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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

Important message to UFS students on NSFAS and financial aid in general
2013-02-01

31 January 2013

Dear Students

There remains some uncertainty as well as misinformation within the student body concerning NSFAS and financial aid in general. This communication is intended to provide the facts on the state of student funding at the University of the Free State (UFS). I hope you find this information helpful and that it would guide you in your decisions as you wait to hear from, or hopefully receive funding from NSFAS or any other source.

  1. Every year the Department of Higher Education and Training (DHET) determines how much funding is available to fund students at all universities in South Africa; this is determined in part by the student numbers. Universities do not ask for, or determine the DHET allocation and are instructed by government that “NSFAS will ensure that the universities comply with the processes, procedures…for the allocated funds.”

  2. On 14 December 2012 the UFS received notice from the DHET that our total allocation would be R108,331,215.66 and that this amount must be apportioned in the following categories:
    General NSFAS Funding R85,174,275.07
    Teacher Training R2,291,940.59
    Disability Funding R1,265,000.00
    Final-Year Programme R19,600,000.00

  3. The UFS received 5 952 applications for NSFAS funding and with the available funding we can only finance up to 3 000 students on the Qwaqwa and Bloemfontein Campuses, provided that those students satisfy the stringent criteria, e.g. the so-called “national means test” determined for all universities in the country. If we funded more students that the available monies allow, the university would be held accountable by the NSFAS Board and the DHET and this would threaten future funding.

  4. Students apply in the previous year and therefore late applications are less likely to receive funding.

  5. Academic merit also counts, therefore students who fail one or more modules are less likely to receive new or ongoing support from NSFAS. The combination of academic standing and financial need are among the important criteria in decision-making on NSFAS funds.

  6. The UFS is one of the few universities with a very efficient record in using every cent made available to support poor students; we are proud of this record. No money is sent back to NSFAS, except small amounts not claimed by students in the disability category. The university is not allowed to shift funds between categories as described in point #2 above.

  7. Allocations are not based on campus, but need.

  8. The UFS sets aside an additional R35,7 million (in 2013) from within its own budget as bursaries so that we can accommodate as many students as possible. We spend every cent of this funding on students.

  9. The UFS also raises millions in bursaries from the private sector to support poor and promising students, though these funds are often linked to the industry granting the money, e.g. Investec for Accounting students and SASOL for Chemistry students. This recruitment of bursaries is a 24/7 commitment of the Marketing Office and the Faculties and Heads of Departments are also active in raising funds from government agencies, parastatals and the private sector for students in their units.

  10. After almost all our 2013 funds were allocated in favour of students, we calculated a shortfall in the NSFAS allocation of approximately R51 million. We are in the process of making an urgent submission to NSFAS to consider this additional allocation, but we cannot guarantee that this plea can or will be met.

Finally, I want all our students to know that the University of the Free State works very hard to raise every cent we can to provide poor students with funding for their studies. Many of my colleagues, including support staff, who do not earn very much, use some of their meagre personal resources to help a student with money for registration or clothing or food. In fact, the No Student Hungry Campaign that raises more than R600,000 by UFS volunteers annually, is another mechanism for trying to assist students who might have money for studies, but not much else.

We do this because we care, and because this is what The Human Project at Kovsies is all about.

I therefore ask for your patience as we continue our labour of raising the funds that enable every deserving student to continue their studies at the University of the Free State.

Should you have any further questions about NSFAS, please leave an email inquiry on choanet@ufs.ac.za or mallettca@ufs.ac.za and we will endeavour to provide you with the information you require.

Sincerely Yours

Jonathan D Jansen
Vice-Chancellor and Rector
University of the Free State

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