“A major challenge we have in South Africa when it comes to managing prostate cancer is late diagnosis which can lead to unnecessary death,” says Lisa Strydom, Cansa’s national manager of care and support.
#MensHealth #ProstateCancer
Helping prostate cancer patients to navigate their screening, treatment and post-treatment journeys is the aim of a year-long project driven by Cansa in collaboration with the KZN Department of Health and funded by Hollard Insurance and the American Cancer Society under its *Beacon Initiative.
Prostate cancer is the most common cancer among men in South Africa with men having a one in 15 chance of being diagnosed in their lifetime according to the National Cancer Registry of 2022.
“While the diagnosis figures are increasing, we still have the challenge that some men, for whichever reason, delay being diagnosed,” says Strydom. “Some of these men, many who could have been treated successfully, land up dying from the disease. Our objective is to make men more aware of symptoms that may need urgent follow up and to provide opportunities for men to screen more regularly. In addition, we want to ensure that those requiring follow ups don’t get lost in the system and receive the treatment they need within a reasonable amount of time.”
Cansa’s project is working to improve results of a research study** on waiting times for prostate cancer diagnosis in KZN conducted by specialist urologist Dr Kiran Singh. Singh, who consults at the Durban Medical Centre and Ahmed Al Kadi Private Hospital, found that despite late presentation of prostate cancer in KZN, patients were waiting an average of three months from initial referral for a prostate biopsy to the start of definitive management.
“In other words,” says Strydom, “way too long. The earlier cancer is detected and treated, the more likely it is that the treatment will be successful.”
The study also found that there was a general lack of personal health awareness among patients, with some seeking medical intervention only when home remedies or traditional medicine had failed. Further, when it comes to healthcare providers in the public sector, it was found that there was inadequate knowledge of prostate screening tests, such as digital rectal examinations and monitoring of prostate specific antigen (PSA) levels, and when to appropriately refer patients. There was also a belief among healthcare workers that prostate cancer progressed slowly and needn’t be referred immediately on diagnosis.
“We can extrapolate these results to many other areas in South Africa,” says Strydom, “But we had to focus our initial efforts to find solutions to these challenges and we selected areas in KZN where Dr Singh’s research had highlighted serious gaps in awareness and treatment of prostate cancer.”
Services provided include awareness and education, prostate cancer screening, accommodation, meals and transport during treatment, psychosocial support, assistance with temporary illness grant applications and referrals to project stakeholders, such as, palliative care facilities and services.
In the first half of this year, Cansa, in collaboration with other project stakeholders, trained 10 people as ‘patient navigators’ on cancer; prostate and testicular cancer signs, symptoms, and screening and treatment processes; and how to run a Cansa Information and Support Desk in a public hospital.
The navigators located at the four clinics and one hospital, attend to men that have been diagnosed with prostate cancer. They walk with the patients throughout their treatment journeys and provide education, practical assistance, and referrals to other resources when necessary. They also ensure that patients return for follow-up appointments and help them overcome any practical challenges they may face. Alongside the Cansa Information and Support Desk, the navigators also assist other cancer patients providing them access to cancer-related information and other resources.
Says Mzonjani Nyadi, a prostate cancer survivor who underwent treatment at the Inkosi Albert Luthuli Central Hospital: “Cansa has been supportive throughout my journey which enabled me to continue cancer treatment. May Cansa continue to help others the same way they have helped me.”
Zakhele Ngcobo, hospital patient navigator, states: “This project has allowed me to make a valuable contribution to cancer patients’ lives, especially men’s lives. When you are a man, it’s somewhat difficult to ask for help and to openly discuss issues and fears when it comes to health issues that pertain to ‘our manhood’. I am there even if a patient just needs to talk. Even within my community I’ve been able to start conversations and educate community members regarding prostate cancer.”
“This project carries a subject that has been ignored for several years in terms awareness to African men, mostly in rural areas. Some are still reluctant to come forward for screening and awareness. The project gives men an opportunity to be educated and screened for prostate cancer and illnesses that some did not even know existed and some were afraid to seek assistance because of the extreme stigma it carries,” adds David Khuzwayo, community patient navigator.
Cansa also runs cancer training programmes and provides information to community outreach health worker team leaders in several provinces and the Department of Health community healthcare workers. By end October this year, 329 men were educated about prostate cancer at community events and home visits. Three prostate screening community events have taken place, with 113 men been screened with two more screening events scheduled in November.
Says Bhekuphila Mzobe, community patient: “Before the project was implemented, I didn’t know what prostate cancer was if the project was not implemented in Maphumulo.”
Cansa has a wide range of services and support mechanisms to guide people affected by cancer, including prostate cancer, through the stages of screening, diagnosis, treatment, and post treatment.
*The American Cancer Society’s Beacon (building expertise, advocacy, and capacity for oncology navigation) Initiative is a global programme that supports health institutions and cancer organisations in low- and middle-income countries and other resource-limited settings. It focuses on addressing health disparities in cancer care by designing, implementing, and sustaining cancer patient navigation programmes.
**https://www.researchgate.net/publication/283101191_Waiting_times_for_prostate_cancer_diagnosis_in_KwaZulu-Natal_South_Africa
