For a pituitary gland tumor, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.
Any person with a pituitary tumor should be seen by an endocrinologist, a doctor who specializes in problems with glands and the endocrine system. In addition, patients should be examined by a neurosurgeon, a specialist who operates on the head, brain, and central nervous system. Patients with vision problems will also need to visit an ophthalmologist, a doctor who specializes in the treatment and diagnosis of eye problems.
Descriptions of the common types of treatments used for a pituitary gland tumor are listed below. Your care plan may also include treatment for symptoms and side effects, an important part of medical care.
Treatment options and recommendations depend on several factors, including:
- The type and classification of the tumor
- Possible side effects
- The patient’s preferences
- The patient’s overall health
Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Talk with your doctor about the goals of each treatment and what you can expect while receiving the treatment. These types of talks are called “shared decision making.” Shared decision making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision making is particularly important for pituitary gland tumors because there are different treatment options.
Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. It is the most common treatment for a pituitary gland tumor. Surgery is performed by a neurosurgeon. Surgery is often successful in removing the entire tumor.
About 95% of surgeries to remove pituitary gland tumors are done by the transsphenoidal route. That means going through the nasal passage and along the septum that separates the 2 nostrils. Then the neurosurgeon goes through the sphenoid sinus cavity located deep above the back of the throat to the pituitary gland immediately behind it. The rest are done through an opening in the skull called a craniotomy. This can be done using a microscope or an endoscope, which is a long flexible tube, or both, so the neurosurgeon can see the tumor.
Both of these methods are equally safe and effective when done by a skilled surgeon. Before surgery, talk with your health care team about possible side effects from the specific surgery you will have.
Radiation therapy is the use of high-energy x-rays or other particles to destroy tumor cells. A doctor who specializes in giving radiation therapy to treat a tumor is called a radiation oncologist.
The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. A radiation therapy regimen, or schedule, which is your treatment plan, usually consists of a specific number of treatments given over a set period. Radiation therapy can be delivered with either photons, protons, or gamma rays. Each of these treatments is effective for pituitary tumors. The specific type that is used may depend on the specific situation.
For some patients, stereotactic radiation therapy is used when any part of the tumor is left after surgery. This kind of radiation therapy delivers a high dose of radiation directly to the tumor.
Not all patients with part of a tumor remaining after surgery need radiation therapy. That is because some benign pituitary gland tumors do not grow back even when some of the tumor is left behind after surgery. If the entire tumor is removed, then radiation therapy is not needed.
Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished.
In the long term, radiation therapy may cause short-term memory or cognitive changes, meaning the thought process is affected. It can also cause the pituitary gland to gradually lose the ability to make hormones after treatment ends. If this occurs, hormone replacement therapy (see below) may be needed. Talk with your doctor about what to expect based on your specific radiation treatment and how side effects will be managed.
Therapies using medication
Systemic therapy is the use of medication during treatment for a tumor. This type of medication is given through the bloodstream to reach the entire body. These types of medication are generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication, or an endocrinologist.
The types of systemic therapies used for pituitary gland tumor include:
- Hormone replacement therapy
- Drug therapy
Each of these types of therapies is discussed below in more detail. A person may receive 1 type of systemic therapy at a time or a combination of systemic therapies given at the same time. They can also be given as part of a treatment plan that includes surgery and/or radiation therapy.
The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with medications. Learn more about your prescriptions by using searchable drug databases.
Hormone replacement therapy (HRT)
HRT is often necessary for people with a pituitary tumor when the gland is not making enough of a hormone due to the disease. This means the patient is given a replacement, often as a pill, to take regularly. This may include replacement of:
- Thyroid hormones
- Adrenal hormones
- Growth hormone
- Testosterone in men
- Estrogen in women
If a pituitary tumor is overproducing a hormone, there are medications that can help. The drugs bromocriptine (Parlodel) and cabergoline (Dostinex) are used to treat tumors that secrete prolactin. Octreotide (Sandostatin) or pegvisomant (Somavert) can be used to treat tumors that make growth hormone. Octreotide can also be used to treat pituitary tumors that secrete thyroid-stimulating hormone.
The medications used to treat pituitary tumors are continually being evaluated. Talking with your doctor is often the best way to learn about the medications you have been prescribed, their purpose, and their potential side effects or interactions with other medications.
Source – Cancer.net