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Prof Panizza is a pioneer

Wednesday 20 January 2021

"We have a research program which is divided into two groups. One is for cancer and the other is for chronic inflammation in sinus disease." – Professor Benedict Panizza

By the time his career as a surgeon and researcher is over, PA Hospital (PAH) based Professor Benedict Panizza will have saved countless lives and been heavily involved in transforming medical practice, particularly as it relates to head and neck cancer.

As one of the world's foremost experts in perineural spread and a renowned ear, nose, and throat (ENT) surgeon, Prof Panizza has worked with the PA Research Foundation for more than a decade to help drive better outcomes for cancer patients.

Prof Benedict Panizza

Prof Panizza has several research projects all at different stages happening at present, including work with Associate Professor Fiona Simpson on shifting surface receptors so the body's immune system identifies and targets tumours better, with a particular focus on adenoid cystic carcinoma.

In addition to his involvement in basic science research, Prof Panizza runs an in house clinical trials unit. One example of this is the world-leading Decibel study.

"Cisplatin is a very important systemic chemotherapeutic agent, but it causes deafness. We're running a study with Decibel, where we're the lead investigator for an international trial and we're delivering injections into the middle ear. A substance which absorbs from the middle into the inner ear and neutralizes cisplatin in the inner ear and so saves hearing," he said.
"The cancer side looks at all translational type research. We're trying to critically assess what we do and improve it by doing basic research, which varies from anatomical studies to animal based studies. We do a lot of skull-base malignancy, skin cancers which extend to the temporal bone and skin cancers which get into nerves.

"Queensland being one of the skin cancer capitals of the world, we have a lot of experience in that and we feel an obligation to not only treat it but study it and to improve our outcomes."

Prof Panizza and his team are currently overseeing and contributing to two higher degree research projects in collaboration with the University of Queensland's Anatomical Facility. One student undertaking a PhD in tumours that extend to the temporal bone, is performing novel anatomical dissections and reviewing radiology results to better inform future operations, while a second student is studying the perineural spread of cutaneous malignancy into the V1 nerve (ophthalmic branch of the trigeminal nerve).

"The V1 nerve runs into the eye and goes back to the brain. These tumours are good at getting into the nerve and tracking back along the nerve, and getting into the brain, but they're terrible at getting outside the nerve".

"If you can resect that nerve with a clear margin, then you'll improve cure rates dramatically, and we have published on that".

"The problem with the V1 is, after a certain period of time it goes back into the eye, and you have to take the eye. We're trying to preserve more eyes, and we've developed techniques where we, transorbitally, go into the eye to take out the nerve, using special equipment."

As both a surgeon and researcher Professor Panizza said improving outcomes for patients is always front of mind with any research he leads or contributes to.

"They go hand in glove. It's all about the patient, and clinical delivery and research flows from that," he said.

"The research flows effortlessly from the clinical delivery. That's what's supposed to happen. You have to view it that every clinical event becomes a research event, almost all our patients are involved, in some way or another, with research".

Though he has had a profound impact throughout his career in head and neck cancer and as an ENT surgeon, it could have been a whole different cohort of patients who benefitted from Prof Panizza's skill base if fate had not intervened.

"I always wanted to be an orthopaedic surgeon, but I really liked the personalities in ENT, I found it diverse and interesting, then when I did ENT and I rotated through the different specialties, head and neck is what I liked the most," he said.

"I liked head and neck, but in particular I liked skull base. The reason is, when I was in England my wife was doing a fellowship in skull base with a guy called Dick Ramsden in Manchester, and I got to see some of his work and that made me fascinated in skull base."

The PA Research Foundation has been an important collaborator in his work and in helping advance the knowledge and experience of young clinicians from across Queensland who have completed over 20 research higher degrees under his supervision in the last 10 years.

In addition, Professor Panizza is a great believer of improvement through education. This has been facilitated by running numerous cadaver, head and neck cancer, skull base, sinus surgery and acoustic neuroma courses.

"The foundation has been absolutely crucial to my work, because If you don't have any funding to start the research, such as seed funding like the Foundation provides, it just doesn't get done. It's also allowed me to partner with them to run all the courses we do here."

Donate to support the work of Prof Panizza and the PA Hospital here.