Lower incidence of prostate cancer but higher mortality rates in South Africa

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One in sixteen South African men will develop Prostate Cancer – it is the most prevalent cancer amongst South African men.

 

(1)(2) And while November is traditionally used to highlight awareness, it may not be enough right now.

 

Janssen South Africa’s Medical Affairs Director, Moustafa Kamel, said that while the incidence rate of prostate cancer in South Africa is lower than in many parts of the world, the mortality rate is significantly higher.

Kamel said: “The incidence of prostate cancer in South Africa is less than other parts of the world, like the US or Western Europe, half in some cases. Naturally, you would expect the mortality to also be lower - but it is actually three-fold higher. That is predominantly due to lack of public awareness campaigns. There is greater awareness among the older population in the US and Western Europe, where men go for regular check-up every six months. Unfortunately, in South Africa and on the continent, due to a lack of awareness, this is still not the case.”

Prostate cancer can creep up on patients, he said, as there are few symptoms during its early stages. Especially when clocking in past middle age, frequent checkups become critical. Kamel said: “Early detection is critical as prostate cancer can be managed and life expectancy prolonged. But you have to catch it early so that treatment can commence as soon as possible.”

 

Symptoms may frequently be mistaken for other ailments or age-related quirks. Earlier in the disease, patients may in fact present with no symptoms. More advanced states include a decreased pressure or force during urination, overall challenges urinating, blood in urine or semen, erectile dysfunction, bone pain and weight loss without effort. (3)

 

The prostate is a small gland in males that produces the seminal fluid that provides nutrition and a means of transportation for sperm. (3)

So prostate cancer is like any other cancer, added Kamel. Simply put, he said: “It's the uncontrolled division of cells. So, what would happen when we have a normal cell, doing its particular function in the body, and starts to divide into two identical normal cells. That's the life cycle of normal cell division.”

 

Cancerous cells are created when cells divide, but they are not doing what they are supposed to. And as they keep dividing, and not doing their job, tumours are created. Some of these cells eventually migrate into the rest of the body, which is when cancer spreads or in medical speak, metastasis.

 

In prostate cancer, said Kamel, the male hormone testosterone triggers the incidence and division of renegade cells. And it is by using hormone therapy, essentially limiting the production of testosterone, that can slow the growth of cancer or even kill it off completely. (4)

 

Chemotherapy is the most common treatment for prostate cancer patients, said Kamel. And in both detection of care there have been several advances since the 1980s, when rectal exams were the only means of initial detection; blood tests have replaced the genesis of diagnosis.

 

Treatment with novel hormonal therapy is also available in South Africa. He said: “There is a lot of research being done presently. There’s precision medicine, where specific medication is directed to patients on a personalised basis to target individuals’ cancer cells. Vaccines are also currently being researched.”



References:

(1) South African National Cancer Registry 2017. [cited 2022 March 14]

(2) Herbst MC. Fact sheet on prostate cancer. Cancer Association of South Africa (CANSA). [cited 2022 March 14].

(3) Mayo Clinic. Prostate Cancer

(4) Mayo Clinic. Hormone therapy for prostate cancer Hormone Therapy.

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