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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

During 2011: Appointments
2011-12-01

Dr Lis Lange: Senior Director: DIRAP

Description: 2011 Appointments_Lis Lange Tags: 2011 Appointments_Lis Lange

Dr Lis Lange, an Argentinean by birth, immigrated to South Africa twenty years ago – a few weeks after Nelson Mandela had walked through the gates of Victor Verster. For the past ten years, she has been involved in quality assurance for higher education institutions at the Council on Higher Education at national level.

She is assisting our university in the areas of quality assurance and academic planning, contributing to the development of deep intellectual debate and multi-disciplinary research.


Prof. Charles Dumas, Department of Drama and Theatre Arts

Description: 2011 Appointments_Charles Dumas Tags: 2011 Appointments_Charles Dumas

Prof. Charles Dumas, Extraordinary Professor in our Department of Drama and Theatre Arts, will be spending three months per year for the next three years at our university to help develop filmmaking, specifically focusing on the development of the Video Unit Planned for the Department.

Prof. Dumas started the year off with the production, Our Father’s Daughters, which was produced during the Mini-festival as well as at the Reitz Four reconciliation meeting. The production was also turned into a short film. Prof. Dumas gave film-acting classes to the third-year drama students. He directed multiple productions, such as the third-year module production Ipi Zombi, the Grahamstown Festival production, Seven Guitars and the Dance/drama production, Race, Reconciliation and the Reitz Four.


Prof. Daniel Plaatjies, UFS Business School

Description: 2011 Appointments_Daniel Plaatjies Tags: 2011 Appointments_Daniel Plaatjies

Prof. Daniel Plaatjies is the former Director and Head of the Graduate School of Public and Development Management at the University of the Witwatersrand. He was mainly responsible for the leading, directing and managing of strategic academic programmes, teaching, research, governance, service management and monitoring. Prof. Plaatjies, who was appointed as Visiting Professor at our Business School this year, will as part of his new duties at our Faculty of Economic and Management Sciences, be lecturing part-time and supervise our PhD students.


Prof. Johann Neethling, Department of Private Law

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Prof. Johann Neethling’s career is now completing its full circle with his appointment as Senior Professor in our Department of Private Law. In 1965 he was a first-year at this university. With his nine law text books and nearly 200 articles, together with 40 years’ experience in academic training he is of inestimable value to this Department. His publications contribute to the establishment of our university as a research institute.


Prof. Hussein Solomon, Department of Political Science

 Description: 2011 Appointments_Hussein Solomon Tags: 2011 Appointments_Hussein Solomon

Prof. Hussein Solomon joined our university this year as Senior Professor in the Department of Political Science. Formerly he worked in peace NGOs, advised diplomats and acts as a serving officer in the South African Air Force.

His area of research expertise includes conflict and conflict resolution in Africa; South African Foreign Policy; international relations theory; religious fundamentalism and population movements within the developing world. He is also the author of a number of books, including one on global jihad and one on India's secret relationship with apartheid South Africa.

He is also member of the internationally renowned Our Humanity in the Balance (OHIB) organisation, where his role is to bring these disparate communities together and to focus energies on a common project.


Prof. André Keet, International Institute for Studies in Race, Reconciliation and Social Justice

Description: 2011 Appointments_Andre Keet Tags: 2011 Appointments_Andre Keet

Prof. André Keet, our Director of the International Institute for Studies in Race, Reconciliation and Social Justice, joined the University of Pretoria on a part-time basis in 2008, whilst being a Commissioner on the Commission for Gender Equality. Later he left the Commission and joined the University of Fort Hare. “I was happy to join academia and now also serve on the Stellenbosch University Council; therefore I am very aware of the challenges facing higher education,” he said.

His vision for the Institute is to support higher-education transformation, promote non-discrimination, reconciliation and human rights, build national, regional and international networks, and developing ‘new’ languages, knowledge and discourses for reconciliation and social justice, all to the benefit of our university and South Africa.”


Prof. Helene Strauss, Department of English

Description: 2011 Appointments_Helena Strauss Tags: 2011 Appointments_Helena Strauss

Prof. Helene Strauss completed her PhD at the University of Western Ontario, London, Canada, where she taught courses on Film Studies, Children’s Literature and South African Literature and Culture. “I was subsequently appointed as an Assistant Professor in the Department of English and Cultural Studies at McMaster University, Hamilton, Canada.” She joined our Department of English this year.

