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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

Legal elite tackle thorny issue of corruption
2013-01-24

 

Our Faculty of Law brought together top experts and judges for a Symposium on Corruption, to investigate one of the most pressing concerns of South Africans.
Photo: Stephen Collett
24 January 2013



   YouTube Video

Chief Justice Mogoeng Mogoeng yesterday (24 January 2013) concluded the proceedings of the first day of the International Symposium on Corruption, hosted by the Faculty of Law of the University of the Free State (UFS). In his address Justice Mogoeng made no excuses as to the magnitude of the threat corruption presents to South African citizens.

“Urgent action and efficient measures are called for to arrest this scourge, for the sake of our constitutional democracy,” he warned. “Our vibrant constitutional democracy will not and cannot survive in the face of rampant corruption.”

Justice Mogoeng said the spate of civil and labour unrest erupting throughout the country can be attributed to corruption. According to him the scope and far-reaching implications of corruption drives South Africans to “boiling point” and evokes “anger, frustration and a don’t-care-attitude that often manifests in widespread protest actions” and disrespect for the rule of law.

“South Africans, irrespective of race or creed, must identify and focus on their common enemies and find a conciliatory and unifying way of dealing with what divides them, including the lingering prejudices of the past,” Justice Mogoeng urged.

Despite the threat corruption poses, he stressed that all South Africans have a role to play in the fight against corruption and that there are different role players that can become involved in the process. Especially important is the media and faith-based agencies which, according to Justice Mogoeng, can regenerate morals and secure a “national moral code.” The State must further ensure enforcement of anti-corruption measures and preside over the selection of individuals of “solid character” to reside in agencies meant to fight corruption.

He highlighted the need for an unbiased and independent judiciary, one immune to outside influences controlled by powerful forces, as well as personal agendas.

Although Justice Mogoeng believes that the private sector is most guilty of transgressions based on corruption, he stated that a “well-coordinated war” against it must be waged in all sectors in order to stamp it out.

Justice Mogoeng presided over the unveiling of the redesigned foyer of the CR Swart Building and praised the Faculty of Law for its innovation with regard to the symposium.

“I look forward with great optimism to more well-organised symposiums that strike at the nerve-centre of the well-being of our constitutional democracy,” he concluded.

Symposium seeks answers and solutions

The Faculty of Law at the University of the Free State (UFS) concluded its International Symposium on Corruption on Friday 25 January 2013. The event featured a stellar cast of speakers, including the Chief Justice of South Africa, three current Supreme Court of Appeal judges, high-court judges, advocates, prosecutors, journalists, as well as local and international legal academics.

Throughout the two-day symposium, corruption was dissected as a severe problem in the South African socio-economic landscape and solutions were sought to alleviate the pressing concern.

The main attractions of the symposium were undoubtedly the attendance and presentations delivered by Chief Justice Mogoeng Mogoeng, as well as Prof. Leon Wessels. Prof. Wessels was described as “one of the founding fathers of the constitution of South Africa” by Judge Fritz Brand, a current Appeal Court judge and the third-longest serving judge in the country.

“Corruption is stealing the constitutional dream of this country. Corrupt leaders are fearless, those who expose corruption, are fearful,” Prof. Wessels warned.

Judge Brand closely trails the second longest serving judge in the country in former Kovsie, as well as former UFS Council Chairman, Judge Faan Hancke. Both judges addressed the symposium and chaired sessions, along with Prof. Johan Henning, Dean of the Faculty of Law, and Judge Ian van der Merwe, Chairman of the UFS Council.

It was, however, not all doom and gloom, as several of the speakers offered tangible ideas in what was often termed the “war on corruption”. Celebrated Sunday Times journalist Mzilikazi wa Afrika who has been arrested following the police leasing scandal which he exposed, urged South Africans to stand together in their fight against corruption, before it is too late.

People on the front lines in the day to day fight against corruption also spoke at the symposium, giving the audience a better understanding of the intricacies and challenges involved in the process. The Head of the National Prosecuting Authority’s Asset Forfeiture Unit, Mr Willie Hofmeyer, as well as Advocate Xolisile Khanyile, who is the Director of Public Prosecutions in the Free State, elucidated this struggle.

The symposium also hosted Prof. Chizu Makajima, a celebrated academic from the United Kingdom.

The two-day symposium ended in style as the delegates gathered in the Centenary Hall on the Bloemfontein Campus for lunch, with a further address by Prof. Leon Wessels


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