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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

Small things matter
2017-01-17

 Description: Prof Felicity Burt  Tags: Prof Felicity Burt

Prof Felicity Burt (right) and Dr Dominique Goedhals
from the Department of Medical Microbiology and
Virology at the University of the Free State.
Photo: Anja Aucamp



The newly established virology section at the University of the Free State (UFS) boasts world class expertise. Not only are they one of just five laboratories in the country tasked with specialised HIV testing, but current research generates publications and subsidised funding.

The driving force behind this initiative is passionate and dedicated people who invest long hours into vital research. One such person is Prof Felicity Burt, who eloquently guides her students while making impressive progress within her own field of interest: vector-borne and zoonotic diseases. Prof Burt was recently awarded a research chair (2016-2020) to, among other areas, investigate medically significant vector-borne and zoonotic viruses currently circulating.

That means that her research focus is mainly on viruses transmitted by mosquitoes and ticks, and viruses transmitted from animals to humans. “Yes,” she laughs, “I catch mosquitoes and check them for viruses.”

Becoming familiar with different viruses
As if big screen moments like Outbreak and Contagion did not create enough virus paranoia, the world was recently bombarded by real world Ebola and Zika outbreaks. But awareness, Prof Burt says, is not a bad thing. “Years ago, when people heard that I did Ebola research, they got that distant look in their eyes, and changed the subject. One outbreak later, backed by many media reports, and Ebola is almost a household name. The same goes for the recent Zika virus outbreak in South America.”

The more familiar people become with these types of viruses, the better, Prof Burt feels. However, getting the right message across is not always that easy. The Zika virus outbreak, for example, was a very large outbreak and therefore presented large numbers of affected people. Generally, not everyone infected with an arbovirus will necessarily present with symptoms. But because vector-borne viruses can spread to new areas, surveillance and awareness is important. Here in Bloemfontein, Prof Burt and her team are establishing surveillance programmes.

Gaining knowledge and preventative measures
So, next time you get all wound up about a “biological disaster”, rest assured that competent people like Prof Burt and her colleagues continuously scan the environment to gain knowledge and develop preventive measures should any risks be looming. For example, developing next-generation vaccines that are very effective, but without risk – since they are not built on the virus itself, but only on the part of the virus that will induce an immune response.

Currently, Prof Burt is also looking into the relationship between the Sindbis virus and arthritis. It is clear that we can expect many exciting findings from the UFS’s new virology unit.

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