A Light in the Darkness: Q&A with Karel Pacak, MD, PhD, DSc

Karel Pacak

At only six years old, Karel Pacak, MD, PhD, DSc, decided that he needed to help “those who suffer the most — cancer patients.” Endocrine News talks to Pacak about his research, the renowned pheochromocytoma symposium he launched, and his thoughts on the next generation of physician-scientists.

Fueled at a very young age by the loss of a close family friend to cancer, Karel Pacak, MD, PhD, DSc, made it his life’s goal to help patients who suffer most from the disease. As the recipient of the 2022 Laureate Outstanding Clinical Investigator Award, Pacak’s work has indeed made a significant contribution to understanding and treating neuroendocrine tumors, especially pheochromocytoma and paraganglioma.

Pacak is chief of the Section on Medical Neuroendocrinology and head of the Developmental Endocrinology, Metabolism, Genetics and Endocrine Oncology Affinity Group of the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the Intramural NIH Research Program in Bethesda, Md. He is also credited with establishing the most internationally recognized meeting in the field of pheochromocytoma research, the International Symposia on Pheochromocytoma.

Pacak was part of the Endocrine Society’s 2014 Pheochromocytoma Task Force and currently serves as a member of The Journal of Clinical Endocrinology & Metabolism’s Editorial Board. Endocrine News spoke with him to learn more about how treating cancer became his life’s goal:

Endocrine News: What did news of the Laureate recognition mean to you?

Pacak: Being recognized as the Laureate Awardee is a dream come true. This is the highest privilege and honor I have received from my colleagues, and it reflects my lifetime dedication and achievements towards endocrinology, particularly endocrine oncology.

“Becoming a physician-scientist was not an easy task. I was constantly oscillating between the demanding clinical care of patients and laboratory experiments with an ultimate desire to improve the lives of patients.”

Karel Pacak, MD, PhD, DSc, chief, Section on Medical Neuroendocrinology; head, Developmental Endocrinology, Metabolism, Genetics and Endocrine Oncology Affinity Group, Eunice Kennedy Shriver National Institute of Child Health and Human Development of the Intramural NIH Research Program, Bethesda, Md. 

I also realize that this award is not solely my own, rather it is the culmination of sacrifice, hard work, and support from my colleagues, collaborators, clinical staff, mentors as well as my institution, the National Institutes of Health (NIH). It is these hard-working individuals and the NIH who have supported and guided me throughout years. I am also grateful for my family and parents from whom I learned what it meant to be cared for and what it means to care for others, especially patients.

EN: Your research has shaped how we treat neuroendocrine tumors. Was there a defining moment that sparked the trajectory into this area of research?

Pacak: My trajectory started very early in life, around six years old, following the death of a close family friend. From this point on, I dreamed that one day I would help those who suffer the most — patients with cancer. I continued to dream about the ways to better understand and treat cancer. During college, I learned about biology, biochemistry, and cancer while performing experimental work at a local hospital. I would secretly admire the physician-scientists who made monumental clinical discoveries and paved the way for new therapeutic discoveries in cancer diagnosis and treatment.

During medical school at Charles University in Prague, I worked alongside a team who focused on breast and colorectal cancer. After finishing medical school, I started at the 3rd Department of Internal Medicine at the First Faculty of Medicine in Prague and specialized in endocrinology. I immediately requested to work as a clinician-scientist and began to focus on endocrine tumors and catecholamines.

Becoming a physician-scientist was not an easy task. I was constantly oscillating between the demanding clinical care of patients and laboratory experiments with an ultimate desire to improve the lives of patients. While I often found myself to be exhausted and neglectful of other areas of my life, my dedication to clinical science provided me with a tremendous sense of purpose in my life: One day, I will help to shine light in moments of darkness and to provide hope in moments of despair.

As a physician, I approach each patient with the utmost respect and ethics, as I understand it is a privilege to care for patients at one of, if not the most, vulnerable times in their life. I understand that patients have unique wishes, desires, memories, and hopes. I teach my students that one day, we all will be patients. As children often judge their “value” by the time and quality that their parents spend with them, patients feel the same way when interacting with healthcare professionals.

EN: You established the International Symposium on Pheochromocytoma, and it’s being held this October in Prague. How many attendees are you anticipating and what are you most looking forward to?

Pacak: In partnership with Graeme Eisenhofer, PhD, we created a new series of international pheochromocytoma conferences: The International Symposium on Pheochromocytoma (ISP), under the NIH for which I served as the first president in 2005. After the inaugural conference, we organized conferences in Paris, Cambridge (UK), Kyoto, and Sydney under the Pheochromocytoma Research and Support Organization (PRESSOR). Although COVID-19 has had many obvious impacts, we are optimistic that about 150 attendees, including certain patients, will participate in the upcoming conference. As outlined in our recent publication in Nature Reviews Endocrinology, this ISP initiative will showcase the newest advances in pheochromocytoma and paraganglioma through science, collaboration, and spreading the word.

“My dedication to clinical science provided me with a tremendous sense of purpose in my life: One day, I will help to shine light in moments of darkness and to provide hope in moments of despair.”

Karel Pacak, MD, PhD, DSc, chief, Section on Medical Neuroendocrinology; head, Developmental Endocrinology, Metabolism, Genetics and Endocrine Oncology Affinity Group, Eunice Kennedy Shriver National Institute of Child Health and Human Development of the Intramural NIH Research Program, Bethesda, Md. 

I am excited to see the new faces of young and promising scientists and clinicians. I am looking forward to learning about how we will study and treat these tumors in the future. Whether through the use of artificial intelligence, novel membrane targets, changes in the tumor microenvironment, intratumoral immunotherapies, metabolomics, new algorithms that aid in clinical prediction, and decision-making applications of sophisticated machine learning and establishing new international clinical trials.

The younger generation is our future and one day we will pass the baton to them so they can make even larger discoveries than we have made. It would be most rewarding to see a reflection of my passion to the field coming full circle through the achievements of these promising young scientists and clinicians.

—Fauntleroy Shaw is a freelance writer/editor based in Carmel, Ind. She is a regular contributor to Endocrine News.

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