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Pituitary Gland Tumor - Overview

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Pituitary Gland Tumor. To see other pages, use the menu on the side of your screen. Think of that menu as a roadmap to this full guide.

About the pituitary gland

The pituitary gland is a small gland located near the brain. This gland is often referred to as the “master endocrine gland” because it releases hormones that affect many bodily functions. The pituitary gland is controlled by the hypothalamus, a small structure also near the brain that is connected to the pituitary gland. A pituitary gland has two lobes, the anterior (front) and the posterior (back), and each lobe is responsible for releasing specific hormones. These different hormones include:

Anterior pituitary lobe hormones

  • Thyroid stimulating hormone (TSH) stimulates the thyroid gland, which helps regulate the body’s metabolism
  • Adrenocorticotrophic hormone (ACTH) controls the hormones released by the adrenal gland that support blood pressure, metabolism, and the body's response to stress
  • Gonadotropins (Follicle stimulating hormone or FSH and Luteinizing hormone or LH) stimulate production of sperm in a man’s testicles or eggs in a woman’s ovaries and regulate a woman's menstrual cycle
  • Growth hormone promotes growth of the long bones in the arms and legs, thickens the skull and bones of the spine, and causes the tissue over the bones to thicken
  • Prolactin stimulates milk production in women after childbirth
  • Lipotropin stimulates the movement of fat from the body to the bloodstream
  • Melanocyte stimulating hormone (MSH) regulates the production of melanin, the pigment in skin

Posterior pituitary lobe hormones

  • Oxytocin stimulates contraction of the uterus during childbirth and the flow of milk during breastfeeding
  • Antidiuretic hormone (called vasopressin) increases reabsorption of water by the kidneys and allows a person to stay hydrated

Tumors in the pituitary gland

When normal cells change and grow uncontrollably, they can form a mass called a tumor. A pituitary gland tumor can be benign (noncancerous and located only in the pituitary gland) or malignant (cancerous, meaning it can spread beyond the pituitary gland). Most often, pituitary gland tumors are noncancerous growths and are called pituitary adenomas. However, a pituitary gland tumor can occasionally act like a cancerous tumor by growing into nearby tissue and structures, or rarely, spreading to other parts of the body.

Pituitary gland tumors are NOT brain tumors, as the pituitary gland is located under the brain and is separate from the brain. It is classified as an endocrine tumor. However, a tumor in this gland can be very serious because a pituitary gland that does not work can cause problems with other organs. This is because the tumor starts in cells that make hormones, so the tumor itself can make too many hormones (called a “functional” tumor) or it can cause the gland to produce too few hormones. The tumor can also press on nearby structures, such as the optic nerves, limiting a person’s sight.

To continue reading this guide, use the menu on the side of your screen to select another section.

Pituitary Gland Tumor - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will find information about how many people learn they have a pituitary gland tumor each year and some general survival information. Remember, survival rates depend on several factors. To see other pages, use the menu on the side of your screen.

About 8,000 pituitary gland tumors are diagnosed in the United States each year. Most of these tumors are noncancerous. Because the pituitary gland is located next to the brain, this type of tumor is sometimes classified as a brain tumor in data collection. Pituitary gland tumors are more common in adults.

People with a tumor located in the cerebellum, spinal cord and cauda equina (bundle of spinal nerves), cranial nerves, pituitary and pineal glands, and nasal cavity have higher survival rates. The ten-year survival rate is the percentage of people who survive at least ten years after the cancer is detected, excluding those who die from other diseases. The ten-year survival rate of people with a pituitary gland tumor ranges from 60% to more than 90%.  

Cancer survival statistics should be interpreted with caution. These estimates are based on data from thousands of people with this type of tumor in the United States, but the actual risk for a particular individual may differ. It is not possible to tell a person how long he or she will live with a pituitary gland tumor. Because theese survival statistics are measured in ten-year intervals, they may not represent advances made in the treatment or diagnosis of this cancer. Learn more about understanding statistics.

Source: American Cancer Society and the Central Brain Tumor Registration of the United States.

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Pituitary Gland Tumor - Risk Factors

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will find out more about what factors increase the chance of a pituitary gland tumor. To see other pages, use the menu on the side of your screen.