Prof. Strauss has an on-going preoccupation with questions concerning social justice, race, gender and ethical interpersonal interaction in South Africa and beyond.


Prof. EC Ejiogu, Centre for Africa Studies

Description: 2011 Appointments_EC Ejiogu Tags: 2011 Appointments_EC Ejiogu

After 22 years in the United States of America, Prof. EC Ejiogu decided to return to Africa – to his roots – to join our university’s Centre for Africa Studies at the beginning of 2011.

Before joining the Centre, he was Assistant Research Professor in the Centre for Innovation at the University of Maryland, College Park. As Senior Researcher at the Centre, he has already helped with the streamlining of the academic programme, restructuring it to enable students to gain skills necessary to deliver a research proposal towards a dissertation after their three years of study. He has also taken up PhD and Master’s supervision.

His latest publications include a book published in March 2011 with the title, Roots of Political Instability in Nigeria, and a book co-edited with Prof. Kwandiwe Kondlo, Director of the Centre for Africa Studies, Africa in focus: Governance in the 21st century, published in April 2011.


Pura Mgolombane, Vice-Dean: Student Affairs

Description: 2011 Appointments_Pura Tags: 2011 Appointments_Pura

Bringing with him a decade of experience in Student Affairs our new Assistant-Dean for Student Life and Leadership, Pura Mgolombane, has big plans for student development. He says his office wants to help Kovsies increase its throughput rate and produce socially well-adjusted and employable graduates in South Africa, the continent and anywhere in the world.

Before joining Kovsies, he was employed as Director: Student Life, Governance and Culture at Walter Sisulu University. Pura, who has a background in Human Resources, Business Management and Corporate Law, says his academic training has empowered him with skills to ensure that the Student Life and Leadership is properly led, governed and managed.


Prof. Hasina Ebrahim, School for Social Sciences and Language Education

Description: 2011 Appointments_Hasina Ebrahim Tags: 2011 Appointments_Hasina Ebrahim

This former academic from the University of Kwa-Zulu Natal was appointed as Associate Professor at our School for Social Sciences and Language Education in the Faculty of Education. Amongst others, she is the project coordinator for the Faculty’s Early Childhood and Foundation Phase Teacher Education Programme and the MEd and PhD supervisor in the programme.

Prof. Ebrahim is also the Deputy-President of the first South African Research Association for Early Childhood Education (birth to nine). “This is certainly a milestone to profile the university in terms of its thrust towards excellence in research,” she says. One of the main aims of the association is to shape the research agenda for a marginalised field in South Africa. 


Prof. Corli Witthuhn, Faculty of Natural and Agricultural Sciences

 Description: 2011 Appointments_Corli Witthuhn Tags: 2011 Appointments_Corli Witthuhn

Prof. Corli Witthuhn, a former Bloemfonteiner, attained her PhD in Microbiology at our university. Therafter, in 1999, she was appointed as a lecturer at Stellenbosch University and later as Vice-Dean.

Currently she is our Vice-Dean in the Faculty of Natural and Agricultural Sciences. She hopes to sustain her research here at our University.

Her life motto? “Opportunities are presented in the form of obstacles,” she says.
 


Prof. Melanie Walker

Description: 2011 Appointments_Melanie Walker Tags: 2011 Appointments_Melanie Walker

Prof. Melanie Walker is a prominent South African scholar who has been working as Professor of Higher Education Studies at the world-leading University of Nottingham in the UK, where she been Director of Postgraduate Students and a Director of Research in the Faculty of Social Sciences. She will join the University of the Free State in February 2012 as Senior University Professor in the Postgraduate School.

She is a graduate of the University of KwaZulu-Natal and the University of Cape Town, where she completed her PhD, after teaching in disadvantaged secondary schools for a number of years. Prior to working at Nottingham she worked at the Universities of Sheffield, West of England and Glasgow, as well as the Universities of Cape Town and the Western Cape. She is also a Fellow of the Human Development and Capability Association. She is currently Director of Research Training and a senior researcher in the EU-funded Marie Curie EDUWEL project, which includes senior researchers from eight European countries and 15 early-stage researchers.

With a long-standing commitment to social-justice research and equality practices, she is currently widely recognised internationally as leading in the application of the capability approach and human development to higher education policy and practice. Among others, she has led or participated in research projects funded by the NRF (South Africa), the Higher Education Academy (UK), HEFCE (UK), EU, and ESRC/DfID, which funded the Public-Good Professionals’ Capability Index research project. 
 

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