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Men still experience a greater share of the burden of disease in South Africa and die at younger ages than women (58 years at birth compared to 64 in women) – often from preventable causes.
Dr Andre Vos, Oncologist practicing at Mediclinic Panorama, discusses some of the most prevalent health risks facing men in South Africa, the root causes that deter them from seeking preventative tests and health screenings, and symptoms they should be on the lookout for.
“Health professionals will agree that men are way less likely to go for any form of preventative health intervention compared to women,” says Dr Vos.
The most prevalent health risks facing men
Cardiovascular disease, together with infectious diseases like TB and HIV remains the most pressing health issues facing SA men with HIV prevalence peaking at 27.1% between the ages of 45 to 49 years. TB is the leading cause of death among men who account for 57% of all recorded TB-related deaths. Cancer, however, is becoming a more prevalent issue as our population ages and more people get access to screening tests.
Dr Vos explains that with cancer, and prostate cancer in particular, one of the most prominent challenges is late diagnosis and the stigma surrounding the disease: “Any disease related to sexual functioning inherently carries some form of stigma. The problem with stigma is that it makes men less likely to talk about their concerns or symptoms and that can lead to misinformation. There’s also a fear that the potential side effects of prostate cancer treatment might lead to sexual dysfunction.”
Late diagnosis is directly related to men being less likely to seek preventative health care and the reasons behind this are multi-faceted. “With regard to prostate cancer, I think men might feel embarrassed about some of the early symptoms like altered bladder functioning and decreased sexual functioning, which will then delay them seeking help early on,” says Dr Vos.
Erectile dysfunction (ED) and other sexual-related disorders are often untreated due to shame and embarrassment. Basic health education and a willingness to have open conversations regarding ED – which affects up to 77% of men worldwide to some degree – will help reduce the stigma.
Testicular cancer is another health concern accounting for 0.5% of malignancies facing men and primarily younger men between the ages of 15 and 40 years. There has been a marked global increase in incidence over the last 50 years and the current worldwide incidence of testicular is between 6 and 11 per 100 000 men.
Healthcare and symptom screening begin at home
In 2022, 13 774 suicides were reported in South Africa and 10 861 of them were men. While suicide and mental health disorders are becoming less taboo, men still often avoid unpacking the issues they face. Dr Vos believes that addressing these challenges and ensuring men have access to the requisite support they need to take charge of their mental health begins at a foundational education level.
“It starts with the way we raise our boys. They who are taught that ‘real men don’t cry’ and that to show any form of weakness is not acceptable while girls are usually encouraged to talk about their feelings. Young boys should be taught basic body self-awareness to be able to distinguish normal from abnormal symptoms.
“As a man ages, changes in urinary or sexual functioning might be a normal part of the aging process, but it would be very difficult for a patient to be able to differentiate between what can be regarded as normal and what should be further investigated without the help of a medical professional,” says Dr Vos adding that for prostate cancer, any changes in urinary or sexual functioning should be investigated.
For testicular cancer, any form of testicular swelling or new developing lumps, regardless of the presence of pain, should be promptly investigated. Although not very common, breast cancer is an issue that affects 1% of men. It can and should be safeguarded against – any mass or swelling in the breast area of a man should always be investigated by a health professional.
The South African National Integrated Men’s Health Strategy 2020-2025 aims to empower and support men and boys to optimise their own and each other’s health and wellbeing and strengthen the capacity of the health system to provide quality appropriate preventative care for men and boys.
Mediclinic runs public health campaigns to raise awareness about common men's health issues, such as cardiovascular disease, cancer (especially prostate and testicular cancer), and mental health challenges. These campaigns emphasise the importance of early detection, regular screenings, and breaking down stigmas around discussing health concerns.
“Once a man realises that he is not the only one suffering from these concerns – that many other men are also struggling with it, he will be more inclined to seek help. I think if we start to raise more emotionally in-tune boys, they will then develop into men who will be more willing to seek help if they are in trouble,” concludes Dr Vos.
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