TAMPA — Standing in front of a row of news cameras, Joshua McAdams had a simple answer when asked how he felt about a judge ordering that his 3-year-old son resume chemotherapy treatment.

"It could have been worse," said the 28-year-old father.

Moments earlier, Hillsborough Circuit Judge Caroline Tesche Arkin ruled Wednesday that Noah McAdams must immediately resume the first phase of chemotherapy to treat his leukemia against the wishes of his parents. Joshua McAdams and Taylor Bland-Ball wanted to use medical marijuana and other natural remedies to treat their son instead of chemotherapy, which experts say is the most effective treatment to keep the child's cancer from returning.

The parents and their attorney Michael Minardi, left the hearing disappointed but also encouraged. They said the judge held off on ruling whether Noah will have to complete the second and third rounds of chemotherapy, and allowed the parents to try other therapies, too.

"The best thing about this ruling is she didn't chart the course for 3½ years," Minardi said. "She charted this course for the first phase of chemotherapy only and encouraged the parties to get together and talk about other possibilities."

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Wednesday's hearing was the latest chapter in a legal and medical tug-of-war over Noah, who was diagnosed April 4 with acute lymphoblastic leukemia, a cancer of the blood and bone marrow.

The parents said the boy underwent two rounds of chemo at Johns Hopkins All Children's Hospital in St. Petersburg last month before they decided to stop the treatment because they worried about side effects. Then deputies said the parents missed scheduled treatments at All Children's and disappeared with their son in late April. Child protective investigators obtained a court order to take Noah into custody and the Hillsborough County Sheriff's Office put out an endangered child alert for the boy on April 29, saying the parents "refused to follow up with lifesaving medical care that the child needs."

Later that day authorities tracked down the family in Kentucky and took them into custody. The parents have said they were on their way to Cincinnati to consult with a doctor, not trying to flee Florida.

The Department of Children and Families asked for the emergency hearing to get the court's permission to treat Noah according to recommendations from oncologists. Arkin made her ruling after several hours of testimony held over two days. Arkin granted a request from a guardian at litem attorney representing Noah to close the proceedings to the news media to keep the child's medical information private.

The only source of what happened in court are the parents and their attorney. No one other parties have spoken about the proceedings. State officials did not respond to a request for comment late Wednesday.

At least two oncologists testified for the state. Minardi complained that he didn't have enough time to schedule his own expert witnesses but was able to arrange for Dr. Kelly King, a co-founder of ReleafMD Center for Medical Marijuana in Brandon, to testify about the benefits of cannabis.

Arkin's written order was not available Wednesday. The parents' attorney said Noah must resume chemotherapy at All Children's as soon as Thursday. Meanwhile the parents can continue searching for other treatment options and get a second medical opinion.

The judge did not rule on the issue of who gets custody of the child. For now, Noah will remain with his grandparents. But the parents said they hope to soon get permission for unsupervised visits and will be there when he gets his chemotherapy treatment.

In addition to cannabais therapy, the parents plan to use oxygen therapy, an alkaline diet and herbal remedies, said the 22-year-old mother.

"Other than that, just giving him the most happiness and the least stress as possible," Bland-Ball she said.

A mediation session between the parents and the state to discuss Noah's treatment is scheduled for June 4. There will be another court hearing the next day, Minardi said.

The type of leukemia Noah has can be cured in greater than 90 percent of cases with a full regimen of chemotherapy that begins as soon as possible after diagnosis, said Dr. Bijal D. Shah, head of the Moffitt Cancer Center's acute lymphoblastic leukemia program. Shah, who is not involved in Noah's treatment or the legal case, told the Tampa Bay Times that the entire chemotherapy regimen, including the final, less intense "maintenance" phase typically lasts about 2½ years.

Shah said experts it's too early to say cannabis shows any promise as an alternative treatment as effective as chemo.

"When we're talking about marijuana, it's really important to put it in the context of experimental therapy," Shah said. "Are we ready at this point to encourage experimental therapy when the alternative is a standard treatment with a high rate of cure? I can't see how marijuana is going to get there."

Contact Tony Marrero at tmarrero@tampabay.com or (813) 226-3374. Follow @tmarrerotimes.