A tumour is an abnormal growth of cells and this can happen anywhere in the body. If it occurs in the pituitary gland (a small pea-sized part of the brain), it is known as a pituitary tumour. While many tumours are benign, it is vital to make sure that the tumour is not malignant. If it is, then action must be taken without delay.
If you or someone you know has been diagnosed with a pituitary tumour or is suspected of having one, there are 4 important things to know when dealing with the condition.
Types of Pituitary Tumours
The pituitary gland is a part of the brain and is located behind the back of the nose. It produces hormones that support and control many functions of the body. A tumour can cause the gland to produce too many or too few hormones and this can cause problems with other parts of the body. There are 4 main types of pituitary tumours:
- Nonfunctional Adenomas (Null Cell Adenomas): This is the most common type of tumour. It does not cause any deviation in the normal production of hormones by the gland and in the early stages may not cause any symptoms. It will continue to grow and once the tumour reaches a certain size it may cause chronic headache and vision problems. Once the tumour becomes large enough, it can crush the pituitary gland itself resulting in the decreased production of hormones.
- Prolactin-Producing Tumors (Prolactinomas): This is another common type of pituitary tumour. The tumour causes an excess of the hormone prolactin.
- In the case of men, this can result in erectile dysfunction and a loss of interest in sexual activity. It may also cause an enlargement of breasts, loss of body hair and a low sperm count. Over time, headaches and vision problems may appear.
- In the case of women, excessive levels of prolactin can cause irregular menstrual periods, or even the cessation of periods. In some cases, it can result in the production of breastmilk among women who are not pregnant or nursing.
- ACTH-Producing Tumors: ACTH (adrenocorticotropic hormone) stimulates the adrenal gland to produce steroids, known as glucocorticoids, that affect metabolic function. Excess or uncontrolled production of this hormone results in the development of swelling and redness all over the body and also slows down the immune system. In severe cases, excessive ACTH can cause Cushing’s disease which causes fat to build up in the belly, chest, back, neck and face while the arms and legs lose fat and become thin. Purple stretch marks may appear on the skin. High blood pressure and weak bones are other effects of too much ACTH.
- Growth Hormone-Producing Tumors: This type of tumour causes the pituitary gland to produce excess growth hormone. In children, it causes unnatural growth of almost all bones in the body resulting in a condition called gigantism where a person can grow to over 2 meters. Joint pain and heavy sweating are other symptoms. In adults, an excess of this hormone can cause extra growth of the feet, hands and skull, a deepened voice, a change in facial appearance because of the growth of facial bones, large gaps between the teeth, snoring and sleep apnea, joint pain and diabetes.
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Symptoms of Pituitary Tumours
The symptoms of a pituitary tumour will depend on the type of tumor and how it affects the pituitary gland and its hormone production. The production of too much or too little of a hormone can lead to the various ailments mentioned above. Because of the varying nature of the symptoms and the way they can resemble other health problems, an erroneous diagnosis of pituitary gland tumour-related health conditions is common. For this reason, a possible patient must be examined and diagnosed by specialists at a hospital that has the facilities for accurate diagnosis and if required, treatment for the tumour.
Diagnosis of Pituitary Tumours
The diagnosis of a pituitary tumour starts with a detailed physical examination and study of a person’s medical history. After that, one or more of the following tests are typically ordered to confirm the diagnosis:
- Urine and Blood Tests: These will show if the hormone levels in the urine and blood are abnormal. If excess levels are found, further tests will be done to find the cause.
- CT Scans: The images produced by these scans will be used to find the presence of any tumours near the pituitary gland.
- MRI: Magnetic and radio waves are used to enable a computer to make detailed images of the structures and organs inside the body. These will indicate any abnormalities which may be connected to a pituitary tumour.
- Biopsies: In this procedure, a small tissue sample is removed for pathological examination to determine if a tumour is present and if it is benign or malignant. The sample is removed either by the use of a needle or by minor surgery.
Treatment of Pituitary Tumours
The treatment of a pituitary tumour will take into account a patient’s age, medical history and overall health, the severity of the ailment, the ability to withstand the side-effects of certain therapies, treatments and medicines, the preferences of the patient and other medical factors that will be assessed by the doctors. The treatment may include:
- Surgery: This may be the preferred option for smaller tumours.
- Radiosurgery (Stereotactic Radiosurgery): Also known as gamma knife treatment, this uses a single strong dose of radiation directed into the cancerous tissue. It destroys the cancerous tissue with minimal damage to adjacent tissue.
- External Radiation (External Beam Therapy): This involves a series of doses of radiation that are sent to the cancer cells to destroy them. Special shielding is used to protect the healthy tissue around the affected area. The treatment is painless and each one lasts just a few minutes.
- Medication: Medicines may be prescribed to control the production of hormones by the pituitary gland. This is often the preferred option in the case of excessive production of growth hormones.
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Suspected tumours should never be ignored. The possible condition must be diagnosed at a multispecialty hospital that has neurology and oncology departments with the most advanced diagnostic facilities. If the tumour is malignant, the hospital will have the medical specialists, surgeons, medical technology and equipment to offer the best treatment. A tumour can be a serious medical problem but with early diagnosis and advanced treatment protocols, the prognosis is today better than it has ever been.