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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

Prestigious awards, membership and two A-ratings from the NRF indicate a boom in research
2014-12-04

Several UFS researchers were honoured with awards this year. This includes, from the left: Prof Jeanet Conradie from the Department of Chemistry, Dr Aliza le Roux from the Department of Zoology and Entomology on the Qwaqwa Campus of the UFS, Profs Jonathan Jansen, Vice-Chancellor and Rector of the UFS.
Photo: Hannes Pieterse

The University of the Free State (UFS) had several highlights in the field of research this year. This includes two A-ratings, which were awarded by the National Research Foundation (NRF) to Prof Maxim Finkelstein from the Department of Mathematics and Actuarial Science, and Prof Melanie Walker, Senior Research Professor and Director of the Centre for Research on Higher Education and Development (CRHED) and DST/NRF Chair in Higher Education and Human Development.

Prof Finkelstein’s A2-rating makes him the only A-rated researcher in ‘Probability and Statistics’ regarding Mathematical Sciences in the country. Prof Walker was evaluated in the division for Research, Innovation Support and Advancement and received an A1-rating.

Prof Jonathan Jansen, Vice-Chancellor and Rector of the UFS, considers these ratings as one of the clearest signs that the standard for research across the institution has increased significantly.

Prof Jansen was honoured with the Academy of Science of South Africa’s (ASSAf’s) Science-for-Society Gold Medal for his outstanding achievement in scientific thinking to the benefit of society.

"An award such as this recognises the power of science and scholarship to improve the human condition," Prof Jansen said.

A further highlight at ASSAf’s prestigious annual awards ceremony was the induction of Prof Jeanet Conradie from the Department of Chemistry and Dr Aliza le Roux from the Department of Zoology and Entomology on the UFS’s Qwaqwa Campus as new members of ASSAf.

Prof Conradie was also this year’s first runner-up in the senior category for Distinguished Women Researchers: Physical and Engineering Science in the Department of Science and Technology’s 2014 Women in Science Awards.

Prof Corli Witthuhn: Vice-Rector: Research, describes Prof Conradie as a highly productive researcher who publishes in high-impact journals.

“Not only is she the first female professor in the Department of Chemistry, but she also has extensive international networks and collaboration which elevates the impact of her work even further,” Prof Witthuhn said.

Dr Le Roux is one of ten young researchers inaugurated as members of the South African Young Academy of Science (SAYAS). She was also elected to serve on the executive committee of SAYAS. According to Prof Witthuhn, Dr Le Roux is an outstanding young scientist.

“I am very excited about the young researchers on our Qwaqwa Campus, with Aliza as one of the leaders, and I am looking forward to what they will achieve in the next five years,” she said.

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