Jim Feusner, MD, likes challenges. As a Washington state high school basketball player—2nd team all-conference—he thrived on the challenge of out-jumping and out-rebounding taller players.

“Rebounding is about hard work, how hard you want to work to get position,” he noted.

Whether it’s rebounding basketballs, or helping kids rebound from cancer, Dr. Feusner works hard. His daily challenge is saving kids’ lives.

Though his dad was a doctor—a radiologist practicing along the coasts of Washington and Oregon—it was the challenges of becoming a doctor that propelled Jim Feusner through medical school—the University of Washington—and pediatric residency and hematology/oncology fellowships—both at Seattle Children’s Orthopaedic Hospital and Medical Center.

“It wasn’t like I had a dream to be a doctor,” he said. “What attracted me was it was difficult, that was the challenge.”

“Difficult but worthwhile,” he added.

“I always wanted my job to be worthwhile, it might be hard, it might drive me crazy at times, but it must always be worthwhile.”

Meeting Dr. V
Early in his medical studies Dr. Feusner was drawn to pediatrics. “I respected the pediatricians I met as people, they seemed like well-rounded, caring people.” He was also drawn to infectious diseases, but the mentor he had hoped to study with moved away. Then he took an interest in hematology.

“I liked the quantification in hematology, in the blood count. And you could look at blood and actually see the diseases. I felt more connected to it.”

While a senior resident, he befriended a junior resident, Elliott Vichinsky, MD, who had an interest in oncology. As their careers evolved, the two ended up swapping interests: Dr. Vichinsky is today a renowned hematologist, and the director of the division of Hematology/Oncology at Children’s Hospital Oakland. And Dr. Feusner is a renowned oncology expert, and director of Oncology at Children’s.

Dr. Feusner first came to Children’s Hospital Oakland 30 years ago, after spending a year practicing general pediatrics and pediatric hematology/oncology in private practice in Seattle.

“I came because of the type of hospital it is, and the community it serves,” he said. “That’s the reason I stayed, too.”

Detective work
Dr. Feusner enjoys the detective work oncology and oncology research offers, sifting through cases for clues, or trying to understand adverse reactions to treatments.

“What I bring is ability to think, to decipher signs and symptoms,” he said.

He also brings great observation skills.

“The clinic is my lab,” he noted.|

Dr. Feusner’s clinical observations led to his discovery of a correlation between premature birth and the most common liver tumor in kids: hepatoblastoma. He is co-investigator on a federally-funded national study on hepatoblastoma.

He is also a frequently consulted expert in treatments for acute promyelocytic leukemia (APL). Dr. Feusner helped get the national Children’s Cancer Group involved in using ATRA, a vitamin A derivative, for APL treatment, and more recently arsenic as well.

“It’s an example of what might be considered folklore-type medicine that ended up being tested scientifically, shown to be effective, and now is at the point of being used world-wide,” he said.

The goal of all modern oncology therapies, Dr. Feusner noted, is to get better at targeting tumors so there are fewer side-effects. “We’re getting better at targeting, and in some cases, like Hodgkin’s lymphoma, we’re so successful, we’re cutting back on therapy, which cuts back on long-term side-effects.”

Oncology’s gains
Oncology has come a long way during Dr. Feusner’s career.

“In my professional lifetime, between my mentors’ careers and now, survival rates for all childhood cancers have gone from less than 10 percent to almost 80 percent,” he said.

The successes, he noted, are only partly attributable to new drugs. It’s a better understanding of doses and sequences of doses, as well as supportive care such as platelet transfusions, better antibiotics, and better antifungal treatments that have made the biggest difference. It’s a far cry from the world his mentors knew.

“In late ‘60s, a lot of places didn’t have platelets, they gave fresh whole blood. Doing hematology/oncology then was basically giving transfusions and a few antibiotics and that was it; most everyone with leukemia died. Those doctors, the men and women, they were like saints, to work in that kind of setting. Guys who were the generation ahead of me, like Art Ablin, MD, at UCSF; and Ron Chard, MD, in Seattle; and Jorge Ortega, MD, in Los Angeles; they were the ones who saw remarkable changes in their professional lifetimes. They went from losing most of their patients to where 80 to 90 percent are cured.”

Still worthwhile
After 30 years, Dr. Feusner estimates that he has been involved in the treatment of more than 1,650 kids with cancer. He still finds his job worthwhile.

“To have families come back—I had a family come back last week, and tell me how much they appreciate what I did—is the really rewarding aspect of what we do.”

“Kids are so incredible,” he said. “So inspirational and resilient. Their ability to adjust to things is just phenomenal. Not having previous life experience or the neuroses that come later is part of it. The longer I’m in it, the more it really is about kids; they reinforce what you do.”

His own kids have reinforced his success, too: two doctors and a lawyer. Jim Feusner has met his challenges.