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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.

Watch video below:

News Archive

Carbon dioxide makes for more aromatic decaffeinated coffee
2017-10-27


 Description: Carbon dioxide makes for more aromatic decaffeinated coffee 1b Tags: Carbon dioxide makes for more aromatic decaffeinated coffee 1b 

The Inorganic Group in the Department of Chemistry
at the UFS is systematically researching the utilisation
of carbon dioxide. From the left, are, Dr Ebrahiem Botha,
Postdoctoral Fellow; Mahlomolo Khasemene, MSc student;
Prof André Roodt; Dr Marietjie Schutte-Smith, Senior Lecturer;
and Mokete Motente, MSc student.
Photo: Charl Devenish

Several industries in South Africa are currently producing hundreds of thousands of tons of carbon dioxide a year, which are released directly into the air. A typical family sedan doing around 10 000 km per year, is annually releasing more than one ton of carbon dioxide into the atmosphere.

The Inorganic Chemistry Research Group in the Department of Chemistry at the University of the Free State (UFS), in collaboration with the University of Zurich in Switzerland, has focused in recent years on using carbon dioxide – which is regarded as a harmful and global warming gas – in a meaningful way. 

According to Prof André Roodt, Head of Inorganic Chemistry at the UFS, the Department of Chemistry has for the past five decades been researching natural products that could be extracted from plants. These products are manufactured by plants through photosynthesis, in other words the utilisation of sunlight and carbon dioxide, nitrogen, and other nutrients from the soil.

Caffeine and chlorophyll 
“The Inorganic group is systematically researching the utilisation of carbon dioxide. Carbon dioxide is absorbed by plants through chlorophyll and used to make interesting and valuable compounds and sugars, which in turn could be used for the production of important new medicines,” says Prof Roodt.

Caffeine, a major energy enhancer, is also manufactured through photosynthesis in plants. It is commonly found in tea and coffee, but also (artificially added) in energy drinks. Because caffeine is a stimulant of the central nervous system and reduces fatigue and drowsiness, some people prefer decaffeinated coffee when enjoying this hot drink late at night. 

Removing caffeine from coffee could be expensive and time-consuming, but also environmentally unfriendly, because it involves the use of harmful and flammable liquids. Some of the Inorganic Group’s research focus areas include the use of carbon dioxide for the extraction of compounds, such as caffeine from plants. 

“Therefore, the research could lead to the availability of more decaffeinated coffee products. Although decaffeinated coffee is currently aromatic, we want to investigate further to ensure better quality flavours,” says Prof Roodt.

Another research aspect the team is focusing on is the use of carbon dioxide to extract chlorophyll from plants which have medicinal properties themselves. Chemical suppliers sell chlorophyll at R3 000 a gram. “In the process of investigating chlorophyll, our group discovered simpler techniques to comfortably extract larger quantities from green vegetables and other plants,” says Prof Roodt.

Medicines
In addition, the Inorganic Research Group is also looking to use carbon dioxide as a building block for more valuable compounds. Some of these compounds will be used in the Inorganic Group’s research focus on radiopharmaceutical products for the identification and possibly even the treatment of diseases such as certain cancers, tuberculosis, and malaria.

 

 

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