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UFS, Universitas Academic Complex first in Southern Africa to use interstitial brachytherapy for cervical cancer

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

Getting out of the dark

2015-06-10

ESKOM is making daily announcements on the status of the power grid.

Anton Calitz, Electrical Engineer at University Estates, is in continuous contact with Eskom and Centlec in an effort to stay abreast of load shedding.

According to Anton, Eskom has recently - the week of 20 April - been focusing on the evening peak, and has announced STAGE 1 load shedding from 17:00-22:00; thus, the Bloemfontein Campus should be able to continue business as usual during the day, except for Thursdays from 18:00 and, possibly, Fridays from 17:00.

Where can I get more information about load shedding stages?

Apart from Eskom’s webpage, staff can also visit GRID WATCH. Click on "Search", then under "Schedules". Look for "Mangaung Local Municipality", and select "GROUP 4". Save this location. “This can even be loaded onto your mobile device.”

“The time slots can be seen for a couple of days in advance, to allow us to plan around the possibility of load shedding in our daily lives,” said Anton.

Please note: ESKOM can change the STAGE level at any time. Therefore, keep an eye on GRID WATCH and News24.

View the typical seven-day planner for the Bloemfontein Campus (Group 4), which indicates the STAGE 2 and 3 possibilities. Take note that, on some days, the STAGE 2 and 3 time slots are the same.

More load shedding tips: Your IT needs

The UFS Data Centre (Computer Room) is fully serviced by a generator facility, and can function without external power supply for a few days.

The generator servicing the UFS data centre does NOT provide power to the outlying facilities. This implies that all digital equipment at gates, booms, and access points will be shut down until the power is restored to these facilities. “We are now, in collaboration with Nico Janse van Rensburg, in a process to install UPS facilities at these points, which will ensure two to three hours of power supply at these points, even during load shedding,” said Dr Vic Coetzee, Senior Director: ICT Services.

No Wi-Fi will be available, as it is dependent on the power supply to the buildings where it is installed.

All servers are contained in the data centre, and will be kept running by our generators.

How to manage load shedding and your IT needs:

1. Get into the habit of saving your work regularly on computer so that you don’t lose your work/files during load shedding.
2. Back up important data. Keep to a schedule of regular back-up. Make sure your computer back-ups are safe and recoverable.
3. Keep all electronic devices charged and ready to run on battery power. Keep your cellphone charged: some old-style Telkom landlines will still operate during power outages, but others won't.
4. Remember, when power supply is restored, it sometimes happens that a power surge is sent through the network, which will damage your computer. Fortunately, laptop computers will not suffer this fate as their power is provided through an external power pack. Often, this power pack will be damaged, but not the laptop itself.
5. It makes good sense to reboot your computer daily, not only in terms of power shedding, but also in terms of updating the drivers, software, etc.
6. Switch off all computers and other electrical equipment at the wall plug overnight and on weekends.
7. Should your IT equipment not switch on after a power outage, log a call with the ICT Services. You can also call them at x2000.

More information, guidelines and contact numbers

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