What are Pituitary Gland Tumors: Causes, Symptoms, Treatment, Diagnosis
The pituitary gland is a small pea-sized gland found at the base of the brain. It is often referred to as the Master Gland which controls the functioning of other glands in the body. Some of the hormones produced by the pituitary gland include growth hormone, prolactin, luteinizing hormone, and thyroid stimulating hormone and many more. It regulates the functioning of certain body organs and glands like the adrenal glands, ovaries, thyroid gland and testicles. However, any disorder like pituitary tumors can lead to variation in the secretion of hormones leading to bodily complications.
What are Pituitary Gland Tumors?
A tumor is an abnormal growth of cells which can occur nearly anywhere in the body. Tumors that develop in the pituitary glands are referred to as pituitary gland tumors. While some tumors can lead to over-secretion of major hormones in the body, others can result in lowered production of hormone levels. Most of the tumors occurring in the pituitary glands are noncancerous. The most common types of the pituitary gland tumors cause a disruption in the hormonal balance of the system.
Causes of Pituitary Gland Tumors
According to the American Brain Tumor Association, benign tumors are known to constitute around 40% of the total occurrence of pituitary gland tumors. Such occurrence has been seen to be more prevalent among the younger group and reproductive age women in their mid-40s or early 50s. However, the reason for the uncontrolled growth of cells in the pituitary gland resulting in such tumor is still not known. Research is still being conducted to identify the actual cause of such occurrence. Scientists state that there is a rare chance of such occurrence from genetic reasons. They are often considered as brain tumors and constitute up to 19% of all primary brain tumors.
Symptoms of Pituitary Gland Tumors
The symptoms experienced during pituitary gland tumor are dependent on the hormones it releases and its size. Sometimes people with pituitary gland tumor experience no symptom at all or sometimes it may be due to the side-effects of other medication. Some of the common symptoms associated with such occurrence include a headache, vision loss, and seizures. Other disease-specific symptoms include:
- Irritability, depression and anxiety
- Nausea and vomiting
- Weight Gain
- High Blood Pressure
- Changes in menstrual cycle
- Irregular heartbeat
- Decrease in sex drive
- Loss of body hair
The symptoms relating to pituitary gland tumors can occur in three different ways discussed below –
- Production of an excessive amount of hormone which may be secretion of growth hormone, Thyroid Stimulating Hormone, Prolactin, Gonadotropins or Adrenocorticotropic hormone or a combination of all or any of the above.
- Excessive pressure on the pituitary gland resulting in reduced secretion of one or more hormones like TSH, Prolactin, ACTH, Growth Hormone and Gonadotropins.
- Putting pressure on the optics nerves or the nerves controlling the eye and resulting in impairment of vision of a person.
Diagnosis of Pituitary Gland Tumors
Doctors use tests to diagnose a tumor. Tests, like imaging tests, are performed to know if the tumors are cancerous and how much has it spread to other parts of the body. In most of the tumors, a biopsy is an assured method to detect the same. If a biopsy is not desirable, the doctor can suggest any other test. The following tests are also conducted to diagnose the tumor but all of them will not be used in every case:
- Neurological examination such as evaluation of the central nervous system of the patient, which includes testing the motor and sensory skills, reflexes, mental status, and balance and coordination.
- The doctor may recommend a blood test to measure the hormone levels in the blood. In Cushing disease, samples of saliva are collected as well as urine samples. These tests may be repeated several times to confirm the hormone levels.
- Magnetic resonance imaging or MRI may be used to measure the size of pituitary gland tumor. A special dye is given before the MRI scan to get a clearer picture. The dye is either given as a pill or can be injected into the vein of the patient.
- Computed tomography or CT scan may be used to measure the size of the pituitary gland tumor.
- In pituitary gland tumor, the patients may face problems in their visual field, wherein they are not able to see the objects outside their field of vision. Therefore, visual test exam is done to check the vision.
