Multidisciplinary Care in Acromegaly Individualized Treatment Improves Patient Outcomes

Presented by

Justin Cetas, MD, PhD, FAANS, Maria Fleseriu, MD, FACE and Elena Varlamov, MD
OHSU Northwest Pituitary Center


Learning Objectives

Recognize the symptoms of acromegaly; early diagnosis and treatment can improve patient outcomes.
Discuss screening recommendations for comorbidities
Counsel patients on how treatment of acromegaly can affect associated morbidity.
Role of pituitary surgery as first line treatment for acromegaly; discuss role of surgical debulking
Review various classes of monotherapy ( including novel drugs in clinical trials) and combination medical therapy for the treatment of acromegaly.

Presenter Bios
Justin S. Cetas, MD, PhD, FAANS is an Associate Professor of Neurosurgery at Oregon Health & Science University, Chief of Neurosurgery at Portland VA Medical Health Center and Residency Program Director in Portland, Oregon, USA. He has an active clinical practice focused on the surgical treatment of pituitary and skull base tumors and cerebrovascular disease and he performs more than 100 pituitary surgery annually. He uses a thoughtfully conservative approach, dedicated to delivering outstanding neurosurgical care with an individual, patient-centered focus. Dr. Cetas is one of few fellowship-trained minimally invasive neurosurgeons in the country.

His clinical research is focused on the development of innovative and novel skull base and endoscopic techniques, residents skills training, pituitary tumor biology, and clinical outcomes after pituitary and cerebrovascular surgery. Beyond his specialty training in the neurosurgical treatment of brain and pituitary tumors, the major focus of Dr. Cetas's laboratory is to understand the effects of subarachnoid hemorrhage on the brainstem and central nervous system and their subsequent role in determining long-term outcomes.

He has extensively published in both clinical and basic science journals and is a reviewer for several specialty journals. He is a member of the American Association of Neurological Surgeons (AANS), Congress of Neurological Surgeons (CNS), North American Skull Base Society (NASBS), and The Pituitary Society

Dr. Cetas received his medical degree and doctorate in philosophy from the University of Arizona and completed his residency and fellowship training in Skull Base and Cerebrovascular Neurological Surgery at Oregon Health & Science University.

Maria Fleseriu, MD, FACE is a Professor of Medicine and Neurological Surgery and Director of the Northwest Pituitary Center at Oregon Health & Science University in Portland, Oregon, USA.

Dr. Fleseriu has a long-standing clinical and research interest in the pathophysiology and treatment of pituitary and adrenal disorders. She is a frequent guest speaker at national and international meetings on treatment of pituitary tumors (especially Cushing’s disease and acromegaly), is the principal investigator in clinical trials, and has authored over 150 manuscripts and book chapters.
Dr. Fleseriu is President Elect of the Pituitary Society, serves on the Board of Directors and chairs it’s Physician Education Committee. She serves on several committees for the Endocrine Society, Pituitary Society, and American Association of Clinical Endocrinology; she is past chair of the Endocrine Society Guidelines Committee and the Hypopituitarism task force.

Dr. Fleseriu is Chief Editor of Pituitary Endocrinology for Frontiers in Endocrinology, Section Head for Pituitary and Neuroendocrine F 1000, Associate Editor for Reviews in Endocrinology and Metabolism and Acta Endocrinologica Senior Editor for Endocrinology, Diabetes and Metabolism CR and a member of the editorial board of Pituitary and Endocrine. She has been involved in leadership positions of educational programs sponsored by the Endocrine Society, the Pituitary Society, and patient advocacy groups to teach physicians and patients about pituitary tumors and neuroendocrine disorders. She has served on multiple scientific advisory boards for biotechnology and pharmaceutical companies and participated in study design for Cushing’s and acromegaly.

Dr. Fleseriu received her medical degree from the University of Medicine and Pharmacy, Timisoara, Romania and completed an endocrinology fellowship with a focus on pituitary disorders. She pursued additional residency in internal medicine at Case Western Reserve University and an endocrinology fellowship at Cleveland Clinic.

Dr. Varlamov is an Assistant Professor in the Department of Neurological Surgery (Pituitary Center) and Division of Endocrinology, Department of Medicine of Oregon Health and Science university, Portland, OR. She attended medical school at Northern State Medical University in Arkhangelsk, Russia. She then moved to the United States and completed her residency in Internal Medicine at Norwalk Hospital, affiliated with Yale University School of Medicine. She finished Endocrinology Fellowship at Oregon Health and Science University and subsequently joined faculty to pursue her academic and clinical interest in pituitary disorders. She has a special interest in neuroendocrinology including pituitary tumors, acromegaly, Cushing’s disease, growth hormone deficiency, post-traumatic and post-radiation pituitary dysfunction. Her research involves treatment and clinical outcomes in the pituitary disease. She has been a co-investigator in multiple clinical trials. She has published in peer-reviewed journals, book chapters and presented at national and international meetings including Endocrine Society and Pituitary Society.

Besides pituitary disorders, her clinical practice is also focused on thyroid, adrenal and metabolic bone disease. She is actively involved in resident, fellow, and medical student teaching as well as community physician education and patient support groups at OHSU.

Outside of work, Dr. Varlamov enjoys spending time outdoors, exploring beautiful Pacific Northwest, biking, kayaking, and working in her garden.

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