PNA Spotlight: Dr. Debraj Mukherjee

 

mukherjeeThis month the PNA Spotlight focuses on Dr. Debraj “Raj” Mukherjee, director of neurosurgical oncology at the Johns Hopkins Bayview Medical Center and assistant professor of neurosurgery and the Johns Hopkins University. Dr. Mukherjee earned his M.D. from Dartmouth Medical School. He went on to study epidemiology, biostatistics, and clinical design at the Johns Hopkins Bloomberg School of Public Health and served as co-director of the Neuro-Oncology Surgical Outcomes Laboratory in the Department of Neurosurgery. He did his residency at Cedars-Sinai Medical Center and an open and endoscopic skull base fellowship at the Center for Skull Base Surgery at University of Pittsburgh Medical Center. Dr. Mukherjee was kind enough to answer some questions from the PNA; his answers follow.

What inspired you to choose your career path?

 My interest in pursuing a career in medicine was sparked by very personal experiences. As the son of immigrant parents who settled just outside of Chicago, I found the physicians caring for my family and me were always compassionate and provided wisdom, guidance, and support that was truly life-altering, regardless of our ability to pay for their services. Beyond this initial curiosity, as I began to interact more with patients as a clinic volunteer in high school and college, I found my ability to connect with patients on an individual level to be inspiring and deeply meaningful. As a medical student, I was drawn to neurosurgery, given its promise of dramatically improving patients’ lives through the surgical sciences. During my training, I found that I excelled in the skull base cases that were often the most challenging, including dissection along critical neurovascular structures with significant implications for patients’ quality of life. As an attending neurosurgeon focused on the surgical treatment of skull base tumors (inclusive of pituitary lesions), I have been fortunate to merge all of these interests and skills into a comprehensive skull base tumor practice that allows me to demonstrate empathy toward my patients and their families, while also providing excellent surgical care and pushing the field forward with my research initiatives focused on quality-of-life issues.

What is the primary focus of your work/research?

The primary focus on my clinical work is the thoughtful surgical care of patients with non-functional and functional pituitary macro- and micro-adenomas. I am fortunate to be able to practice at Johns Hopkins University School of Medicine, where the subspecialties of modern neurosurgery and endocrinology were founded more than a century ago. Built into the foundation of our institution was the understanding that multi-disciplinary research and collaboration were necessary to meaningfully advance patient care, and this tradition continues to this day. I have the great honor of working with world class colleagues in neurosurgery, otolaryngology, endocrinology, ophthalmology, oncology, radiation oncology, radiology, biomedical engineering, and health services research to bring cutting-edge clinical care inclusive of surgical trials to our patients.
My current research projects focus on the development and validation of patient-centered, disease-specific quality-of-life instruments for patients with pituitary adenomas. This work involves collaboration with qualitative researchers at the Johns Hopkins Schools of Nursing and Public Health, as well as countless hours interacting with patients and families to better understand their needs, such that we may target our future interventions in more thoughtful and holistic ways. Additionally, I work with colleagues in otolaryngology and biomedical engineering to develop novel endonasal instrumentation to more gently approach the region of the pituitary gland with the goal of decreasing nasal mucosal trauma and secondarily improving post-operative smell, taste, and quality of life.

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

I believe the future of our field will unquestionably be more personalized, minimally invasive, and quality-of-life focused care for patients with pituitary adenomas. These efforts are already afoot at centers like Johns Hopkins, where we have pioneered novel imaging paradigms to localize functional microadenomas and have developed personalized biomarkers to monitor tumor control or growth. Additionally, we and others have used our skull base neuroanatomy laboratory space to develop and perfect trauma-minimizing operative approaches to the pituitary region inclusive of the cavernous sinus, where the most challenging pituitary adenomas lie. Living with a pituitary adenoma can be truly life altering, potentially causing debilitating vision loss, headaches, weight fluctuations, depression, and fatigue, among a constellation of other symptoms. Quality-of-life focused efforts, inclusive of smell training for those who develop post-operative anosmia, will be vital to help ensure patients receive the most targeted and gentle treatment possible to help minimize complications and maximize durable post-treatment outcomes and cure.

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

Patients should know they have a choice when identifying their multi-disciplinary treatment team. One of the most consequential decisions a person with a pituitary adenoma can make will be deciding who their neurosurgeon and endocrinologist will be. Longitudinal clinical data demonstrates that pituitary tumor patients treated at high-volume centers of excellence have the best outcomes. In short, experience matters, and patients shouldn’t feel shy about asking their providers to clarify their experience and outcomes. Particularly given the rise of telemedicine, patients should feel empowered to seek out opinions from experts in the field before finalizing their treatment team. At Johns Hopkins, I regularly consult on patients from across the country and world, often working with patients’ local endocrinologists, ophthalmologists, and other associated providers to create a comprehensive care plan and virtual multi-disciplinary team. It is an honor to connect with patients and their families, and to help guide them through the diagnostic and treatment process, regardless of whether they live locally or far away.

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

I genuinely aim to treat all patients with the same thoughtfulness and care that I have for my own family members. As such, all patients I see have direct access to me, and I aim to respond to their questions right away (once I am out of the operating room!). Making decisions about surgery, medical management, or careful observation of pituitary lesions can be very stressful and potentially life-altering, and I want all patients to know that I will be with them side-by-side through their entire diagnostic and treatment journey.

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

I have long admired the PNA, given its focus on pituitary diseases, its multi-disciplinary composition, and its patient-focused initiatives. As a member, I am honored to participate in this thriving community, inclusive of an upcoming patient education webinar focusing on improving post-operative quality-of-life. I look forward to more and more involvement with the PNA in the coming years, and my door is always open to talk with patients, providers, and advocates to optimize patient care and continue to advance the field in the decades ahead!

Dr. Mukherjee can be contacted at dmukher1@jhmi.edu.

 

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