A risk factor is anything that increases a person’s chance of developing a tumor. Although risk factors often influence the development of a tumor, most do not directly cause a tumor. Some people with several risk factors never develop a tumor, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

There is no evidence that environmental factors play a role in the development of a pituitary gland tumor. The only known risk factors are the three hereditary syndromes explained below. Genetic testing is available for these conditions.

Multiple endocrine neoplasia type 1 (MEN1). Families with MEN1 have an increased risk of pituitary gland tumors.

Carney complex. This is another genetic condition that can increase the risk of a pituitary gland tumor.

Familial acromegaly. Acromegaly is a condition in adults that is caused by too much growth hormone. Familial acromegaly can occur as part of MEN (see above) or alone within a family.

Choose “Next” (below, right) to continue reading this guide to learn about what symptoms a pituitary gland tumor can cause. To continue reading this guide, use the menu on the side of your screen to select another section.  

Pituitary Gland Tumor - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. To see other pages, use the menu on the side of your screen.

People with a pituitary gland tumor may experience the following symptoms or signs. Sometimes, people with a pituitary gland tumor do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not related to a pituitary gland tumor. If you are concerned about a symptom or sign on this list, please talk with your doctor. General symptoms may include:         

  • Headaches
  • Vision problems
  • Changes in menstrual cycles in women
  • Impotence (the inability to achieve or maintain an erection) in men, caused by hormone changes
  • Infertility (the inability to have children)
  • Inappropriate production of breast milk
  • Cushing’s syndrome (a combination of weight gain, high blood pressure, diabetes, and easy bruising), caused by overproduction of ACTH
  • Acromegaly (enlargement of the extremities or limbs and thickening of the skull and jaw), from too much growth hormone
  • Unexplained tiredness
  • Mood changes
  • Irritability

A pituitary tumor causes symptoms in three different ways, which are discussed below:

  • By producing too much of one or more hormones.

Growth hormone. The symptoms depend on a patient’s age. In children, before the bone plates have closed, increased growth can cause gigantism (excessive body size and height). In adults, increased growth hormone causes acromegaly, a syndrome that includes excessive growth of soft tissues and bones, high blood sugar, high blood pressure, heart disease, sleep apnea, increased snoring, carpal tunnel syndrome, and pain (including headaches).

Thyroid stimulating hormone (TSH). Too much TSH causes increased production of thyroid hormone, leading to nervousness and irritability, fast heart rate and high blood pressure, heart disease, increased sweating, thin skin, and weight loss.

Prolactin. Too much prolactin causes inappropriate secretion of breast milk (even in men), osteoporosis (bone weakening), loss of sex drive, infertility, irregular menstrual cycles, and impotence.

Adrenocorticotropic hormone. Too much of this hormone causes weight gain (particularly in the body’s trunk, not the legs or arms), high blood pressure, high blood sugar, brittle bones, emotional changes, stretch marks on the skin, easy bruising.

Gonadotropins (FSH and LH).  These are usually not high enough to cause symptoms but can rarely cause infertility and irregular menstrual cycles in women.

  • By pressing on the pituitary gland, causing it to make too little of one or more hormones.

Growth hormone. Not enough growth hormone causes late growth in children, poor muscle strength, irritability, weakening of bone strength, and overall unwell feeling.

TSH. Low TSH causes fatigue, low energy, sensitivity to cold temperatures, constipation, and weight gain.

Prolactin. Too little prolactin causes inability to breastfeed after a woman gives birth to a baby.

Adrenocorticotropic hormone. Too little of this hormone causes fatigue and low energy, low blood pressure, low blood sugar, and upset stomach.

Gonadotropins (FSH and LH).  Low levels of gonadotropins cause infertility, decrease in sex drive, impotence, and irregular menstrual cycles.

  • By pressing on the optic (eye) nerves or (less commonly) the nerves controlling eye movements, and causing either loss of part or all of a person’s sight, or double vision.

Your doctor will ask you questions about the symptoms you are experiencing to help find out the cause of the problem, called a diagnosis. This may include how long you’ve been experiencing the symptom(s) and how often.

If a tumor is diagnosed, relieving symptoms and side effects remains an important part of care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.

