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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

Afromontane Research Unit makes climate change inroads
2017-10-28



Description: Prof Mukwada Tags: Prof Mukwada

Prof Geofrey Mukwada

The Afromontane Research Unit (ARU) has recently made inroads in climate-change research. This has been achieved through work published by Professor Geofrey Mukwada and Professor Desmond Manatsa, whose research could make it possible to predict El Nino Southern Oscillation (ENSO) several months before its occurrence. 

Professor Manatsa is an ARU postdoctoral fellow currently collaborating with Professor Mukwada on an ongoing climate-change research project. The two experts noted that ENSO is one of the most important climate phenomena on earth, due to its ability to change the global atmospheric circulation, which in turn, influences temperature and precipitation across the world.

Climate change scientific breakthrough

“This is a tremendous breakthrough, because humanity as a whole has been looking for answers regarding the origins of climate-related hazards which are worsening, yet becoming more frequent and difficult to predict. In some cases, floods and droughts occur in the same season, and within the same geographical area. These extreme climate events are becoming more frequent, often leading to loss of life and threatening national economies and livelihoods,” said Professor Mukwada, coordinator of the ARU sub-theme on Living and Doing Business In Afromontane Environments.

During an interview with the Southern Times, Professor Manatsa revealed that the El Nino Southern Oscillation (ENSO) is initiated and sustained in the tropical Pacific, a fact that has eluded climate scientists for years. “It was an unresolved puzzle which limited the successful prediction of ENSO events with reasonable lead time. Climate scientists were only able to know with some degree of certainty that the event would occur once it had started, just a few months before its impacts were felt,” Professor Manatsa said.

Prof Manatsa is upbeat that a lot of headway has now been made towards unravelling the mystery of ENSO’s origin. “The necessity of the inclusion of the solar energy changes due to ozone alterations in the upper atmosphere should significantly impact on the realistic version of ENSO in climate models. This in turn should not only provide more accurate ENSO forecasts for the region, but a longer lead time for users to prepare for the event,” he said.

ENSO is a climate phenomenon based in the tropical Pacific Ocean. Its events bring good rains and even floods over most parts of the world in some years and droughts in others, depending on whether the phenomenon is in a warm or cold phase. The warm phase is referred to as El Nino, when the waters over the tropical east Pacific are heated up, but when cooled, it is termed La Nina. La Nina was responsible for the favourable rains over much of Southern Africa, including Zimbabwe, during the 2016/17 rainfall season. The El Nino occurrence a year before had devastating drought effects that was characterised by scorching heat and widespread water shortages. This work was published in a high-profile journal, Nature Scientific Reports

ARU is a flagship inter- and trans-disciplinary research programme focusing on the under-researched area of montane communities. It was launched in June 2015 and is based on the Qwaqwa Campus. 

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