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18 August 2021 | Story André Damons | Photo André Damons
Dr Osayande Evbuomwan is a Senior Lecturer and medical specialist in nuclear medicine in the Department of Nuclear Medicine, Faculty of Health Sciences, at the University of the Free State (UFS).

The University of the Free State (UFS) Department of Nuclear Medicine has, for the first time, started using Lutetium 177 PSMA (Lu-177 PSMA) therapy for the treatment of metastatic castrate-resistant prostate cancer (MCRPC) – an advanced stage of prostate cancer.

The UFS and the Free State province are now joining other South African universities, such as the University of Pretoria, the University of the Witwatersrand, and other provinces in using this method to treat MCRPC patients. 

Dr Osayande Evbuomwan, a Senior Lecturer and medical specialist in the Department of Nuclear Medicine, Faculty of Health Sciences, says they have started treating their first MCRP patient (first cycle) with peptide receptor radionuclide therapy (PRRT) on 15 July. It is the first time that Lutetium 177 PSMA – a type of PRRT used for treating patients with MCRPC – has been used in the Free State. This method is used on MCRPC patients who are not eligible for chemotherapy or have failed first- or second-line chemotherapy.

Expertise and funds are now available for this treatment

Dr Evbuomwan was trained and exposed to this therapy at the University of the Witwatersrand during his registrar training in nuclear medicine. When he joined the UFS in 2019, he – with the always available help of the Head of Department, Dr Gerrit Engelbrecht – pushed for the therapy to be used in the department. 

“We in the Department of Nuclear Medicine are happy that expertise is now available and that some funds have been released for this treatment to commence. The index patient is very sick with MCRPC and was too sick to qualify for first-line chemotherapy. Each patient will need about four-six cycles for complete treatment. The patient is being treated in the Department of Nuclear Medicine at the Universitas Academic Hospital and Annex.” 

“We are hoping that he will be able to complete at least four cycles and respond well to the treatment. We believe that the ability to administer this treatment now is good news for the Free State, as the people of the Free State also deserve to be exposed to this level of treatment. We are hoping that the government will continue to provide more funds for more of these patients to be treated in our facility,” says Dr Evbuomwan.

It was budgeted to treat five patients (20 cycles), with each cycle (just the Lu-177 PSMA) costing more than R50 000. 

A googled image from the internet of a case before, during, and after completing the full course of therapy. The first image is before
treatment and the last image is after completing treatment, while the images in between are during treatment.
(Source: Google) 

Prostate cancer one of the leading causes of morbidity and mortality

Dr Evbuomwan says prostate cancer is one of the leading causes of morbidity and mortality in the world, including South Africa. When it progresses to the advanced stage of MCRPC, the prognosis becomes bad. 

Dr Evbuomwan explains that there are various conventional systemic therapies, including first- and second-line chemotherapy that could be used to treat patients at this bad stage. However, not all patients are fit for chemotherapy. The few who are fit, according to Dr Evbuomwan, usually end up failing the first-line chemotherapy, which has a lot of undesirable side effects and require long-stay hospital admissions. 

Only a few centres are able to offer second-line chemotherapy. So many of these patients end up suffering from prolonged bone pains before eventually dying from the disease.

PRRT is a targeted nuclear medicine therapy that offers the opportunity to deliver very high levels of radiation specifically to cancer cells, because these cancer cells express specific receptors to which certain peptides can bind. This specificity to cancer cells offers the advantage of providing lower doses of radiation and damage to normal organs and tissues, a characteristic that conventional therapies do not offer, explains Dr Evbuomwan.  

According to him, Lutetium 177 PSMA (Lu-177 PSMA) is a type of PRRT used for treating patients with MCRPC, who are not eligible for chemotherapy or have failed first-line chemotherapy. Numerous research studies around the world have proven that this treatment improves quality of life, slows down disease progression, and improves overall survival, with little or very tolerable side effects in most patients. 

The University of Pretoria is one of the pioneers of this treatment in the world, having done a lot of research with it since 2017. Other provinces such as the Western Cape and KwaZulu-Natal have also recently become involved with the therapy. This therapy is expensive and requires a lot of expertise. It also involves the input of a multidisciplinary team (MDT), which must at least include a nuclear medicine physician, a radiation oncologist, and a urologist. The Departments of Urology and Radiation Oncology at the UFS were also instrumental in the initiation of the therapy and form part of the MDT team at the UFS in the management of these patients.

