Following a diagnosis of a pituitary adenoma, you may have a lot of questions about next steps and what to expect in the coming months. One of those questions probably pertains to the most effective treatment of pituitary adenoma. While there are several effective treatment options of a pituitary adenoma, the most effective treatment for you will depend on several factors. The following information will help you understand a little more about your condition, the available treatment options and specifically, why your doctor may recommend one treatment option over another in your particular case.
Overview of Pituitary Adenomas
A pituitary adenoma is a benign tumor, which means it grows slowly and very rarely spreads to other sites in the body. It arises from the pituitary gland, which is a small but very important gland located deep within your skull, just behind and above your nose. It is made up of various types of cells, each of which release a different hormone that results in physiological effects across the body.
Because of these different cell types, there is a lot of variability across pituitary adenomas. Sometimes the tumor is made up of secreting cells, which release excess hormones into your body. These are referred to as functioning pituitary adenomas. Other tumors do not release hormones, but can still cause symptoms by impinging on surrounding structures. These are non-functioning pituitary adenomas.
Treatment Options
There are three forms of treatment of pituitary adenoma: surgery, Gamma Knife Radiosurgery and a combination approach. This brief overview should help you better understand what is involved with each treatment option.
Surgical Treatment of Pituitary Adenoma
The most common surgical treatment of pituitary adenoma is a minimally invasive procedure through the nose to remove your tumor. The surgeon uses microscopic visualization, such as an endoscope or operating microscope, to visualize the tumor through a small incision at the back of your nasal passage using what’s referred to as a transnasal, transsphenoidal approach. The surgeon then uses specialized instruments to remove the pituitary adenoma, disrupting as little surrounding tissue as possible.
Occasionally, the surgeon will need to perform a craniotomy to access your pituitary adenoma. During this procedure, the surgeon removes a small piece of skull, then removes the tumor. The bone is replaced and secured with small screws or a plate. This approach is rarely needed; minimally invasive techniques are more often used.
Gamma Knife Radiosurgery
Despite the name, Gamma Knife Radiosurgery is not actually a surgical procedure but rather an innovative form of radiation therapy that delivers a focused beam of radiation directly to the tumor. This is in contrast to traditional fractionated radiation therapy, which irradiates both tumor and healthy tissue, producing unpleasant side effects.
Gamma Knife Radiosurgery is done on an outpatient basis, and the number of treatments required depends on your individual tumor. You may also see it referred to as stereotactic radiosurgery, which is a more general name for the treatment method.
A Combination Approach
Some patients benefit from a combination of surgery and Gamma Knife Radiosurgery. If your pituitary adenoma is a secreting or producing tumor, your doctor may also prescribe medications to help counteract the effects of the excess hormone in your body, easing some of your symptoms.
Which Treatments Are Used When?
The treatment options your doctor recommends will be based on multiple factors, including the size of your tumor, whether it is producing or non-producing and your individual health condition.
Surgical removal is often the first course of action if your tumor is producing and/or large. In most cases, a transnasal endoscopic procedure will be recommended. However, if your tumor is especially large or difficult to reach, your pituitary adenoma surgeon may need to perform a craniotomy.
Gamma Knife Radiosurgery is most often used as a secondary treatment following surgery in a combination approach. If your tumor is large and cannot be completely removed, your doctor may recommend a combination approach to ensure all of the tumor cells are eradicated. Similarly, if your tumor regrows, Gamma Knife Radiosurgery may be used to eliminate the growing tumor. It may also be used as a primary treatment if you are not a candidate for surgery because of complicating health conditions.
A Unique Treatment for You
Your doctor will make recommendations for the treatment of pituitary adenoma based on whether or not your tumor is functioning, its size and your individual condition, including your age, weight and health history. Because of the variable nature of these tumors, it is important that you work with a doctor who is experienced in the treatment of pituitary adenomas.
If you find you still have questions or concerns regarding the treatment of pituitary adenomas, be sure to bring them up with your doctor at your next visit. Your physician will work with you to ensure all your questions are addressed, allowing you to be more at ease through this process.
Continue to self-educate and increase your understanding about your condition and treatment options. This will allow you to take a more active role in your health care and give you peace of mind during what could be an overwhelming process.
