits, situational barriers, and perceived risk of developing prostate cancer. The majority of the primary healthcare providers demonstrated poor knowledge (64.8%), neutral attitudes (58.6%) and poor practice (40.0%) related to prostate cancer screening. Female providers, lower cadre nurses and community health workers had lower knowledge scores.”

The study also found lack of prostate cancer-related continuing education was significantly associated with poor knowledge, negative attitudes, and poor practice among healthcare providers. The study proposed strategies to address the identified gaps among black men and primary healthcare providers. Community-oriented approaches involving the active participation of both healthcare providers and community members were emphasised. These strategies focused on the discussion of prostate cancer health education topics in public spaces, employing diverse, comprehensive, user-friendly, and culturally sensitive methods.

Delay in diagnosing

According to Dr Benedict, the delay in diagnosing prostate cancer among South African individuals is linked to the absence of a dedicated screening programme, and a predominantly rural population facing challenges like low socioeconomic status, high unemployment rates, and limited health literacy. Cultural perceptions of the disease, men's perspectives on masculinity and illness, a hesitancy to seek help, and a reluctance to assume the sick role also contribute.

“Furthermore, adherence to strong traditional beliefs often steers individuals towards consulting traditional healers instead of seeking medical assistance in clinics or hospitals. Numerous barriers to accessing health services in impoverished rural communities compound the issue, leading to instances of ‘lost to follow-up’ [patients who drop out of research studies or treatment programmes].”

Symptoms of prostate cancer

Prostate cancer might not exhibit noticeable symptoms during its initial stages, explained Dr Benedict, but as the condition progresses patients may experience diverse symptoms. The majority of these patients commonly experience signs of bladder outflow obstruction, such as a weakened urine stream, hesitancy in urination, nocturia, and a sense of incomplete bladder emptying. In certain instances, the tumour can lead to acute urinary retention. Advanced prostate cancer may present with symptoms linked to ureteric obstruction or bony metastasis. Night-time pain that alleviates with movement can result from bone metastasis.

According to the researcher, the primary focus of the research is on screening and early diagnosis. Screening involves assessing apparently healthy individuals for the presence of a disease, even if symptoms are not evident. While specific symptoms like lower urinary tract symptoms may indicate conditions such as benign prostatic hyperplasia or urinary tract infections rather than prostate cancer, the presence of more advanced symptoms like lower back pains, weight loss, and bloody urine often suggest a more progressed stage of the disease.

Enhanced screening practices

The study highlights deficiencies in prostate cancer screening of black men in the Free State, and Dr Benedict said he anticipates receiving support to facilitate the implementation of the recommended strategies stemming from this research. Implementing the proposed targeted strategies designed for black men and their primary healthcare providers has the potential to elevate awareness and knowledge and ultimately enhance screening practices among black men.

News Archive

A position statement by the School of Medicine, UFS, regarding the crisis in health care in the Free State
2009-05-27

The executive management of the School of Medicine (SOM) at the University of the Free State (UFS) and its senior members wish to express their grave concern at the way the financial crisis in the Free State has negatively impacted on the provision of health care to the population. The unavailability of goods and services at every level of care has become so severely compromised that the staff of the SOM can no longer remain silent on this issue. By remaining silent it may be construed that we are either indifferent to, or even accepting the situation. Neither is true. The SOM can in no way condone, sanction or accept the current situation of health care in the Free State.

Other concerns expressed by the SOM include:

  • Medical services have been severely compromised due to the disintegrating primary health care system in the FS. This has resulted in patients who were in need of more advanced levels of medical care not being referred appropriately or timeously to level two hospitals and from there for tertiary care. Inpatient as well as outpatient numbers are steadily declining and the tendency now is to fill fewer beds with critically ill or terminally ill patients. It is also becoming increasingly difficult to find suitable patients for training and examination purposes.
     
  • It becomes more difficult to attract and retain experienced and suitably qualified medical specialists interested in an academic career, due to the inability to provide prospective career opportunities. This is particularly the case in the surgical disciplines.
     
  • It is also becoming more difficult to attract and appoint highly qualified registrars (future specialists) since the reputation of this SOM has been compromised by the negative publicity created by the financial difficulties of the FSDoH. Registrars form the backbone of the clinical work force in all teaching hospitals. If vacant posts cannot be filled in time service provision, as well as undergraduate teaching are severely jeopardised.
     
  • As a direct consequence of the rationing of health care, fewer surgical procedures are being performed. The point may soon be reached where registrars in the surgical disciplines may not get sufficient hands-on experience to allow them to qualify within the required time frame.
     
  • Non-payment of accounts to service providers and suppliers including the National Health Laboratory Services (NHLS), maintenance contracts and industry will severely compromises health care and future loyalty, goodwill and provision of critical services.
     
  • The dwindling number of qualified and experienced nurses in the public (and private) health care sector is an ongoing unresolved issue. Despite the fact that primary health care is mainly nurse-driven, nursing colleges were closed during the previous decade. These colleges must now be re-commissioned at high cost adding to the financial burden.
     
  • The morale of health care workers at all levels of health care has reached an all-time low
     
  • It is becoming increasingly difficult to conduct meaningful research in all disciplines due to staff shortages and lack of funding.

See attachment for the full statement on by the School of Medicine, regarding the crisis in health care in the Free State.

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt.stg@ufs.ac.za
26 May 2009
 

We use cookies to make interactions with our websites and services easy and meaningful. To better understand how they are used, read more about the UFS cookie policy. By continuing to use this site you are giving us your consent to do this.

Accept