ON THIS PAGE: You will read about your medical care after treatment for the tumor is completed, and why this follow-up care is important. To see other pages, use the menu.
Care for people diagnosed with a pituitary gland tumor doesn’t end when active treatment has finished. Your health care team will continue to check to make sure the tumor has not returned, manage any side effects, and monitor your overall health. This is called follow-up care.
Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. Once surgery to remove a pituitary gland tumor is done, the patient is usually monitored by both an endocrinologist and a neurosurgeon. Follow-up care for a pituitary gland tumor may include regular tests to measure hormone levels and MRI scans, usually done yearly, to learn how well treatment worked. Talk with your doctor about any new symptoms you experience.
Side effects depend on a variety of factors, including the tumor’s size, the length and dosage of treatment(s), and your overall health. Specifically, treatment of a pituitary gland tumor can cause:
Fatigue. Fatigue is extreme exhaustion or tiredness. It is the most common problem that people with pituitary tumors experience. Patients who feel fatigue often say that even a small effort, such as walking across a room, can seem like too much. A pituitary gland tumor may cause fatigue if it lowers levels of cortisol, thyroid hormone, or growth hormone. High levels of cortisol can weaken muscles, which may also cause fatigue.
Gastrointestinal upset. Patients being treated with medicines such as bromocriptine or cabergoline for a prolactin-secreting pituitary tumor known as prolactinoma may have gastrointestinal upset. This may sometimes limit the patient’s ability to take a particular medication.
Gallstones. People being treated for too much growth hormone may develop gallstones, which are rock-like formations of cholesterol and bile salts in the gallbladder or bile duct. Therefore, people receiving this treatment must be monitored for gallstones throughout the treatment.
Learn more about the importance of follow-up care.
Watching for recurrence
One goal of follow-up care is to check for a recurrence. A tumor recurs because small areas of tumor cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms.
During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will also ask specific questions about your health. Some people may have blood tests or imaging tests as part of regular follow-up care, but testing recommendations depend on several factors including the type of tumor originally diagnosed and the types of treatment given.
As most pituitary tumors are noncancerous, these tumors do not usually spread to other parts of the body. However, most people treated for a pituitary tumor need regular follow-up tests to make sure that the tumor has not come back.
In addition, patients may be at risk for developing other types of cancer. For example, patients with too much growth hormone have a higher risk of developing colon cancer or thyroid cancer, but only if the tumor was not completely removed during surgery and growth hormone levels are still high. People with MEN1 syndrome or Carney complex need regular screening for the other tumors associated with that condition.
Managing long-term and late side effects
Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. In addition, other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.
Patients with impaired vision may need special accommodation after treatment. Studies show that people with Cushing's disease are most affected after treatment, mostly because they are also most affected before treatment, meaning recovery often takes longer. Some people with too much prolactin or growth hormone may also be significantly affected.
Radiation therapy can have late effects, in particular decreasing hormone production from the pituitary gland. These can take 5 to 7 years to develop, but they do not occur in all patients. Talk with your doctor about the symptoms or signs to watch for during the recovery period.
Talk with your doctor about your risk of developing such side effects based on the type of tumor, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may also have certain physical examinations, scans, or blood tests to help find and manage them.
Keeping personal health records
You and your doctor should work together to develop a personalized follow-up care plan. Be sure to ask about any concerns you have about your future physical or emotional health. ASCO offers forms to help create a treatment summary to keep track of the treatment you received and develop a survivorship care plan once treatment is completed.
This is also a good time to decide who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the general care of their family doctor or another health care professional. This decision depends on several factors, including the type of tumor, side effects, health insurance rules, and your personal preferences.
If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with him or her, as well as all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.
The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a diagnosis. Or, use the menu to choose another section to continue reading this guide.