PNA Spotlight: Dr. Jeffrey Bruce
This month’s PNA Spotlight focuses on Dr. Jeffrey Bruce, a pituitary neurosurgeon in New York. Dr. Bruce is currently the Edgar M. Housepian Professor of Neurological Surgery at Columbia University’s College of Physicians and Surgeons, where he serves as Vice-Chairman, Residency Program Director, Co-Director of the Brain Tumor Center, Program Director for Neuro-oncology in the Cancer Center and Director of the Bartoli Brain Tumor Research Laboratory. Dr. Bruce earned his M.D. from the University of Virginia and received his medical degree from Rutgers-Robert Wood Johnson Medical School. He was a medical staff fellow in the Surgical Neurology Branch of the N.I.H. before completing a neurosurgery residency at the Neurological Institute of New York, Columbia University. The PNA posed a series of questions to Dr. Bruce; his answers follow.
What inspired you to choose your career path?
I’m not really sure why, but I wanted to be a doctor since childhood. I always liked science anddoing something to help people appealed to me even at an early age. Interestingly, when I first started medical school, I wanted to go into family practice, as I recalled our own family doctor who was an impressive, caring individual who actually made house calls. Once I started on my clinical clerkships, however, I was drawn to the excitement and intensity of the surgical specialties. Since I had interests in research and neuroscience, neurosurgery became the obvious choice. I like the technical, physical component of surgical procedures combined with the intellectual challenge of dealing with the brain and the ability to contribute novel findings to the profession through research.
What is the primary focus of your work/research?
From the neurosurgical side, my work is focused on improving surgical technique with an emphasis on minimally-invasive approaches and analysis of outcomes to improve survival while minimizing complications. From the research side, our laboratory is mostly devoted to malignant tumors of the central nervous system. We are working on ways to improve drug delivery using a technique called convection-enhanced delivery that infuses drugs directly into brain tissue, allowing delivery of drugs at high concentrations without the side effects that occur with oral or intravenous delivery. We are also involved in using the immune system as a means of eradicating tumors. Finally, we are investigating personalized medicine by analyzing the molecular biology of individual tumors with the intent of exploiting this information to provide treatments that are specific to the individual patient’s tumor. Both immunotherapy and personalized medicine have features that may be useful in the treatment of patients with pituitary tumors, particularly those that are not responsive to standard treatment strategies.
What do you consider to be the future of your field?
This is an exciting time for research and new advances in the field. From a research perspective, many new analytical techniques in molecular biology and genomics are available to get a better understanding of what causes tumors and how to develop better treatments. In the field of pituitary tumors, most of these advances will be in the medical areas where new drugs will be developed that are more effective and have fewer side effects.
What should patients know about your field/what deserves more recognition/awareness?
From the neurosurgical side of pituitary therapy, patients should be aware that the refinement of Minimally-invasive techniques has minimized the likelihood of complications and has led to a much higher “cure rate” for patients with both secreting and non-secreting pituitary tumors, along with shorter hospital stays. With the team approach to treatment that includes endocrinologists, radiation oncologists and neurosurgeons, we are able to provide comprehensive treatment strategies for tumors that recur.
What would you like to convey about yourself to your patients?
Mostly that I feel extremely fortunate to find myself in a wonderful profession that fosters strong feelings of gratification in being able to help patients with difficult problems. Doctors in general and neurosurgeons in particular have a unique and privileged vantage point for gaining insight into the human condition through our intense contact with patients and their families. I am extremely grateful for the opportunity to know and interact with my patients and their families. Whatever I have given to these extraordinary people has been returned a thousand-fold.
Why did you get involved with the PNA and what is the extent of your involvement?
I originally became involved with the PNA around 15 years ago. Because I treat many pituitary patients, I was motivated to find an organization that could serve as a reliable source for information about pituitary tumors. The PNA website is outstanding and allows patients and their families to find out much more about their tumors. Personally, I have found the PNA website to be very informative in helping me to understand some of the side effects of hormonal irregularities and how patients are able to cope with these problems.