James Feusner, MD is an expert in pediatric oncology, with particular expertise in acute promyelocytic leukemia (APL), a kind of cancer in which abnormal white blood cells replace normal blood cells in the bone marrow and surrounding blood. Dr. Feusner is a specialist in oncology, tumor growth, babies with increased risk of developing tumors, and supportive care to improve the quality of life for patients with cancer.
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.”
Dr. Feusner enjoys the detective work oncology and oncology research offers, sifting through cases for clues, or trying to understand adverse reactions to treatments. He also brings great observation skills.
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 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. 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.”