September 23, 2021 by John Fernandez and Bethany Rundell
Miles for Margot: Teen Undergoing Cancer Treatment Inspires Others to Reach the Finish Line
When Margot Palma’s family and friends cross the finish line of the virtual ZooRun5k on October 10, it will mean more than collecting another medal. They will be celebrating the end of treatment for 15-year-old Margot, who was diagnosed with Ewing sarcoma, a rare form of cancer, in January.
“It’s really symbolic,” said Monica Palma, Margot’s mother. “It’s the finish line for her treatment. The finish line is the hardest part of any race. You can see the ending. Your body wants to rest, but it’s not time yet.”
Supporting Margot, family and friends shaved their heads when Margot began losing her hair due to chemotherapy. In an additional show of solidarity and to recognize Margot’s love of animals, they started Miles for Margot, running or walking 60 miles leading up to the October race. The distance matches the number of chemotherapy and proton radiation treatments Margot will receive at Miami Cancer Institute.
It was about a year ago that Margot first complained of lower back pain. “At first we didn’t think anything of it,” recalls her mother. “But it began to get worse. We made several trips to the pediatrician, where it was suggested that she might have bruised her tailbone.”
When Margot didn’t improve, they thought the problem could be digestive and added more water and fiber to her diet. She lost 15 pounds between August and December. The girl who loved theater and dance at Palmetto Senior High ― where she was a freshman at the time ― had no energy. The pain persisted and worsened.
Finally, severe discomfort sent Margot to Baptist Children’s Emergency Center. It was January 8. The next day, they had their answer. Margot had a lesion in her sacrum, the bony pelvis below the spine. It extended into her pelvic cavity. After a biopsy, pediatric oncologist Doured Daghistani, M.D., of Miami Cancer Institute, told them it was Ewing sarcoma.
Sarcomas grow in connective tissues and are rare, but are more common in children than adults. Ewing sarcoma can occur in the pelvis, thigh, lower leg, upper arm or rib.
Margot immediately began chemotherapy, with a plan to continue treatment with proton therapy and then surgery. The COVID-19 pandemic made care even more tricky and put a strain on the family. “Miami Cancer Institute did an amazing job of making everything safe,” Monica said. “But no one could visit. We even debated having our two sons live elsewhere so that they could still continue activities, but we decided we’d rather stay in a bubble as a family.”
Then, Good News
The sacrifice was worth the effort. After months of chemotherapy, around Easter, a scan showed that Margot’s tumor had shrunk 99 percent. “It was miraculous,” her mother said. “We got the news that she wouldn’t need surgery, which would have been very complex, and we could go straight to radiation treatment.”
For Margot, radiation was 36 sessions in a row (nearly every weekday) of specialized proton therapy, a sophisticated form of radiation that targets the tumor and any leftover cells with high precision and reduces the likelihood of long-term side effects. Miami Cancer Institute is the only cancer center in the world that offers all radiation technologies under one roof, and one of a handful that has proton therapy.
“With proton therapy, we can deliver higher doses and improve the chance of a cure while reducing potential damage to nearby organs,” said Matthew Hall, M.D., the lead pediatric radiation oncologist and an expert in proton therapy at Miami Cancer Institute. “When done each day, it causes irreversible damage in the cancer cells, enabling us to maximize our ability to cure the cancer and kill any cells that were resistant during earlier treatments.”
For children, proton therapy is especially beneficial because it reduces the side effects often seen months or years after traditional radiation treatment. And, for Margot, proton therapy meant preserving her future fertility by sparing her left ovary, uterus and reproductive organs.
“I would advise anyone with a child slated for radiation to ask for both proton therapy and reproductive specialist consultations,” Dr. Hall said. He also believes it is critical to allow young patients and their families to participate in decision-making and to ask questions about treatment and fertility.
At Miami Cancer Institute, Margot also took part in several virtual child life activities, including a cooking class, a trip to a dolphin facility in the Keys and a talk with a polo player who was a childhood cancer survivor. “He even invited us to see his horses in person when it is safe,” Monica said. “I absolutely love her team at the Institute. I call them our angels. They are amazing.”
Back to the Race
As Margot finishes treatment, she is excited about her future and looks forward to the trip to Disney World she missed earlier in the year. “I’m feeling good,” she said. “I want to be in my school’s shows again and I want to travel.”
Benefiting the Zoo Miami Foundation and West Kendall Baptist Hospital, the 2020 virtual ZooRun5k takes place October 2-11 and honors conservation and healthcare heroes, two causes close to Margot’s heart. You can join her team and register for the run at www.ZooMiami.org/run.