The next section helps explain what tests and scans may be needed to learn more about the cause of the symptoms. Use the menu on the side of your screen to select Diagnosis, or you can select another section, to continue reading this guide.

Pituitary Gland Tumor - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will find a list of the common tests, procedures, and scans that doctors can use to find out what’s wrong and identify the cause of the problem. To see other pages, use the menu on the side of your screen.

Doctors use many tests to diagnose a tumor and find out if it has metastasized (spread). Some tests may also determine which treatments may be the most effective. For most tumors, a biopsy is the only way to make a definitive diagnosis. For a pituitary tumor, the biopsy is done as part of surgery to remove the tumor, and a biopsy alone is not usually recommended. The doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the tumor has spread, but very few pituitary tumors ever spread. When they do, they are called pituitary carcinoma instead of the much more common, noncancerous pituitary adenoma. Your doctor may consider these factors when choosing a diagnostic test:

  • Age and medical condition
  • Type of tumor suspected
  • Signs and symptoms
  • Previous test results

In addition to a physical examination, the following tests may be used to diagnose a pituitary gland tumor. This list describes options for diagnosing a pituitary gland tumor, and not all tests listed will be used for every person.

Neurological examination. An evaluation of the patient’s central nervous system may include testing a person’s reflexes, motor and sensory skills, balance and coordination, and mental status.

Laboratory tests. A blood test may be recommended so the doctor can measure the amounts of certain hormones in the blood. If Cushing's disease (see Symptoms and Signs) is suspected, samples of saliva may be collected as well as one or more 24-hour urine samples (in which all urine produced in a 24-hour period is saved and sent for analysis of cortisol levels). These tests may need to be repeated several times so the doctor can understand how hormones are produced over time, or to confirm that hormone levels are consistently abnormal. Sometimes a person may be given a drug or hormone before the blood measurements are done; this is called provocative testing.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. A contrast medium (a special dye) may be injected into a patient’s vein or given orally (by mouth) to create a clearer picture. MRI is better than a computed tomography scan (see below) to diagnose most pituitary gland tumors, and it is now the standard method.

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. Sometimes, a contrast medium is injected into a patient’s vein or given orally to provide better detail. A CT scan is usually used only for patients who have a pacemaker or an aneurysm clip, which may prevent them from having an MRI (see above).

Visual field exam. A large pituitary gland tumor may press on the optic nerves, which are located above the pituitary gland. In this test, the patient is asked to find points of light on a screen, using each eye separately. The most common visual field problem caused by a pituitary gland tumor is loss of the ability to see objects along the outside of the person’s field of vision. Because other diseases can also cause vision loss, it is important for the doctor to consider all possible causes carefully before coming to a conclusion about the reason for the vision problem.

Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that a tumor is present, but only a biopsy can make a definite diagnosis. The sample removed during the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease). A pituitary gland tumor should be checked by the pathologist for production of each of the hormones mentioned in the Overview section (except for lipotropin and melanocyte stimulating hormone) to correctly classify the tumor. As mentioned above, the biopsy is done as part of the surgery to remove the pituitary tumor.

Lumbar puncture (spinal tap). A lumbar puncture is a procedure in which a doctor uses a needle to take a sample of cerebrospinal fluid (CSF) to look for tumor cells, blood, or tumor markers (substances found in higher than normal amounts in the blood, urine, or body tissues of people with certain kinds of tumors). CSF is the fluid that flows around the brain and the spinal cord. Doctors generally give an anesthetic to numb the lower back before the procedure. However, this test is rarely needed to help diagnose a pituitary tumor.

After these diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is a tumor, these results also help the doctor describe the tumor; this is called staging.

The next section helps explain the different stages for this type of cancer. Use the menu on the side of your screen to select Stages, or you can select another section, to continue reading this guide.

Pituitary Gland Tumor - Stages

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will learn about how doctors usually describe a tumor’s growth or spread, called the stage, and how this differs for a pituitary gland tumor. To see other pages, use the menu on the side of your screen.

Staging is a way of describing where a tumor is located, if or where it has spread, and whether it is affecting other parts of the body. Doctors use diagnostic tests to determine the tumor’s stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient’s prognosis (chance of recovery). There are different stage descriptions for different types of tumors. 

