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06 September 2023 | Story André Damons | Photo Supplied
radiation dose distribution
The patient is still under anaesthesia, the placement of the brachytherapy applicators is completed, and they are connected to the Iridium source for the radiation to be given.

Medical personnel at the Universitas Academic Hospital and the University of the Free State (UFS) in Bloemfontein became the first in Southern Africa to use Interstitial brachytherapy as a method for treating cervical cancer. 

A multidisciplinary team, consisting of an anaesthetist, clinical oncologists, application specialists, medical physicists, radiation therapy radiographers and professional nurses, completed the first interstitial cervical cancer brachytherapy in Southern Africa at Universitas Academic Complex in June this year.

Prof Alicia Sherriff, Head of the UFS Department of Oncology and a clinical oncologist, explained: “Brachytherapy is a method of internal radiation therapy, where a source of radiation is placed inside or near the cancer. This type of radiation travels only a short distance and makes it possible to deliver curative doses to the cancer while staying within the tolerance of the surrounding bladder, rectum, and small bowel.” 

She further emphasised that intracavitary brachytherapy has been an essential component of the curative management of cervical cancer since 1938.

According to her, feasibility studies were published for the use of applicators that combine intracavitary and interstitial brachytherapy in 2006. In 2014 prospective clinical trials started reflecting on the clinical value to improve local control for the locally advanced cervical cancers with combining intracavitary and interstitial brachytherapy to get higher doses of radiation where the cancer has grown outside of the cervix. Interstitial brachytherapy where the applicators are placed into the tissue with cancer are also used in prostate and breast cancer. 

Second-most common cancer in South African women

As per the Catalan Institute of Oncology (ICO) and the International Agency for Research on Cancer (IARC) information Centre on Human Papilloma Virus and cancer publication of March 2023, the current new diagnoses of cervical cancer annually in South Africa are 10,702 with 5,870 patients passing away annually due to cervical cancer. It is the second-most common cancer in women in South Africa and the most common among women between 15 and 44. Due to late/delayed presentation and diagnoses most cervical cancer patients seen have more advanced stages where the cancer has infiltrated outside of the cervix into the surrounding tissue.

“At the Universitas Academic Complex we have been approaching cervical brachytherapy with CT (Computer Tomography)-based image guidance for more than a decade already and the past five years we have been doing Adaptive CT-based image guided brachytherapy. 

“This means that with each brachytherapy treatment the cancer and all the surrounding normal organs are delineated based on a new CT image to ensure that we consider how the cancer has shrunk from one brachytherapy to the next and to see how we can limit the dose to the surrounding organs but at the same time achieve the highest possible dose of radiation with each treatment,” says Prof Sherriff. 

Planning to expand the use to other cancers

The intracavitary brachytherapy applicators which are used most frequently are placed within the cervix and uterus and deliver high doses there but cannot address the infiltration into the surrounding tissue adequately, she continued. “That is where these additional needles that are placed via the Venezia applicator into the surrounding tissue give the ability to also reach those areas with high-dose radiation while sparing the organs.”

Prof Sherriff explained that the interstitial brachytherapy does add additional time, expertise and logistical planning to the management and would not be utilised for all cervical cancer patients, but for those patients with locally advanced disease whose general health would support a more aggressive approach. The other academic training institutions are aiming to add interstitial brachytherapy to their platforms as well as at the UFS which is also planning to expand the use to other cancers. 

Save more lives

The MEC for Health in the Free State province, Mathabo Leeto, has congratulated medical professionals on this groundbreaking medical intervention. 

She said this breakthrough is in line with goals set by the United Nations in not only the provision of quality health services, but also and importantly, saving lives.

“This milestone is responsive to our targets for improvement of women’s health and reducing mortality. It is responsive also to Goal 3 of the United Nations’ Sustainable Development Goals which seeks to reduce global maternal mortality ratio, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes,” she said.

“Hopefully this breakthrough will help us save many more lives. I wish to congratulate everyone who contributed to this innovative way of cancer treatment and assure you that your province and the people are indebted to you,” concluded Leeto.

 


The medical staff who were involved in the first interstitial cervical cancer brachytherapy in Southern Africa were, from left: Dr Marnus Booyens (Anaesthetist); Dr Karin Vorster (Head Clinical unit and Clinical Oncologist); Dr Willie Shaw (Head of Medical Physics for the division of Radiation Oncology); Khalil Ben Fredj (Application Specialist ELEKTA for the TIMEA region and medical physicist); Prof Alicia Sherriff (HOD Oncology and clinical oncologist); Dr Dedri O’Reilly(medical physicist); Chantel Stroebel (Radiation therapy radiographer at brachytherapy); Dr Lourens Strauss (Medical physicist); Karl Sachse (Medical physicist); Sr Angelique Engelbrecht (professional nurse); Marga Claassen (Clinical and Commercial Account Specialist, SA for Elekta and Medical physicist).

