What Is the Best Treatment for Pituitary Tumors?

You’ve been feeling a little more tired than usual and, your vision has been going blurry. You drag yourself to the doctor’s office for a check-up and, they do a blood test. It comes back that you have elevated hormones, so the doctor orders an MRI.

There’s a tiny lump attached to your pituitary gland. You have a pituitary tumor.

Don’t panic. In 99% of cases, these tumors are non-cancerous. Treatment for pituitary tumors comes in multiple options thanks to advances in modern medicine. 

What exactly is a pituitary tumor? How do they affect the body and what problems do they cause? What are the different types of treatments and which one is the best for you? Should you get traditional surgery or try something like Gamma Knife treatment?

To find the answer to these questions, read on. First, let’s start by explaining what a pituitary tumor is.

What Is a Pituitary Tumor?

A pituitary tumor is a clump of abnormal cells that are growing off of your pituitary gland. The majority of people have what is called pituitary adenomas. Pituitary adenomas are the most common type of tumor on the pituitary gland and most often appear in people in their 30’s and 40’s, but can affect people of all ages.

pituitary gland

Some pituitary adenomas produce extra hormones that can cause a whole array of different symptoms depending on the hormone they secrete. Other pituitary adenomas don’t produce anything but rather put pressure on nearby cranial nerves and can even cause vision problems by pushing on the optic nerves.

There isn’t a consistent explanation for what causes pituitary tumors. The majority of research has shown that most pituitary tumors just happen due to mutation of DNA, however, there are a few studies that show that some types of pituitary tumors may be linked to heredity

Now that we know what a pituitary tumor is, let’s take a look at the function of the pituitary gland.

What Does the Pituitary Gland do? 

The pituitary gland is a structure located at the base of the brain.  A tumor of the pituitary gland is not considered a brain tumor because it’s a different organ. It’s responsible for regulating hormones in the body and often controls other organs responsible for distributing hormones (such as the thyroid).

Some examples of hormones that the pituitary gland controls are:

  • Prolactin: This hormone is most commonly elevated (normally) in women who are breastfeeding. Too much prolactin can cause breast milk to flow outside of pregnancy or nursing. For males, an over secretion of prolactin can cause sexual problems with sperm and libido.
  • Adrenocorticotropic hormone (ACTH): This hormone released by the pituitary gland directly affects the adrenal glands. Adrenal glands secrete cortisol, which is also called our “stress” hormone. A high level of cortisol can affect our sleep quality as well as our feels of satiety. 
  • Thyroid-stimulating hormone (TSH): This hormone is very important because it directly affects our thyroid gland. Our thyroid gland is responsible for regulating growth and temperature, and even our heart rate. 
  • Luteinizing hormone (LH) and follicle-stimulating hormone (FSH): These hormones affect our reproductive organs. Luteinizing hormone aids in the production of healthy sperm while follicle-stimulating hormone aids in the production of healthy eggs.
 

As you can see, making sure that our pituitary gland is functioning properly is imperative to our overall health. 

What Are the Symptoms of a Pituitary Tumor?

Knowing the symptoms of a pituitary tumor can help you catch one faster before it starts causing more problems, like blurred vision. Here is a list of common symptoms that you may have with a pituitary tumor:

  • Headaches in the middle of your forehead.
  • Unexplained nausea and vomiting.
  • Sexual dysfunction, like low sperm count or irregular periods.
  • Unexplained weight loss or weight gain.
  • Unexplained fatigue.
  • Loss or inhibited sense of smell.
  • Vision problems, like drooping eyelids or double vision.
  • Growth problems, like dwarfism or gigantism.
  • Aching joint pain.
  • A runny or dripping nose that isn’t explained by allergies or illness.
  • Sweating more than usual.
  • Trouble sleeping because of sleep apnea, snoring, or general restlessness.
  • For women only, spontaneous discharge of breast milk outside of pregnancy or nursing.
 

If you’re experiencing one or more of these symptoms, it’s always a good idea to set up an appointment with your primary doctor. If your primary doctor suspects a pituitary tumor, they’ll run blood tests and a CT scan or an MRI. If it turns out you have a pituitary tumor, the next step is finding the right treatment option that works for you.

