Dr. Tabar: One of the most exciting things about building a team like this is to have that camaraderie and that expertise. I think the patients benefit. The pituitary and skull-based program at Memorial Sloan Kettering includes myself as a neurosurgeon, Dr. Mark Cohen as a head and neck expert, and Dr. Eliza Geer, who is a neuro endocrinologist.
Dr. Cohen: In our treatment team, we have so much expertise. All we do is focus on patients that have these types of problems, so we are the optimal place to care for a patient with a pituitary tumor.
Dr. Tabar: The team also includes nurses for each of us and the nurse coordinator, Jenna.
Jenna Longo: “I would just ask that you call us.” I speak to the patient, get their symptoms, get their history, and from there I can determine who the patient sees in clinic, whether it be the surgeons or the endocrinologist.
Dr. Geer: “So I reviewed your pathology. It’s all good.” The pituitary gland is kind of like the conductor of the orchestra. It regulates most of the hormones in the body. It's involved in growth and reproduction, muscle and fat tissue, mood and cognition and sleep wake cycles, so it really has major effects throughout the body.
Dr. Tabar: It's important to keep in mind that pituitary tumors are quite common now up to 20% that's one out of five people. Not all of them will require intervention, but if it is making some hormones or if it reaches a large enough size than it is wiser to have it removed.
Dr. Tabar: “Are you seeing Dr. Geer today?”
Dr. Cohen: The clinic is a truly unique experience.
Dr. Geer: Patients can come into our clinic and see us all in the same day.
Dr. Tabar: All three specialists are discussing the patient's symptoms, images,
Dr. Cohen: and by the end of the day they know what we're going to do to help them.
Dr. Geer: “This young woman is 21. She initially had surgery here in 2009...”
Dr. Tabar: We have seen a rise in consultations of really challenging cases and so very quickly we realized that we should build a specialized tumor board.
Dr. Cohen: We call on other members of the Memorial Sloan Kettering team to look at patient's scans to talk about the symptoms and we're able to go over every single patient.
Dr. Tabar: "Well it's only around the mass." It's important to clarify from the beginning whether there are nonsurgical solutions to their problem. If we determine that surgery is the solution, we describe what exactly we will be doing for the patient. It is a very critical central location and so protecting the nervous system during the procedure is one of the main goals of performing this operation safely.
Dr. Cohen: Dr. Tabar and I perform the surgery with an endoscope and really use a very, very minimally invasive approach with as little side effects as possible.
Dr. Geer: "Your numbers look excellent, everything's perfect. Great." After surgery there's no changes in the facial appearance or swelling or bruising. Um, they're up walking around quickly. So, patients recover very well. For many patients it's a long relationship and I, I know them well and I know them for a long time. And that's very valuable to me. And it's very important because we're trying to understand what they're experiencing so we can best treat it.