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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

Ghanaian academic speaks about next generation of African scholars
2013-10-08

 

Attending the seminar were from left: Adv Erika Cilliers, Sisa Mlonyeni (both from the Office of the Public Protector), Prof Adomako Ampofo and Prof Heidi Hudson, Head of the Centre for Africa Studies.
Photo: Jerry Mokoroane
08 October 2013

Prof Akosua Adomako Ampofo, one of the Centre for Africa Studies’newly-appointed advisory board members, addressed students and staff on 3 October 2013. Her topic Are you the scholar Africa needs?enthralled the audience with the passionate way in which she argued for nurturing activist-scholars rather than scholars who simply produce knowledge for the sake of it. “It is more urgent than ever before that … we do not simply see our roles as researchers and teachers, but that we are committed to impacting our communities” for the better – also by “making our knowledge production globally visible,” she argued. Africa is said to contribute less than 0.5 percent of the world’s scientific publications. The fact that most of these – and nearly all of the social science production – emanate from just three nations (Egypt, Nigeria and South Africa) means that many countries are absent from the radar.

According to her, the next generation of African scholars will have to compete within a hostile terrain where private universities are proliferating and costs of higher education are on the rise. These scholars will have to possess 22nd century skills, but a 20th century heart and sensitivity for the continent and its people.

Drawing on Kwame Nkrumah, Prof Ampofo proposed three guiding principles for becoming the scholars Africa needs. Firstly, by having a passion for knowledge as well as an Africa-centred knowledge – “nobody can tell our stories better than we can.”. Secondly, to translate our research into outputs not only in the form of internationally-recognised publications, but also in popular sources that will be read by a much wider public. And lastly, to carrying the torch for teaching and learning in the classroom – preparing our students to serve Africa or, as Nkrumah said, producing “devoted men and women with imagination and ideas, who, by their life and actions, can inspire our people to look forward to a great future.”.

Akosua Adomako Ampofo is a Professor of African and Gender Studies, and Director of the Institute of African Studies at the University of Ghana, Legon. An activist-scholar, her current work addresses African knowledge systems; race, ethnicity and identity politics; gender-based expressions of violence; constructions of masculinities; women and work; and popular culture. She is currently co-editing a volume titled, Transatlantic Feminisms: Women and Gender in Africa and the African Diaspora.In 2010, she was awarded the Sociologists for Women in Society Feminist Activism Award.


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