Dr. Ira J. Dunkel, Perry's lead doctor at Memorial Sloan-Kettering, is a pediatric oncologist, specializing in the care of children, teenagers, and young adults with brain and eye tumors. Dr. Dunkel is working to develop new treatments for retinoblastoma. These include the use of intensive therapy for children whose retinoblastoma has metastasized (spread outside of the eye) and local chemotherapy for those with advanced cancer in the eye.
At a recent research meeting, Dr. Dunkel, Dr. Yasmin Khakoo (a pediatric neurologist at Memorial Sloan-Kettering who was also treating Perry), and colleagues presented a paper describing a series of patients with central nervous system (CNS) retinoblastoma who were treated with intensive chemotherapy, including the intention to use high-dose chemotherapy with stem cell rescue. Of the 14 patients treated, nine had trilateral retinoblastoma and five had CNS metastatic retinoblastoma. The conclusion of the research was that intensive chemotherapy, like Perry received, is effective for some of these patients.
"Memorial Sloan-Kettering is one of a very few centers with great expertise in both retinoblastoma and pediatric brain tumors," says Dr. Dunkel. "We have an expert multidisciplinary pediatric neuro-oncology team (including physicians with medical expertise in pediatric oncology, pediatric neurology, or pediatric neurosurgery), and Dr. David Abramson, our ophthalmologist, is arguably the world expert in retinoblastoma."
Dr. Dunkel explains that aside from Perry's pneumonia, which he characterized as being especially severe, Perry did not face any other unexpected side effects. However, he adds, the expected side effects are quite significant with the treatment prescribed. "Thankfully," he explains, "most are short-term and resolve as expected."
Commenting on Perry's parents' determined involvement in her care, Dr. Dunkel says, "Mr. and Mrs. Zimmerman's dedication to Perry and her recovery was remarkable."
Since malignant brain tumors in very young children tend to occur within the child's first year or two if they are going to recur, Dr. Dunkel is optimistic that Perry has been cured of her trilateral retinoblastoma.
"Caring for Perry and working with her family has been tremendously rewarding," he says with real satisfaction. "We are all thrilled that she has done so well despite what seemed to be a very life-threatening diagnosis at the beginning."
