Men’s Health: Your Age, Your Family and Your Prostate Cancer Risk

Prostate cancer requires year-round awareness and regular screening across all South African communities to protect the nation’s fathers, brothers, husbands, and sons. Three leading urologists share insights on the latest advances that are enabling earlier detection, more targeted treatments, and person-centred care.

A Growing Concern Among SA Men

“Prostate cancer is the most common non-skin-related cancer in South African men,” says Dr Sumesh Padayachee, urologist at Netcare Rosebank Hospital.

“In the past 15 years, prevalence has increased by 60%. While better screening and technology partly explain this rise, the fact remains: prostate cancer is on the rise. The good news is that we are better equipped than ever to detect and manage it.”

Age, Genetics and Risk Factors

According to Dr Amit Kalpee, urologist at Netcare Christiaan Barnard Memorial Hospital, there are two main variants:

• Aggressive variant: Often appears in men in their 40s or 50s, with a strong genetic link and family history of cancer. Though rare, it progresses quickly.
• Slower-growing variant: More common in men over 70. Often so indolent that treatment may not be necessary.

Risk factors include:

• Family history (father or brother with prostate cancer)
• African heritage
• Lifestyle factors such as smoking, obesity, high-fat diets, and sedentary living

New Technology Shaping Prostate Cancer Care

“Emerging tools are transforming both diagnosis and treatment,” says Dr Megan Fisher, urologist at Netcare Linksfield Hospital.

• Multiparametric MRI scans: More accurate targeting for biopsies, reducing unnecessary interventions.
• Minimally invasive treatments: Options such as brachytherapy seed implants, robotic-assisted and laparoscopic surgery shorten recovery time and reduce complications.
• Combination therapies: For higher-risk localised cancers, radiotherapy and androgen deprivation may be combined for better outcomes.
• Biomarkers and advanced imaging: Allow clinicians to predict progression more accurately and tailor monitoring or treatment.

Active Surveillance – Sometimes the Best Option

For many men, active surveillance may be the most appropriate approach.

This involves regular PSA tests and MRI scans, allowing men to avoid treatment unless necessary while still monitoring the cancer closely.

“In many cases, prostate cancer grows so slowly that a man may live for 10–15 years without symptoms,” explains Dr Padayachee. “But for aggressive subtypes, especially in African men, early detection and treatment remain critical.”

Person-Centred Treatment Options

Treatment is highly individualised and guided by a multidisciplinary team of urologists, oncologists, radiologists, nuclear physicians, and psychologists.

Options range from robotic surgery and radiation therapy to chemotherapy and hormonal therapy – always weighed against overall health, cancer aggressiveness, and quality-of-life considerations.

“The focus today is on both prolonging life and improving quality of life,” adds Dr Kalpee.

Why Screening Is Key

All three specialists stress that screening is essential, especially for men with a life expectancy of more than 10 years.

Screening guidelines:

• All men from age 50
• Black African men and men with a family history of prostate/breast cancer from age 45
• Men with BRCA2, BRCA1, HOXB13, ATM or CHEK2 genes from age 40 (or 10 years younger than the earliest family case)

To book a screening at a Netcare or Netcare Medicross facility, call Appointmed on 0860 5555 65 or visit Netcare Appointmed.