Because a pituitary gland tumor is most commonly noncancerous and called a pituitary adenoma, it is usually classified according to its size on an MRI (see Diagnosis).

  • A microadenoma is small (10 millimeters [mm] or less).
  • A macroadenoma is larger and can extend outside the sella turcica (the bony structure around the pituitary gland). A macroadenoma is larger than 10 mm at its widest point.

Other factors considered when classifying a pituitary gland tumor include whether the tumor is functional (meaning, what, if any, hormone(s) it makes) and whether it has grown into nearby structures (most commonly, the cavernous sinus, an area near the pituitary gland that contains the carotid artery and several important nerves that control eye movement).

Information about the cancer’s stage will help the doctor recommend a treatment plan.  The next section helps explain the treatment options for this type of cancer. Use the menu on the side of your screen to select Treatment Options, or you can select another section, to continue reading this guide.

Pituitary Gland Tumor - Treatment Options

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will learn about the different ways doctors use to treat people with a pituitary gland tumor. To see other pages, use the menu on the side of your screen.

This section outlines treatments that are the standard of care (the best proven treatments available) for this specific type of tumor. When making treatment plan decisions, patients are also encouraged to consider clinical trials as an option. A clinical trial is a research study to test a new treatment to evaluate whether it is safe, effective, and possibly better than the standard treatment. Your doctor can help you review all treatment options. For more information, see the Clinical Trials and Latest Research sections.

Treatment overview

For a pituitary gland tumor, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Any patient with a pituitary tumor should be seen by an endocrinologist (a doctor who specializes in problems with glands and the endocrine system) and by a neurosurgeon (a specialist who operates on the head, brain, and central nervous system). Patients with vision problems will also need to visit an ophthalmologist (a doctor who specializes in the treatment and diagnosis of eye problems).

Descriptions of the most common treatment options for a pituitary gland tumor are listed below. Treatment options and recommendations depend on several factors, including the type and stage of the tumor, possible side effects, and the patient’s preferences and overall health. Take time to learn about your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.

Active surveillance

Active surveillance is an option for some people with a pituitary gland tumor who have no symptoms from the tumor and have hormones that work normally. This approach can also be called watchful waiting. During active surveillance, the patient is monitored closely with periodic examinations and tests, to watch for signs of tumor growth or progression. Treatment would begin only if the tumor started causing symptoms.

Surgery

Surgery is the removal of the tumor and surrounding tissue during an operation. It is the most common treatment for a pituitary gland tumor. Surgery is often successful in removing the entire tumor. About 95% of surgeries to remove pituitary gland tumors are done by the transsphenoidal route (through the nasal passage, going along the septum that separates the two nostrils, then through the sphenoid sinus cavity located deep above the back of the throat to the pituitary gland immediately behind it). The rest are done through a craniotomy (an opening in the skull). This can be done using a microscope or an endoscope (a long flexible tube), or both, so the surgeon can see the tumor. Both of these methods are equally safe and effective when done by a skilled surgeon. Talk with your surgeon beforehand to learn about possible side effects based on the type of surgery you will have. Learn more about surgery for a tumor.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy tumor cells. A doctor who specializes in giving radiation therapy to treat a tumor is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time.

For some patients, stereotactic radiation therapy (delivering a high dose of radiation directly to the tumor) is used when any part of the tumor is left after surgery. Not all patients with part of a tumor remaining after surgery need radiation therapy because some noncancerous pituitary gland tumors do not grow back even when some of the tumor is left behind after surgery. If the entire tumor is removed, then radiation therapy is not needed.

Side effects from radiation therapy include fatigue, mild skin reactions, and upset stomach. Most side effects go away soon after treatment is finished. Depending on where the radiation therapy is directed, it may also cause vision problems and short-term memory or cognitive (thought-process) changes. However, the risk of developing vision problems or short-term memory or cognitive changes from radiation treatment is small because advances in external-beam radiation therapy allow doctors to aim the radiation more directly at the pituitary gland, sparing more of the surrounding normal tissue from the effects of radiation. Radiation therapy can cause the pituitary gland to gradually lose the ability to make hormones after treatment ends. If this occurs, hormone replacement therapy (see below) may be needed. Talk with your doctor about what to expect based on your specific radiation treatment and how side effects will be managed.

