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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

Emma Sadleir talks about social media etiquette
2016-05-18

Description: Emma Sadlier Tags: Emma Sadlier

Emma Sadleir
Photo: Supplied

“We have all become celebrities, we have become social figures because of our power to publish information. We have all become brands, and we need to protect our brand. Digital content is sometimes dangerous content,” said Sadleir.

On 11 May 2016, the University of the Free State, in collaboration with the Postgraduate School, hosted, Emma Sadleir, a leading social media expert, in the Equitas Auditorium on the Bloemfontein Campus. She is an admitted advocate, specialising in social media law.  Dr Henriette van den Berg, Director of the Postgraduate School, described Sadleir’s presentation as a privilege for all the staff and students who attended.

Sadleir said that there are two important rules that staff and students of an institution should try to follow. The first is not to bring the name of the institution into disrepute; and the second is not to breach the goodwill of the institution or, in other words, not to bite the hand that feeds you.

“The common law, even if there is no policy, is that anything that brings the company into disrepute can lead to disciplinary consequences up to termination,” said Sadleir.

Sadleir focused on hate speech and free speech, stating that free speech is a right that is entrenched in the constitution, but, like every other right, it has limitations. She mentioned Penny Sparrow, Matt Theunissen, Velaphi Khumalo, and Judge Mabel Jansen, all of whom have been lambasted by the public over their racist posts on social media. Sadleir stressed that, even on social media, content has to be within the confines of the law, and people must remember our rights are not absolute. We have a lot of freedoms, but no one cannot disseminate hate speech.

“Would you publish whatever you thinking on a billboard, close to a busy highway with your name, picture and employers details or the institution you studying at? If you have no grounds to justify the comment, do not post it,” warned Sadlier.  

According to the South African Bill of Rights, everyone has the right to privacy, but an expectation of privacy has to be enforced. She said people over-document their lives on social media, decreasing your right to privacy drastically. “It is like CCTV footage of your life. It is simple, the more you take care of your privacy, the more you have,” said Sadleir.

Sadleir said it was important for Facebook users to have privacy settings where they can review posts where they are tagged. According to Sadleir, managing your reputation is not only limited to what you post about yourself but also managing what others post about you.

She cited a 2013 case in the Pretoria High Court in which a new wife wrote a scandalous Facebook post about her husband’s ex-wife, tagging the husband in the post. The courts found both the new wife and the husband guilty of defamation.

“If you have been tagged in something but have not been online and seen the content, you are then an innocent disseminator. The moment you are aware of the post you are liable for the content,” said Sadleir.

“It takes 20 years to build a reputation and five minutes to ruin it. If you think about that, you'll do things differently,” Sadleir said, concluding her presentation with the quotation from Warren Buffet.

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