Treatment for Fisher's baby 'unique'

Specialized chemo is not done at Utah facilities

Published: Wednesday, July 4, 2007 12:05 a.m. MDT
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"Why not here?" is a question Utahns are asking in the wake of Derek Fisher's announcement that he's leaving the Utah Jazz to be closer to where his infant daughter, Tatum, can receive treatment for a potentially deadly childhood cancer.

She has retinoblastoma, a rare cancer that occurs in the retina, about which her dad has spoken frankly since she was diagnosed a couple of months ago. The eye tumor, which can steal vision, typically appears between birth and age 5, and it's widely believed that children are born with it. It's so rare that in the Mountain West that only a handful of cases are diagnosed each year. Nationally, there are 200 to 250 cases a year. If the tumor spreads along the optic nerve and into the brain, it can be deadly.

Although much of the discussion has centered on the Huntsman Cancer Institute and why Derek Fisher and his wife, Candace, don't seek treatment there, HCI is not even a possibility. The institute doesn't treat children's cancer, a task that falls to Primary Children's Medical Center.

The other potential player for this type of cancer is Moran Eye Center, also on the University of Utah campus. And pediatric ophthalmologists work at both facilities.

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But the decision on where a child receives treatment — and what kind of treatment — is a very personal choice that each family must make for itself. And the latter decision often drives the former, as appears to be the case for the Fishers.

Fisher has told the media that they opted for a treatment that infuses chemotherapy directly into the affected eye. That's not a treatment offered at Primary Children's or Moran.

"I have not talked to Fisher's family," said Dr. Nick Mamalis, a professor of ophthalmology who specializes in eye pathology. But that's "a specialized treatment not done here — or most places, for that matter. It's a unique treatment."

Mamalis said with any serious disease, parents or patients select what they believe is the best course of treatment for them, then they go where that treatment is offered. "This always comes down to an individual decision. Family members do what they think is best for their child. This is the course they've chosen."

Primary Children's doctors could not speak specifically about Tatum Fisher's case. But Dr. Edward Clark, medical director, addressed in general terms treatment decision-making processes.

"When patients receive a medical diagnosis, we educate their family about the medical condition, the treatment options available and where they might receive treatment. There are many reasons parents take their children to different facilities.

"Ultimately, the parent makes the final decision for the treatment of their child and where they receive that treatment. They do what feels best to them. Primary Children's Medical Center is a pediatric specialty hospital and provides a full range of medical specialty services for children within our service area," he said.

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