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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

Dialogue between Science and Society series looks at forgiveness and reconciliation
2013-03-24

 

Taking part in the discussion on forgiveness and living reconciliation, were from left: Olga Macingwane, a survivor of the Worcester bombing of 1993; Dr Juliet Rogers, a Scholar on Remorse from the University of Melbourne in Australia and Dr Deon Snyman, Chairperson of the Worcester Hope and Reconciliation Process.
Photo: Mandi Bezuidenhout
24 March 2013

How do you, as a mother who lost her only daughter, forgive the man who claimed responsibility for the attack that killed her?  How do you forget his crime while travelling with him across the world?  

These were some of the questions posed to Jeanette Fourie at a Dialogue between Science and Society series on forgiveness and living reconciliation. Jeanette, whose daughter Lyndi was killed in an attack on the Heidelberg Pub in Cape Town in 1993, was one of three people telling their stories of forgiveness while dealing with traumatic experiences. 

Sitting next to Letlapa Mphahlele, the man who owned up to the attack that killed her daughter, Jeanette spoke about their story of forgiveness traveling the world together, spreading the message of forgiveness and conciliation. 

"Don't ever think you can forget, because that’s not possible. What you do with the pain is to find peace, and that's what forgiveness does. Forgiveness allows you to stop all the dialogue in your head on why he did it. You don't forget, you confront it and you deal with it." 

Letlapa, Director of Operations of Apla, the military wing of the PAC at the time of Lyndi's death, spoke about dealing with the response to his crime. "Sometimes you wish that you were not forgiven, because now you have the great burden of proving that you are worthy of forgiveness."

Also telling her story of forgiveness was Olga Macingwane, a survivor of the Worcester bombing of 1993 in which four people were killed and sixty-seven others injured. Four people were sent to prison. In 2009 Olga met one of the perpetrators, Stefaans Coetzee, and what came out of that meeting, is her story. 

"When I met Stefaans I was very angry, but when you sit down with somebody and listen to him or her, you find out what the reasons were that made him or her do something. I can say that I forgave him." 

Facilitating the conversation, Prof Pumla Gobodo-Madikizela, Senior Research Professor on Trauma, Forgiveness and Reconciliation, said the seminar was meant to get in touch with the truth that forgiveness is possible. 

"Before we had the Truth and Reconciliation Commission (TRC) in South Africa, the experts always said that forgiveness was not possible in these stories of the past. And then the TRC came into life as a response to mass atrocities. For the first time in the history of these traumatic experiences, of political traumas, we witness something that we have never seen.  Even us on the TRC, although it was framed as reconciliation, we never imagined there would actually be stories of forgiveness emerging out of that process, and then we witness that this too is possible." 

Others who took part in the two-hour-long seminar, were Dr Juliet Rogers, a Scholar on Remorse from the University of Melbourne in Australia and Dr Deon Snyman, Chairperson of the Worcester Hope and Reconciliation Process. They spoke about the dynamics behind the processes of engagement between victims/ survivors and perpetrators. 

The Dialogue between Science and Society series was co-hosted by the Institute for Reconciliation and Social Justice. 

 

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