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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

Judge Albie Sachs and Candice Mama discuss traumas of the past and forgiveness in the present
2015-08-05

 

Judge Albie Sachs embraces Candice Mama for her courage in confronting Eugene de Kock, who killed her father.

Two generations. Two stories of triumph. Two South Africans who have displayed immense courage.

Public Dialogue on Trauma, Memory, and Representations of the Past

Judge Albie Sachs and Candice Mama exchanged their experiences of past trauma and subsequent transformation in a public conversation. The event was co-hosted by Prof Pumla Gobodo-Madikizela and The Institute for Justice and Reconciliation (IJR) in Cape Town on Thursday 30 July 2015.

The event was the first instalment in a series entitled Public Dialogue on Trauma, Memory, and Representations of the Past. The theme of the discussion was ‘Intergenerational Dialogue on Trauma and Healing’.

"The aim of these public dialogue events we are co-hosting with IJR is to place the issues of trauma and memory, and the strategies that individuals and communities use to heal, in the public sphere," Prof Gobodo-Madikizela, Senior Research Professor in Trauma, Forgiveness, and Reconciliation Studies at the University of the Free State (UFS) said.

Judge Albie Sachs and Candice Mama in conversation

Former Constitutional Court Judge, Albie Sachs, talked about his participation in South Africa’s liberation struggle, the loss of his right arm in an assassination attempt, and meeting the man responsible – Henri van der Westhuizen. Despite years of exile and extended periods of solitary confinement, Judge Sachs maintains that “we need to acknowledge our history, not be trapped by it.” Judge Sachs also remarked, though, that “we’re seeing too much lamentation, not enough activation.” In a heartrending gesture, Judge Sachs embraced Candice Mama in a hug for her courage in confronting Eugene de Kock, who killed her father.

How poignant then, when Mama said, “I wanted to embrace the brokenness within him,” when she spoke about her meeting with De Kock. By the time I met with Eugene, I could meet him as a human being, not as a villain.” Mama believes that forgiving someone translates into an investment in the person you are forgiving and in your own sanity. She also emphasised the importance of dialogue to move our country forward: “When we share our stories with each other authentically, walls break down.”

This is a stance that Prof Gobodo-Madikizela supports strongly: “When we listen to one another, something unexpected emerges; we encounter the human in each other,” she said. “When we listen with open hearts to each other, we see and experience each other’s humanity.”

Building a bridge between research and society

Referring to the research aspect of the event, Prof Gobodo-Madikizela said that, "in establishing the series of public dialogue events, our vision is to create a bridge between scholarly research and the community at large, on the one hand, and a visual conscience of society, on the other." The UFS is collaborating with the IJR on this research project, which is funded by the Andrew W. Mellon Foundation. The endeavour is led by Prof Gobodo-Madikizela, who also serves as Board Member of the IJR.

 

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