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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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Top PhD graduates hailed for excellent research in development and historical studies
2017-07-11

 Description: Top PhD graduates hailed for excellent research  Tags: Top PhD graduates hailed for excellent research  

Prof Melanie Walker and Prof Ian Phimister

The Centre for Research on Higher Education and Development and the International Studies Group celebrated its PhD graduates on 26 June 2017. The four graduates were joined by their PhD promoters Prof Ian Phimister and Prof Melanie Walker, the Dean of the Faculty of Economic and Management Sciences, and their families, who came from far and wide, as well as various faculty academics and staff. Their areas of study ranged between Development Studies and Africa Studies, exploring issues that make a significant impact on the Southern African region and the continent as a whole.

In the Faculty of Economic and Management Sciences, specialising in Development Studies, Dr Faith Mkwananzi, promoted by Prof Merridy Wilson-Strydom, explored the lives and educational aspirations of marginalised migrant youth, a case study in Johannesburg. She focused on the complex nature of the daily lives and experiences of marginalised migrant youth and the complexities that influence the formation and achievement of educational aspirations in contexts of vulnerability and disadvantage. The study provides compelling evidence for policy and practice that can make the lives of marginalised young migrants better.

A focus on teaching and learning in Zimbabwean universities with a focus on quality as a human development, was what Dr Patience Mukwambo, put her research efforts into. Her work makes an original contribution to national, continental, and international debates on conceptualising and operationalising the quality of teaching and learning in higher education. She successfully developed a significant alternative approach to understanding what quality in higher education teaching and learning entails, the factors that influence the realisation of quality as she theorises it, and the overall importance for human development and human well-being in universities and society.

Dr Bothwell Manyonga, who also specialised in Development Studies, examined the broader debates on the purposes and practices of teaching and learning in higher education with a case study at two South African universities, with an emphasis on principles of social justice and equity. In the thesis, he developed a model that proposes grounds for (re)thinking sociology teaching and learning to address how the capabilities approach and dominant human capital theory might complement each other in higher education and curriculum development. This takes into account both the instrumental aim of employment, which is of concern to students, as well as the intrinsic goods of critical discourse and personal development.

In the Faculty of the Humanities, with a specialisation in Africa Studies, Dr Abraham Mlombo’s doctoral research explored the relationship between Southern Rhodesia and South Africa 1923-1953, examining the ‘special relationship’ between the two countries from the former’s perspective, highlighting the complexity of the ties between them by examining (high) political relations, economic links and social and cultural ties. “It is through Abraham’s research that for the first time, black experiences of both sides of the colonial border are detailed,” said Prof Phimister.

In congratulating the graduates, Prof Melanie Walker expressed that a lot of hard work was put into training the PhD candidates and they had without a doubt produced work that was of the highest level, at international standards.

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