November, Men’s Health Awareness Month, sees the Cancer Association of South Africa (CANSA) take stock of its Prostate Cancer Patient Navigation Project which launched in KwaZulu-Natal earlier this year.
“A major challenge we have in SA in managing prostate cancer is late diagnosis, which can lead to unnecessary death,” said Lisa Strydom, CANSA’s national manager of care and support.
Helping prostate cancer patients navigate their screenings, treatments, and post-treatment 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.
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Prostate cancer is the most common cancer among men in SA, with men having a 1 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,” said Strydom.
“Some of them, many who could have been treated successfully, end up dying from the disease.
“Our objective is to make men more aware of the symptoms that may need urgent follow-up and to give men opportunities 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 in a reasonable amount of time.”
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CANSA’s project works to improve the results of a research study on waiting times for prostate cancer diagnosis in KZN by specialist urologist Dr Kiran Singh.
Singh, who consults at the Durban Medical Centre and the Ahmed Al-Kadi Private Hospital, found that despite the late presentation of prostate cancer in KZN, patients waited an average of three months from initial referral for a prostate biopsy to the start of definitive management.
“In other words, way too long. The earlier cancer is detected and treated, the more likely the treatment will be successful,” said Strydom.
The study also found a lack of personal health awareness among patients, with some seeking medical intervention only when home remedies or traditional medicine had failed.
Regarding 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.
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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 SA. 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 the treatment of prostate cancer,” said Strydom.
Services provided include awareness and education, prostate cancer screening, accommodation, meals and transport during treatment, psychosocial support, help 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, screening and treatment processes, and how to run a CANSA Information and Support Desk in a public hospital.
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The navigators located at the four clinics and one hospital attend to men diagnosed with prostate cancer.
They walk with the patients throughout their treatments and provide education, practical assistance and referrals to other resources when necessary.
They also ensure patients return for follow-up appointments and help them overcome any practical challenges they might face.
Alongside the CANSA Information and Support Desk, the navigators help other cancer patients, giving them access to cancer-related information and other resources.
Zakhele Ngcobo, a hospital patient navigator, said; “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 difficult to ask for help and openly discuss issues and fears when it comes to health issues that pertain to ‘our manhood’.
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“This project carries a subject ignored for several years about awareness for African men, mostly in rural areas.
“The project gives men a chance to be educated and screened for prostate cancer and illnesses some did not even know existed, and some were afraid to seek help because of the extreme stigma it carries,” added David Khuzwayo, a community patient navigator.
CANSA also runs cancer training programmes and provides community outreach health worker team leaders in several provinces and the Department of Health community healthcare workers with information. By the end of October, 329 men were educated about prostate cancer at community events and home visits.