- A Biopsy is the most accurate diagnosis to detect the type of pituitary gland tumor. A sample of a tissue is removed for examination by the pathologist.
- Lumbar puncture is a method used by the doctor where he takes out a sample of the cerebrospinal fluid using a needle and looks for the tumor cells. Very rarely this test is required to diagnose a pituitary tumor.
- After the diagnostic tests are concluded, the doctor reviews the results and decides the proper treatment regime.
Treatment for Pituitary Gland Tumors
In order to treat a patient suffering from pituitary gland tumor, different types of doctors devise a particular treatment strategy which combines various treatment procedures. This is referred to as a multi-disciplinary team which includes a range of healthcare professionals such as oncology nurses, physician assistants, pharmacists, dieticians, counselors among others. At first, an endocrinologist must be consulted, who specializes in complications associated with the endocrine system and the glands. Then a neurosurgeon must study the condition to identify any problems associated with the brain, head, and the Central Nervous System. On the other hand, a patient with visionary problems needs to visit an ophthalmologist who specializes in the diagnosis and treatment of the eye.
The possible treatment options for pituitary gland tumor include –
- Active Surveillance
- Radiation Therapy
- Hormone Replacement Therapy (HRT)
- Drug Therapy.
However, the treatment procedure to be undertaken for pituitary gland tumor is influenced by a number of factors such as –
- Stage and type of pituitary gland tumor
- Probable adverse effects
- Preference of the patient
- Overall health of the patient
- Present medications.
Therefore, proper care and research must be conducted before opting for a particular treatment strategy for pituitary gland tumor as it will determine the future well-being of the patient.
Treatment Advancement for Pituitary Gland Tumors
Doctors want to know about the pituitary gland tumors, ways of prevention, how to treat them and provide the best possible care to them after they are diagnosed with them. The areas of research that may open new treatment options for patients include the following:
- The researchers want to reason out about the growth of the pituitary gland tumor and the genetics of the tumor in order to find out the new treatment methods.
- Removal of the pituitary gland tumors using better surgical methods is being studied. The large tumors can be also removed with surgery. However, the tumors that have grown into cavernous sinus cannot be removed completely through surgery and may require further treatment like medications and radiation therapy.
- The researchers are exploring the targeted therapy for the pituitary gland tumors. This treatment targets the protein and the specific genes that contribute to tumor growth and its survival.
- Researchers are also targeting the proton therapy for treatment. It is a kind of external-beam radiation therapy that makes use of protons rather than the x-rays.
- Clinical trials are conducted to look for better ways to reduce the symptoms and side effects of the pituitary gland tumor treatments and improve a patient’s quality of life.
Follow-up Care for Pituitary Gland Tumors
Care does not end after the treatment of the pituitary gland tumor is completed. In fact, the patient needs to be monitored continuously to ensure the tumor does not return and also to check the overall health. The follow-up care includes regular physical examination and medical tests. Once the surgery is done, the patient is monitored by a neurosurgeon and an endocrinologist. Regular blood tests to check the hormonal levels and MRI scan once in a year are done to know how far the treatment has worked. The goal of follow-up is to check for recurrence. During a follow-up care, the doctor may tell the patient about the risk of recurrence. Most of the pituitary gland tumors are non-cancerous in nature and they do not spread to other areas of the body.
It is important to talk to your doctor and discuss the risk of developing a pituitary gland tumor, treatment plan, and the overall health. If the treatment plan can cause delayed side-effects, physical examination, blood tests, and scans are conducted to manage them.
Therefore, in order to restrict or prevent the occurrence of any adverse effects on the body, it is advised to consult a physician at the earliest possible. The doctor will inquire into the matter for how long the symptoms have been occurring in addition to other queries. Upon diagnosis of a pituitary gland tumor, the relieving symptoms play a crucial role in the care and treatment procedure, commonly referred to as palliative care, supportive care or symptom management. So, be sure to take necessary precautionary and preventive measures before the situation goes out of hand.