Treatment puts department, university, and hospital on the map

Dr Evbuomwan says the ability to administer this treatment puts the department, the UFS, and the hospital on the map, alongside other top universities within and outside the country. “It also creates an avenue for us to gather data for research purposes and for publications. We are now able to offer a promising, safe, and highly efficacious therapy for patients with MCRPC in the Free State. Some of these patients no longer need to travel to other provinces to get the treatment.”

There are plans to expand the treatment to more patients – and hospital management, who were present at the first treatment, are excited and looking forward to the outcome of this current treatment.

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News Archive

Historians must place African history on world stage – Dr Zeleza
2017-05-30

 Description: Historians must place African history on world stage Tags: Historians must place African history on world stage

From the left: Panellists Rev Henry Jackson,
Prof Irikidzayi Manase and Arno Van Niekerk at a book
launch and panel discussion on Africa Day hosted by the
UFS Sasol Library.
Photo: Mamosa Makaya

“African historians must take seriously the challenge of placing African history in world history, and in the history of our species, Homo sapiens.”

With these words, Dr Paul Tiyambe Zeleza, Vice Chancellor of the United States International University-Africa in Nairobi, Kenya, stressed the continent’s challenge.

According to him the contest should continue to recover and reconstruct Africa’s long history. Liberating African knowledges can be done by: “Provincialising Europe that has monopolised universality, universalising Africa beyond its Eurocentric provincialisation, and engaging histories of other continents on their own terms.”

University celebrates Africa Month in various ways  
Dr Zeleza delivered the ninth Africa Day Memorial Lecture, titled The Decolonisation of African Knowledges, at the University of the Free State (UFS). The lecture, hosted by the Centre for Africa Studies (CAS), took place on 24 May 2017 in the Equitas Auditorium on the Bloemfontein Campus and was one of the ways in which the UFS celebrated Africa Month.

Scholars should immerse themselves in these thoughts

Dr Zeleza focused on two issues, which he said were interconnected. They were the unfinished project of decolonising African knowledges and the continent's positioning in global knowledge production.

He said Africa’s scholars and students should “immerse themselves in the rich traditions of African social thought going back millennia”. According to him the continent’s research profile still remains weak in global terms.

“It is imperative that the various key stakeholders in African higher education from governments to the general public to parents, and to students, faculty, staff, and administrators in the academic institutions themselves, raise the value proposition of African higher education for 21st century African societies, economies, and polities.”

“Colonialism is associated with injustice
and inequality, but what happens when
our liberators become our oppressors?”

Library celebrates with panel discussion and book launch
The UFS Sasol Library celebrated Africa Day by presenting a book launch and panel discussion on 25 May 2017, on the pertinent and current political theme of land redistribution with a comparative basis of land invasions in Zimbabwe.

Prof Irikidzayi Manase discussed his book White Narratives: The Depiction of Post-2000 Land Invasions in Zimbabwe, accompanied by Rev Henry Jackson who wrote Another Farm in Africa. A perspective of the economic implications of land redistribution in South Africa was discussed by panellist Arno Van Niekerk: Senior Lecturer of Economics at the UFS Faculty of Economic and Management Sciences.

Inequality still an African problem
The content of the books are a stark reminder of the burning issues of inequality and loss of identity of those who lost their farms in Zimbabwe, a collection of memoirs by white farmers and their families. Rev Jackson gave a religious perspective on reconciliation, forgiveness and the question of land ownership, saying that healing of injustice begins with forgiveness of past transgressions.

Van Niekerk highlighted that while land issues were important, “social cohesion is affected by the economic decisions that will be made”. In closing, Prof Manase called for serious consideration of what the future may hold. “Colonialism is associated with injustice and inequality, but what happens when our liberators become our oppressors?” 

The panel discussion was attended by staff and students of the university, and was lit up by robust discussions on possible historical and future solutions to the question of land, decolonisation and political power struggles in Southern Africa and lessons to be learned from Zimbabwe.

UFS celebrates Africa Month (24 May 2017)

 

 

 

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