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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.

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News Archive

Academic and security arrangements on the Bloemfontein and South Campuses for the coming week
2016-02-28

All academic and administrative services on the Bloemfontein and South Campuses of the University of the Free State (UFS) will resume on Monday 29 February 2016.

The following academic and security arrangements have been put in place:

1.    Academic arrangements:

It is important to remember that losing an academic week has major implications for all students, particularly for first-year students, and for purposes of academic planning. The university will therefore resume its normal work on Monday 29 February 2016. Losing any additional time will severely disadvantage students, especially those who desperately need the time to catch up with lectures ahead of the coming tests and examinations. Many more students will struggle to complete the academic year if any further time is lost.

In order to ensure that the academic work of the university is not undermined, the UFS will extend this academic term by one week.
This will allow the completion of the work scheduled for last week. Given the impact that disruptions had on the emotions and concentration of many of our students, academics are requested to manage the setting and re-setting of all tests and assignments scheduled for last week with sensitivity, and to be supportive of students as they re-start their academic work.  No student should be disadvantaged in terms of tests or assignments as a result of last week’s closure. We know you would do this anyway, but this is a reminder to all staff of what we expect to be a common approach and understanding on the part of lecturers.

We rely on the leadership of the deans in the seven faculties to support staff and students in dealing with the lost time in the most appropriate manner and in supporting all efforts to refocus energies on the academic project.

As the senior leadership and management of the university, we will continue to do everything in our power to make sure that the academic programme continues uninterrupted.

2.    Security arrangements:
The Bloemfontein Campus is secure and we have more than doubled the security arrangements, with the interdict firmly in place.

The university management condemns in the strongest possible terms the violence that took place at Xerox Shimla Park on the night of Monday 22 February 2016. It also condemns the disruptions of the university that followed Monday’s event, which resulted in the suspension of academic and administrative activities on the Bloemfontein Campus. In line with the terms of the interdict - and now that we are at full capacity to secure this very large and spread-out campus - the university will act swiftly and firmly if any protests or disruption recur.

The following security arrangements are in place:
2.1  Staff and students must have their staff and student cards with them when entering the campus. Passengers in motor vehicles will have to present their cards to security personnel before access could be granted. Security personnel will check this physically by verifying that each person has a valid staff or student card.

2.2  Buses will not be allowed to enter the campus and passengers will have to be dropped off outside the gates - passengers will enter through the turnstiles with their valid access cards. Anyone without a valid access card will have to go to the Visitors Centre and present positive proof of ID (SA ID, passport or driver’s licence).

2.3  Pedestrians will have to swipe their cards at the turnstiles at the gates. Those without cards will have to enter through the Visitors Centre by presenting positive proof of ID (SA ID, passport or driver’s licence).

2.4  Visitors must report to the Visitors Centre (at Gate 5 in DF Malherbe Drive) and present positive proof of ID (SA ID, passport or driver’s licence).

2.5  Due to anticipated delays, it is advised that people allow some additional time when planning their routes to campus and to also make use of the less busy gates, such as Gate 4 (Furstenburg Road) and Gate 2 (Roosmaryn Residence).

2.6  It is advised that walkways be used, especially at night, and that pedestrians should keep to areas that are well lit.

Security helpline: +27(0)51 401 2911 | +27(0)51 401 2634.
 

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