Learn more about radiation therapy.

Hormone replacement therapy (HRT)

HRT is often necessary for patients with a pituitary tumor when the gland is not making enough of a hormone due to the disease. This may include replacement of thyroid and adrenal hormones, growth hormone, and/or testosterone in men or estrogen in women.

Drug therapy

If a pituitary tumor is overproducing a hormone, there are medications that can help. The drugs bromocriptine (Parlodel) and cabergoline (Dostinex) are used to treat tumors that secrete prolactin, and octreotide (Sandostatin) or pegvisomant (Somavert) can be used to treat tumors that make growth hormone. Octreotide can also be used to treat pituitary tumors that secrete thyroid-stimulating hormone.

The medications used to treat pituitary tumors are continually being evaluated. Talking with your doctor is often the best way to learn about the medications you've been prescribed, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Getting care for symptoms and side effects

A tumor and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the tumor, an important part of care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care can help a person at any stage of illness. People often receive treatment for the tumor and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the tumor, such as surgery and radiation therapy. Talk with your doctor about the goals of each treatment in the treatment plan.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and supportive care options. And during and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it is addressed as quickly as possible. Learn more about palliative care.

Recurrent pituitary gland tumor

A remission is when the tumor cannot be detected in the body and there are no symptoms. This may also be called “no evidence of disease” or NED.

A remission can be temporary or permanent. This uncertainty leads to many survivors feeling worried or anxious that the tumor will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the tumor returning. Understanding the risk of recurrence and the treatment options may help you feel more prepared if the tumor does return. Learn more about coping with the fear of recurrence.

If the tumor does return after the original treatment, it is called a recurrent tumor. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence), which is rare. If there is a recurrence, the tumor may need to be staged again (called re-staging) using the system described in the Staging section.

When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence, including whether the tumor’s features have changed. After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the therapies described above (such as surgery and radiation therapy) but they may be used in a different combination or given at a different pace. Your doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent tumor.

People with a recurrent tumor often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with a recurrence.

Aggressive pituitary gland tumor

If a tumor grows quickly in the pituitary gland and spreads into nearby structures, it is called a locally invasive tumor. If it has spread to another location in the body, it is called a metastatic tumor. Both metastatic and locally invasive tumors can be aggressive (grow and spread quickly) and are more likely to need treatment with radiation therapy than a noncancerous pituitary adenoma. However, many pituitary tumors do not grow quickly even when they are invasive, which is different from most other types of tumors.

Patients with this diagnosis are encouraged to talk with doctors who are experienced in treating this type of tumor, because there can be different opinions about the best treatment plan. Learn more about seeking a second opinion before starting treatment, so you are comfortable with the treatment plan chosen. This discussion may include clinical trials.

Your health care team may recommend a treatment plan that includes a combination of surgery and radiation therapy. Supportive care will also be important to help relieve symptoms and side effects.

For most patients, a diagnosis of an aggressive pituitary gland tumor is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

If treatment fails

Recovery from a tumor is not always possible. If treatment is not successful, the disease may be called an advanced or terminal tumor.

This diagnosis is stressful, and this is difficult to discuss for many people. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have an advanced tumor and who are expected to live less than six months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to think about where you would be most comfortable: at home, in the hospital, or in a hospice environment. Nursing care and special equipment can make staying at home a workable alternative for many families. Learn more about advanced care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and bereavement.

The next section helps explain clinical trials, which are research studies. Use the menu on the side of your screen to select About Clinical Trials, or you can select another section, to continue reading this guide.

Pituitary Gland Tumor - About Clinical Trials

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. To see other pages, use the menu on the side of your screen.

Doctors and scientists are always looking for better ways to treat patients with a pituitary gland tumor. To make scientific advances, doctors create research studies involving volunteers, called clinical trials.

Many clinical trials are focused on new treatments, evaluating whether a new treatment is safe, effective, and possibly better than the current (standard) treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials are often among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.

There are also clinical trials that study new ways to ease symptoms and side effects during treatment and manage the late effects that may occur after treatment. Talk with your doctor about clinical trials regarding side effects. In addition, there are ongoing studies about ways to prevent the disease.

