Boston Symphony Orchestra music director James Levine will miss the remainder of the summer season at Tanglewood to have a kidney removed.
His condition, due to a cyst "causing pressure and discomfort," will require six weeks of recuperation, and he hopes to be ready to conduct the BSO's season opening at Symphony Hall in the fall, the orchestra announced in a statement yesterday.
The BSO said the Tanglewood schedule, which called for Levine to conduct eight more concerts, will continue as planned. Assistant conductor Julian Kuerti will take Levine's place Sunday afternoon in a concert featuring pianist Peter Serkin. Other conductors will be announced as they are lined up.
Levine was not available for comment yesterday, but in a statement he described it as "extremely frustrating" to be faced with the surgery during a tightly planned summer. "I especially regret not being here with [composer] Elliott Carter for his 100th birthday celebration, which I was looking forward to more than I can say," Levine said.
His departure from Tanglewood was abrupt. On Sunday night, after conducting the second part of Berlioz's epic "Les Troyens," Levine headed to a party meant to celebrate his 65th birthday. There he pulled aside BSO managing director Mark Volpe and board chairman Edward Linde to tell them about his condition and his need for surgery later this week. By Monday, he had left Tanglewood for New York, where he will have the operation.
BSO officials said they knew no more about his condition than what was in the statement, not even which hospital Levine is going to, but doc tors contacted by the Globe wondered about the severity of his illness.
There are various categories of cysts, said Dr. Leslie Spry, a spokesman for the National Kidney Foundation. Some small, round, "simple" cysts need no treatment. But if doctors decide to remove a kidney, he said, it may mean that the patient has a "complex large cyst," bigger than 1 or 2 inches in diameter, and the majority of those are malignant, he said.
Spry said doctors tend not to biopsy a cyst before a surgery because sticking a needle into the growth sometimes spreads the cancer. They make the decision to operate in consultation with imaging specialists, based on the cyst's size and appearance.
Before an operation, doctors "can't say it's cancer because they don't know," Spry said. "All we're talking about is statistics, and even with the large ones, there's still a 5 or 10 percent chance it's not malignant."
Scott McDougal, chief of urology at Massachusetts General Hospital, said that he doesn't know Levine's case. "But usually when kidneys are removed because they have a cyst, they're removed for cancer," he added.
Both doctors agreed that if the cancer is confined to the kidney, a prognosis for full recovery is good.
"People will live perfectly normal lives with one kidney," McDougal said. "I wouldn't anticipate that it would alter his ability to fully perform."
The news caught the BSO's artistic administrator, Anthony Fogg, off guard. Levine shuffled him into a quiet room during Sunday night's party to tell him and also make suggestions for potential replacements. Monday, Fogg talked to Kuerti, reminding him not to tell anybody because the board, orchestra, and news media wouldn't be told until Tuesday.
Kuerti kept the news to himself. He also canceled plans to have drinks at the home of BSO cellist Martha Babcock Monday, instead heading home to study scores for Sunday's concert, which will include works by Haydn, Bach, and Schubert.
"The number one thing for me was to make sure I could prepare the music," said Kuerti.
Fogg said that Levine's Tanglewood schedule includes more than concerts. He leads master classes and coaches the stable of young singers on campus during the summer. He meets with composers and holds sessions with conducting fellows. He also works on planning future BSO seasons.
"He's in a way the sort of glue that holds everything together," Fogg said.
The BSO will split these roles between guest artists and other faculty members on the Tanglewood campus.
That said, there was no talk of canceling any programs, including the Festival of Contemporary Music talking place July 20-24 and centered entirely on the works of Elliott Carter, one of Levine's favorite composers.
"In any cancellation, you try to keep the artistic product as intact as you can," said Fogg. "We wanted to try to present everything we had planned."
BSO administrators and board members said they were stunned by the news, particularly because Levine appeared so energetic during last weekend's opening of the Tanglewood series.
"That's one of the ironies in this," said Volpe. "The energy level was fantastic" during opening weekend. "They were hot performances. He feels great in that sense."
Arts and business leaders in the Berkshires were also shocked to hear of Levine's illness. The region's cultural scene centers around Tanglewood. A recent economic impact study conducted for the BSO estimated the organization's annual economic impact in Berkshire County at $60.6 million.
Ella Baff, executive director of Jacob's Pillow Dance in nearby Becket, called the news a disaster.
"James Levine is one of the most important forces in the music world, so I'm concerned for his health," she said. "I'm sure that it's a stress on the organization. And so my sympathies are with them."
Still, Baff and others don't think the news will keep people from coming to the Berkshires. "It's a summer ritual," said Joan Mears, the owner of Whistler's Inn in Lenox. "But it will definitely put a damper on the summer."
The pending surgery is the latest in a series of health setbacks for Levine, who, along with his BSO position, serves as music director of the Metropolitan Opera.
He has long struggled with his weight, and also must deal with sciatica and occasional hand tremors. He has taken to conducting from a seat to ease pressure on his back.
Levine, who took over as BSO music director in 2004, is in the fourth year of a five-year contract, and the BSO is close to negotiating an extension, said Volpe.
In March 2006, Levine fell onstage during a Symphony Hall concert. He needed rotator cuff surgery, which forced him to miss four months of performances with the BSO and the Met.
He returned that summer to Tanglewood after losing 35 pounds, thanks to what he said was a changed diet, exercise on a recumbent bicycle, and Pilates.
Carey Goldberg of the Globe staff contributed to this report. Geoff Edgers can be reached at firstname.lastname@example.org