Pituitary Tumor Treatment

The pituitary gland is a pea-sized structure located at the base of your brain, behind your nose. It produces hormones that direct other glands in your body to produce the hormones involved in a variety of body functions.

Tumors on the pituitary gland are common and often don't cause problems. But if the tumor causes your body to produce too many or too few hormones, it can create an imbalance that may lead to a variety of symptoms and conditions. A pituitary tumor can also press on nearby nerves connected to your eyes, causing vision problems.

Most pituitary tumors are benign (called pituitary adenoma). Rarely, a pituitary tumor is cancerous (called pituitary carcinoma) and can spread beyond the pituitary gland.

Your care team will recommend treatments based on the size, location, and characteristics of your tumor, as well as other factors such as your overall health.

Medicine

Your doctor may prescribe medicine to stop your pituitary tumor from producing excess hormones and shrink the tumor. In many cases, this is the only treatment needed. If your tumor requires surgery or radiation treatment, you may need to take medications before those treatments to keep your hormones in balance. After treatment, your doctor may prescribe medication to treat any hormone deficiency that may arise as a result of the tumor or the treatment.

Surgery

The goal of surgery is to remove the entire tumor safely while also preserving the function of the pituitary gland and nearby structures, such as the optic nerves. If your pituitary tumor is relatively small and easy to reach, your surgeon may perform the surgery by placing a small tube called an endoscope through your nose to reach and remove it. For larger tumors, our surgeons offer keyhole craniotomies, in which the tumor is removed through openings in the skull about the size of a nickel. In rare cases, a pituitary tumor may require more extensive surgery.

Radiation Therapy

If your pituitary tumor extends to an area where surgery could pose risks to nearby structures, our experts may radiation therapy (high energy x-ray treatment). This may be given as a once-daily treatment for about five weeks or as stereotactic radiosurgery.  The treatment recommendation will be determined by your radiation oncologist, who considers multiple factors such as the size of the tumor and its exact location within the brain.

Follow-Up Care

After your tumor has been effectively treated -- through medication, surgery, or radiation -- your care team will continue to monitor your condition through regular MRI scans and hormone tests. Pituitary tumors can sometimes return, although it is rare. If your tumor caused vision problems, your eye specialist will continue to monitor your vision.

These are the basic tests our doctors rely on most often in diagnosing and recommending treatment for a pituitary tumor. Your doctor may order additional tests based on your particular symptoms and circumstances.

MRI of the Brain

This painless scan gives doctors a detailed visual image of the pituitary area. You may be given a special dye -- through an injection into your vein or a pill that you swallow -- to increase the contrast of the image.

Tests of Hormone Levels

Samples of your blood will be tested to determine whether your pituitary tumor is causing a hormone imbalance. Blood tests can also tell your doctor which hormones the tumor is producing, if any, and how they may be affecting your health. In some cases, your doctor may order urine or saliva tests to gather more information.

Eye Exam

An ophthalmologist or optometrist will test for the clarity of your vision as well as for problems such as double vision and peripheral vision loss that can be caused by a pituitary tumor pressing on an optic nerve.

Advanced Specialists
Your care team will include specialists with advanced training in endocrinology, neurosurgery, and otolaryngology (ear, nose, and throat, or ENT). Depending on your needs, your team may also include experts from ophthalmology, radiation oncology, neuroradiology, and other specialties. Our experts meet regularly to review patients' scans and test results, and determine the best possible course of treatment.

Coordinated Care
Your care will be coordinated by our nurse navigator, a single point of contact who will answer your questions and guide you through the treatment process. Whenever possible, you'll be scheduled for office visits, tests, and treatments on the same day. Our goal is to make the most of your time and to ensure your care team has the information they need to work together toward the best possible outcome for you. If you don’t live near Duke but choose to have surgery here, we can coordinate with your local doctors for your follow-up care.

Expert Surgeons
If you need surgery, you'll be treated by neurosurgeons and ENT skull base surgeons with extensive training and experience in the most advanced techniques. This includes endoscopic techniques to reach the pituitary tumor through the nose as well as keyhole surgery to remove even large tumors through very small openings in the skull. These minimally invasive techniques can mean you heal faster and feel less pain.

High-Volume Center
You'll be among others from around the region and across the country who travel to Duke for pituitary tumor care. Our high-volume center frequently sees -- and successfully treats -- some of the most challenging cases.