New York Cancer & Blood Specialists (NYCBS) recently announced the addition of oncologist-hematologist Neal Murphy, MD.
Dr. Murphy will practice at 750 Old Country Rd, Riverhead,640 County Rd, Southampton, and 49 Route 347, Port Jefferson Station.
“Dr. Murphy’s dedication to research and patient care is truly commendable,” said Jeff Vacirca, MD, CEO of NYCBS. “We are proud to have Dr. Murphy join our practice and look forward to the positive impact he will make in the lives of our patients.”
Dr. Murphy has dedicated his time to research focusing on kidney and bladder cancer. Dr. Murphy completed two translational research studies, including “Prognostic molecular signatures for metastatic potential in clinically low-risk stage I and II clear cell renal cell carcinomas,” which was published in Frontiers in Oncology, and “Predictive molecular biomarkers for determining neoadjuvant chemosensitivity in muscle-invasive bladder cancer” which was published in Oncotarget.
Dr. Murphy has several other peer-reviewed publications and has presented his work at national conferences. He remains passionate about optimizing treatments in hematology/oncology and treats a broad spectrum of diseases with a focus on genitourinary, lung, head and neck, colorectal and skin malignancies, as well as multiple myeloma and lymphoma.
“I strive to get to know all my patients, build trust and provide the kind of care that one of my family members or I would want to receive,” Dr. Murphy said.
“When communicating with patients, I am honest and open, explaining all treatment options and agreeing on the best, personalized treatment plan together. It is rewarding to be able to alleviate a patient’s anxiety and fear about their diagnosis and to be able to provide hope because there are so many effective treatments NYCBS and I can offer to help patients.”
To make an appointment with Dr. Murphy, please call 631-751-3000. For more information, visit nycancer.com.
Consequences can be greater than snoring and fatigue
By David Dunaief, M.D.
Dr. David Dunaief
Good sleep contributes to our physical and mental wellbeing, however many of us struggle to get quality, restful sleep. For those with obstructive sleep apnea (OSA), quality sleep is especially elusive.
Sleep apnea is an abnormal pause in breathing that occurs at least five times an hour while sleeping. It can have an array of causes, the most common of which is airway obstruction. Some estimates suggest that about 30 million people suffer from sleep apnea in the United States (1).
Obstructive sleep apnea (OSA), also known as sleep-disordered breathing, may affect up to 30 percent of adults. OSA diagnoses are classified as either mild, moderate or severe. It’s estimated that roughly 80 percent of moderate and severe OSA sufferers are undiagnosed.
Risk factors for OSA include chronic nasal congestion, large neck circumference, excess weight or obesity, alcohol use, smoking and a family history (2). Many of these factors, however, are modifiable.
Significant symptoms of OSA tend to be quality of life issues and include daytime fatigue, loud snoring, breathing cessation observed by another, impaired concentration and morning headaches. While these are significant, it’s more concerning that OSA is also associated with an array of more serious health consequences, such as cardiovascular disease, high blood pressure and depression.
Fortunately, we have an arsenal of treatment options, including continuous positive airway pressure (CPAP) devices; oral appliances; lifestyle modifications, such as diet, exercise, smoking cessation and reduced alcohol intake; and some medications.
What is the impact oncardiovascular disease risk?
In an observational study, the risk of cardiovascular mortality increased in a linear fashion with the severity of OSA (3). For those with mild-to-moderate untreated sleep apnea, there was a 60 percent increased risk of death; for those in the severe group, this risk jumped considerably to 250 percent. However, the good news is that treating patients with CPAP considerably decreased their risk by 81 percent for mild-to-moderate patients and 45 percent for severe OSA patients. This study involved 1,116 women over a six-year duration.
Another observational study with male subjects showed similar risks of cardiovascular disease with sleep apnea and benefits from CPAP treatment (4). There were more than 1,500 men in this study with a 10-year follow-up. The authors concluded that severe sleep apnea increases the risk of nonfatal and fatal cardiovascular events, and CPAP was effective in curbing these occurrences.
In a third study, this time involving the elderly, OSA increased the risk of cardiovascular death in mild-to-moderate patients and in those with severe OSA by 38 and 125 percent, respectively (5). But, as in the previous studies, CPAP decreased the risk in both groups significantly. In the elderly, an increased risk of falls, cognitive decline and difficult-to-control high blood pressure may be signs of OSA.
Is there a cancer connection?
In sleep apnea patients under age 65, a study showed an increased risk of cancer (6). The authors believe that intermittent low levels of oxygen, caused by the many frequent short bouts of breathing cessation, may be responsible for the development of tumors and their subsequent growth.
The greater the percentage of time patients spend in hypoxia (low oxygen) at night, the greater the risk of cancer. For those patients with more than 12 percent low-oxygen levels at night, there was a twofold increased risk of cancer development when compared to those with less than 1.2 percent low-oxygen levels.
Does OSA affect male sexual function?
It appears that erectile dysfunction (ED) may also be associated with OSA. CPAP may decrease this incidence. This was demonstrated in a small study involving 92 men with ED (7). The surprising aspects of this study were that, at baseline, the participants were overweight, not obese, on average and were only 45 years old. In those with mild OSA, the CPAP had a beneficial effect in over half of the men. For those with moderate and severe OSA, the effect was still significant, though not as robust, at 29 and 27 percent, respectively.
An array of other studies on the association between OSA and ED have varying results, depending on the age and existing health challenges of the participants. Some study authors have postulated that other underlying health problems may be the cause in some patient populations.
Can diet help?
