Top doctors: Childhood brain tumors

Mark A. Mittler, M.D., co-chief, Division of Pediatric Mark A. Mittler, M.D., co-chief, Division of Pediatric Neurosurgery, Cohen Childrens Medical Center, points to the 4th ventricle of the brain where many pediatric brian tumors arise. (Dec. 6, 2011) Photo Credit: Newsday/Karen Wiles Stabile

advertisement | advertise on newsday

Every day, there are Long Island families coping with the heartache of a child with brain cancer -- the second most common childhood cancer after leukemia and the deadliest overall.

However, most kids with brain tumors can be cured. Here's what you should know:

1. BRAIN CANCER IN CHILDREN IS UNCOMMON

A child is extremely unlikely to develop a brain tumor. The Pediatric Brain Tumor Foundation reports that about 4,150 children in the United States are diagnosed with brain cancer each year. Several types of brain cancer in children develop in the early ages -- before age 10 and often between 5 and 8 years of age, according to the U.S. National Institutes of Health.

Some children are susceptible to brain cancer from the moment they're born because of the presence of abnormal cells, said Dr. Mary Andriola, director of child neurology and clinical neurophysiology at Stony Brook University Medical Center.

2. BRAIN TUMORS IN KIDS OFTEN ARE DIFFERENT FROM ADULT TUMORS

The most common type of brain tumor in kids is called medulloblastoma, which strikes in the back of the brain, said Dr. Mark A. Mittler, co-chief of pediatric neurosurgery at Steven and Alexandra Cohen Children's Medical Center of New York in New Hyde Park.

"The treatment for medulloblastoma consists of complete surgical removal, when possible, followed by a course of chemotherapy and sometimes radiation therapy," Mittler said. "The treatment success of medulloblastoma has improved dramatically over the past 20 years, and the vast majority of these children are curable in centers that have the proper expertise."

It's rare for medulloblastomas to occur in adults, he said, whereas glioblastomas -- another kind of tumor -- appear in adults but are rare in kids. "Prognosis for glioblastoma remains very poor despite aggressive surgery, chemotherapy and radiation treatment," Mittler said.

3. A VARIETY OF SYMPTOMS COULD INDICATE BRAIN CANCER

"One of the classic symptoms of a brain tumor is a headache that is frequently present upon waking up in the morning," Mittler said. "This should always be evaluated by a pediatrician or pediatric neurologist."

Other symptoms include dizziness, unexplained vomiting and even coma, Mittler said. In some cases, a child will first go to a gastroenterologist to be treated for nausea and vomiting before anyone realizes he or she has a brain tumor, he said.

Andriola mentioned other symptoms that could be indicative of a brain tumor, such as seizures, imbalance, vision changes, unusual eye movement and changes in behavior and alertness. Symptoms often occur, she said, because "there's not enough room in the head to accommodate the brain, the mass that's growing and the swelling that often grows around the tumor."

4. BRAIN SCANS PROVIDE INSIGHT INTO TUMORS

MRI scans help doctors determine if a child has a brain tumor, Andriola said. If so, the next step is "usually some type of surgery, either to get the whole tumor out or at least to biopsy it to plan treatment if total removal would cause more harm than good," she said. In some cases, she explained, it may be unwise to remove an entire tumor because it's too close to crucial parts of the brain.

Radiation is sometimes used as a treatment in children, Andriola said, but with radiation comes significant potential for long-term side effects.

5. TREATMENT ADVANCES ARE ON THE HORIZON

Scientists and physicians are developing and testing several treatments, including new drugs and drug combinations that may slow tumor growth, and radiation treatment that could decrease side effects by more effectively targeting tumors.

Andriola said that genetic testing of children and their tumors also has the potential to help doctors better understand the structure of tumors and determine which sections to remove, and improvements in scanning technology could provide more important details about tumors.

 

Neurologists, neurological surgeons and neuroradiologists

 

This is the 25th installment of a 26-week series in which Newsday presents Castle Connolly's list of top Long Island doctors.

NEUROLOGISTS

advertisement | advertise on newsday

Dr. Richard Blanck

1991 Marcus Ave.

Lake Success

516-466-4700

Dr. Daniel Cohen

370 E. Main St.

Bay Shore

@Newsday

631-666-4767

Dr. Patricia Coyle

Stony Brook University

Medical Center

Dept. Neurology

HSC T12, Rm. 020

Stony Brook

631-444-2599

Dr. Alan Ettinger

Neurological Surgery, PC

1991 Marcus Ave.

Lake Success

516-442-2250

Dr. Oded Gerber

advertisement | advertise on newsday

Stony Brook University

Medical Center

Dept. Neurology

HSC Bldg. Fl. 12-Rm. 020

Stony Brook

631-444-2599

Dr. Marc Gordon

LI Jewish Medical Ctr.

