The recent article in the Journal of the National Cancer Institute details a retrospective comparison of the rates of brain tumors in Scandinavia with the rise of cell phone use since the 90′s.  In particular, they looked to see if the incidence of gliomas and meningiomas, two types of brain tumor,  increased between 1974 and 2003. Here is what they found:

From 1974 to 2003, brain tumor incidence rates in Denmark, Finland, Norway, and Sweden were stable, decreased, or continued a gradual increase that started before the introduction of mobile phones. No change in incidence trends was observed from 1998 to 2003, the time when possible associations between mobile phone use and cancer risk would be informative about an induction period of 5–10 years. JNCI

Similarly, Dr. Bruce and his colleagues performed a retrospective study in 2002 that compared 90 people who were diagnosed with Acoustic Neuromas, tumors near the ear, against a group of 86 without.  They gathered information from each person like: whether they even used a cell phone, how many minutes they talked per month, how long they had the phone, and which ear did they normally hold the phone to. Not only was there no correlation between those that had tumors and any cell phone use but there was a tendency for people to have tumors on the other side of the head than they usually held their phone.

As more time passes, the use of cell phones increases, and more research is done, then perhaps a connection will be made but by then it is quite possible that a newer technology will have developed for us to worry about.  Besides, with hands-free and texting who is going to be holding their phone to their ear anyway?

*See Dr. Bruce‘s and his colleagues’ paper: Handheld cellular telephones and risk of acoustic neuroma in Neurology 2002;58:1304-1306

Video

Dr. Mandigo’s practice is devoted to spinal deformity, degenerative spine disease, interveterbral disc disease, spinal column tumors, spinal cord tumors, brain tumors, skull base tumors, meningiomas, acoustic neuromas, pituitary tumors, microvascular decompression for trigeminal neuralgia, hemifacial spasm, and cerebral aneurysm treatment.

Dr. Mandigo uses minimally invasive techniques for spinal surgery including the use of narrow tube retractor systems for cervical and lumbar microdiscectomy and spinal fusion. He also has expertise in artificial disc replacement surgery in the cervical spine. He has particular expertise evaluating and, if required, treating disorders of spinal alignment such as scoliosis or sagittal imbalance.

He also uses state-of-the-art technology such as frameless image guidance systems and stereotactic radiosurgery (i.e. BrainLab, GammaKnife, Tomotherapy) for the treatment of primary and metastatic brain tumors.

Dr. Mandigo helps direct our Lenox Hill Hospital practice based in the Upper East Side of Manhattan. His main offices are at Lenox Hill Hospital and in the Columbia Presbyterian Eastside building located on the southwest corner of Madison Avenue and East 60^th Street.

Acoustic neuromas occur at a rate of one per 100,000 people and make up eight percent of intracranial tumors.

Symptoms

Because of the location of acoustic neuromas, the initial symptoms of these tumors involve hearing and balance. Tinnitus (ringing in the ears), hearing loss, disequilibrium, and vertigo are common and caused by compression of the eighth cranial nerve. As the tumor enlarges, it expands in the space of the cerebellopontine angle, a region near the brainstem, and the seventh cranial nerve, which controls the facial muscles. When a tumor is large enough to compress surrounding structures, it may cause headaches, facial numbness and/or weakness, double vision, nausea, vomiting, and hydrocephalus, a blockage in the flow of the cerebrospinal fluid that bathes the brain and spinal cord.

Diagnosis

As with most brain tumors, imaging studies are essential to diagnosis. Both magnetic resonance imaging (MRI) and computed tomography (CT) scans can be used. In the case of small tumors, CT scans may show only an enlargement of the ear canal, while MRI scans may show only a thickened eighth cranial nerve. For either study, an agent that provides contrast in the image is administered intravenously so neurological surgeons can visualize the tumor against the normal tissue in the background. Larger tumors will appear more distinctly on MRI scans, and symptoms caused by their effects on surrounding structures will be apparent.

After a patient has been diagnosed with an acoustic neuroma, several functional tests usually are performed. These include detailed audiologic tests to assess hearing and the House and Brackmann Scale that assesses the degree of function of the facial nerves. These tests provide a detailed picture of the functional involvement of the tumor so that surgery can be tailored to preserve this level of function. Preservation of hearing is a significant concern; there are surgical approaches that result in hearing loss and those that do not. Neurological surgeons choose an approach based on the results of functional tests, size of the tumor and the patients overall health.

Treatment

If a tumor is small and does not cause symptoms, it may be observed over time rather than treated immediately. In cases in which treatment is necessary, surgical removal has been considered the best therapeutic option. Because acoustic neuromas are slow-growing benign tumors, complete removal often results in a cure. The advent of stereotactic radiosurgery, which involves the use of a highly focused beam of radiation to target the tumor, now provides an option that does not require open surgery and poses less threat to functional areas of the brain. Stereotactic radiosurgery, however, is a relatively new procedure, and it remains to be seen whether it will achieve the positive long-term outcomes associated with conventional surgery. In addition, stereotactic radiosurgery is not used for large tumors (greater than three centimeters in diameter), which must be removed with open surgery.

Dr. D’Ambrosio’s practice is devoted to brain tumors, skull base tumors, meningiomas, acoustic neuromas, pituitary tumors, microvascular decompression for trigeminal neuralgia and hemifacial spasm, cerebral aneurysm treatment, degenerative spine disease, and intervertebral disc disease.

He uses state-of-the-art technology such as frameless image guidance systems, awake craniotomy, and stereotactic radiosurgery (i.e. GammaKnife, BrainLab, Tomotherapy) for the treatment of primary and metastatic brain tumors.  He has particular expertise in the use of endoscopic techniques to remove complex intracranial tumors at the base of the brain.

Dr. D’Ambrosio directs our Northern New Jersey practice based in Ridgewood, NJ.  He is the Director of Neuro-Oncology – Disease Management Team at the Luckow Cancer Center of The Valley Hospital in Ridgewood, NJ.  Dr. D’Ambrosio is also the Director of Neurosciences for the St. Joseph’s Healthcare System in Paterson and Wayne, NJ.  He sees patients at The Valley Hospital, St. Joseph’s Regional Medical Center, St. Joseph’s Wayne Hospital, Chilton Memorial Hospital, and Mountainside Hospital.  With his main office in Ridgewood, New Jersey, Dr. D’Ambrosio has helped to establish a center of excellence for Columbia Neurosurgery in the communities of Bergen, Passiac and Essex counties.

Learn more here: The Making of a Neurosurgeon: Dr. Michael Sisti

Dr. Sisti’s Bio featured in The Cooper Union Summer 2010 Issue

They Walk in the Shoes of Giants and Even Sit in Their Chairs

Video

2010 Columbia University Medical Center Attending Physician of the Year Award

Dr. Sisti on Senator Kennedy’s brain tumor

Interview with Katie Couric

Interview with Meredith Vieira

Links

• Dr. Sisti’s Bio featured in The Cooper Union Summer 2010 Issue

Patient Story:  Waiting For Michael