Dr. Philip Cezayirli
This month the PNA Spotlight focuses on neurosurgeon Dr. Philip Cem Cezayirli, part of the Haynes Neurosurgical Group in Birmingham, Alabama. Dr. Cezayirli is affiliated with four local medical centers: Princeton Baptist, Shelby Baptist, Grandview, and Brookwood Baptist Medical Centers.
He is a board-certified neurosurgeon with a focus on neurosurgical oncology and spine surgery and is licensed to practice neurosurgery in Alabama.
He earned his MD at the University of Alabama at Birmingham School of Medicine in Birmingham, Alabama. He spent a year studying with Dr. Uğur Türe at Yeditepe University and Hospital in Istanbul, Turkey. He did his neurosurgery residency at the Albert Einstein College of Medicine in Montefiore, Bronx New York. And he completed a neurosurgical oncology fellowship at MD Anderson Cancer Center in Houston, TX.
Dr. Cezayiri was kind enough to speak with the PNA about a range of issues. Here is the conversation, edited for clarity.
Tell me about your practice – what do you want pituitary patients to know?
I am from Birmingham, Alabama and work here now, but I did med school here at U.A.B., and then I did my training for residency up in New York at Albert Einstein College of Medicine and Montefiore Medical Center. Then I did a fellowship in Istanbul, Turkey, with Professor Mahmut Gazi Yaşargil and his mentee, Dr. Uğur Türe, in microsurgical neuroanatomy and micro neurosurgery training.
Later, I went back to my chief residency year at Einstein at Montefiore where I trained with Dr. Vijay Agarwal, a pituitary specialist who trained with the Mayo Clinic. During my fellowship in neurosurgical oncology at MD Anderson in Houston, Texas, I worked with neurosurgeons who focus on cancers of the brain, spine, skull base and nerves. We spend a third of our time working on the skull base, a large part of it, pituitaries.
What do you want patients to understand about your approach?
I think the important thing is our job is to help the patient, and so sometimes that means we don’t even need to operate. We can just watch the problem. Then sometimes, if it’s causing issues, or we think it’s going to cause issues, then we kind of have to weigh the risks and benefits with the patient. We try to use a patient-first approach. Just because we see something on imaging, that doesn’t necessarily mean we have to do surgery.
We focus on what the patient wants and needs and where they are in their life and try to balance all that. We are comprehensive and highly involved with the patient’s workup. For instance, we’ve had patients with a fairly large lesion, but they didn’t notice any vision problems. So, we waited to make sure. We got the labs and got the vision checked. The vision was completely normal, even though it looked like it was pushing on the nerves. And the labs actually came back showing that that the patient had a prolactinoma. So the patient ended up getting medical treatment with for the prolactinoma, and now the lesions smaller and the patient is completely fine.
We had another patient who was pregnant and had headaches. She got an MRI which showed a lesion in the pituitary, pushing on the nerves. But her vision was fine, and since she was in the third trimester, we watched it, and she delivered their baby. A repeat MRI three months later showed the pituitary is normal size now. So, we’ll continue to watch patients like that, just to make sure, but we don’t always have to do surgery. Our goal is to do right by the patient and focus on what they need and want.
I think it’s important with pituitary care in particular, that we use a team-based approach, and rather than it being just a neurosurgeon, an endocrinologist, an eye doctor or an E-N-T alone. We all work together to improve our patients’ outcomes.
What are the misconceptions out there that you want to clear up?
I think that there are people who may be afraid to get imaging, or afraid to see a neurosurgeon, because they think if we find something on the imaging, they’ll be forced to do surgery. That’s not how we work.
You know the old adage, when you’re a hammer, everything looks like a nail…
Right? And maybe 30 or 40 years ago, that might have been the case, especially when MRIs first came out, we would find lesions, and think that we had to operate on it. But now we know a lot more. And so, I don’t think there’s much downside to getting imaging or seeing a neurosurgeon when in doubt. Especially if you go to someone who has experience in this and understands the natural history of the diseases. No one is going to insist on surgery.
Also, there’s no downside to getting your vision checked regularly. A lot of times with pituitary problems, the vision issues can be so subtle and so slow that that you might miss them. It’s better to closely watch your health with your endocrinologist, primary care doctor, eye doctor and neurosurgeon, who are all of what symptoms can be there rather than avoiding diagnosis out of fear of needing surgery. It is much easier to preserve vision when people are doing well, than when the vision has been lost for a long period of time.
Why are you a member of the PNA? Why do you think it’s a worthy venture?
I think it’s good to have an official resource for people with a pituitary lesion and to have a support group. It’s very important for patients to know where to go and who to see and how to follow up. It’s very nice that the PNA maintains a provider directory of people who focus on lesions in the pituitary. An official, respected resource is important, so people don’t believe everything they read on the internet or social media.
Reach Dr. Cezayirli:
Haynes Neurosurgical Group
Cell: 2054825198
Office: 2057878676
Fax: 2057857944u
Email: drphilcez@haynesneuro.com
Website: http://haynesneurosurgery.com
Address:
801 Princeton Ave SW
P. O. B. I, Suite 310
Birmingham, AL 35211-1307
