Dr. G L article

[Mark]

for those who are newer to the forum, I thought the attached article might shed some light on the issues surrounding the Dr at Cabrini and what my previous comments were based on

http://nymag.com/nymetro/health/features/10817/

Mark

[Kate B]

I finished the article from 2005. The following comments are not support nor criticism of the above named individual.

This quote sums it up: Depending on your point of view, when it comes to new technologies, Dr. GL is either a forward-thinking early adopter or unacceptably reckless.

It seems that the criticism is related to  three things: his handling of his professional relationship with George Harrison, radiating other parts of the body which move versus the brain, and his approach to treat patients without going through clinical trials. It really doesn't reference his treatment of acoustic neuromas.

From the previous listserv format, there are several patients that will rally to support Dr. GL's treatment as a pioneer.  Let me ask this question: until a treatment has a patient following, aren't the doctors and their treatments all pioneers? How would that differ from some of the newer protocals available now that weren't available 10 years ago?  Do they have the clinical trials yet? What makes some go for pioneer treatment and others choose more traditional?  The answer of course is it is an individual decision and a person's willingness to color outside the lines... It becomes a factor in the decision making process.   

[ppearl214]

*sits on sofa, pulls out bowl of popcorn......*

[leapyrtwins]

Thanks for the article, Mark.  I found it very interesting; I've never heard of this doctor before.

I'm not supporting or criticizing either, but I think Kate raises some very good questions.

Jan

[Jim Scott]

Mark:

Thanks for the link.  I read the article and what I took away was that the doctor seems to be a self-aggrandizing man who may have had good intentions but misled patients and their families on the benefits of FSR.  Many patients seemed to believe their cancer would be 'cured' by FSR, when that clearly wasn't the case.  Doctor Lederman seems to have encouraged that belief without ever saying 'cure'.  That the New York Board of Professional Medical Conduct has gone after him and he is being sued by families of former patients doesn't speak well of his conduct.  His behavior in the George Harrison case appears to be boorish, at best. I can't evaluate his professional ethics without knowing the details of the patients he is being accused of misleading and what, exactly, was said, promised and/or understood.  It doesn't look good, though.  This is not a doctor I would seek out.  I know tort lawyers exist to file lawsuits and that doctors are especially vulnerable, so I'll give this doctor some benefit of the doubt, but I think there is probably some merit to these suits. 

As a AN patient who underwent successful FSR treatment, I am confident of it's efficaciousness on Acoustic Neuromas but I cannot translate that success to malignant tumors, although it may well be useful, if not a slam-dunk 'cure'.  Unfortunately, this article from New York magazine doesn't address AN's and FSR, so while it was interesting reading, it isn't all that relative to me.  However, I still appreciate your posting the information.  Certainly food for discussion, if nothing else.   

Jim
   

[Mark]

Kate,

There are a number of articles on Dr. GL similar to this one. I frankly don't care about the guy either way and personally don't have an opinion of him, but since his name came up in a post and many newer forum members weren't familiar with him, I thought this one might explain what the controversy was about.

I think the difference between being a pioneer vs. reckless is a couple of things. How much science and testing of the concept did one do before trying the new technique and did the patient fully understand the risks involved? Was one's motivation truly about creating a better outcome or to further one's own professional interest. I think some of the comments from the other doctors shed some doubt on the first aspect and the george harrison incident coupled with a demonstrated practice of self promotion cast some doubt on the latter.

 I am sure there are those who had good experiences with GL and would sing his praises.  However, in the course of my research for choosing radiosurgery, having been on this board for 7 plus years as well as reading others, I can say that reading really bad outcomes is quite rare, but the name associated with most I saw were his. take that for what it's worth, but my impression is that he opted to "experiment" on patients without really studying the protocol in advance and that is different from a pioneer.

I am curious though,was your friend who helped with the radiosurgery component of AN World treated by GL?

Mark

[sgerrard]

Wow, that was pretty interesting reading. Better than the ANA book club, in fact.

If I got the story right, Dr. Lederman (you can say that now) did good work in developing FSR for use on the brain. He was already somewhat commercial minded at the time, with all the marketing materials and testimonials, but it also brought radiation treatment, especially FSR, further forward in the medical world.

