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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

Reaction by the Rector of the UFS after a meeting with student leaders
2008-02-25

Reaction by the Rector and Vice-Chancellor of the UFS, Prof. Frederick Fourie, on the agreement reached at a meeting with student leaders held on Friday, 22 February 2008

Note: This is meant to be used together with the full joint statement that was issued by the UFS management and student leaders on 22 February 2008.

The memorandum of the primes of the University of the Free State’s (UFS) residences was handed to top management on Wednesday, 20 February 2008. In the memorandum they asked for a meeting with the UFS management by Friday, 22 February 2008. Such a meeting was arranged and took place.

The UFS top management, all the residence primes as well as the house committee member for first years, the executive of the Main Campus Student Representative Council (SRC) and residence heads were present.

In contrast to what is suggested in the Volksblad report of Saturday, the discussion went off very well. There was no consternation or shouting or “emotions that ran high”. It was a civilised, decent meeting as it should be at a good university. Of course, now and again individuals spoke out strongly and very enthusiastically, but it was all decent and orderly. The contribution of the primes was insightful and well formulated.

Because the top management and I wanted to listen very carefully what the problems and frustrations were, we spent nearly five hours in the meeting. The issues in the memorandum were discussed one by one. In some cases I could take a decision immediately and finalise the matter, in other cases, the management provided information that could largely finalise a matter. A number of other matters must be investigated further.

The management undertook to respond comprehensively and in writing to all the issues raised in the memorandum by Monday, 25 February 2008. This will be handed to the primes but will not be handed to the media beforehand.
It is obvious that there are matters at the university that can be better managed and that there are problems with communication within the Student Affairs division. A major change such as the new policy on diversity places huge demands on management and the administration, and problems were to be expected. However, we understand the frustration of the students in residences.

On the other hand, students don’t always make matters easier. The strong opposition of white student leaders last year, and their unwillingness to co-operate in preparation for 2008 is well known. This year it is going better. But often student leaders take positions that are very inflexible. They also see no room for adapting old habits and simply want their own way. Their contributions are then full of statements such as “It cannot be done”. This delays measures such as the full implementation of expert interpreting services, which, for the management, is a very important measure (and which is functioning very well in certain residences). Communication from student leaders to management is also not always what it should be.

At the end of the meeting student leaders and management reached an important agreement and issued a joint statement in which they committed themselves to the integration process and to good co-operation and communication. This was an important step which is a sign of rebuilding trust. Naturally everyone will still have to work hard to build on this and to strengthen mutual trust.

The course and outcome of Friday’s discussions, as requested by the student leaders, show that issues can be addressed and resolved by means of us talking to one another. This is why it is so sad that primes and house committee members went on strike on Wednesday already and stayed in tents in front of the Main Building – leaving their residences without its leadership. This created an opening for what appears to have been well planned and co-ordinated acts of vandalism by inhabitants of residences on the campus on Wednesday.

Such vandalism is unacceptable and no one can justify it.

Fortunately, order could be restored quickly during the night and all academic activities could resume without any disruption on Thursday and Friday.

FCvN Fourie

Media Release
Issued by: Lacea Loader
Assistant Director: Media Liaison
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: loaderl.stg@ufs.ac.za   
24 February 2008

 

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