PNA Spotlight: Georgiana Dobri, MD

Dr. DobriThis month’s PNA Spotlight focuses on Georgiana Dobri, MD, a member of the PNA and is an Associate Professor of Neuroendocrinology in clinical neurological surgery at Weill Cornell Medicine’s Brain and Spine Center. She received her medical degree from Carol Davila University of Medicine and Pharmacy in Bucharest, Romania. She did a three-year residency in endocrinology in Romania and then completed an internal medicine residency at Cook County Hospital in Chicago, then a fellowship at the Cleveland Clinic. She joined the staff at the Cleveland Clinic and became an Associate Professor of Endocrinology at Case Western Reserve University before joining Weill Cornell. Dr. Dobri kindly answered a few questions from the PNA. Her answers are below.

 

What inspired you to choose your career path?

I was fascinated by the complex and intricate relationship between the pituitary gland and all the body’s systems since I first came across it in the medical school. I was interested in the pituitary and adrenal diseases, which is why I chose endocrinology as my career path. I looked for a center that would provide outstanding education and training in these disorders – Cleveland Clinic.

What is the primary focus of your work/research?

The main focus is to provide expert diagnosis and compassionate care to my patients and offer the best med¬ical/hormonal treatment approaches and monitoring in the pre- and post-surgical period as well as long-term evaluation and treatment.
I have a particular interest in the diagnostic challenges of acromegaly, pheochromocytoma/paraganglioma and treatment of prolactinomas.

What do you consider to be the future of your field?

As already recognized, because of the complexity of some of these diseases, the patients with pituitary conditions should be cared for in the setting of a multidisciplinary neuroendocrine program.

I would like to see further research in the pathogenesis of Cushing’s disease (the pattern of excess secretion if any, why recurrence many years after initial remission) which would hopefully lead to better tools in diagnosis and then medical treatment.

“Personalized” medicine would ideally be the future of the field – better understanding of any genetic mutations, even if not familial, would fuel research for targeted medications.

What should patients know about your field/what deserves more recognition/awareness?

Neuroendocrinology is the part of endocrinology which concentrates on the management of the pituitary and neuroendocrine tumors and diseases. As these disorders are not very common, give variable signs and symptoms, influence many organs and at times have unpredictable behavior it is frequently hard to properly diagnose and treat them and expertise is hard to be achieve outside of the centers with dedicated pituitary centers.

Even more than in other endocrine conditions, one-time hormonal testing might not tell the tale. I believe dynamic testing is needed for proper diagnosis. It is important to mention the quality-of-life issues that a lot of the patients with pituitary disease experience.
A multidisciplinary approach is needed and the neuroendocrinologist needs to have a close collaboration with a skull base neurosurgeon, as well as specialists from neuro-ophthalmology, ENT, Interventional Neuroradiology, Neuroradiology, and Stereotactic Radiosurgery/Radiation Oncology to encompass all the aspects of such a condition.

What would you like to convey about yourself to your patients?

It is my duty to empower each person with the knowledge to make the most for their health, determine the best medical decision and find the best treatment. Nobody knows the body better than the person inside it and the doctor needs to collaborate with the patient rather than just tell him/her what to do.

My approach to each patient and their disease is very individualized, depending on how it impacts their life and what the expectations are.

Why did you get involved with the PNA and what is the extent of your involvement?

I recognized that the PNA plays tremendous role in offering support and guidance to the pituitary patients, and it was my honor to put a webinar together to further enrich the knowledge and offer a different perspective on elevated prolactin and prolactinomas. I appreciate the opportunity and I look forward to getting involved in other activities that would increase the awareness of the pituitary disorders and bring the patients one step closer to disease control, or even to a cure.

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