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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

UFS physicists publish in prestigious Nature journal
2017-10-16

Description: Boyden Observatory gravitational wave event Tags: Boyden Observatory, gravitational wave event, Dr Brian van Soelen, Hélène Szegedi, multi-wavelength astronomy 
Hélène Szegedi and Dr Brian van Soelen are scientists in the
Department of Physics at the University of the Free State.

Photo: Charl Devenish

In August 2017, the Boyden Observatory in Bloemfontein played a major role in obtaining optical observations of one of the biggest discoveries ever made in astrophysics: the detection of an electromagnetic counterpart to a gravitational wave event.
 
An article reporting on this discovery will appear in the prestigious science journal, Nature, in October 2017. Co-authors of the article, Dr Brian van Soelen and Hélène Szegedi, are from the Department of Physics at the University of the Free State (UFS). Both Dr Van Soelen and Szegedi are researching multi-wavelength astronomy.
 
Discovery is the beginning of a new epoch in astronomy
 
Dr van Soelen said: “These observations and this discovery are the beginning of a new epoch in astronomy. We are now able to not only undertake multi-wavelength observations over the whole electromagnetic spectrum (radio up to gamma-rays) but have now been able to observe the same source in both electromagnetic and gravitational waves.”
 
Until recently it was only possible to observe the universe using light obtained from astronomical sources. This all changed in February 2016 when LIGO (Laser Interferometer Gravitational-Wave Observatory) stated that for the first time they had detected gravitational waves on 14 September 2015 from the merger of two black holes. Since then, LIGO has announced the detection of two more such mergers. A fourth was just reported (27 September 2017), which was the first detected by both LIGO and Virgo. However, despite the huge amount of energy released in these processes, none of this is detectable as radiation in any part of the electromagnetic spectrum. Since the first LIGO detection astronomers have been searching for possible electromagnetic counterparts to gravitational wave detections. 
 
Large international collaboration of astronomers rushed to observe source
 
On 17 August 2017 LIGO and Virgo detected the first ever gravitational waves resulting from the merger of two neutron stars. Neutron star mergers produce massive explosions called kilonovae which will produce a specific electromagnetic signature. After the detection of the gravitational wave, telescopes around the world started searching for the optical counterpart, and it was discovered to be located in an elliptical galaxy, NGC4993, 130 million light years away. A large international collaboration of astronomers, including Dr Van Soelen and Szegedi, rushed to observe this source.
 
At the Boyden Observatory, Dr Van Soelen and Szegedi used the Boyden 1.5-m optical telescope to observe the source in the early evening, from 18 to 21 August. The observations obtained at Boyden Observatory, combined with observations from telescopes in Chile and Hawaii, confirmed that this was the first-ever detection of an electromagnetic counterpart to a gravitational wave event. Combined with the detection of gamma-rays with the Fermi-LAT telescope, this also confirms that neutron star mergers are responsible for short gamma-ray bursts.  
 
The results from these optical observations are reported in A kilonova as the electromagnetic counterpart to a gravitational-wave source published in Nature in October 2017.
 
“Our paper is one of a few that will be submitted by different groups that will report on this discovery, including a large LIGO-Virgo paper summarising all observations. The main results from our paper were obtained through the New Technology Telescope, the GROND system, and the Pan-STARRS system. The Boyden observations helped to obtain extra observations during the first 72 hours which showed that the light of the source decreased much quicker than was expected for supernova, classifying this source as a kilonova,” Dr Van Soelen said.

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