Q&A Topic: Do You Have a Pituitary Tumor?
Alain C.J. de Lotbinière, MD, CM, FACS, FRCSC
Q. What are pituitary tumors?
A. The pituitary gland is a pea-sized gland in the middle of the head, just below the brain. As the “master conductor” of the endocrine system, it produces critical hormones and controls other glands, so it affects many processes of the body, including growth, blood pressure, metabolism, sexual functions, pregnancy, childbirth, pain relief, and more. Unfortunately, the pituitary gland is also the site of tumors that—although they are benign—can create havoc in the body by putting pressure on the brain or causing too much or too little hormone to be produced. We’re not sure why these tumors develop, though there may be a genetic component. Pituitary tumors tend to occur more in women than in men, and can happen at any time in life.
Q. What are the symptoms of a pituitary tumor?
A. It depends on the specific type of tumor. It can be silent, meaning it has no endocrine consequences, or it can devastate someone’s health and shorten his/her life. In Cushing’s disease, for example, too much of the stress hormone cortisol is secreted, and the symptoms are high blood pressure, diabetes, very fragile skin, stretch marks and easy bruising. In prolactinoma, too much prolactin causes irregular (or lack of) menstrual periods in women, and erectile dysfunction and loss of sex drive in men. Pituitary tumors that put pressure on the brain can cause headaches or vision problems.
Q. How is a pituitary tumor diagnosed?
A. It depends on the patient’s symptoms. If a woman has symptoms of prolactinoma, for example, she would get an MRI or X-ray. If other types of tumors are suspected, patients would get blood tests. Because pituitary tumors grow very slowly, they often escape medical attention and are diagnosed later in life.
Q. What’s the most common treatment for pituitary tumors?
A. If you’re diagnosed with a pituitary tumor, you’ll likely be treated with medication, surgery or radiation—and sometimes a combination of these. At Northern Westchester Hospital, we often use a minimally invasive procedure called an endonasal approach. I make an incision no more than half an inch along the cartilage inside the nose to access and remove the tumor. The procedure is not painful and usually takes a couple of hours. The good news? Because this surgery requires very tiny incisions, you can go back to your normal lives fairly quickly.
Q. What if my tumor comes back?
A. If you have a recurring tumor, we’ll use Gamma Knife radiosurgery to treat it. The Gamma Knife is basically a tool that allows me to treat any spot in the head with exquisite precision. It uses multiple beams of radiation that crisscross at a certain point. If you place the tumor in the crosshairs of those converging beams, the radiation dose is very high, and if you move outside those crosshairs, the radiation to the surrounding tissues is very low.
Dr. de Lotbinière has been treating patients with a multitude of intracranial disorders using stereotactic radiosurgery since 1991. He has performed over 1,000 stereotactic radiosurgical interventions and is recognized worldwide as a leading authority in the field. He was the first director of the Gamma Knife Center at Yale, having introduced the technology there in 1998.
Learn More About Dr. de Lotbinière
Medical Director of the Gamma Knife Center
Medical Director of the Cancer Treatment and Wellness Center
Northern Westchester Hospital
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