These smaller, functional adenomas are usually detected earlier because the increased levels of hormones cause abnormal changes in the body. Approximately 50 percent of pituitary adenomas are diagnosed when they are smaller than 5 millimeters in size. Adenomas larger than 10 millimeters the size of a dime are called macroadenomas and usually do not secrete hormones. The symptoms of a pituitary tumor, other than mass effect, generally result from endocrine dysfunction.
For example, this dysfunction can cause overproduction of growth hormones, as in acromegaly gigantism , or underproduction of thyroid hormone, as in hypothyroidism. Hormonal imbalances can impact fertility, menstrual periods, heat and cold tolerance, as well as the skin and body in other ways.
The most common circumstance involves compression of the optic nerves leading to a gradual loss of vision. This vision loss usually begins with a deterioration of peripheral vision on both sides. The presence of three or more of the following symptoms may indicate a pituitary tumor:.
When a pituitary tumor is suspected, a physician will perform a physical examination as well as vision testing to detect visual field deficits, such as loss of peripheral vision. Hormone testing of the blood and urine and imaging studies of the brain are used to confirm diagnosis.
The most accurate diagnostic imaging test is magnetic resonance imaging MRI , performed with and without a contrast agent. Early intervention provides the best chance for cure or control of a pituitary tumor and its side effects. There are three types of treatment used for pituitary tumors: surgical removal of the tumor, radiation therapy using high-dose x-rays to kill tumor cells and medication therapy to shrink or eradicate the tumor.
The transsphenoidal approach involves accessing the tumor through the nasal cavity using either a microsurgical or endoscopic approach, whichever the surgeon prefers. Surgery is usually combined with the use of computer guidance, allowing a minimally invasive approach.
In prolactinomas prolactin hormone-secreting microadenomas or macroadenomas , the use of a specific dopamine agonist medication is generally advised with surgery reserved for those tumors failing to show a good response to the treatment.
Transsphenoidal surgery is generally very well tolerated because of its minimally invasive characteristic, few side effects and quick patient recovery.
Patients can often leave the hospital as early as two to three days after surgery. The transcranial approach, or craniotomy , is less commonly used and reserved for particularly large and invasive tumors which cannot be safely removed through the transsphenoidal route. Radiation therapy uses high-energy x-rays to kill abnormal pituitary tumor cells. Radiation is extremely effective in stopping tumor growth and, with time, will lead to tumor shrinkage.
Radiation therapy may be an option if the tumor cannot be treated effectively through medication or surgery. There are three types of radiation suggested:. Standard external beam radiotherapy uses a form of radiation called photons. These photons are generated by the use of a linear accelerator. Proton beam treatment employs a different type of radiation called protons. Proton therapy can generally be more targeted than photon therapy, with the ability to deliver higher doses of radioactivity.
Higher doses of radiation carry a better chance of tumor control but also a higher risk of injury to surrounding normal brain tissue. Stereotactic radiosurgery Gamma Knife , Novalis BrainLab and CyberKnife combines standard external beam radiotherapy with a technique that focuses the radiation through many different ports. After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left.
Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.
External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy tissue.
This type of radiation therapy may include the following:. Drugs may be given to stop a functioning pituitary tumor from making too many hormones. Chemotherapy may be used as palliative treatment for pituitary carcinomas , to relieve symptoms and improve the patient's quality of life. Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.
When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body systemic chemotherapy. When chemotherapy is placed directly into the cerebrospinal fluid , an organ , or a body cavity such as the abdomen , the drugs mainly affect cancer cells in those areas regional chemotherapy.
The way the chemotherapy is given depends on the type of the cancer being treated. Information about clinical trials is available from the NCI website. For information about side effects caused by treatment for cancer, see our Side Effects page. For some patients, taking part in a clinical trial may be the best treatment choice.
Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring coming back or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. Clinical trials supported by other organizations can be found on the ClinicalTrials. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated.
Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred come back. These tests are sometimes called follow-up tests or check-ups. For information about the treatments listed below, see the Treatment Option Overview section.
Treatment for luteinizing hormone -producing and follicle-stimulating hormone -producing tumors is usually transsphenoidal surgery to remove the tumor. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done.
General information about clinical trials is also available. Treatment of pituitary carcinomas is palliative , to relieve symptoms and improve the quality of life.
Treatment may include the following:. For general cancer information and other resources from the National Cancer Institute, see the following:. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions.
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The PDQ summaries are based on an independent review of the medical literature. This PDQ cancer information summary has current information about the treatment of pituitary tumors. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
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The date on each summary "Updated" is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board. A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another.
Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works.
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It's natural for you and your family to have questions throughout the diagnosis and treatment of a pituitary tumor. The process can be overwhelming — and frightening. That's why it's important to learn as much as you can about your condition. The more you and your family know and understand about each aspect of your care, the better.
You might also find it helpful to share your feelings with others in similar situations. Check to see if support groups for people with pituitary tumors and their families are available in your area. Hospitals often sponsor these groups. Your medical team also may be able to help you find the emotional support you might need. You're likely to start by seeing your primary care provider.
If your doctor finds evidence of a pituitary tumor, he or she might recommend you see several specialists, such as a brain surgeon neurosurgeon or a doctor who specializes in disorders of the endocrine system endocrinologist.
When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a specific test. Make a list of:.
Take a family member or friend along, if possible, to help you retain the information you receive. Pituitary tumors care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Diagnosis Pituitary tumors often go undiagnosed because their symptoms resemble those of other conditions.
Endoscopic transnasal transsphenoidal surgery Open pop-up dialog box Close. Endoscopic transnasal transsphenoidal surgery During transsphenoidal endoscopic surgery, a surgeon accesses the pituitary tumor by inserting a tiny, specialized surgical instrument into the nostril and alongside the nasal septum.
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Show references Pituitary tumors information page. National Institute of Neurological Disorders and Stroke. Accessed Oct.
Pituitary tumors. American Cancer Society. Snyder PJ. Clinical manifestations and diagnosis of gonadotroph and other clinically nonfunctioning pituitary adenomas. Loeffler JS, et al. Radiation therapy of pituitary adenomas. Bancos I, et al. Impulse control disorders in patients with dopamine agonist-treated prolactinomas and non-functioning pituitary adenomas: A case-control study.
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