Life The Glynnwood
Life The Glynnwood offers nuclear medicine to the community. What exactly is nuclear medicine?
Nuclear Medicine involves the use of radioactive pharmaceuticals (whether injected or taken in pill form) that allows the nuclear physician to see how organs or tissues are functioning. This assists in the evaluation of disease and other pathological processes. It can also be used for treatment by destroying diseased organs or tissue – most used in the treatment of various cancers (such as thyroid cancer, prostate cancer and neuroendocrine tumours). Nuclear Medicine thus has two main practice areas – imaging and therapy, with two different types of imaging technology used, namely: gamma imaging and PET imaging.
Total cancer incidence in South Africa is predicted to more than double from 80,000 in 2019 to c.175,000 in 2030.2 South Africa could reduce cancer mortality rates1 through structural changes, and by adopting global best practices for cancer care.
One area identified is the increased adoption of PET-CT into clinical practice. PET-CT scans help in identifying the location of tumours or cancerous lesions, assessing the extent of the disease, determining whether lesions are benign or malignant, and identifying any potential spread of the disease.
PET-CT is predominantly used by the oncology community (radiation and medical oncologists, clinical haematologists, urologists, surgeons etc), however other applications where PET-CT can be useful in the management of dementia, inflammatory conditions, and infectious disease.
There are currently only 17 PET-CT scanners in the private sector nationally6. Knowing the impact PET-CT can have on diagnosis and treatment, and patient outcomes, Life Healthcare is committed to providing more accessible and reliable PET-CT services in South Africa. Based across the road from Life The Glynnwood, TheraMed Nuclear is impacting the lives of many in our community by providing these services to patients in their community, and opening a new spectrum of services in the East Rand to our oncology community. The non-clinical operations of TheraMed is managed wholly by Life Healthcare.
Dr Bruce Young is a nuclear medicine physician based at TheraMed Nuclear, who works closely with various specialists at Life The Glynnwood, providing detailed information regarding disease profiles and offering guidance with regards to the management of various diseases. He is also able to offer nuclear medicine therapies, in a specially designed radiation room at the hospital.
“A PET-CT can deliver, when appropriately used, better sensitivity, specificity, and accuracy than conventional imaging. This allows me to provide valuable information to the referring specialist about the disease being investigated, potentially assisting in more accurate cancer staging, and allowing the oncologist the ability to develop a personalised management and treatment plan for patients,” says Young. “Studies have shown that this can impact patient outcomes with an improvement in patient survival, avoiding over or under treatment, and, in certain clinical pathways, a reduction in the total cost of care”.
Another scan used within nuclear medicine is gamma scintigraphy, this imaging technology is most useful to physicians, endocrinologists (e.g. thyroid and parathyroid imaging), surgeons and gastroenterologists, hepatobiliary and pancreatic surgeons, cardiologists, oncologists, urologists and nephrologists. These scans differ to a PET-CT in that they leverage a different radiation type (gamma radiation, as compared to positron emission) with images acquired on a gamma camera, rather than a PET scanner.
When it comes to therapy in nuclear medicine, radioactive substances are ingested that emit radiation capable of causing cell death. This approach can be effective for treating both benign and malignant conditions, for example benign thyroid disease, thyroid cancer, neuroendocrine tumours, and prostate cancer. These radioactive substances are administered in controlled doses. The duration and extent of the treatment is determined by the personalised treatment plan and administered in consultation with a patient’s oncologist.
Life The Glynnwood has a very active oncology team who work closely with surgeons and other clinical professionals. A multi-disciplinary team approach is applied and supported by the East Rand Multi Specialist Oncology Board that is based at the hospital and overseen by Dr Elize Wethmar, gynaecological oncologist. Since inception, this board has brought together a variety of healthcare practitioners to promote clinical best practice in the field of oncology.
References
1. Cairncross L, MBChB, FCS, PARKES MmJ, MBBCh, CRAIG FROH, et al. Cancer on the Global Stage: Incidence and Cancer-Related Mortality in South Africa – The ASCO Post [Internet]. ascopost.com. 2021 [cited 2024 Feb 5]. Available from: https://ascopost.com
Meyer, Salomé , and Dr Gcinashe Nqabeni. “Cost of Cancer: Challenges for the next 10 Years.” Cancer Alliance, Cancer Alliance, Aug. 2021, canceralliance.org.za/cancer-in-sa/sa-cancer-burden/. Accessed June 2023.
3. EAU Guidelines on Prostate Cancer – Uroweb [Internet]. Uroweb – European Association of Urology. Available from: https://uroweb.org/guidelines/prostate-cancer
4. Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, et al. Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification. Journal of Clinical Oncology. 2014 Sep 20;32(27):3059–67.
5. Song R, Jeet V, Sharma R, Hoyle M, Parkinson B. Cost-Effectiveness Analysis of Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography/Computed Tomography (PET/CT) for the Primary Staging of Prostate Cancer in Australia. PharmacoEconomics. 2022 Jun 27;40(8):807–21.
6. Improving cancer patient outc omes in South Africa through investment in a vertically integrated medical imaging and nuclear medicine network. Life Healthcare.
7.Alexander GG, Doruter JP, Carr J, Warwick JM. “PET-CT in brain disorders: The South African context”. SA Journal of Radiology, Nov. 2021, https://sajr.org.za/index.php/sajr/article/view/2201/3009. Accessed May 2024
