Top doctors: Childhood brain tumors
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
Dr. Richard Blanck
1991 Marcus Ave.
516-466-4700
Dr. Daniel Cohen
370 E. Main St.
631-666-4767
Dr. Patricia Coyle
Medical Center
Dept. Neurology
HSC T12, Rm. 020
Stony Brook
631-444-2599
Dr. Alan Ettinger
Neurological Surgery, PC
1991 Marcus Ave.
516-442-2250
Dr. Oded Gerber
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.
718-470-7366
Dr. Itzhak Haimovic
170 Great Neck Rd.
516-487-4464
Dr. Brian Hainline
3 Delaware Dr.
516-622-6088
Dr. Ronald Kanner
L.I. Jewish Medical Ctr.
Dept. Neurology
270-05 76th Ave.
718-470-7311
Dr. John Kelemen
824 Old Country Rd.
516-822-2230
Dr. Jeffrey Kessler
1991 Marcus Ave.
516-466-4700
Dr. Roger Kula
865 Northern Blvd.
516-570-4400
Dr. Lewis Levy
777 Sunrise Hwy.
516-887-3516
Dr. Richard Libman
L.I. Jewish Medical Ctr.
Dept. Neurology
270-05 76th Ave.
718-470-7311
Dr. Henry Moreta
877 E. Main St.
631-727-0660
Dr. Stephen Newman
824 Old Country Rd.
516-822-2230
Dr. Philip Ragone
1010 Northern Blvd.
516-482-4100
Dr. Neil Schaul
1575 Hillside Ave.
New Hyde Park
516-352-2441
Dr. Ira Turner
824 Old Country Rd.
516-822-2230
CHILD NEUROLOGISTS
Dr. Mary Andriola
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
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.
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.
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.
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.
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.
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