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that these studies are the only way to make progress in treating a pituitary gland tumor. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with a pituitary gland tumor.

Sometimes people have concerns that, by participating in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” The use of placebos in cancer clinical trials is rare. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

To join a clinical trial, patients must participate in a process known as informed consent. During informed consent, the doctor should list all of the patient’s options, so that the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different from the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

For specific topics being studied for a pituitary gland tumor, learn more in the Latest Research section.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trial before it ends.

Cancer.Net offers a lot of information about clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of tumor.

The next section helps explain the areas of research going on today about this type of cancer. Use the menu on the side of your screen to select Latest Research, or you can select another section, to continue reading this guide.

Pituitary Gland Tumor - Latest Research

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will read about the scientific research being done now to learn more about pituitary gland tumors and how to treat them. To see other pages, use the menu on the side of your screen.

Doctors are working to learn more about pituitary gland tumors, ways to prevent them, how to best treat them, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the diagnostic and treatment options best for you.

Risk factors and genetics. Researchers are looking into how and why pituitary gland tumors develop, as well as the genetics of pituitary gland tumors in the hope of finding new methods of treatment.

Surgical advances. Better methods of surgery to remove pituitary gland tumors are being studied. Even large tumors and tumors that have grown into nearby structures can now be removed with surgery. However, pituitary gland tumors that have grown into the cavernous sinus cannot usually be removed completely with surgery and may need further treatment (either medications or radiation therapy); research on these methods is ongoing.

Targeted therapy. Targeted therapy is a treatment that targets the specific genes, proteins, or the tissue environment that contributes to a tumor growth and survival. This type of treatment blocks the growth and spread of tumor cells while limiting damage to normal cells. For pituitary gland tumors, one targeted therapy researchers are exploring as a treatment is lapatinib (Tykerb).

Radiation therapy. Researchers are also looking at proton therapy as a treatment option. Proton therapy (also called proton beam therapy) is a type of external-beam radiation therapy that uses protons rather than x-rays. At high energy, protons can destroy tumor cells.

Supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current pituitary gland tumor treatments in order to improve patients’ comfort and quality of life.

Looking for More about the Latest Research?

If you would like additional information about the latest areas of research regarding pituitary gland tumors, explore this related item that takes you outside of this guide:

The next section addresses how to cope with the symptoms of the disease or the side effects of its treatment. Use the menu on the side of your screen to select Coping with Side Effects, or you can select another section, to continue reading this guide.  

Pituitary Gland Tumor - Coping with Side Effects

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will find out more about steps to take to help cope with physical, social, and emotional side effects. This page includes several links outside of this guide to other sections of this website. To see other pages, use the menu on the side of your screen.

Fear of treatment side effects is common after a diagnosis of a tumor, but it may help to know that preventing and controlling side effects is a major focus of your health care team. This is called palliative or supportive care, and it is an important part of the overall treatment plan, regardless of the stage of disease.

Common side effects from each treatment option for a pituitary gland tumor are described in detail within the Treatment section. Learn more about the most common side effects of a tumor and different treatments, along with ways to prevent or control them. Side effects depend on a variety of factors, including the tumor’s stage, 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, and 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 for a prolactin-secreting pituitary tumor (prolactinoma) with such medicines as bromocriptine or cabergoline may have gastrointestinal upset, and it may sometimes limit the patient’s ability to take a particular medication.
  • Gallstones. People being treated for too much growth hormone may develop gallstones (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.

Before treatment begins, talk with your doctor about possible side effects of each type of treatment you will be receiving. Ask which side effects are most likely to happen, when they are likely to occur, and what can be done to prevent or relieve them. And, ask about the level of caregiving you may need during treatment and recovery, as family members and friends often play an important role in the care of a person with a pituitary gland tumor. Learn more about caregiving.

In addition to physical side effects, there may be psychosocial (emotional and social) effects as well. Patients and their families are encouraged to share their feelings with a member of their health care team who can help with coping strategies. Learn more about the importance of addressing such needs, including concerns about managing the cost of your medical care

During and after treatment, be sure to tell the health care team about the side effects you experience, even if you feel they are not serious. Sometimes, side effects can last beyond the treatment period, called a long-term side effect. A side effect that occurs months or years after treatment is called a late effect. Treatment of both types of effects is an important part of survivorship care. Learn more by reading the After Treatment section or talking with your doctor.  

