Originally appeared in Children's View: Faces of Cancer.
Hanna and Fran McNinchOn a warm sunny morning, 10-year-old Hanna McNinch should be doing laps in her pool, watching the Food Network or cooking up a storm — her favorite hobby. Instead she's at the Roberts Proton Therapy Center to receive radiation treatment for a brain tumor.
"It was Easter Sunday," says Fran, Hanna's mother, about the moment they knew something was wrong. "We noticed her eyes were jumping up and down in her head."
An emergency MRI revealed a large tumor around Hanna's brainstem. Surgeons carefully performed a biopsy and gave her new reality a name: pilocytic astrocytoma.
The tumor increased pressure in Hanna's brain, leading to nausea, vomiting and problems with her balance, coordination and vision. Surgery was only a stopgap; due to the tumor's delicate location, it could only be partially removed. Radiation remained a good option, but Hanna's doctors worried about damaging the healthy parts of her growing brain.
To minimize this risk, the doctors recommended a cutting-edge treatment: proton therapy.
Proton therapy targets the tumor with a thin bean of radiation, sparing as much healthy tissue as possible. CHOP is one of only nine sites around the country to offer proton therapy and the only one specifically designed for children. The Roberts Proton Therapy Center, which opened in 2010, is the world's largest, most advanced facility of its kind. It was named in recognition of a generous donation from the Roberts family: former CHOP Trustee Aileen Roberts and her husband, Brian, and his parents, Suzanna and Ralph Roberts.
An intensely bright and curious child whose favorite subject is science, Hanna patiently explain how her treatment works.
"You basically lie down on a bed," she says. "The machine rotates around you, but it's not scary, it doesn't touch you. It moves to get at your tumor from different angles, and it's precise."
Hanna will come to CHOP five days a week until she has had 30 outpatient sessions, a typical treatment cycle. Fran and her husband, Grant, take turns driving Hanna from their home in New Hope, Pa.
Hanna reports to the clinic for a quick checkup, then changes into a gown. Wherever Hanna goes, staff greet her cheerfully, compliment her white dress and ask about her cooking.
A radiation therapy technologist escorts her to a treatment room. The far wall is dominated by the gantry, the mechanism that maneuvers the proton beam around Hanna, while she lies perfectly still on a bed that is adjusted into position by computer. A therapist fits a plastic mesh mask over Hanna's face so that her head is in the exact same spot for every session. Hanna even wears the same pink sneaker sandals on treatment days to maintain a consistent height.
Sheryl Crow's "Real Gone" from Hanna's mix CD fills the cavernous room; sometimes she hums along to her music during therapy.
Hanna's neuro-oncologist, Angela Sievert, MD, says that Hanna's specific tumor type — associated with a genetic mutation first identified by Sievert and other CHOP researchers — generally responds well to proton therapy. "Our goal is for a long-term cure with minimal side effects," Sievert says.
While it will take at least a month to learn whether the treatment was effective, doctors are encouraged that Hanna's symptoms haven't worsened. In fact, her balance has improved enough that she doesn't fall anymore — except when she trips over Max, their 6-year-old Westie who often manages to get underfoot.
Hanna sometimes gets nauseous — Fran always carries a small bucket and bottle of water, just in case — and her striking red hair is thinning in spots from the radiation. But Hanna sees a bright side even in that: She has heard that lost hair can return with different color or texture.
"She's hoping for curly hair," Fran says with a smile.
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