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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

Link between champagne bubbles and the UFS?
2012-11-16

Prof. Lodewyk Kock with an example of a front page of the publication FEMS Yeast Research, as adapted by F. Belliard, FEMS Central Office.
Photo: Leatitia Pienaar
15 November 2012

What is the link between the bubbles in champagne and breakthrough research being done at the Mayo Clinic in America? Nano research being done at our university.

Prof. Lodewyk Kock of Biotechnology says a human being consists of millions of minute cells that are invisible to the eye. The nano technology team at the UFS have developed a technique that allows researchers to look into such a cell, as well as other microorganisms. In this way, they can get an idea of what the cell’s “insides” look like.

The UFS team – consisting of Profs. Kock, Hendrik Swart (Physics), Pieter van Wyk (Centre for Microscopy), as well as Dr Chantel Swart (Biotechnology), Dr Carlien Pohl (Biotechnology) and Liza Coetsee (Physics) – were amazed to see that the inside of cells consist of a maze of small tunnels or blisters. Each tunnel is about 100 and more nanometres in diameter – about one ten thousandth of a millimetre – that weaves through the cells in a maze.

It was also found that these tunnels are the “lungs” of the cells. Academics doing research on yeast have had to sit up and take notice of the research being done at the UFS – to the extent that these “lungs” will appear on the front page of the highly acclaimed FEMS Yeast Research for all of 2013.

The Mayo Clinic, in particular, now wants to work with the UFS to study cancer cells in more detail in order to fight this disease, says Prof. Kock. The National Cancer Institute of America has also shown interest. This new nano technology for biology can assist in the study and development of nano medicine that can be used in the treatment of cancer and other life threatening diseases. Nano medicine uses nano metal participles that are up to one billionth of a metre in size.

Prof. Kock says laboratory tests indicate that nano medicine can improve the efficacy of anti-cancer medicine, which makes the treatment less toxic. “According to the Mayo Clinic team, nano particles are considered as a gold cartridge which is being fired directly at a cancer tumour. This is compared to fine shot that spreads through the body and also attacks healthy cells.”

“This accuracy implies that the chemotherapy dose can be lowered with fewer side effects. The Mayo Clinic found that one-tenth of the normal dosage is more effective against pancreas cancer in this way than the full dosage with a linkage to nano particles. According to the clinic, this nano medicine could also delay the spread of cancer,” says Prof. Kock.

The nano particles are used as messengers that convey anti-cancer treatment to cancer cells, where it then selectively kills the cancer cells. The transport and transfer of these medicines with regard to gold nano particles can be traced with the UFS’s nano technology to collect more information, especially where it works on the cell.

“With the new nano technology of the UFS, it is possible to do nano surgery on the cells by slicing the cells in nanometre thin slices while the working of the nano medicine is studied. In this way, it can be established if the nano medicine penetrates the cells or if it is only associated with the tiny tunnels,” says Prof. Kock.

And in champagne the small “lungs” are responsible for the bubbles. The same applies to beer and with this discovery a whole new reach field opens for scientists.

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