Radiation therapy in children with cancer is UM specialty

Dr. Joseph Panoff smiled as he walked through the radiation oncology department at UM’s Sylvester Comprehensive Cancer Center.

“Have you ever seen a linear accelerator?” asks Panoff, assistant professor of radiation oncology at the University of Miami’s Miller School of Medicine. “It’s really cool!”

He’s not exaggerating.

The silver and blue machine stands about 10 feet tall, and looks like it came out of Star Wars. It’s used for radiation therapy to treat children 12 and younger who have cancer.

“Radiation is a central component of oncological treatment, especially with kids. You need to really have an academic center for that, ” said Panoff, who estimates that he treats 60 to 100 children annually. “It’s a lot of resources involved with radiation for kids.”

Panoff often receives patients from area hospitals, such as Nicklaus Children’s Hospital and Baptist Children’s Hospital.

Dr. Ziad Khatib, director of neuro-oncology at Nicklaus, said childhood cancer can be treated using varying methods, such as chemotherapy and surgery.

“The only thing we outsource is radiation,” he said.

In South Florida, physicians tend to collaborate when caring for children with cancer, said Dr. Doured Daghistani, medical director of pediatric oncology at Baptist Children’s Hospital.

“We work together and we consult with each other,” Daghistani said. “On an ethical level, we’re all on the same team.”

Although childhood cancer rates in the United States have been rising slightly for the past few decades, children make up less than 1 percent of all new cancer diagnoses each year, according to the American Cancer Society. In 2015, roughly 10,380 children in the United States under 15 will be diagnosed with cancer.

The American Cancer Society also reports that more than 80 percent of children with cancer survive five years or more.

While not all childhood cancer patients are treated with radiation, radiation therapy is often part of the treatment for brain tumors, as it is more precise and can reach areas of the brain that are difficult to access through surgery.

In December, Elizabeth Hernandez, 10, was diagnosed with a germinoma, a brain tumor that in her case was malignant. She has since gone through chemotherapy followed by radiation.

She recently received a series of treatments at Alex’s Place, the pediatric hematology-oncology clinic at Sylvester.

“I love it here because they treat me very good,” Elizabeth said. “I like the radiation doctor. He’s funny.”

She told Panoff about a Disney Cruise she took with her family through the Make-A-Wish Foundation.

“What did you eat?” Panoff asked.

“Pizza and ice cream,” Elizabeth said, smiling.

“So junk food?”

“Yes!”

Although Elizabeth is finished with radiation therapy, she remembers being strapped down during the procedure with a mask over her face to keep her head still, and thinking about “getting out of there.”

“It’s boring cause it’s a dark room with a machine going,” Elizabeth said. “But it’s for your own good.”

Panoff looked at images of Elizabeth’s brain scans and said she has an “excellent prognosis.”

“It’s a really big privilege for me,” said Panoff, about treating children. “These families allow me into their lives, in a personal way and I get to be there in an emotional time for them. It’s a privilege that they allow me to participate.”

By 2017, children will have another option for cancer treatment. The Miami Cancer Institute at Baptist Health South Florida will open next year and it will include the first proton therapy center in South Florida, which will open in 2017. Proton therapy uses a beam of protons to destroy cancer cells while avoiding healthy tissues. It’s often used in childhood cancers that are difficult to treat.

This story was originally published July 24, 2015 at 8:43 AM with the headline "Radiation therapy in children with cancer is UM specialty."