36 In this particular study only 22.3% of men diagnosed with prostate cancer had ever heard of the condition. Whilst we understand that the majority of study participants were from rural areas this seems very low. What do you think needs to be done to improve awareness levels about prostate cancer in rural areas? To enhance prostate cancer awareness in the rural areas of the Free State, targeted strategies should be implemented, focusing on healthcare providers, users, and other relevant community stakeholders. As previously discussed, Continuing Medical Education (CME) is crucial. Additionally, training female primary healthcare providers in men's health practices is essential, given the prevalence of nurse-driven primary healthcare clinics in South Africa. To effectively raise awareness, culturally tailored and sensitive methods of prostate cancer health education should be employed. These methods may include print media like leaets, pamphlets, and posters, audio and audio-visual materials, and internet-based media. Addressing misconceptions and harmful cultural beliefs relating to prostate cancer is paramount. Collaboration with and education of spiritual and traditional healers should also be considered to engage the community effectively. Choosing appropriate venues for awareness campaigns is critical. Engaging religious gatherings, barbershops, taxi ranks, barbecues, and cultural events can maximize outreach and community involvement. To overcome screening access barriers, collaboration between the government and nongovernmental bodies is essential. These partnerships can lead to targeted interventions and resource allocation, ensuring that prostate cancer screening services are more accessible to rural communities. In this study <50% of the men who were experiencing symptoms sought help within 6 months from the onset of symptoms. What do you think the reason for this is and is this the case for other medical conditions? The delay in seeking medical attention among men with symptoms can be attributed to various factors, such as: Limited Awareness: Lack of knowledge about the disease is prevalent, especially in indigenous languages in South Africa where there is no direct translation for "prostate.” Misconceptions and Cultural Beliefs: Certain misconceptions and traditional cultural beliefs concerning men's health and masculinity may discourage seeking medical care promptly. Health-Seeking Behavior: Some men exhibit poor health-seeking behavior, nding it challenging to assume the sick role, leading to delays in seeking timely medical attention. Signicant attention has been channeled towards tackling the quadruple burden of disease in South Africa, with men's health having received relatively limited focus in comparison. An enhanced prostate cancer awareness might help improve men's health-seeking behavior, similar to other medical conditions. The turn around time between men being seen at the urology department at Universitas Academic Hospital and a biopsy was only 3 months. This is far better than is the case at many other tertiary hospitals. Is there less pressure on tertiary hospitals in the Free State compared to other provinces? I believe tertiary hospitals, including those in the Free State, face signicant pressure. The improved turnaround time observed in this study could be attributed to the prioritization and individualized approach to managing cases. There is an obvious need to increase levels of awareness about prostate cancer in the Free State and to make screening more easily accessible. Hopefully The Prostate Cancer of South Africa will be able to assist you with this in the future. We would sincerely appreciate your kind support and assistance in enhancing prostate cancer awareness in the Free State. Your help would be invaluable to us. Thank you in advance for your consideration. Thulani Sibisi and Ian Johnston, vice-chairman and chairman of The Prostate Cancer Foundation helping to raise awareness at last year's Soweto Marathon Expo UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE
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