Supporting men with prostate cancer: from diagnosis to long-term wellbeing

Prostate cancer is the second most commonly diagnosed cancer in men globally, with just under an estimated 1.5 million new cases and nearly 400,000 related deaths in 2022. While survival rates in high-resource settings have been improving, significant disparities remain between socioeconomic groups, including within countries.

Furthermore, incidence rates are rising across the globe (possibly due to more effective detection), with highest rates recorded in Australia/New Zealand, North America, and Latin America/Caribbean, which also records the highest mortality along with sub-Saharan Africa.

From the moment of a suspected symptom or diagnosis, many men experience fear, confusion, and stigma that can delay access to care. During and after treatment, they face complex side effects and limited follow-up support. These ongoing challenges – from awareness and prevention to supportive and survivorship care – underscore the need for coordinated, people-centred care that supports men throughout their journey.

To explore how some of these challenges are being addressed in practice, UICC spoke with Lisa Strydom, National Manager of Care and Support at the Cancer Association of South Africa (CANSA), a UICC member organisation, and Dr Anna Green, Research Fellow at the University of Southern Queensland and coordinator of the Prostate Cancer Essentials Hormone Therapy study, a national research project led by UICC Immediate Past President Professor Jeff Dunn, and in which UICC is formally involved.

Addressing delays in diagnosis and treatment adherence

In South Africa, prostate cancer is the most common cancer among men, accounting for nearly a quarter of all male cancer cases in 2022. An estimated 12,903 men were newly diagnosed and 5,411 died from the disease that year.

“We’ve found that many men wait months, even up to a year, from experiencing symptoms to being diagnosed,” said Strydom. “Often this is because they don’t recognise the symptoms, or delay seeking medical help. By then, the cancer may be more advanced.”

To address gaps in access and support, CANSA launched the Prostate Cancer Patient Navigation Project in KwaZulu-Natal, in partnership with the Cancer Alliance, with support from Hollard Insurance and the American Cancer Society under its BEACON Initiative.

“The idea was to support men through the entire process by offering individualised guidance,” said Strydom. “Part of our goal is to raise awareness about the need for screening and to recognise symptoms, so that men are more proactive about their health. But we saw men often fall through the cracks of the health system between diagnosis and treatment. So our work also involves encouraging an earlier follow-up, and to make sure those who do need treatment don’t get lost in the system."

The initiative trains and deploys community-based navigators – often people who have had cancer themselves – who provide information, accompany men to appointments, and help manage logistical challenges such as transportation or accommodation. This helps reduce delays and ensure optimal follow up, as well as identify and address any barriers that may prevent them from seeking care or continuing treatment.

"There is still a silence around men's health," said Strydom. "Many men feel uncomfortable discussing symptoms or side effects of treatment, such as urinary changes or sexual dysfunction. Having someone they can trust, who is there to listen and guide them, makes a difference."

Addressing these often-unspoken concerns is central to a major clinical trial underway in Australia, led by the University of Southern Queensland in collaboration with multiple centres nationwide, including ICON Cancer Centre, a UICC partner.

Coordinated by Dr Anna Green and under the leadership of Prof. Jeff Dunn AO, Immediate Past President of UICC, the PC Essentials Hormone Therapy Study is investigating how structured, nurse-led support can improve the long-term wellbeing of men undergoing androgen deprivation therapy (ADT) for prostate cancer. This hormone therapy is used in advanced prostate cancer to lower the levels of male hormones, called androgens, and slowing or stopping the growth of cancer cells, which rely on these hormones for fuel. 

With an estimated 28,868 new cases of prostate cancer and 3,975 related deaths for 2025 in Australia, prostate cancer is the most frequently diagnosed cancer in men and the most commonly diagnosed cancer overall.

“Most men are diagnosed at an early stage of disease, raising the chances of survival, but many still face challenges related not only to long-term side effects of treatment but also during therapy,” said Dr Green. “Therefore, while we use ‘survivorship’ as the terminology, survivorship care starts at the point of diagnosis, and includes interventions that support the individual’s health and wellbeing beyond active treatment.”

The PC Essentials Hormone Therapy project is a trial of a five-month prostate cancer specialist nurse-led programme delivered via telehealth. It includes distress screening, tailored education, support for treatment decisions, and the development of a personalised wellbeing plan.

"The project is underpinned by the widely endorsed Prostate Cancer Survivorship Essentials Framework. The framework was developed by an expert clinical and community group to provide guidance to health professionals, health care and cancer control organisations, government and consumers about the essential domains for survivorship care." Dr Green said. "At the centre of the framework is personal agency. We want men to understand their needs, and to be equipped with the knowledge, skills, and support to manage their health and the effects of cancer and its treatment. Men-centred care is key."

The programme emerged in response to growing evidence that many men felt ill-equipped to manage the long-term effects of ADT, such as fatigue, metabolic issues, bone density loss, and sexual dysfunction. Nurses reported that men often did not anticipate these effects.

“We heard again and again from participants, ’You don’t know what you don’t know’,” said Dr Green. “Some men went into the study thinking they didn’t need it, but also many didn’t realise what the side effects of treatment might be, or what kind of support was available to them. Within a few sessions, they were telling us how helpful it was.”

Though operating in different contexts, both initiatives in South Africa and Australia share a commitment to delivering practical, people-centred care. CANSA's navigation model offers a direct response to social stigma as well as a systemic fragmentation in the health system. The Australian study on supporting men with prostate cancer is providing evidence on the often neglected component of supportive and survivorship care, showing how proactive support can mitigate long-term effects and improve outcomes.

“By creating space for conversation and guidance, early on and throughout the process,” said Dr Green, “we can help men make informed decisions and plan for the future, rather than feeling overwhelmed or left in the dark.”