Dept. Neurology

270-05 76th Ave.

New Hyde Park

718-470-7366

Dr. Itzhak Haimovic

170 Great Neck Rd.

Great Neck

advertisement | advertise on newsday

516-487-4464

Dr. Brian Hainline

3 Delaware Dr.

Lake Success

516-622-6088

Dr. Ronald Kanner

L.I. Jewish Medical Ctr.

Dept. Neurology

270-05 76th Ave.

New Hyde Park

718-470-7311

Dr. John Kelemen

824 Old Country Rd.

Plainview

516-822-2230

Dr. Jeffrey Kessler

1991 Marcus Ave.

Lake Success

516-466-4700

Dr. Roger Kula

865 Northern Blvd.

Great Neck

516-570-4400

Dr. Lewis Levy

777 Sunrise Hwy.

Lynbrook

516-887-3516

Dr. Richard Libman

L.I. Jewish Medical Ctr.

Dept. Neurology

270-05 76th Ave.

New Hyde Park

718-470-7311

Dr. Henry Moreta

877 E. Main St.

Riverhead

631-727-0660

Dr. Stephen Newman

824 Old Country Rd.

Plainview

516-822-2230

Dr. Philip Ragone

1010 Northern Blvd.

Great Neck

516-482-4100

Dr. Neil Schaul

1575 Hillside Ave.

New Hyde Park

516-352-2441

Dr. Ira Turner

824 Old Country Rd.

Plainview

516-822-2230

CHILD NEUROLOGISTS

Dr. Mary Andriola

Stony Brook University

Med. Ctr., Dept. Neurology, HSC T12-020

Stony Brook

631-444-2599

Dr. Marcia Bergtraum

3003 New Hyde

Park Rd.

New Hyde Park

516-488-2323

Dr. Lydia Eviatar

410 Lakeville Rd.

New Hyde Park

516-465-5255

Dr. Joseph Maytal

Dept. Ped. Neurology

410 Lakeville Rd.

New Hyde Park

516-465-5255

NEUROLOGICAL SURGEONS

Dr. Jeffrey Brown

600 Northern Blvd.

Great Neck

516-478-0008

Dr. Raphael Davis

24 Research Way

East Setauket

631-444-1213

Dr. Mark Eisenberg

900 Northern Blvd.

Great Neck

516-773-7737

Dr. Nancy Epstein

410 Lakeville Rd.

New Hyde Park

516-354-3401

Dr. David Langer

300 Community Dr.

Manhasset

516-562-3023

Dr. Mitchell Levine

900 Northern Blvd.

Great Neck

516-773-7737

Dr. Mark Mittler

L.I. Neurosurgical Associates

410 Lakeville Rd.

New Hyde Park

516-354-3401

Dr. Michael Schulder

North Shore

University Hospital

300 Community Dr.

Manhasset

516-562-3062

Dr. Henry Woo

24 Research Way

East Setauket

631-444-1213

NEURORADIOLOGISTS

Dr. David Fiorella

Stony Brook University

Medical Center

Hospital Level 4,

Suite 430

Stony Brook

631-444-1213

Dr. Orlando Ortiz

120 Mineola Blvd.

Mineola

516-663-2123

Dr. John Pile-Spellman

Neurological Surgery, PC

1991 Marcus Ave.

Lake Success

516-442-2250

Dr. Avi Setton

North Shore

University Hosp.

300 Community Dr.

Manhasset

516-562-3021

 

How they were picked

 

Castle Connolly Medical Ltd. is a health-care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of doctors and the medical leadership of leading hospitals.

Castle Connolly's team of researchers follows a rigorous screening process to select doctors on national and regional levels. Using mail and telephone surveys, and electronic ballots, they ask physicians and the leadership of top hospitals to identify exceptional doctors. Careful screening of doctors' educational and professional experience is essential to the committee. Not every good physician makes the list. Rather, the list is a way for patients to get started on their search for the best medical professional. Newsday is not part of the selection process.

Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors.

 

To see the whole list . . .

 

Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.

You also may be interested in: