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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

Johann Naudé talks at first Beyers Naudé lecture for 2012
2012-08-02

At the event were, from the left: Ms Bontle Senne, Managing Director for the PUKU Children’s Literature Foundation, Mr Sipho Hlongwane, writer and columnist for the Daily Maverick, Prof. Nicky Morgan, Vice-Rector: Operations at the UFS, Mr Themba Mola, Chief Operations Officer at Kagiso Trust, Mr Johann Naudé, son of Dr Beyers Naudé, and Dr Choice Makhetha, Vice-Rector: External Relations.
Photo: Stephen Collett
2 August 2012

The University of the Free State (UFS) together withKagiso Trust, presented the first Beyers Naudé lecture for 2012 on its South Campus in Bloemfontein last week. Speakers like Dr Wilmot James, Member of Parliament, Mr Johann Naudé, son of Dr Beyers Naudé, Mr Sipho Hlongwane, writer and columnist for the Daily Maverick and Ms Bontle Senne, Managing Director for the PUKU Children’s Literature Foundation, all gave a lecture around this year’s theme: Collaborative partnerships for social cohesion: Building a nation with ethics.

Dr Beyers Naudé played a major role in the formation of Kagiso Trust. His contribution to the trust and the fight against oppression in South Africa, as well as his challenging of the establishment from which he came, makes him one of South Africa’s courageous heroes. Kagiso Trust thus saw it fit to celebrate the life of this clerical activist through a Memorial Lecture The Beyers Naudé Memorial Lecture is an effort by the Trust to engage South Africans into a dialogue about issues affecting our nation.

Mr Johann Naudé talked about the lessons they as children learnt from their parents as well as his father’s decision to respond to the needs of the people in South Africa. Even before the Sharpeville Massacre, Dr Naudé began a self-transformation that led to his rejection of apartheid. “Apartheid had no theological or scriptural grounds and my father decided to resign from the church. After that, he started to talk openly against apartheid and he also paid the price for that. For seven years he was under house arrest and we as his children also felt the effect of his decision. At the University of Pretoria in a residence where I stayed as a student I was called in and told that I would be treated as an outcast. Loans and jobs were also closed for us as children and as a result, we all started our own businesses,” Mr Naudé said.

“Furthermore, our parents taught us to believe in ourselves. He also said we have rights and we can only demand those rights if we take the responsibility that goes with it. My father also taught us to honour and to respect our fellow men, elderly people and the culture of people different from us. We were also taught to apologise for the wrongs to our fellow men and to acknowledge earnestly that we were wrong.”

Dr Wilmot James said that there were two things consistent in the life of Dr Beyers Naudé, namely justice and fairness. “There are many Nelson Mandelas and Beyers Naudés out there. It is the responsibility of political parties and institutions to motivate such leadership. We must ask ourselves: Are my actions and decisions ethical and will they have fair consequences?” Dr James said.

Mr Hlongwane focused his presentation on the ethics part of the theme. He said: “We in South Africa fall very short of ethics. We can start by respecting each other and taking care of one another. The Constitution will not mean a thing if we fail to respect and trust one another. We will have no cohesive society if we continue to treat those different from us like dirt. It is also our ethical duty to build up the disadvantaged.

In her discussion, Ms Senne emphasised the role of the youth in South Africa. “Our youth is failing our state because our state is failing our youth. Their role is to bring cohesion and acts of courageousness to the table. For them to contribute in a practical and sustainable manner, they need to start making the changes they want to see in society. They are young people and they can make it work because they do have access to the necessary means (social networks) to get things done. They must get involved,” she said.

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