Treatment for Pituitary Tumors

There are several different types of treatment for pituitary tumors and the best type for you depends greatly on the size of the tumor and what hormones are being affected. If the tumor is very small when first detected (under 5mm), the doctor may opt to wait and see if it continues to grow. 

If it does become a problem there are the three treatment options and what they work best for.

  1. Drug Treatment: One type of pituitary adenoma is called a prolactinoma because they increase the production of the hormone prolactin. Using medications like Cabergoline and Bromocriptine can help shrink tumors within a year of starting them. Other functional (secreting) adenomas can also be treated with drugs in hopes of stopping their growth or shrinking them.
  2. Surgery: If the tumor becomes too large and obstructive or isn’t responding well to drug treatments, surgery can be an option. Thanks to modern medical technology, surgery isn’t as invasive and has a good prognosis of recovery. Most surgery is performed through the nasal cavity (called transsphenoidal surgery).
  3. Radiation Treatment: This type of treatment for pituitary tumors has become increasingly popular due to its non-invasive approach, less damage to surrounding tissues, and a high success rate of killing and shrinking tumors. One form of radiation treatment is called stereotactic radiosurgery and involves a headpiece that directly shoots x-ray radiation at the pituitary tumor. Gamma Knife is a popular form of radiation treatment.
 

Regardless of the type of treatment you choose, if your pituitary is not functioning properly, hormone replacement therapy is often recommended by an expert endocrinologist. This is due to the imbalance that the tumor caused on your body’s natural hormones. Your body needs the right amount of hormones to function properly and, hormone replacement medications help with that. 

What is Gamma Knife Radiosurgery?

Gamma Knife is an advanced, non-invasive form of stereotactic radiosurgery that shoots multiple beams of radiation at the precise location of the pituitary tumor. Because it is so precise, there’s less damage to surrounding tissues that could happen with physical surgery or to whole-brain radiation.

From start to finish, there are 6 simple steps to a Gamma Knife procedure:

  1. Head Stabilizing: With a headframe, the surgeon and Nurse Navigator will adjust it to make it fit your head perfectly.  In some cases, the headframe isn’t necessary at all.  A custom face mask can be crafted to gently hold your head in the proper position during Gamma Knife treatment.  In this situation, the Gamma Knife ICON is being used.
  2. Imaging: Once you’re fitted with your frame, the next step is to get an MRI scan to capture an image of your brain. This is so that the Gamma Knife team can make sure they’re targeting the right spot on your tumor. Imaging takes place on the day of your procedure immediately after the headframe is placed.
  3. The Treatment Plan: Once the MRI identifies the exact location of the tumor, the surgeon will talk with you about how much radiation you’ll need and how long the procedure will take. Some procedures take 10 minutes while others can take up to 70 minutes to complete. It all depends on the type and size of the tumor.
  4. The Procedure: The surgeon will take you into the Gamma Knife treatment room and will have you sit comfortably while they make sure your headframe is in the correct position. The procedure will begin. While you’re in treatment, you can still listen and talk to your doctor. After the time stated in the treatment plan, you’re all done!
  5. Quiet Room: Once the procedure finishes, the surgeon will remove your headframe (if used). You will then be taken to a peaceful room to relax and to have a post-procedure assessment.
  6. Recovery: Once you pass the assessment and feel ready to leave, you’re done!

Why Gamma Knife is a Great Treatment Option for Pituitary Tumors

Gamma knife is painless, quick, and effective. Not only does the entirety of the procedure last, on average, an hour and a half, but the majority of patients are also back to their regular activities in one to two days. That’s more time to live your life without a pituitary tumor weighing on your mind (literally)!

Contact Us for a Consultation

Finding treatment for pituitary tumors doesn’t have to be complicated with options like Gamma Knife on the market. If you sound like Gamma Knife radiosurgery is the best option for you and your health, please contact us to set up a consultation with one of our highly trained neurosurgeons.

Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Anthony D’Ambrosio, M.D., M.B.A., F.A.A.N.S
Dr. Anthony D’Ambrosio is a board-certified neurosurgeon that specializes in Neurosurgery, Stereotactic Radiosurgery, Gamma Knife Radiosurgery (GKRS) and more. He is the Director of Neurosurgery and Co-Director of the Gamma Knife Program at The Valley Hospital. Dr. D’Ambrosio is an expert in treating patients with trigeminal neuralgia, benign or malignant brain tumors, as well as many other neurological conditions.

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