This month the PNA Spotlight focuses on William Couldwell, MD, PhD, who serves as Professor and Chair of the Department of Neurosurgery at the University of Utah. He is also a member of the PNA’s Scientific Advisory Panel. He studied at the University of British Columbia in Vancouver and at Dalhousie University in Halifax, Nova Scotia, majoring in physical chemistry and biology. Dr. Couldwell attended medical school at McGill University in Montreal. He did internship in surgery at the University of Southern California and completed a neurosurgical residency there in 1989. He served as a research fellow in neuroimmunology at the Montreal Neurological Institute and Hospital and research fellow in the neurosurgical service in Lausanne, Switzerland. He returned to U-S-C as an assistant professor of neurological surgery in 1991, where he stayed for four years. Later he became professor and chairman of the Department of Neurological Surgery at New York Medical College, as well as program director of neurosurgical residency in 1997. In 2001 he became professor and chairman of the Department of Neurosurgery at the University of Utah. Dr. Couldwell was kind enough to answer some questions from the PNA. His answers follow.

• What inspired you to choose your career path?

I attended medical school at McGill University in Montreal. Professor Jules Hardy was a faculty member and was one of my mentors. He was an inspirational figure. I then trained in neurosurgery with Martin Weiss in Los Angeles, a fantastic surgeon and educator. Both of these mentors were pituitary surgeons and fostered my interest in pituitary tumor surgery.

• What is the primary focus of your work/research?

We are actively pursuing studies in novel mechanisms of growth arrest in pituitary tumors and meningioma. I am also interested in optimizing outcomes following surgery for these tumors with novel approaches

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

Specific medical therapy targeting pathways necessary for growth of these tumors.

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

While most pituitary tumors are benign and eminently treatable, a minority are very challenging to manage despite being labelled as benign tumors. Examples include recurrent Cushing’s disease and acromegaly, diseases which have significant morbidity and can shorten life expectancy.

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

We have a multidisciplinary team approach to the management of pituitary tumors and have significant clinical experience.

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

I have known (PNA Chairman emeritus) Robert Knutzen for many years and have appreciated his relentless efforts in promoting the importance of pituitary issues, including multimodal management of pituitary tumors. He has been a champion for improving care in this domain.

This month the PNA Spotlight focuses on Adriana G. Ioachimescu, MD, PhD, FACE Professor of Medicine (Division of Endocrinology and Molecular Medicine) and Neurosurgery at the Medical College of Wisconsin, a lifetime professional member of the PNA.

Dr. Ioachimescu was a Professor of Medicine in Endocrinology and Neurosurgery at the Emory University School of Medicine.  Dr. Ioachimescu was also co-director and co-founder of the Emory Neuroendocrine Pituitary Center and a consulting editor at Endocrinology and Metabolism Clinics. Previously she worked at Carol Davila University in Bucharest, Romania, and at the Cleveland Clinic.

Dr. Ioachimescu was born in Bucharest, Romania and earned her PhD in Neuroendocrinology from Carol Davila University of Medicine. She completed an internship in internal medicine at Danbury Hospital and then a fellowship in Endocrinology at the Cleveland Clinic. She did residencies in internal medicine at Carol Davila University, Yale University and the Cleveland Clinic.

Dr. Ioachimescu was kind enough to respond to a few questions from the PNA:

What inspired you to choose your career path?

 In medical school, I had a wonderful professor of endocrinology, Dr. Mihai Coculescu, who inspired me to follow this path. Endocrinology was a great fit for me because I loved biochemistry and math. I became fascinated by feedback loops and hormonal circadian rhythms. I noticed the how hormones disturbances influence many organs and systems, especially in patients with pituitary tumors. I was captivated by the link between hormones and the brain and started research in this field early on in my medical career.

What is the primary focus of your work/research?

I am a pituitary endocrinology specialist, which means I see patients with disorders of the pituitary gland, as well as adrenal disorders that cause high cortisol levels., In terms of research, one of my current interests is to establish prognostication systems for pituitary adenomas, which will allow personalized treatments. Let’s take acromegaly, for example. When I saw my first patient with this condition 25 years ago in Romania, all we had in terms of medical treatment was bromocriptine. We now have available several classes of medications that we use based on a “trial and error” approach. I hope research will move us closer to customized treatment plans that get our patients in control and feeling better faster.

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

 These are exciting times for specialists like me who dedicated their career to the pituitary gland. Several histological and molecular markers have been developed that have allowed us to move translational research closer to the patients and their problems. Physicians will soon have the right tools to predict clinical course of pituitary adenomas more precisely and to develop individualized plans to manage them. Also, scientists are working on treatments that specifically target certain genetic or molecular pathways that will create a paradigm shift in how we treat pituitary disorders.

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

 Pituitary disorders are complex and usually require a multidisciplinary approach. Every day, I am in contact with neurosurgeons, neuroradiologists, pathologists, radiation oncologists, gynecologists, urologists, psychologists and other specialists. Most importantly, I constantly communicate with the internists or primary care physicians. While the hormones and/or the tumor itself are at the center of the problem, they cause diverse health problems that warrant specific evaluation and management.

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

It is a privilege for me to take care of you. I am honored by the trust you place in me and I will continue to work tirelessly to help you feel better. I know that the same condition affects different patients in different ways and that laboratory results can be confusing. I realize the complexity of your condition. I learn something new every day. I assure you, we make progress in our diagnostic and therapeutic abilities. I am here to guide you through the process and offer you a treatment plan that suits your needs.

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

I like working with the PNA because this organization offers a reliable source of information for patients and their families. The PNA has provided valuable patient advocacy in the field of pituitary diseases since 1992. I partnered with PNA thirteen years ago because we share the goals of improving awareness about pituitary disorders and educating both patients and the medical community. I am a member of the PNA scientific advisory board and together we published books and other educational materials, and we recorded webinars. The PNA staff is friendly and passionate about their mission.