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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

‘Sola Scriptura’ — Does Scripture still reign as authority?
2017-02-21

Description: Theology Open Day Tags: Theology Open Day

Thania Labuschagne, Nico Oosthuizen, and
Suthea van der Westhuizen.
Photo: Supplied


Reformation 500: Sola Scriptura [scriptural authority] and contemporary conflicts of interpretation was the theme for the Faculty of Theology and Religion’s official opening and annual Open Day on the Bloemfontein Campus of the University of the Free State (UFS). The faculty was recently renamed to be more inclusive of other denominations, as well as to be sensitive to the impact religion has on society, both in the past and presently.

In his welcoming address to first-year students, Prof Fanie Snyman, Dean of the Faculty of Theology and Religion, said, “I hope that you indulge in the theological dish served to you, and that it will create in you a deep hunger to know more.”

One first-year, Neo Kgaje, had this to say, “I first wanted to do Archaeology, but then I decided to follow my calling as a missionary and study Theology. I would like to serve in my own community in Botshabelo.”

Thania Labuschagne, former chairperson of the Sola Gratia student association, said, “The annual opening is always very special for me. We become part of a family here.” Her message for first-years was, “Maintain your passion for what you do. Make sure of your calling, and everything else will fall into place.”

Prizes awarded
Prizes were awarded to several students who excelled in the previous year. The best third-year student in 2016 was Suthea van der Westhuizen; best fourth-year BTh student, Thania Labuschagne; and Nico Oosthuizen was recognised as the best Master of Divinity in the fifth year.

The Director of Shepherd Centre for spiritual leaders, Dr Gerhard Botha, awarded certificates for the completion of a 9-module short learning programme presented by the centre.

"May you hunger to know more"—
Prof Fanie Snyman, Dean of the
Faculty of Theology and Religion

Current affairs addressed through scriptural analysis
While acknowledging that the debates around the authority of Scripture are complex and not easily resolved, Prof Hendrik Bosman from the Faculty of Theology at Stellenbosch University (SU) argued that it is an indispensable precept of Christian theology. However, it can no longer be taken as a given, since the authority of Scripture is increasingly vulnerable. He said, “Sceptic academics and critical theologians are challenging the more traditional ways of accepting the authority of Scripture.”

Prof Bosman highlighted the negative impact that certain claims of scriptural authority have had on the marginalised and vulnerable groups in society — “the suffering endured by people of colour, Jews, the LGBTQI community, and women due to prejudice and hatred. … [When reading the Bible], one must also be held accountable by the marginalised and the vulnerable in society.”

Prof Juliana Claassens (Faculty of Theology, SU) presented Beyond Revenge: Responsible Bible Reading Practices in a Traumatised Land. “As a community of believers who hold dear the principle of Sola Scriptura, what do we do with texts that revel in the downfall of the enemy and propagate revenge as a viable solution to the hurt and pain people are experiencing?”

Prof Claassens continued, “This question is particularly relevant given the deep wounds that many in this beautiful country of ours carry. … There is thus a real danger that expressions of violence survive and grow ever stronger with each utterance, until the violent ideas they propagate are considered to be normal.” Her recommendation? “Foster communities of care, focused on breaking down walls, instead of erecting them.”

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