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02 January 2024 | Story Leonie Bolleurs
UFS scientists contribute to the battle against cancer
From top left, moving clockwise: Dr Nerina van der Merwe, Dr Osayande Evbuomwan, Prof Alicia Sherriff, Profs Andreas Roodt and Alice Brink.

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

Media: Sunday Times
2006-05-20

Sunday Times, 4 June 2006

True leadership may mean admitting disunity
 

In this edited extract from the inaugural King Moshoeshoe Memorial Lecture at the University of the Free State, Professor Njabulo S Ndebele explores the leadership challenges facing South Africa

RECENT events have created a sense that we are undergoing a serious crisis of leadership in our new democracy. An increasing number of highly intelligent, sensitive and committed South Africans, across class, racial and cultural spectrums, confess to feeling uncertain and vulnerable as never before since 1994.

When indomitable optimists confess to having a sense of things unhinging, the misery of anxiety spreads. We have the sense that events are spiralling out of control and that no one among the leadership of the country seems to have a definitive handle on things.

There can be nothing more debilitating than a generalised and undefined sense of anxiety in the body politic. It breeds conspiracies and fear.

There is an impression that a very complex society has developed, in the last few years, a rather simple, centralised governance mechanism in the hope that delivery can be better and more quickly driven. The complexity of governance then gets located within a single structure of authority rather than in the devolved structures envisaged in the Constitution, which should interact with one another continuously, and in response to their specific settings, to achieve defined goals. Collapse in a single structure of authority, because there is no robust backup, can be catastrophic.

The autonomy of devolved structures presents itself as an impediment only when visionary cohesion collapses. Where such cohesion is strong, the impediment is only illusory, particularly when it encourages healthy competition, for example, among the provinces, or where a province develops a character that is not necessarily autonomous politically but rather distinctive and a special source of regional pride. Such competition brings vibrancy to the country. It does not necessarily challenge the centre.

Devolved autonomy is vital in the interests of sustainable governance. The failure of various structures to actualise their constitutionally defined roles should not be attributed to the failure of the prescribed governance mechanism. It is too early to say that what we have has not worked. The only viable corrective will be in our ability to be robust in identifying the problems and dealing with them concertedly.

We have never had social cohesion in South Africa — certainly not since the Natives’ Land Act of 1913. What we definitely have had over the decades is a mobilising vision. Could it be that the mobilising vision, mistaken for social cohesion, is cracking under the weight of the reality and extent of social reconstruction, and that the legitimate framework for debating these problems is collapsing? If that is so, are we witnessing a cumulative failure of leadership?

I am making a descriptive rather than an evaluative inquiry. I do not believe that there is any single entity to be blamed. It is simply that we may be a country in search of another line of approach. What will it be?

I would like to suggest two avenues of approach — an inclusive model and a counter-intuitive model of leadership.

In an inclusive approach, leadership is exercised not only by those who have been put in some position of power to steer an organisation or institution. Leadership is what all of us do when we express, sincerely, our deepest feelings and thoughts; when we do our work, whatever it is, with passion and integrity.

Counter-intuitive leadership lies in the ability of leaders to read a problematic situation, assess probable outcomes and then recognise that those outcomes will only compound the problem. Genuine leadership, in this sense, requires going against probability in seeking unexpected outcomes. That’s what happened when we avoided a civil war and ended up with an “unexpected” democracy.

Right now, we may very well hear desperate calls for unity, when the counter-intuitive imperative would be to acknowledge disunity. A declaration of unity where it manifestly does not appear to exist will fail to reassure.

Many within the “broad alliance” might have the view that the mobilising vision of old may have transformed into a strategy of executive steering with a disposition towards an expectation of compliance. No matter how compelling the reasons for that tendency, it may be seen as part of a cumulative process in which popular notions of democratic governance are apparently undermined and devalued; and where public uncertainty in the midst of seeming crisis induces fear which could freeze public thinking at a time when more voices ought to be heard.

Could it be that part of the problem is that we are unable to deal with the notion of opposition? We are horrified that any of us could be seen to have become “the opposition”. The word has been demonised. In reality, it is time we began to anticipate the arrival of a moment when there is no longer a single, overwhelmingly dominant political force as is currently the case. Such is the course of history. The measure of the maturity of the current political environment will be in how it can create conditions that anticipate that moment rather than seek to prevent it. We see here once more the essential creativity of the counter-intuitive imperative.

This is the formidable challenge of a popular post-apartheid political movement. Can it conceptually anticipate a future when it is no longer overwhelmingly in control, in the form in which it is currently, and resist, counter-intuitively, the temptation to prevent such an eventuality? Successfully resisting such an option would enable its current vision and its ultimate legacy to our country to manifest in different articulations, which then contend for social influence. In this way, the vision never really dies; it simply evolves into higher, more complex forms of itself. Consider the metaphor of flying ants replicating the ant community by establishing new ones.

We may certainly experience the meaning of comradeship differently, where we will now have “comrades on the other side”.

Any political movement that imagines itself as a perpetual entity should look at the compelling evidence of history. Few movements have survived those defining moments when they should have been more elastic, and that because they were not, did not live to see the next day.

I believe we may have reached a moment not fundamentally different from the sobering, yet uplifting and vision-making, nation-building realities that led to Kempton Park in the early ’90s. The difference between then and now is that the black majority is not facing white compatriots across the negotiating table. Rather, it is facing itself: perhaps really for the first time since 1994. Could we apply to ourselves the same degree of inventiveness and rigorous negotiation we displayed leading up to the adoption or our Constitution?

This is not a time for repeating old platitudes. It is the time, once more, for vision.

In the total scheme of things, the outcome could be as disastrous as it could be formative and uplifting, setting in place the conditions for a true renaissance that could be sustained for generations to come.

Ndebele is Vice-Chancellor of the University of Cape Town and author of the novel The Cry of Winnie Mandela

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