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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

Inauguration of Prof Francis Petersen as 14th Vice-Chancellor and Rector of the UFS
2017-05-23

Description: Prof Petersen Inauguration Charl Devenish photo Tags: Prof Petersen Inauguration Charl Devenish photo

Dr Khotso Mokhele, Chancellor of the UFS, robes Prof Francis Petersen as Vice-Chancellor and Rector of the UFS.
Photo: Charl Devenish

“At the UFS, we want to produce graduates for the world, and we need to ensure that we use our knowledge to uplift society”
— Prof Francis Petersen, 14th Vice-Chancellor and Rector of the University of the Free State (UFS)

On Friday 19 May 2017, the University of the Free State (UFS) celebrated the inauguration of its 14th Vice-Chancellor and Rector, Prof Francis Petersen. The formal inauguration was held in the Odeion Theatre on the Bloemfontein Campus. The ceremony was preceded by a week-long welcoming programme on the three UFS campuses.

The guest list included representatives from local and provincial government, vice-chancellors and rectors from across South Africa, and senior members of the university’s executive management.

During the inaugural address, Prof Petersen paid tribute to his predecessors for the role they played in making the university what it is today. This included former rectors and vice-chancellors who attended the ceremony, such as Prof Francois Retief and Prof Frederick Fourie, and Prof Stef Coetzee and Prof Jonathan Jansen who were unable to attend.

Prof Petersen characterised 2015 and 2016 as watershed years for the South African higher-education system. “The Rhodes Must Fall, and subsequent Fees Must Fall student and staff protests challenged us, and re-energised a critical engagement around the purpose of the university in an equal society, both as a site of complicity and as a potential agent for social change,” said Prof Petersen.

He committed himself to developing the UFS into an institution that will have an even greater impact than before.

“This institution I am striving to establish will be one that responds positively to inclusivity, diversity, and transformation, and which can incorporate these values into our curriculum, scholarship, and research in a productive way,” said Prof Petersen.

Prof Petersen emphasised the importance of the three-campus model. “The University of the Free State is ONE university with three campuses: the Bloemfontein Campus, our South Campus, and the Qwaqwa Campus. I am committed to align the activities of the three campuses, and to integrate our activities to a greater extent.

“We must work together to infuse each campus with the values we have identified as essential if we are to make our mark as a united University of the Free State: academic excellence, diversity and inclusivity, and innovation.”

The Chancellor, Dr Khotso Mokhele, had the honour of handing over the gown to Prof Petersen. Prof Lis Lange, Vice-Rector: Academic, explained the relationship between the university and the Basotho people, and how this relationship is honoured through the official procession gowns of the UFS. The Basotho blanket is worn by kings, and the university therefore hopes that the symbolism of the gown would be a source of inspiration to Prof Petersen.

The event was concluded by congratulatory messages from former colleagues and the President of the Student Representative Council on the Bloemfontein Campus, SK Luwaca. The event was elegant and graceful – the inaugural address was thought-provoking and inspiring.

 

Official Inauguration Ceremony:

19 May 2017
Bloemfontein Campus

 Description: Official Inauguration photo small Tags: Official Inauguration photo small


"I challenge you to dream big and do big." - Prof Petersen

 

Photo Caption: Dr Khotso Mokhele, Chancellor of the UFS, robes Prof Francis Petersen as Vice-Chancellor and Rector of the UFS.
Photo: Johan Roux

Short biography of Prof Francis Petersen
Inaugural address: 19 May 2017
Transcription of the ceremony
Photo Gallery
Video

 

Welcoming Ceremonies:

The week of 11-19 May 2017 was one of the highlights in this year’s calendar for staff and students of the University of the Free State (UFS), with various ceremonies taking place to welcome Prof Francis Petersen – who assumed his duties on 1 April 2017 – as the 14th Vice-Chancellor and Rector. The festivities culminated in the official inauguration ceremony at the Bloemfontein Campus on 19 May 2017.
 
