A state appeals court yesterday ordered immediate medical treatment for Pamela Hamilton, 12, who suffers from deadly bone cancer, despite her preacher father's claim that the family's religion forbids use of medicine.

A Tennessee Supreme Court justice later refused to block the order until the case could be appealed, allowing treatment to begin. Associate Justice Frank F. Drowota denied the stay after hearing a deposition from the girl's doctor that said her condition had worsened.

Dr. Frank Haraf said the girl will live only three months unless she receives immediate chemotherapy and radiation treatments. The football-sized Ewing's sarcoma tumor that has destroyed much of her upper left leg bone has moved into her hip and may break through the skin, he said.

Even with immediate treatment, doctors say her chance of survival is less than 50-50.

Chemotherapy was expected to start this morning, Haraf said, but radiation treatment cannot begin until the tumor is smaller.

"If we feel that the tumor is not responding . . . we will reconsider stopping treatment," Haraf said at a news conference. "Delay in treatment has definitely reduced her chance of cure."

Larry Hamilton, the girl's father, has fought treatment for two months because he said the family's religion forbids the use of medicine.

An attorney for the family said he would go to Nashville early today to ask for permission to appeal the case to the Tennessee Supreme Court, and Drowota said the request would likely be considered by the court Friday or Monday.

In a seven-page opinion, three Tennessee Court of Appeals judges unanimously upheld a juvenile court's decision to declare Pamela a neglected child, award temporary custody to the state and order treatment.

"While the prognosis with treatment in Pamela's case is guarded, the consequence of no treatment is certain, painful death," the judges said.

"The right to freedom of religion does not include the right to endanger the child's life," Judge James W. Parrott said.

Hamilton sat quietly in the courtroom as the opinion was read. His daughter has been at East Tennessee Children's Hospital in Knoxville since Saturday.