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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

African Student Affairs Conference a huge success
2011-05-24

 
Mr Rudi Buys, UFS Dean of Student Affairs, Mr. Folabi Obembe, Managing Director of Worldview International, Ms Birgit Schreiber, Director of the Centre for Student support services at the University of the Western Cape, Dr. Augustinah Duyilemi, Dean of Student Affairs at the Adekunleh Ajasin University in Nigeria, Dr. Christina Lunceford, assistant Director for the Centre for Research on Educational Access and Leadership at California State University in America, and Prof. Cecil Bodibe, student affairs veteran and consultant.
Photo: Earl Coetzee

The African Student Affairs Conference (ASAC), which took place on our Main Campus last week, was a major success, with two days of lectures and discussions and two pleasant social gatherings, where delegates had the opportunity to get to know each other.

The conference, hosted on African soil for the first time, and co-hosted by the University of the Western Cape (UWC), started on Wednesday 18 May 2011 with an informal welcoming session. Delegates got to meet each other and Mr Rudi Buys, UFS Dean of Student Affairs, explained the meaning of South African words like "kuier" and "lekker'.

The official start of events took place on Thursday 19 May 2011, in the Reitz Hall in our Centenary Complex. The conference was attended by delegates from universities across the continent and aimed to place the focus on issues relating to student affairs in an African context.

Delegates shared and exchanged strategies, ideas and resources, and discussed issues related to the work of student affairs professionals. The conference hoped to promote an exchange of best practice and assist attendees in identifying successful programmes.

Among the topics discussed on the first day, were “Constructing Post-Conflict Democracy on campus: a case study of transformation of student governance and political engagement as post-conflict intervention”, by Mr. Buys, and a discussion on ways in which social and online media can be used to ease the challenges of student interaction, development and support, by Ms Birgit Schreiber, Director of the Centre for Student Support Services at UWC.

A panel discussion, led by Mr Buys and several members of our Interim Student Council (ISC), discussed the specific challenges faced at the UFS.  The importance of buy-in from role-players in decisions taken by University management in order to ensure their success, was discussed, using the UFS and our recent changes as an example.

The successful integration of residences on campus inevitably came under the spotlight and the recently resolved Reitz-saga was named as a catalyst in getting students less apathetic and more involved in attempts at creating racial and social harmony.

Dr Christina Lunceford, Assistant-Director of the Centre for Research on Educational Access and Leadership at California State University, presented a paper entitled A National Approach to Building Capacity in Student Affairs in South African Higher Education.

She commented on the fact that there is little or no philosophical framework or explicit theory that informs practice of student services in South Africa.

According to Dr Lunceford, student development should be a key concern for every department or unit within student services and emphasized the need for a centralized student development unit at each university.
She also touched on the need for institutions to implement support from international student affairs professional associations, professional development for student affairs practitioners, the utilization of technology to support professionals in the field, and working with international partners to explore future opportunities, as ways in which student affairs can be used to drive performance and change at universities.

The conference continued in the Scaena theatre on Friday 20 May 2011, with presentations by Dr Augustinah Duyileme, Dean of Student Affairs at Adekunle Ajasin University in Nigeria, and Prof. Bobby Mandew, Executive Director of Student Affairs at the University of Johannesburg (UJ).

Dr Duyileme presented a paper on the challenges faced by Nigerian universities with regard to student conflict and protests, which often turn violent, and how such violence can be curbed through proper planning and management.

Prof. Mandew presented a very well-received presentation on UJ’s successful off-campus housing initiative, which involves home-owners and business owners in the areas surrounding their campuses.

Their approach demonstrated how proper planning can prevent problems associated with over-population in private homes and conflict with neighbours of the university, usually related to an influx of students into residential neighbourhoods.

This problem is faced by many universities, as more and more students flock to universities on the continent and campus residents cannot accommodate them.

The conference came to a close on Friday, with most delegates agreeing that the exchange of knowledge which took place was extremely valuable.

Ms Deborah Lahlan, of Nigeria, said: “This is an important conference for Africa and it should become a regular event.”
 

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