Roger J. Packer, MD, is senior vice president of
the Center for Neuroscience and Behavioral Medicine, director of The Brain
Tumor Institute and also director of the Gilbert Neurofibromatosis Institute at
the Childrens National Medical Center in Washington, D.C.
He is professor of neurology and pediatrics at George
Washington University, professor of neurology at Georgetown University and
professor in neurosurgery at University of Virginia, Charlottesville.
Packers viewpoint on the management of children
with brain tumors is heavily based upon his upbringing as a child of Holocaust
survivors. Education and, even more importantly, personal dignity are
Overall, his wish is that when clinicians go into this
field, they view it not as a business but as a calling. He said he hopes that
physicians have an understanding that they are not only taking care of children
to cure their disease, but also working toward developing therapies that will
cause fewer long-term side effects so that quality of life is optimal.
I like spending time with the family, which includes my
wife and two grown children, ages 30 and 27 years. My passion is sports of
almost any type. I particularly like baseball, and my favorite team is the
I always thought my calling in life was to be a sports
writer. If not for parental intervention, I probably would have pursued that.
As a child neurologist, one of the most important things
is trying to define my role in the care of children with brain tumors and
developing more effective interventions to not only improve survival but also
to improve quality of life, particularly neurocognitive and neurologic
function. I have made two major contributions in this area.
One is developing, early in my career, with
collaborators in oncology and neurosurgery, one of the most effective treatment
protocols for children with medulloblastoma, which raised survival rates from
approximately 50% at five years to 80% to 90%.
The second is developing, again with collaborators, a
different protocol for children aged younger than 5 years with low-grade
gliomas, which has remained the national standard for about the last 20 years.
Im most proud that the results we initially
published were replicated by multiple centers around the world, so this was not
a one-time exception. In other words, any result that cannot be replicated by
many others puts your own results into question, and our results were
replicated several times.
Interestingly, it was very early in my career, when I
took over the brain tumor program at The Childrens Hospital of
Philadelphia, which had really been the province almost exclusively of
oncologists and neurosurgeons.
When I was asked to take over the position, about a year
into my attending time, the two leaders of the oncology program there,
Audrey Evans, MD, a renowned pediatric oncologist, and Giulio
DAngio, MD, an equally internationally known radiation oncologist,
told me they wanted me to make the program we developed the best in the
They emphasized developing the most innovative care for
children with brain tumors and stressed that that should always be the priority
when developing a new program, and I followed that advice. You cannot worry
about obstacles; rather, you overcome them and create the best program. Never
settle for second place, even though I am a Chicago Cubs fan.
Ive had so many, but a couple stand out in my
mind. Peter Berman, MD, who trained me in child neurology, was certainly
a mentor. Others include some incredible senior physicians in Philadelphia,
when I first started in the field: Drs. Evans, DAngio, Robert
Zimmerman, MD, in neuroradiology, Lucy Rorke, MD, in neuropathology
and Luis Schut, MD, and Derek Bruce, MD, in neurosurgery.
Overall, I think they impressed upon me that taking care
of children with tumors is a multidisciplinary effort. I had great mentors in
all different disciplines, and it helped me along in my career.
Dr. Packer with his wife Bashi,
both dressed in their Chicago Cubs gear.
Courtesy: R Packer, MD
We are going through a major transition in how we
evaluate and manage children with brain tumors. The driving force will be how
we translate and harness the new understanding in neuroscience and cancer for
the treatment of these children. Many of the therapies that we now use will
look barbaric because of the side effects they cause, and we will be evolving
into molecularly based therapies in the very near future.
There are actually two. One was a biography of Leroy
Robert Satchel Paige, a pitcher who started out in the Negro
baseball leagues of the time and later pitched in Major League Baseball.
Its about baseball and race relations in that era.
The other is a biography of Franklin Roosevelt by Doris
Kearns Goodwin. I am a child of Holocaust survivors, and one thing I am very
interested in and confused about is the U.S. response in the early portion of
the Holocaust and the role of leadership, including that of Roosevelt.
I enjoy the Impressionists at the Art Institute of
Chicago. I grew up in Chicago, and the Impressionist room is my favorite room
in the museum.
It was probably something by Bob Dylan.
I have a fairly good exercise regimen. I workout or go
to the gym or run five to seven days of the week, but my diet would be
considered modified junk food. Im not particularly healthy, but I try to
stay away from large amounts of red meat.
I have two: Italy, especially around the area of Padua,
and Cape May, N.J.
Im fairly eclectic. I usually like Italian but
havent found the perfect Italian restaurant. I also look for kosher
restaurants because of my upbringing, and Im still looking for the
perfect one of those too. by Christen Cona