How nuclear tech saves lives: great story of a cancer patient in SA

C CHANGE: Mike Sathekge, head of nuclear medicine at the University of Pretoria, with Walter Pike as the latter goes under the gamma camera in Steve Biko Academic Hospital, where he is being treated for prostate cancer. 
Image by: MASI LOSI
Times reported last week: “Down the corridors of Steve Biko Academic Hospital’s nuclear medicine department Walter Pike smiled brightly. One would not say that days before he had received treatment for his inoperable stage 4 prostate cancer.”

“I’m feeling great. It really is amazing. If I’d had chemotherapy I wouldn’t have been able to get out of bed. The day after [treatment] I rode horses for four hours,” the 60-year-old media strategist said.

Pike is referring to the new targeted radionuclide therapy (Lutetium-177) that is being used to treat his cancer and appears to be working.

Pike had turned to crowdfunding to pay for the pricey procedure after his medical aid scheme initially refused to fund the “experimental” treatment, but Fedhealth later changed its mind and has now come on board. This has paved the way for Pike to continue receiving the treatment aided by Mike Sathekge and his team of nuclear physicians.

They are among the first in the world to use the theranostics approach, which is both diagnostic and therapeutic, to treat castration-resistant metastatic prostate cancer. Sathekge and his team have also begun experiments to fight breast cancer.

The physicians use a compound called prostate-specific membrane antigen, which identifies and settles onto prostate cancer cells wherever they happen to be in the body. This is combined with Lutetium, a radioactive isotope, to kill individual cancer cells.

The radiation has a short range, which means the side effects are minimal.

The treatment has been used in trials in Germany and Australia and was recently approved by the Food and Drug Administration in the US for final clinical trials.

Sathekge is optimistic about the treatment. He and his team have treated about 26 other patients and about half have responded favourably.

“We don’t have big numbers in trials and the big pharmaceutical companies behind us. It’s always been a problem in nuclear medicine,” he said.

Pike is not alone in his struggle to fund the treatment. “We had one gentleman sell one of his cars to get treatment. Some have borrowed money from their children,” Sathekge said.

The greatest expense is the Lutetium isotope itself, which is imported from Germany at R58,000 per dose. Sathekge said he hopes prices will drop when the Lutetium isotope can be sourced locally. The SA Nuclear Energy Corporation produces it, but is not yet registered to sell it.

Fedhealth has agreed to fund Pike’s treatment on compassionate grounds after he appealed its decision to refuse funding four times.

But the team at Steve Biko were able to obtain approval from the Medicines Control Council, enabling Fedhealth to pay without breaking the scheme’s rules.

Pike, who expected to live for just three more years, said his treatment programme had given him hope of entering remission completely.

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