The next section helps explain medical tests and check-ups needed after finishing cancer treatment. Use the menu on the side of your screen to select After Treatment, or you can select another section, to continue reading this guide.  

Pituitary Gland Tumor - After Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will read about your medical care after treatment is finished and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

After treatment for a pituitary gland tumor ends, talk with your doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. 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.

During treatment, patients with pituitary tumors may experience a number of symptoms that may affect the ability to function fully and conduct a normal life; however after treatment, most people can lead full and active lives. 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 (a hormone that stimulates lactation and the secretion of progesterone) 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 five to seven 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.

As most pituitary tumors are noncancerous, these tumors do not usually spread to other parts of the body. However, 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 (see Treatment Options) for the other tumors associated with that condition, but most people treated for a pituitary tumor need regular follow-up tests to make sure that the tumor has not come back. ASCO offers treatment summary forms to help keep track of the treatment you received and develop a survivorship care plan once treatment is completed.

People recovering from a pituitary gland tumor are encouraged to follow established guidelines for good health, such as maintaining a healthy weight, not smoking, eating a balanced diet, and having recommended cancer screening tests. Talk with your doctor to develop a plan that is best for your needs. Moderate physical activity can help you rebuild your strength and energy level. Your doctor can help you create an appropriate exercise plan based on your needs, physical abilities, and fitness level. Learn more about the next steps to take in survivorship, including making positive lifestyle changes.

The next section offers a list of questions you may want to ask. Use the menu on the side of your screen to select Questions to Ask the Doctor, or you can select another section, to continue reading this guide.

Pituitary Gland Tumor - Questions to Ask the Doctor

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team, to help you better understand your diagnosis, treatment plan, and overall care. To see other pages, use the menu on the side of your screen.

Talking often with the doctor is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for an e-list and other interactive tools to manage your care.

  • Is my tumor cancerous?
  • Is the tumor still making hormones? What does this mean?
  • Can you explain my pathology report (laboratory test results) to me?
  • How many patients with this type of tumor do you treat each year?
  • Do you attend expert meetings to discuss complicated tumor issues? What kinds of specialists attend such meetings?
  • What treatment options do I have?
  • What clinical trials are open to me?
  • What treatment plan do you recommend? Why?
  • What is the goal of each treatment? Is it to eliminate the tumor, help me feel better, or both?
  • Who will be part of my health care team, and what does each member do?
  • Who will be coordinating my overall treatment and follow-up care?
  • How successful is surgery to remove this type of tumor?
  • How experienced is the surgeon with this specific type of surgery?
  • Do you recommend additional treatment after surgery?
  • Should I get a second opinion?
  • Are you willing to follow my case if I have my treatments provided in another center?
  • What are the possible side effects of this treatment, both in the short term and in the long term?
  • What are the chances that the tumor will come back after treatment?
  • How can I keep myself as healthy as possible during and after treatment?
  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?  
  • Could this treatment affect my sex life? If so, how and for how long?
  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before treatment begins?
  • If I’m worried about managing the costs related to my medical care, who can help me with these concerns?
  • What follow-up tests will I need, and how often will I need them?
  • Do you have reading material that would help me understand my disease?
  • What support services are available to me? To my family?
  • Whom should I call for questions or problems?

The next section offers some more resources that may be helpful to you. Use the menu on the side of your screen to select Additional Resources, or you can select another section, to continue reading this guide.

Pituitary Gland Tumor - Additional Resources

This section has been reviewed and approved by the Cancer.Net Editorial Board, 09/2013

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about medical care and treatment. This is the final page of Cancer.Net’s Guide to Pituitary Gland Tumor. To go back and review other pages, use the menu on the side of your screen.

Cancer.Net includes many other sections about the medical and emotional aspects of a tumor, both for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond. Here are a few sections that may get you started in exploring the rest of Cancer.Net:

This is the end of Cancer.Net’s Guide to Pituitary Gland Tumor. Use the menu on the side of your screen to select another section to continue reading this guide.