The Qwaqwa Campus welcoming ceremony took place on Thursday 11 May 2017, attracting a wide spectrum of community leaders from the area. Prof Petersen was welcomed by representatives from the two trade unions, National Education Health and Allied Workers Union (Nehawu) and UVPERSU, as well as representatives from the Student Representative Council (SRC), the Thabo Mofutsanyana Education District, and the House of Traditional Leaders. Paramount Queen Mopeli of the Bakoena Royal House bestowed a special honour upon Prof Petersen by clothing him in a traditional Basotho blanket and hat. She said, "From our heart of hearts, welcome, Prof Francis ..., and all Godspeed during your tenure."
 
The South Campus in Bloemfontein hosted a welcoming ceremony for the new Vice-Chancellor and Rector on 18 May 2017. The ceremony included a number of vocal performances and messages from various stakeholder groups. The same afternoon, the Institute for Reconciliation and Social Justice (IRSJ) also facilitated a panel discussion, titled Diversity, inclusivity, and social justice and the renewed call for decolonisation, in the Albert Wessels Auditorium (AWO) on the Bloemfontein Campus.

The welcoming ceremonies culminated in an event in the Callie Human Centre on Friday 19 May 2017 at the Bloemfontein Campus, with a number of performances by musicians associated with the UFS, marimbas, drum majorettes from Jim Fouche Secondary School, the Grey College Gumboots, and school choirs from Eunice Secondary School, Brebner Primary School, and Willem Postma Primary School. Representatives from key stakeholders such as Nehawu, UVPERSU, the Campus Ministries Forum, SRC, Alumni, Convocation, and the UFS Council had the opportunity to convey their messages of welcome to Prof Petersen.
 
The formal inauguration ceremony took place in the Odeion Theatre on the Bloemfontein Campus the same day.

 

Qwaqwa Campus ceremony:

11 May 2017
Qwaqwa Campus

 Description: Prof Petersen with the queen 2 Tags: Prof Petersen with the queen 2

 

"Qwaqwa Campus is the perfect laboratory for sustainable sciences.” – Prof Petersen

 

Photo caption: Paramount Queen Mopeli of the Bakoena Royal House with Prof Petersen and his wife, Cheslyn.
Photo: Mamosa Makaya

Photo Gallery
Video

Read the full story
Transcription of the ceremony

 

South Campus ceremony:

18 May 2017
South Campus

 Description: South Campus welcoming Tags: South Campus welcoming

 

"South Campus: you aspire excellence, adding to diversity and you are innovative in what you do." - Prof Petersen

Photo caption: Flag bearers and drummers walking to the Madiba Arena.
Photo: Hannes Pieterse

Photo Gallery

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Transcription of the ceremony

 

 

Bloemfontein Campus panel discussion:

Panel discussion: Diversity, inclusivity and social justice and the renewed call for decolonisation
18 May 2017
Bloemfontein Campus

 Description: Panel discussion 18 May 2017 Tags: Panel discussion 18 May 2017


"The UFS should be a place of belonging for everyone." - Prof Petersen

 

Photo caption: from left: SK Luwaca (SRC President, Bloemfontein Campus), Prof Elelwani Ramugondo (UCT), Prof Francis Petersen (UFS), Prof Melissa Steyn (WITS), Prof Andre Keet (UFS)
Photo: Lelanie de Wet

Photo Gallery

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Transcription of panel discussion



 

Bloemfontein Campus ceremony:

19 May 2017
Bloemfontein Campus

 Description: Bloem welcoming ceremony on 19 May 2017 Tags: Bloem welcoming ceremony on 19 May 2017


"I can just say, Wow! I've experienced a lot during the welcoming functions on all three campuses." - Prof Petersen

 

Photo caption: Prof Francis Petersen, Vice-Chancellor and Rector of the UFS
Photo: Rulanzen Martin

Photo Gallery

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Transcription of the ceremony


 

 

Description: Inauguration and welcoming of Prof Petersen combined gallery Tags: Inauguration and welcoming of Prof Petersen combined gallery

Photo gallery of Inauguration and Welcoming Ceremonies

 

 

 

 

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