Treatment for pituitary tumours

This page is about treatment for pituitary tumours. There is information about

A quick guide to what's on this page
What pituitary tumours are
Adenomas that don't produce hormones
Hormone producing adenomas
After effects of radiotherapy

Treatment for pituitary tumours

Most pituitary tumours are pituitary adenomas, which are benign (non cancerous) slowly growing tumours that start in pituitary tissue cells. Some pituitary adenomas produce hormones and are called secretory tumours. Others do not produce hormones and are called non secretory tumours. The treatment depends on whether your tumour produces hormones or not.

Adenomas that don't produce hormones

Non secretory tumours are usually larger than the hormone producing tumours. They can press on the optic nerves and cause changes in your eyesight. Some may block the normal fluid drainage channels and cause a collection of fluid in the brain (hydrocephalus). The treatment is surgery to remove as much of the tumour as possible. If any tumour is left after the surgery, you will be offered radiotherapy or radiosurgery.

Hormone producing adenomas

There are several different types of secretory tumours, which produce different types of hormones. Prolactinomas cause milk production by the breasts, infertility and loss of sex drive. They are usually treated with tablets that reduce prolactin production by the tumour. Other types of tumours produce steroids, growth hormone or thyroid stimulating hormone. These tumours should be completely removed if at all possible. If your hormone levels are still raised in your blood after surgery, your doctor will normally advise that you have radiotherapy to the remaining tumour. Some years after radiotherapy to the pituitary gland, you may develop low levels of pituitary hormones. If this happens, you will need to take replacement hormones for the rest of your life.

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Most pituitary tumours are pituitary adenomas, which are benign (non cancerous) slowly growing tumours that start in pituitary tissue cells. Most are microadenomas (small tumours) although a few patients have macroadenomas, which are larger. Some pituitary adenomas produce hormones and are called secretory tumours. Others do not produce hormones and are called non secretory tumours. The treatment depends on whether your tumour produces hormones or not. Your care and treatment should be managed by a team specialising in the treatment of pituitary tumours. This will include an endocrinologist, who is a specialist in hormone system diseases.

The treatment is surgery to remove as much of the tumour as possible. Any tumour left behind will be treated with radiotherapy, or possibly radiosurgery.

There are several different types of secretory tumours

Prolactinomas, (causing milk production by the breasts, infertility and loss of sex drive)
Steroid producing tumours (causing Cushing’s syndrome - weight gain on the trunk of the body, a moon face, acne, mood swings, diabetes, and high blood pressure)
Growth hormone producing tumours (causing excess height in young people or acromegaly in adults - overgrowth of hands, feet, lower jaw and brows)
Thyroid stimulating hormone producing tumours (causing an overactive thyroid - with weight loss, feeling hot, irregular periods, moods swings, and irregular heart beat)

Prolactinomas are usually treated with tablets that reduce prolactin production by the tumour. Drugs that may be used include cabergoline (brand name Dostinex) and quinagolide (brand name Norprolac). Women who want to have a baby are usually treated with a drug called bromocriptine (brand name Parlodel).

The other types of hormone producing tumours should be completely removed if at all possible. Surgery is better than radiotherapy at controlling pituitary tumours. Usually, you would only have radiotherapy if hormone levels were still raised in your blood after surgery. Radiotherapy takes quite a long time to work.

With pituitary tumours that produce adrenocorticotrophic hormone (ACTH), the radiotherapy can take up to 9 months to control the tumour. So it will take up to 9 months for your hormone level to get back to normal.

Years after radiotherapy to the pituitary gland, you may develop low levels of all the pituitary hormones. This is because the radiotherapy can damage healthy pituitary tissue. But like most radiotherapy damage, this can take a long time to show up. If this happens, you will need to take replacement hormones for the rest of your life.