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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

Space-based information plays vital role in disaster-risk reduction
2017-02-28

Africa is one of the continents most affected by disasters triggered by natural hazards. The result of climate change is a reality that affects every human being, whether it is extreme heat waves, cyclones, or the devastation of drought and floods. Climate change can provoke injuries or fatalities and affects the livelihoods of people in both rural communities and urban areas. It triggers damage and losses in various sectors of development, such as housing, road infrastructure, agriculture, health, education, telecommunications, energy, and affects routine economic processes leading to economic losses.

According to Dr Dumitru Dorin Prunariu, President of the Association of Space Explorers Europe, space programmes have become an important force defining challenges of the 21st century. “Space observation is essential for climate-change monitoring,” he said.

Dr Prunariu was the keynote speaker at a two-day symposium on climate resilience and water that was hosted by the Disaster Management Training and Education Centre for Africa (DiMTEC), at the University of the Free State (UFS). He participated in the Soviet Union’s Intercosmos programme and completed an eight day-mission on board Soyuz 40 and the Salyut 6 space laboratory, where he and fellow cosmonaut Leonid Popov completed scientific experiments in the fields of astrophysics, space radiation, space technology, space medicine, and biology. He is the 103rd human being to have travelled to outer space.

The focus of Dr Prunariu’s lecture was: Space activities in support of climate change mitigation and climate resilience.

Description: Dr Dumitriu Dorin Prunariu Tags: Dr Dumitriu Dorin Prunariu

Dr Dumitru Dorin Prunariu, the 103rd human
being in outer space and President of
the Association of Space Explorers Europe.
Photo: Charl Devenish

Space-based information, an extra eye that can detect a way out during disasters
“For governments to support communities affected by any disaster, precise and up-to-date information on its impacts is essential as a way to respond in a timely and effective way,” said Dr Prunariu.

Space-based information (derived using Earth observation, global navigation satellite systems, and satellite communications) can play a vital role in supporting disaster-risk reduction, response, and recovery efforts, by providing accurate and timely information to decision-makers.

“With space-based information, disaster management teams will be able to take note of recently established roads that may not appear in typical maps produced by National Geographic Institutes, but which could be used as emergency evacuation routes or as roads to deliver humanitarian assistance to those who require it in remote areas."

Space-based tools help decision-makers to improve planning
“Space-based tools and spatial data infrastructure is also crucial for policy planners and decision-makers in increasing the resilience of human settlements. Using geographic data and information collected before the occurrence of major disasters in combination with post-disaster data could yield important ideas for improved urban planning, especially in disaster-prone areas and highly-populated regions.

“In the recovery process, information on impact is used by governments to provide assistance to those affected, to plan the reconstruction process, and to restore the livelihoods of those affected,” said Dr Prunariu.

“Space observation is
essential for climate-
change monitoring.”

The symposium was attended by representatives from Liberia, Nigeria, Kenya, Ghana, Namibia, and Zimbabwe, with various international scientists from Europe imparting their expert knowledge on water and global resilience. The presence of these international experts strengthened global networks.

It isn't important in which sea or lake you observe a slick of pollution, or in the forests of which country a fire breaks out, or on which continent a hurricane arises, you are standing guard over the whole of our Earth. - Yuri Artyukhin: Soviet Russian cosmonaut and engineer who made a single flight into space.

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