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UFS scientists contribute to the battle against cancer

02 January 2024 | Story Leonie Bolleurs

Cancer stands as a prominent contributor to deaths worldwide, with a big impact on families and communities. Prostate cancer is one of the leading causes of mortality in the world. The recent diagnoses of cervical cancer are 10 702 annually, with 5 870 patients passing away. Female breast cancer surpassed lung cancer as the most commonly diagnosed cancer in 2020 (American Cancer Society), representing 11,7% of all cancer cases, making it the fifth leading cause of cancer mortality worldwide. Researchers at the university are doing their part in the fight against cancer.

Treating prostate cancer

In July 2021, Dr Osayande Evbuomwan, Senior Lecturer and Medical Specialist in the Department of Nuclear Medicine, along with a team of university doctors, initiated patient treatment using radioligand therapy (RLT). This targeted nuclear medicine therapy delivers high radiation levels precisely to cancer cells, minimising damage to normal organs and tissue, a benefit not typically provided by conventional therapies.

It was the first time that Lutetium 177 PSMA – a type of PRRT – has been used to treat patients with metastatic castrateresistant prostate cancer (MCRPC) in the Free State, providing hope when standard treatments and conventional therapy are not an option. This treatment generally enhances quality of life, slows disease progression, and extends overall survival, with minimal side effects.

All three patients treated with Lu 177 PSMA so far have completed at least four therapy cycles and tolerated it well. The first two patients, while initially responding well, sadly passed away due to unrelated causes. The third case stands out as the most successful, responding excellently to seven treatment cycle and remaining in good health.

Dr Evbuomwan recently also obtained a license for a more effective therapy, AC 225 PSMA, as an alternative to Lu 177 PSMA.

Precise cervical cancer therapy

Medical personnel at the Universitas Academic Hospital also became the first in Southern Africa to use interstitial brachytherapy as a method for treating cervical cancer. Prof Alicia Sherriff, Head of the Department of Oncology, explains that brachytherapy – a form of internal radiation therapy – places the radiation source near or inside the cancer. “Precise delivery of curative doses to the cancer protects surrounding organs such as the bladder, rectum, and small bowel,” she explains.

Three to five weekly brachytherapy sessions under conscious sedation usually begins after two weeks of daily external beam radiation. On brachytherapy days, external beam radiation is not administered. “The intracavitary brachytherapy applicators are placed within the cervix and uterus and deliver high doses locally, but for surrounding tissue infiltration, additional needles are inserted via the Venezia applicator, delivering high-dose radiation while sparing organs,” says Prof Sherriff.

Their work aligns with the broader goals of the university and its commitment to advancing health care in the region by ensuring the continued growth of their skills and technology, while applying these skills to improve the possibility of disease control, cure or palliation with quality of life.

Familial breast and ovarian cancer testing

Dr Nerina van der Merwe, a principal medical scientist in the Division of Human Genetics, and colleagues are engaged in breast cancer research. They are involved in translational research using new technologies that, once validated as a first-tier diagnostic test, could revolutionise genetic testing for familial breast and ovarian cancer in South Africa when used in conjunction with genetic counselling. This parallel application is ideally suited for primary hospitals and rural clinics, as it will dramatically increase accessibility and uptake of genetic testing in rural areas.

By performing first-tier genetic testing at a community clinic, patients no longer have to be transported to tertiary hospitals for testing, and more patients and related family members who are unaware of a familial predisposition will be reached. “By warning unaffected related individuals about their potential increased risk, we can play a part in the earlier detection or diagnosis of patients, improving their cancer survival rate,” states Dr Van der Merwe.

Patenting cancer research

Prof Andreas Roodt, a retired Distinguished Professor in the Department of Chemistry, and colleagues – particularly Prof Alice Brink and co-worker Prof Roger Alberto from the University of Zurich – have published widely on the chemistry of radiopharmaceutical models. Since the 2000s, the world has introduced the concept of ‘theranostics,’ which involves the use of a single compound for both cancer detection and therapy. “These compounds contain a radioisotope that provides internal radiation for cancer detection (diagnostic) and a second part for treatment,” explains Prof Roodt.

