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UFS treating first patient with advanced prostate cancer

Staff Reporter

The University of the Free State (UFS) has started treating a patient with advanced prostate cancer using a special treatment called Lutetium 177 PSMA (Lu-177 PSMA) therapy.

The university said on Tuesday it was the first time that it was using the method to treat metastatic castrate-resistant prostate cancer (MCRPC) – an advanced stage of prostate cancer.

Other universities such as the University of Pretoria and the University of the Witwatersrand have been using this method to treat MCRPC patients.

Dr Osayande Evbuomwan, a senior lecturer and medical specialist in the UFS Department of Nuclear Medicine, Faculty of Health Sciences, says they started the first treatment cycle on the patient in July.

He said it is the first time that Lutetium 177 PSMA treatment has been used in the Free State.

It is used on MCRPC patients who are not eligible for chemotherapy or have failed first- or second-line chemotherapy.

“We . . . are happy that expertise is now available and that some funds have been released for this treatment to commence,” said Evbuomwan.

The patient is being treated in the Department of Nuclear Medicine at the Universitas Academic Hospital and Annex.

“The index patient is very sick with MCRPC and was too sick to qualify for first-line chemotherapy,” said Evbuomwan.

“Each patient will need about four-six cycles for complete treatment.

“We are hoping that he will be able to complete at least four cycles and respond well to the treatment.

“We believe that the ability to administer this treatment now is good news for the Free State, as the people of the Free State also deserve to be exposed to this level of treatment.

“We are hoping that the government will continue to provide more funds for more of these patients to be treated in our facility.”

The department has budgeted to treat five patients, which would add to 20 cycles.

Each cycle is said to cost more than R50 000. 

Evbuomwan said prostate cancer is one of the leading causes of morbidity and mortality in the world.

He said when it reaches the advanced stage, the prognosis becomes very bad. 

According to Evbuomwan, there are various conventional systemic therapies, including first- and second-line chemotherapy that could be used to treat patients at this very bad stage.

However, not all patients are fit for chemotherapy.

He said the few who are fit usually end up failing the first-line chemotherapy which has a lot of undesirable side effects and require long-stay hospital admissions. 

Only a few centres are able to offer second-line chemotherapy.

As a result, many of these patients end up suffering from prolonged bone pains before eventually dying from the disease.

PRRT is a targeted nuclear medicine therapy that offers the opportunity to deliver very high levels of radiation specifically to cancer cells, because these cancer cells express specific receptors to which certain peptides can bind.

This specificity to cancer cells offers the advantage of providing lower doses of radiation and damage to normal organs and tissues, a characteristic that conventional therapies do not offer.

Numerous research studies around the world have proven that this treatment improves quality of life, slows down disease progression, and improves overall survival, with little or very tolerable side effects in most patients. 

The University of Pretoria is one of the pioneers of this treatment in the world, having done a lot of research with it since 2017.

Other provinces such as the Western Cape and KwaZulu-Natal recently became involved with the therapy.

The therapy is expensive and requires a lot of expertise.

On average, a team administering this treatment may include a nuclear medicine physician, a radiation oncologist and a urologist.

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