A highly sophisticated procedure to treat inoperable and metastatic neuroendocrine tumours has been successfully completed for the first time ever in KwaZulu-Natal (KZN) on a patient with advanced stage IV cancer.
According to specialist nuclear physician, Dr Masha Maharaj, who heads up the Umhlanga Molecular Imaging and Therapy: Nuclear Medicine Centre at Netcare Umhlanga Hospital, the Lu-177 DOTATATE procedure is well established in other major centres of South Africa, however this is the first time it has been undertaken in KZN.
“Lutetium-177 is a radioactive substance that we can add to a carrier called DOTATATE. Lutetium-177 is an atom that sends out radioactive particles. DOTATATE joins to the neuroendocrine tumour with the radioactive Lutetium atom attached to it. Once in the body, Lu-177 DOTATATE attaches to specific tumour cells and destroys these cancerous cells. It is known to be effective in neuroendocrine tumours, paragangliomas, neuroblastomas and certain types of thyroid cancer,” she explains.
Dr Maharaj adds, “Lu-177 DOTATATE therapy is considered the first line treatment in metastatic and inoperable neuroendocrine tumours. The targeted radionuclide therapy binds and directly targets tumour cells resulting in significant improvement in undesirable side effects and quality of life for those affected by the tumour.”
The side effects of this therapy are few and mild and less than those from other cancer therapies. Umhlanga Molecular Imaging and Therapy: Nuclear Medicine Centre at Netcare Umhlanga Hospital has now made this therapy available in KZN. The centre is the only facility that provides the specialised treatment in KZN and it will continue to provide advanced nuclear medicine services to the community and introduce new techniques and therapies as these become available.”
“Neuroendocrine tumours (NETs) are rare, slow growing and are often not diagnosed until the cancer has metastasised or spread, eventually going on to become stage IV. In selected patients Lu-177 DOTATATE has been shown to be a safe and effective palliative therapy and can reduce mortality,” says Dr Maharaj.
She explains that palliative therapy is a form of care that is used for patients with serious or life threatening illnesses or conditions in order to provide them with relief from symptoms, pain, and physical and mental stress, thereby providing them with an improved quality of life. Some stage IV neuroendocrine cancer patients develop tumours on for example the spinal cord, which may negatively impact an individual’s mobility and cause a great deal of pain. In these patients, the treatment of the responsible tumour using the Lu-177 DOTATATE therapy can reduce negative symptoms and meaningfully improve quality of life.
Unlike a treatment such as chemotherapy, which is systemic therapy and has an impact on the entire body, Lu-177 DOTATATE is a highly directed therapy. For this reason it has few side effects.
“During the procedure we are able to clearly visualise the neuroendocrine tumour and destroy it with great precision, doing as little damage to surrounding tissue as possible. For this reason we are able to successfully treat many of these tumours even when they occur in a sensitive organ such as the brain. The procedure that was undertaken on this particular patient was highly successful and we expect her to greatly benefit from it,” explains Dr Maharaj.
“Such procedures can only be undertaken in a highly specialised nuclear medicine centre by specialist nuclear physicians with properly trained support staff. We are now offering a dedicated nuclear medicine service, the first of its kind in the province, at Netcare Umhlanga Hospital. Members of the public will no longer have to travel to other provinces in order to have certain nuclear diagnostic and treatment procedures done,” notes Dr Maharaj.
Nuclear medicine was first developed in the 1950s and is a branch of medicine. Nuclear medicine procedures enable the determination of medical information that may otherwise be unobtainable, require surgery, or necessitate more expensive and invasive diagnostic tests. The procedures often identify abnormalities very early in the progression of a disease, long before some medical problems are apparent with other diagnostic tests. This early detection allows a disease to be treated sooner in its course when a more successful prognosis may be possible.
Powerful imaging equipment such as the gamma camera uses radioactive tracers which emit gamma rays from within the body, to visualise an organ in three dimensions. This can be used to make rapid diagnosis of a medical condition and to guide intricate procedures. Disorders and diseases of the heart, liver, kidneys, bones, thyroid and other organs can easily be imaged and diagnosed using such technology.
Dr Maharaj says that there is a great need to exchange knowledge within the field of nuclear medicine and to improve awareness of the latest techniques. Therefore the centre also provides an active educational and training facility and provides a forum in which knowledge can be shared across the private and public healthcare sectors. In line with this goal doctors from Inkosi Albert Luthuli Central Hospital were present to witness the breakthrough procedure.
Dr Maharaj thanked the dedicated nursing staff and management at Umhlanga Netcare Hospital for their support and excellent work in the management of the procedure.
“Netcare Umhlanga Hospital congratulates Dr Maharaj and her staff not only for providing a new treatment option to patients but also for establishing the province’s first private independent dedicated nuclear medicine centre at our hospital. We know that this facility will positively impact numerous lives and are proud to be associated with the initiative, which we expect to grow from strength to strength,” says the nursing services manager of Netcare Umhlanga Hospital, Karen Viljoen.
Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare Umhlanga Hospital
Contact : Martina Nicholson, Graeme Swinney, or Sarah Wilson
Telephone: (011) 469 3016
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