Find out about pituitary tumours and their treatment.
What it is
About 8 out of 100 (8%) of brain tumours are in the pituitary gland.
The pituitary gland lies in a small hollow, just behind the eyes. It controls many physical functions by making and releasing hormones into the bloodstream.
Most tumours develop from the gland tissue and are called adenomas. They are nearly always benign, so they grow slowly and tend not to spread.
Some pituitary tumours affect hormone levels. These are called secreting tumours. These tumours can cause quite unusual symptoms because they make too much of one of the pituitary hormones.
Tumours that don't make hormones are called non secreting tumours.
Examples of hormone producing tumours
There are different types of hormone producing tumours (secreting tumours). For example:
- prolactinomas can cause infertility, loss of sex drive in men and milk production in the breasts of women
- steroid producing hormones can cause weight gain, diabetes and high blood pressure (Cushing's syndrome)
- growth hormone producing tumours can cause growth spurts in young people and overgrowth of hands, feet and lower jaw in adults
- thyroid stimulating hormone producing tumours cause an overactive thyroid leading to symptoms such as weight loss
Diagnosing pituitary tumours
Your doctor will examine you and you might have blood tests to check your general health. Other tests include:
- CT or MRI scan
Your treatment team
Your treatment team includes:
- an endocrinologist (a specialist in hormone system diseases)
- a neurosurgeon (a specialist in brain surgery)
- a neuro oncologist (a specialist in radiotherapy for tumours in the brain)
- a specialist nurse
Your treatment depends on whether your tumour produces hormones or not.
Treatment for adenomas that produce hormones
Some tumours are treated with drugs to lower the high levels of hormones. For example, you have tablets that reduce prolactin production if you have a prolactinoma.
Other hormone producing tumours
Your surgeon will remove all of the tumour if possible. This can be a cure for many people.
Your surgeon passes a tube into your nose to remove the tumour. This operation is called an endoscopic transphenoidal resection.
You might have radiotherapy to the area if your hormone levels are still high after surgery. You might have one of the following types of radiotherapy:
- external beam radiotherapy
- stereotactic radiotherapy
Radiotherapy can take a while to lower the hormone levels. So you take hormone blocking medicines until this happens.
If your pituitary tumour comes back
You might be able to have more surgery. Your specialist might suggest a chemotherapy drug called temozolamide.
Treatment for tumours that don't produce hormones
Pituitary tumours that don't produce hormones (non secretory) are usually larger than tumours that produce hormones. They can press on the optic nerve and cause changes in your eyesight. They might also affect normal pituitary gland tissue, so that you have lower levels of some hormones.
You usually have surgery to remove as much of the tumour as possible. Your surgeon passes a tube into your nose to remove the tumour. This operation is called an endoscopic transphenoidal resection.
You might have radiotherapy to any tumour that has been left behind. You may have external beam radiotherapy over about 5 weeks. Or a type of radiotherapy called radiosurgery. Radiotherapy is very good at controlling these tumours. Very few grow back again after treatment.
Coping with pituitary tumours
Coping with a diagnosis of cancer can be difficult, both practically and emotionally. It can be especially difficult if you have a rare cancer. Being well informed about your cancer and its treatment can make it easier to make decisions and cope with what happens.
You will have regular check ups once you finish your treatment. Your doctor will examine you and ask about your general health.
This is your chance to ask questions and to tell your doctor if anything is worrying you.
How often you have check ups depends on your individual situation.
Research and clinical trials
There may be fewer clinical trials for rare types of cancer than for more common types.
It is hard to organise and run trials for rare cancers. Getting enough patients is critical to the success of a trial. The results won't be strong enough to prove that one type of treatment is better than another if the trial is too small.
The International Rare Cancers Initiative (IRCI) aims to develop more research into new treatments for rare cancers. They are designing trials that involve several countries so that more people will be available to enter trials.