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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

Emma Sadleir talks about social media etiquette
2016-05-18

Description: Emma Sadlier Tags: Emma Sadlier

Emma Sadleir
Photo: Supplied

“We have all become celebrities, we have become social figures because of our power to publish information. We have all become brands, and we need to protect our brand. Digital content is sometimes dangerous content,” said Sadleir.

On 11 May 2016, the University of the Free State, in collaboration with the Postgraduate School, hosted, Emma Sadleir, a leading social media expert, in the Equitas Auditorium on the Bloemfontein Campus. She is an admitted advocate, specialising in social media law.  Dr Henriette van den Berg, Director of the Postgraduate School, described Sadleir’s presentation as a privilege for all the staff and students who attended.

Sadleir said that there are two important rules that staff and students of an institution should try to follow. The first is not to bring the name of the institution into disrepute; and the second is not to breach the goodwill of the institution or, in other words, not to bite the hand that feeds you.

“The common law, even if there is no policy, is that anything that brings the company into disrepute can lead to disciplinary consequences up to termination,” said Sadleir.

Sadleir focused on hate speech and free speech, stating that free speech is a right that is entrenched in the constitution, but, like every other right, it has limitations. She mentioned Penny Sparrow, Matt Theunissen, Velaphi Khumalo, and Judge Mabel Jansen, all of whom have been lambasted by the public over their racist posts on social media. Sadleir stressed that, even on social media, content has to be within the confines of the law, and people must remember our rights are not absolute. We have a lot of freedoms, but no one cannot disseminate hate speech.

“Would you publish whatever you thinking on a billboard, close to a busy highway with your name, picture and employers details or the institution you studying at? If you have no grounds to justify the comment, do not post it,” warned Sadlier.  

According to the South African Bill of Rights, everyone has the right to privacy, but an expectation of privacy has to be enforced. She said people over-document their lives on social media, decreasing your right to privacy drastically. “It is like CCTV footage of your life. It is simple, the more you take care of your privacy, the more you have,” said Sadleir.

Sadleir said it was important for Facebook users to have privacy settings where they can review posts where they are tagged. According to Sadleir, managing your reputation is not only limited to what you post about yourself but also managing what others post about you.

She cited a 2013 case in the Pretoria High Court in which a new wife wrote a scandalous Facebook post about her husband’s ex-wife, tagging the husband in the post. The courts found both the new wife and the husband guilty of defamation.

“If you have been tagged in something but have not been online and seen the content, you are then an innocent disseminator. The moment you are aware of the post you are liable for the content,” said Sadleir.

“It takes 20 years to build a reputation and five minutes to ruin it. If you think about that, you'll do things differently,” Sadleir said, concluding her presentation with the quotation from Warren Buffet.

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