Justus Apffelstaedt

Justus Apffelstaedt

South Africa - Cape Town


Qualifications/Degrees: State Exam. Med. Germany; Doctorate in Medicine (Toxicology) on structure-activity relationships in the carcinogenic potential of chemical compounds; Master of Medicine (Surgery), University of Stellenbosch; Fellowship of the College of Surgeons of South Africa; Master of Business Administration (Bond University, Australia); Diploma in Wine (Cape Wine Academy).

Principal of Apffelstaedt and Associates, Breast and Thyroid Health in Cape Town, South Africa and Windhoek, Namibia.

1994 - 2017: Associate Professor of Surgery, University of Stellenbosch, South Africa and Head: Surgical Oncology Service, University of Stellenbosch. The service is the tertiary referral center for 4 million inhabitants; responsible for the management of about 1000 new cancer cases annually in multidisciplinary clinics in breast, head & neck, soft tissue and skin tumors.

Was Principal Investigator for several international breast cancer research consortia.

More than 50 publications in the peer-reviewed international literature.

More than 100 invited lectures at congresses internationally and postgraduate courses world-wide.

Co-founder and member of Breast Surgery International; long time council member for developing countries.

Founding President of the Breast Interest Group of Southern Africa.

Was panelist in the Breast Health Global Initiative.

Formulated breast cancer screening policy for National Department of Health of South Africa.

Former examiner for the Master’s degree in surgery internationally and Fellowship of the College of Surgeons of South Africa.

Established Apffelstaedt & Associates, the first fully vertically integrated breast and thryoid health centre in Southern Africa.


- Apffelstaedt, Hoosain & Associates
- Breast Surgery International

Areas of expertise

- Breast cancer
- Thyroid health


Alcohol and cancer

Alcohol and cancer

Alcohol use has convincingly been linked to a number of cancers with those of the esophagus, liver, breast, colon, oral cavity the most common. Risk correlations with alcohol volume consumption have been described with light to moderate use of alcohol having limited influence on cancer incidence, which rises steeply for heavy users. The mechanisms of alcohol causation of cancer comprise direct effects by alcohol and its metabolites such as carcinogenic DNA alterations, DNA repair inhibition, oxidative stress and dysregulation of oncogenes and tumor suppressor genes. Indirect effects include: Production of radical oxygen species whose metabolism in turn interfere with cell cycle regulation, promotion of proliferation and metastasis. Systemic effects are promotion of inflammation, deleterious changes to retinoid and estrogen metabolism, suppression of immune system responses to cancer cells, changes to the microbiome in upper aerodigestive tract and intestines as well as promotion of liver cirrhosis and activation of smoking and industrial chemicals related carcinogens. Interactions of the mechanisms occur at several levels, making estimation of individual factor importance difficult. Further interactions factors beyond biochemical considerations of pure ethanol such as the impact of other chemicals in the alcoholic beverage, interactions with diet in general, physiologic factors such as obesity, exercise and socio-economic environment are difficult to investigate and data consequently are lacking. Currently, it is estimated that only about 4% of cancers world-wide are related to alcohol intake making alcohol consumptions as a target for cancer control efforts questionable.