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30 August 2022 | Story André Damons | Photo André Damons
UFS Nuclear Medicine
The team of doctors in the Department of Nuclear Medicine behind the success story are, from the left (standing): Dr Osayande Evbuomwan, nuclear medicine specialist and Senior Lecturer; Dr Gerrit Engelbrecht, Clinical Head of the Department of Nuclear Medicine at the UFS; and Dr Walter Endres, nuclear medicine registrar. In front is Dr Tebatso Tebeila, nuclear medicine registrar.

The University of the Free State (UFS) Department of Nuclear Medicine is proud to announce the successful treatment outcome of a patient with metastatic castrate-resistant prostate cancer (MCRPC) – an advanced stage of prostate cancer – by using Lutetium 177 PSMA (Lu-177 PSMA) therapy. This was initially a case of advanced stage prostate cancer, which had failed first-line chemotherapy, leaving little or no other treatment options.

This is a proud and happy moment for the department and the UFS, which started this treatment just over a year ago. The university and the Free State province are now joining other South African medical universities, such as the University of Pretoria, and other provinces in using this method to treat MCRPC patients. Lutetium 177 PSMA (Lu-177 PSMA) therapy is used on MCRPC patients who are not eligible for chemotherapy or have failed first- or second-line chemotherapy.

Dr Gerrit Engelbrecht, Clinical Head of the Department of Nuclear Medicine at the UFS, says the department is proud to be able to offer this treatment option to some of these patients. “It is a big win for the Free State and our oncology patients to be able to offer these expert services.” The UFS and Universitas Academic Hospital have now been able to join up with other academic institutions and hospitals in other provinces to offer these services. So far, three patients have been offered this therapeutic option, with the third patient currently undergoing his treatment.

Funds and equipment for proper treatment selection are needed

The expertise is no longer an issue for the UFS, as Dr Osayande Evbuomwan, nuclear medicine specialist and consultant, was trained and exposed to this therapy at the University of the Witwatersrand during his training as a nuclear medicine resident. Current registrars in the Department of Nuclear Medicine at the UFS are also being trained in the application of this treatment modality. However, proper patient selection is key in the management of these cases with Lu 177 PSMA. Without a PET/CT camera, it is challenging to appropriately select the patients who are most likely to respond to this therapy. This is an example of how PET/CT is crucial in the management and monitoring of oncology patients.

Both Drs Engelbrecht and Evbuomwan hope that the training of more registrars will increase their department’s capacity to treat more patients. They also hope that funds will be made available to acquire a much-needed PET/CT camera, which will greatly assist them in identifying the correct patients in need of this treatment. 

With the permission of the patient, the images above show the dramatic treatment response following Lu-177 PSMA therapy. The images on the left show widespread bone disease from the prostate cancer, including the skull. The images on the right show the dramatic response after completing four cycles of Lu 177 PSMA, with the normal excretion of the radiotracer seen in the liver, kidneys, and bladder.


Treatment puts the department, UFS, and hospital on the map

According to Dr Evbuomwan, 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. Says he: “It also creates an avenue for us to gather data for training, research purposes, and 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 will no longer have to travel to other provinces to receive this treatment.”


“We are also well aware that not every patient will respond this way; however, proper patient selection is key in identifying responders – an area that is still being researched. We also do not know how long these patients will have their disease under control after the treatment. Nuclear medicine’s greatest cancer therapy success story is the treatment of well-differentiated thyroid cancer with radioactive iodine.” 

“After treatment, most of these patients remain cancer-free for a very long period of time, if not for life. With continuing research in the field of MCRPC radioligand therapy, we aim to improve the treatment modality, hopefully getting it to the success level of thyroid cancer therapy.”

 

News Archive

#Women'sMonth: Long hours in wind and cold weather help to reconstruct Marion Island’s glacial history
2017-08-10

 Description: Liezel Rudolph  Tags: Liezel Rudolph, Process Geomorphology, Marion Island, periglacial geomorphology, Department of Geography  

Liezel Rudolph, lecturer for second-year students in Process
Geomorphology at the University of the Free State (UFS).
Photo: RA Dwight

Liezel Rudolph, a lecturer for second-year students in Process Geomorphology, aims to reconstruct the glacial history of Marion Island through cosmogenic nuclide dating techniques. She is interested in periglacial geomorphology, a study of how the earth’s surface could be formed by ice actions (freezing and thawing of ice).

Liezel is a lecturer in the Department of Geography at the university and is researching landscape development specifically in cold environments such as Antarctica, the Sub-Antarctic islands, and high mountain areas. “My involvement with periglacial geomorphology is largely due to academic giants who have carved a pathway for South Africans,” says Liezel.

Liezel visited Marion Island for the first time during her honours year in 2011, when she investigated the impact of seals on soil conditions and vegetation. Three years later, she visited Antarctica to study rock glaciers.

The challenge of the job
A workday in Antarctica is challenging. “Our time in the field is very limited, so you have to work every possible hour when the weather is not life-threatening: from collecting soil samples, to measuring soil temperature and downloading data, we measure polygons and test the hardness of rocks. The only way to get the amount of work done, is to work long hours in wind and rain with a positive and competent team! We take turns with chores: the person carrying the notebook is usually the coldest, while the rest of us are stretching acrobatically over rocks to get every nook and cranny measured and documented.”

A typical workday
Liezel describes a typical workday: “Your day starts with a stiff breakfast (bacon and eggs and a bowl of oats) and great coffee! After that comes the twenty-minute dressing session: first a tight-fitting under-layer, a middle layer – sweater and T-shirt, and then the outer windbreaker (or a quilt jacket on an extra cold day). Then you start applying sunscreen to every bit of open face area. Beanie on, sunglasses, two pairs of socks, two pairs of gloves. The few kilograms of equipment, one vacuum flask containing an energy drink, one vacuum flask containing drinking water (it would freeze in a regular bottle), and a chocolate bar and piece of biltong for lunch. After this, we drive (on snowmobiles) or fly (in helicopter) to our study area for about eight hours of digging, measuring, downloading, testing and chopping. Back at the base and after a long and tiresome undressing session, we move to the lab with all our data to make sure that it is downloaded safely and captured onto a database. Afterwards, depending on the day of the week, we enjoy a good meal. If you are lucky, such a typical day will coincide with your shower day. We can only shower every second day due to the energy-intensive water production (we have to melt snow) and the sewage system (all the water has to be purified before it could be returned to the environment). Then you grab your eye shield (since the sun is not sinking during summer) and take a nap before the sun continues to shine into the next day.”

Theoretical knowledge broadened 
“Going into the field (whether island or mountains) provides me with an opportunity to test geomorphic theories. Without experience in the field, my knowledge will only be limited to book knowledge. With practical experience, I hope to broaden my knowledge so that I could train my students from experience rather than from a textbook,” says Liezel.

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