News Archive

Moshoeshoe film screened at UFS as part of transformation programme
2004-10-14

A ground-breaking documentary film on the life and legacy of King Moshoeshoe I, the founder of the Basotho nation, will be screened at the University of the Free State (UFS) tonight (Wednesday 13 October 2004) at 19:00.

Rector and Vice-Chancellor of the UFS, prof. Frederick Fourie, said the UFS commissioned the documentary as a practical demonstration of the university’s commitment to the continued transformation of the campus and the creation of a new inclusive institutional culture for all staff and students.

It is part of a larger UFS project to honour the Moshoeshoe legacy of nation-building and reconciliation and to explore his role as a model of African leadership.

The documentary tells the life story of the legendary king, with emphasis on his remarkable leadership skills, his extraordinary talent for diplomacy and conflict resolution and his visionary commitment to creating a new nation from a fragmented society.

Almost all the filming was done on or around Moshoeshoe’s mountain stronghold, Thaba Bosiu.

The last part of the documentary explores the lessons for African leadership to be learnt from Moshoeshoe. The hour-long documentary film was produced by the well-known journalist Mr Max du Preez and was commissioned by the UFS as part of its centenary celebrations.

“Through this documentary film about King Moshoeshoe, the UFS commits itself to developing a shared appreciation of the history of this country,” said prof. Fourie.

“King Moshoeshoe was a great African statesman and leader. He was born in this region of the country, but his influence and legacy extends way beyond the borders of the Free State, Lesotho and even way beyond the borders of South Africa,” said prof. Fourie.

As part of the larger project, the UFS is investigating a possible annual Moshoeshoe memorial lecture that will focus on African leadership, nation-building and reconciliation, possible PhD-level research into the life and legacy of King Moshoeshoe and a literary anthology including prose and poetry.

“We must gain a deeper understanding of what really happened during his reign as king. Therefore the University of the Free State will encourage and support further research into the history, politics and sociology of the Moshoeshoe period, including his leadership style,” said prof. Fourie.

According to prof. Fourie the Moshoeshoe project will enable the UFS to give real meaning to respect for the diversity of our languages and cultures, and the unity South Africans seek to build as a democratic nation through such diversity.

According to the producer of the documentary, journalist Mr Max du Preez, the UFS deserves credit for recognising this extraordinary man and for financing this important documentary.

Du Preez said: “It was about time that South Africa rediscovered Moshoeshoe. Colonialist and Afrikaner Nationalist historians have painted him as a sly, untrustworthy and weak leader. Most historians have preferred to glorify leaders in South Africa’s past who were aggressors and conquerors. In the process most present-day South Africans came to regard Moshoeshoe as a minor tribal figure.”

“Yet this was the man who broke the cycle of violence, famine and suffering during the traumatic time in central South Africa in the early 1800s. During the entire 19th century, Moshoeshoe was virtually the only leader in South Africa who did not answer violence with violence, who did not set forth to conquer other groups and expand his land,” said Mr du Preez.

“I have no doubt that the stability that the Free State region has enjoyed over more than a century was largely due to Moshoeshoe’s leadership and vision. He can quite rightly be called “The Nelson Mandela of the 19th Century,” Mr du Preez added.

Explaining the title of the documentary film, Mr du Preez said: “We decided to call the documentary “The Reniassance King” because whichever way one looks at it, Moshoeshoe symbolised everything behind the concept of an African Renaissance.”

“He was progressive, just and fair; he deeply respected human life and dignity (we would nowadays call it human rights); he embraced modernity and technology without ever undermining his own people’s culture or natural wisdom; he never allowed European or Western influence to overwhelm him, make him insecure or take away his pride as an African,” said Mr du Preez.

“Moshoeshoe was the best of Africa. If only contemporary African leaders would follow his example of what African leadership should be,” Mr du Preez said.

Among the interviewees in the film were Lesotho’s most prominent historian, Dr LBBJ Machobane, the head of the UFS’s Department of History, prof. Leo Barnard, Moshoeshoe expert and Gauteng educationist Dr Peter Seboni, Lesotho author and historian Martin Lelimo and Chief Seeiso Bereng Seeiso, Principal Chief of Matsieng and direct descendant of the first King of the Basotho.

The documentary film on King Moshoeshoe will be screened on SABC 2 on Thursday 4 November 2004.
 

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