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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

Migration is a developmental issue - experts
2010-06-01

Pictured from the left, front, are: D. Juma, Mr Williams and Prof. Hussein Solomon (University of Pretoria); back: Prof. Bekker, Prof. Lucius Botes (Dean: Faculty of the Humanities, UFS) and Dr Wa Kabwe-Segatti.
Photo: Stephen Collett


“Migration offers more opportunities for economic growth than constraints. It is an integral part of the processes of globalisation and regional integration.”

This was a view shared by one of the speakers, Dr Monica Juma from the Africa Institute of South Africa, during a panel discussion hosted by the Centre for Africa Studies (CAS) at the University of the Free State (UFS) last week as part of the celebrations of Africa Day on 25 May 2010.

The discussion was premised on the theme, Migration and Africa: From Analysis to Action.

Dr Juma said migrants could be assets for host countries or cities because of their resourcefulness. She said they brought along essential skills that could contribute immensely to the economic development of their host countries or cities.

“Governments are beginning to see migration as a tool for development and working together in developing immigration policies,” concurred another speaker, Mr Vincent Williams from the Institute for Democracy in South Africa (IDASA).

He said, if managed properly, migration could yield positive results. He said effective management of migration should start at local and provincial levels.
And for this to happen, he said, the current immigration laws should be amended as he felt they were no longer relevant, because they were based on what countries wanted to achieve in the past.

“Reform national immigration legislation to encourage permanent settlement and improve service delivery mechanisms and bureaucracy to match population movements,” Dr Aurelia Kazadi Wa Kabwe-Segatti, from the Forced Migration Studies Programme at the University of the Witwatersrand recommended.

However, Mr Williams pointed out that policy convergence was a difficult thing to achieve as migration was a politically sensitive issue. He said decisions that countries made on migration could have a negative or a positive bearing on their relations with one another.

Dr Juma also raised the issue of unskilled migrants which, she said, could be a burden to governments. This was reflected in the current South African situation where foreigners offered cheap labour and thus rendered South Africans who demanded higher salaries unemployable. This was a contributory factor to the xenophobic attacks of 2008. What was essentially a labour problem then manifested itself as a migration problem.

Prof. Simon Bekker from the University of Stellenbosch said South Africa was still losing a significant number of skilled professionals to Europe and North America due to an assumption that spatial mobility led to social or economic mobility.

He also suggested that the government should not restrict internal migration but should address the problem of migration across the borders into South Africa.

Senior Professor at the CAS, Prof. Kwandiwe Kondlo, said while the discussion covered a broad scope, there were some gaps that still needed to be filled in order for an all-inclusive view to prevail. One such gap, he said, was to also accord indigenous traditional institutions of governance space in such deliberations and not base discussions on this issue only on the Western way of thinking.

Africa Day is the day on which Africa observes the creation of the Organisation of African Unity (OAU) on 25 May 1963, to promote the unity and solidarity of African states and act as a collective voice for the African continent; to secure Africa’s long-term economic and political future; and to rid the continent of all remaining forms of colonialism. The OAU was formally replaced by the African Union in July 2002.

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt@ufs.ac.za  
1 June 2010
 

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