Their research enables the high-yield preparation of compounds containing multiple isotopes often present in very low concentrations. “This allows combining diagnostic isotopes such as technetium-99m (used in >80% of diagnostic patient studies worldwide) with therapeutic radioisotopes, such as rhenium-186 (used for bone cancer therapy), with ease. Many therapeutic radioisotopes do not have good diagnostic radiation; thus, by combining the two types of radioisotopes in one medicine, the oncologist can now clearly see where the therapeutic part is going and apply more effective treatment,” he says.

News Archive

To tan or not to tan: a burning issue

2009-12-08

Prof. Werner Sinclair

“Some evidence exists which implies that sunscreens could indeed be responsible for the dramatic rise in the incidence of melanoma over the past three decades, the period during which the use of sunscreens became very popular,” says Prof. Werner Sinclair, Head of the Department of Dermatology at the University of the Free State. His inaugural lecture was on the topic Sunscreens – Curse or Blessing?

Prof. Sinclair says the use of sunscreen preparations is widely advocated as a measure to prevent acute sunburn, chronic sun damage and resultant premature skin aging as well as skin malignancies, including malignant melanoma. There is inconclusive evidence to prove that these preparations do indeed achieve all of these claims. The question is whether these preparations are doing more harm than good?

He says the incidence of skin cancer is rising dramatically and these tumours are induced mostly by the ultra-violet rays.

Of the UV light that reaches the earth 90-95% belongs to the UVA fraction. UVC is normally filtered out by the ozone layer. UVB leads to sunburn while UVA leads to pigmentation (tanning). Because frequent sunburn was often associated with skin cancer, UVB was assumed, naively, to be the culprit, he says.

Exposure to sunlight induces a sense of well-being, increases the libido, reduces appetite and induces the synthesis of large amounts of vitamin D, an essential nutritional factor. The use of sunscreen creams reduces vitamin D levels and low levels of vitamin D have been associated with breast and colon cancer. Prof. Sinclair says the 17% increase in breast cancer from 1981 to 1991 parallels the vigorous use of sunscreens over the same period.

Among the risk factors for the development of tumours are a family history, tendency to freckle, more than three episodes of severe sunburn during childhood, and the use of artificial UV light tanning booths. He says it remains a question whether to tan or not. It was earlier believed that the main carcinogenic rays were UVB and that UVA merely induced a tan. The increase in UVA exposure could have severe consequences.

Prof. Sinclair says the UV light used in artificial tanning booths consists mainly of pure UVA which are highly dangerous rays. It has been estimated that six per cent of all melanoma deaths in the UK can be directly attributed to the use of artificial tanning lights. The use of an artificial tanning booth will double the melanoma risk of a person. “UVA is solely responsible for solar skin aging and it is ironical that tanning addicts, who want to look beautiful, are inflicting accelerated ageing in the process,” he says.

On the use of sunscreens he says it can prevent painful sunburn, but UVA-induced damage continues unnoticed. UVB blockers decrease vitamin D synthesis, which is a particular problem in the elderly. It also prevents the sunburn warning and therefore increases the UVA dosage that an individual receives. It creates a false sense of security which is the biggest problem associated with sunscreens.

Evidence obtained from the state of Queensland in Australia, where the heaviest and longest use of sunscreens occurred, boasted the highest incidence of melanoma in the world. A huge study in Norway has shown a 350% increase in melanoma for men and 440% for women. This paralleled the increase in the use of UVB blocking sunscreens while there was no change in the ozone layer. It did however, occur during that time when tanning became fashionable in Norway and there was an increase especially in artificial tanning.

Prof. Sinclair says: “We believe that sunscreen use does not directly lead to melanoma, but UVA exposure does. The Melanoma Epidemic is a reality. Sunscreen preparations are not the magical answer in the fight against melanoma and the irresponsible use of these preparations can worsen the problem.”

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt.stg@ufs.ac.za
7 December 2009

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