For some of my patients, their goal is to discontinue their CPAP. Diet may be an alternative to CPAP, or it may be used in combination with CPAP to improve results.
In a small study of those with moderate-to-severe OSA levels, a low-energy diet showed positive results. A low-energy diet implies a low-calorie approach, such as a diet that is plant-based and nutrient-rich. It makes sense, this can help with weight loss. In the study, almost 50 percent of those who followed this type of diet were able to discontinue CPAP (8). The results endured for at least one year.
The bottom line is that if you think you or someone else is suffering from sleep apnea, it is important to be evaluated at a sleep lab and then follow up with your doctor. Don’t suffer from sleep apnea and, more importantly, don’t let obstructive sleep apnea cause severe complications, possibly robbing you of more than sleep. There are many effective treatments.
References:
(1) sleepapnea.org. (2) JAMA. 2004;291(16):2013. (3) Ann Intern Med. 2012 Jan 17;156(2):115-122. (4) Lancet. 2005 Mar 19-25;365(9464):1046-1053. (5) Am J Respir Crit Care Med. 2012;186(9):909-916. (6) Am J Respir Crit Care Med. 2012 Nov. 15. (7) Sleep. 2012;35:A0574. (8) BMJ. 2011;342:d3017.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.
Stony Brook Medicine team performed a life-saving surgery on a Long Island football coach just a few days before the championship game to take place on Saturday, November 20.
Kyle Moodt, 38, a Bellport High School Varsity Assistant Football Coach, 5th grade general education teacher, father, and husband, battled debilitating headaches daily since July 2021. He and his wife Michelle have three children ages 3 (Emma), 5 (Brody) and 7 (Kayla), and live in Center Moriches.
The chronic headaches were isolated in one area, the front right side of his head. Kyle said “they were constant from wake up to bedtime. I’ve had two back surgeries in the past and I would probably take that sciatica pain over the headaches. The headaches never went away. It was hard to function with a headache all day long. Took a lot of Tylenol. At times, I would have to lay down whether I had practice or even in school. It was affecting my teaching in the classroom. I was teaching more from my desk than I have in most of my years. When I went home, after work, I was very tired. I felt like I wasn’t able to contribute to the household as much and more fell on my wife’s shoulders.”
Shortly after Kyle saw Stony Brook Medicine doctors, the medical team quickly identified that these were not normal headaches from reading a computed tomography (CT) and a computed tomography angiogram (CTA) scan. David Fiorella, MD, PhD, Neurointerventional Radiologist; Director, Stony Brook Cerebrovascular Center; and Co-Director, Stony Brook Cerebrovascular and Comprehensive Stroke Center and Michael Guido, MD, Neurologist; Director, Stony Brook Neurology Stroke Program; and Co-Director, Stony Brook Cerebrovascular and Comprehensive Stroke Center determined Kyle had a life-threatening malformation of the arteries in his brain. The diagnosis was arteriovenous fistula, or DAVF. This dangerous increased pressure in his head was a risk for fragile veins bursting which would cause a life-threatening brain bleed.
On November 11, Dr. Fiorella was able to use an angiogram to map out the malformation and make a treatment plan to allow him to be at the football team’s playoff game. And, subsequently treated Kyle’s complex brain malformation on November 16 through a small puncture site in his right wrist, performing a minimally invasive surgery that took less than one hour. The special procedure Kyle had was embolization of a dural fistual with a material Onyx. The goal of the procedure is to block off the abnormal arteries while preserving the normal arteries and veins.
Kyle is ecstatic. “Dr. Fiorella said I’m going to get this taken care of and I feel great 24 hours later after the successful surgery. It’s amazing. I don’t have brain fog. Had a good night’s sleep. I slept through the night. Woke up without a headache. I haven’t taken any medicine or Tylenol in 24 hours. The headaches that I’ve had for months are not there. Luckily, we were able to get to the bottom of this.”
“His angiogram showed the cure after the treatment and his MRI and MRA of his blood vessels indicated his brain is completely normal. He is neurologically perfect,” said Dr. Fiorella.
Kyle is grateful for Dr. Fiorella’s expertise and quality of care received at Stony Brook University Hospital. “About a year ago, he performed surgery on my father who had a stroke. I was very happy to know I was going to him for care. I remember, he put me, my mom, my brother, my sister at ease, talking and dealing with my father’s illness. So, if he’s confident, then I’m confident. And, they set the standards pretty high at Stony Brook.”
This positive outcome couldn’t be more timely as Kyle will not miss the opportunity to coach the offensive and defensive line as his Bellport Clippers face off against the Lindenhurst Bulldogs for the DII Suffolk County Championship at Stony Brook University’s Kenneth P. LaValle Stadium on Saturday at 7pm. Bellport last won a Suffolk title in 2010.
In sharing what it means for Stony Brook doctors to urgently treat Kyle with very little recovery time needed and getting him back to his “two families” touches him on a very emotional level. “Football is a passion of mine, but my main goal is the three kids I have at home. Definitely, I wanted to make sure that I would be able to make it to the game as the team gets ready for one of the biggest moments in their life but more importantly, family and my well-being came first. But the football team is family too. Some of these kids I’ve known since fifth grade. Some I played with their fathers or uncles as an offensive lineman for three years between 1998 and 2000. My parents are still very involved. Football brings the community together. We have all walks of races and socioeconomic backgrounds. My wife will cook for the lineman dinners at my house with 10 to 15 kids. We’re building a community and camaraderie between the team and this leads to our success. Kids care about each other. As coaches, we care about them too on and off the field. It’s why I love the district and where I am. It’s a big family affair.”
