 My name is Dr. Bill Regine, and I'm the chair of Radiation Oncology here at the University of Maryland, and welcome to drawing outside the lines. Today we're going to talk about how we at the University of Maryland Greenbaum Cancer Center have some very unique and advanced cancer fighting tools to deal with recurrent cancer. Recurrent cancer has become more common because of advanced treatments like immunotherapy have allowed people to live longer and be cured, but one of the challenges posed, and this is a tumor cell here, is many of these tumors have been radiated in the past. And keep in mind, when you radiate a tumor in the body, it has some normal tissue organ around it. So it could be the lung, it could be the heart, or lower down in the body, it could be the bowel, or the bladder. If it's been radiated once, these organs have also had some low, some radiation exposure to them, right? So the challenge now is when these tumors grow back, or come back and it's the only area and still a chance for cure, how do you do rear radiation safely? Well, that goes to two advanced modalities that we have. One is proton radiation, which is a very advanced form of radiation that can deliver radiation intensely. And in such a way that when it hits the tumor, because it's a charged particle, there is no additional radiation exposure to these surrounding organs that have already been radiated. And that's key because that means you can get more radiation safely without hurting the organs that have already been radiated. The second thing we now have available to help the radiation be even more effective when it gets into the cancer cell is something called hypothermia. And hypothermia is the ability to heat around the tumor in such a way that's equivalent to a low-grade fever, 102, 103 degrees. And what that does is dilates blood vessels. And by dilating blood vessels, you deliver more oxygen to the cancer. And that's important because oxygen combined with radiation makes the radiation more effective in killing these tumor cells. So that is the way we take two advanced modalities which you can find nowhere else in the state of Maryland to help cure our patients with recurrent cancer.