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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 forgive is not an obligation. It’s a choice.” – Prof Minow during Reconciliation Lecture

2014-03-05

“To forgive is not an obligation. It’s a choice.” – Prof Minow during the Third Annual Reconciliation Lecture entitled Forgiveness, Law and Justice.
Photo: Johan Roux

No one could have anticipated the atmosphere in which Prof Martha Minow would visit the Bloemfontein Campus. And no one could have predicted how apt the timing of her message would be. As this formidable Dean of Harvard University’s Law School stepped behind the podium, a latent tension edged through the crowded audience.

“The issue of getting along after conflict is urgent.”

With these few words, Prof Minow exposed the essence of not only her lecture, but also the central concern of the entire university community.

As an expert on issues surrounding racial justice, Prof Minow has worked across the globe in post-conflict societies. How can we prevent atrocities from happening? she asked. Her answer was an honest, “I don’t know.” What she is certain of, on the other hand, is that the usual practice of either silence or retribution does not work. “I think that silence produces rage – understandably – and retribution produces the cycle of violence. Rather than ignoring what happens, rather than retribution, it would be good to reach for something more.” This is where reconciliation comes in.

Prof Minow put forward the idea that forgiveness should accompany reconciliation efforts. She defined forgiveness as a conscious, deliberate decision to forego rightful grounds of resentment towards those who have committed a wrong. “To forgive then, in this definition, is not an obligation. It’s a choice. And it’s held by the one who was harmed,” she explained.

Letting go of resentment cannot be forced – not even by the law. What the law can do, though, is either to encourage or discourage forgiveness. Prof Minow showed how the law can construct adversarial processes that render forgiveness less likely, when indeed its intention was the opposite. “Or, law can give people chances to meet together in spaces where they may apologise and they may forgive,” she continued. This point introduced some surprising revelations about our Truth and Reconciliation Commission (TRC).

Indeed, studies do report ambivalence, disappointment and mixed views about the TRC. Whatever our views are on its success, Prof Minow reported that people across the world wonder how South African did it. “It may not work entirely inside the country; outside the country it’s had a huge effect. It’s a touchstone for transitional justice.”

The TRC “seems to have coincided with, and maybe contributed to, the relatively peaceful political transition to democracy that is, frankly, an absolute miracle.” What came as a surprise to many is this: the fact that the TRC has affected transitional justice efforts in forty jurisdictions, including Rwanda, Sierra Leone, Cambodia and Liberia. It has even inspired the creation of a TRC in Greensborough, North Carolina, in the United States.

There are no blueprints for solving conflict, though. “But the possibility of something other than criminal trials, something other than war, something other than silence – that’s why the TRC, I think, has been such an exemplar to the world,” she commended.

Court decision cannot rebuild a society, though. Only individuals can forgive. Only individuals can start with purposeful, daily decisions to forgive and forge a common future. Forgiveness is rather like kindness, she suggested. It’s a resource without limits. It’s not scarce like water or money. It’s within our reach. But if it’s forced, it’s not forgiveness.

“It is good,” Prof Minow warned, “to be cautious about the use of law to deliberately shape or manipulate the feelings of any individual. But it is no less important to admit that law does affect human beings, not just in its results, but in its process.” And then we must take responsibility for how we use that law.

“A government can judge, but only people can forgive.” As Prof Minow’s words lingered, the air suddenly seemed a bit more buoyant.

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