Then he went to Sweden, decided the Swedes were being too cautious, and got the idea of doing body FSR as well. That seems like the point where he stopped being a pioneer, and started being reckless, and perhaps misleading enough to be considered fraudulent. He ignored the obvious theoretical problems, stopped listening to other doctors, stopped paying attention to outcomes, and just plowed ahead. Sometimes just wanting it to work is not enough.

The George Harrison story is sad. It is difficult to say what really happened, but it is hard to see it in a good light. There is something obsessive about his behavior in that story that is quite alarming. Yes, George was a Beatle; but Dr. Lederman is a doctor; he should have remembered that.

All in all, an interesting chapter in the saga of acoustic neuromas. Pass the peanuts, please.

Steve

[jb]

While doing some research on swelling of AN's following radiation (my own AN continues to misbehave in this area), I came across a website written by one of Dr. Lederman's AN patients and her husband .  She originally had a 5 cm tumor which was incompletely removed surgically.  A couple of years later, the tumor had regrown to 4 cm.  She didn't want another surgery, but was refused radiation treatment at Mayo Clinic.  (They insisted she needed a debulking surgery first.)  According to her website, she contacted Dr. Lederman and was treated by him with FSR to the 4 cm AN in Nov. 2003, with no debulking.  Sadly, she died in Oct. 2004 from swelling-induced complications and possible radiation damage according to her husband's notes on the website. Dr. Lederman would never acknowledge it had anything to do with the FSR treatments despite the obvious swelling on her MRI's.

Link to her website: http://www.raccoonhouse.com/an/

It's a very disturbing and tragic story to be sure, but it's also amazing that the woman (Val) was able to maintain such a positive attitude through everything she had to endure.  Understandably, her husband has some very strong opinions regarding Dr. Lederman, which he discusses in the last link in the "Topics" section on their website.  I can't help but wonder how Dr. Lederman sees fit to treat a 4 cm tumor with FSR when it seems the rest of the radiation community generally refuses to treat above 3 cm.  In light of the New York article, I guess it's not so surprising though.

[claire1]

Mark

What an article. It sounds like something out of the outter limits or Jules Vern.  With all the hype that we AN'ers go through in our daily life in regards to finding the best treatments available for us, we need to contend with those dr's such as dr. L that have a god complex and over inflated ego as well.  It's like "Buyer Beware"
Such a sad story for those left behind at the hands of Dr L.

I had lots of butter on my pop corn.
Have a Great day Claire

[leapyrtwins]

Well said, Claire!

[Mark]

Claire,

As I noted in an earlier post, I was just passing on an article which seemed to capture the elements of what makes him one of , if not the, most controversial figure in radiosurgery in an effort to address another posters inquiry. I thought the author made a reasonable effort of framing things for the reader to draw their own conclusion: ego driven or tries to do too much for patients, innovating pioneer or reckless practitioner. I have no personal knowledge of the man, so I would not make a judgment other than to say he's probably not the most conservative clinician out there. Perhaps, if one has a  life threatening illness, and is looking for something new to try, then a doctor willing to push the envelope of conventional treatments is a good thing as long as the patient understands the risks. An AN rarely fits that definition in my view. However, as someone else said, most physicians have their proponents and detractors and at the end of day you go to who your comfortable and confident in.

Mark

[Kate B]

There is a parallel thread running about acoustic neuroma's and Dr. Lederman that may interest you if you have found this link.

http://anausa.org/forum/index.php?topic=6391.msg61640#msg61640

[sgerrard]

Not to beat on a dead horse, or anything, but I just did a little math for myself (using Excel, of course).

Stating the size of an AN as a length can be pretty misleading. The volume of the AN goes up quite a lot with diameter, and I  think that's where Dr. L. lost his way. Consider this little list, based on a sphere shape:
Size, cm     Volume, cc
1                  2.1
2                16.8
3                56.5
4              134.0

A 4 cm tumor is 8 times larger than a 2 cm tumor - not just twice the size. If a 4 cm tumor swells up 10%, it needs to find room for the equivalent of another 2 cm tumor. That is some serious pressure.

Also, if you look at the link jd posted, you will see that Val's 5 cm AN had noticeable anatomy inside it, including fairly large blood vessels. Radiating a tumor like that means radiating the blood vessels, and radiating a large blood vessel near the brain stem just can't be a good idea.

Steve