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Pituitary Gland Tumor - Introduction

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2016

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. 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 2 lobes, the anterior, or front, and the posterior, or back. 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, which supports blood pressure, metabolism, and the body's response to stress.

  • Gonadotropins, a family of hormones that include follicle stimulating hormone (FSH) and luteinizing hormone (LH), stimulate production of sperm in a man’s testicles or eggs in a woman’s ovaries. Gonadotropins also regulate a woman's menstrual cycle.

  • Growth hormone promotes growth of the long bones in the arms and legs, and thickens the skull and bones of the spine. The hormone also causes the tissue over the bones to thicken.

  • Prolactin stimulates milk production in women after childbirth. Prolactin is also found in men.

  • 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, also known as vasopressin, increases reabsorption of water by the kidneys and allows a person to stay hydrated.

Tumors in the pituitary gland

A tumor begins when healthy cells change and grow out of control, forming a mass called a tumor. A pituitary gland tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

Most often, pituitary gland tumors are noncancerous growths 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. 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. This is called a “functional” tumor. The tumor can also cause the gland to produce too few hormones. If the tumor presses on nearby structures, such as the optic nerves in the eye, it can limit a person’s sight.

The next section in this guide is Statistics. It helps explain how many people are diagnosed with this disease and general survival rates. Or, use the menu to choose another section to continue reading this guide.  

Pituitary Gland Tumor - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2016

ON THIS PAGE: You will find information about how many people are diagnosed with a pituitary gland tumor each year. You will also learn some general information on surviving the disease. Remember, survival rates depend on several factors. To see other pages, use the menu.

About 11,700 pituitary gland tumors will be diagnosed in the United States in 2016. 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, including by the World Health Organization. Pituitary gland tumors are more common in older adults.

The survival rates of a person with a pituitary tumor depend on the type of tumor, the person’s age, and other factors.

It is important to remember that statistics on how many people survive this type of tumor are an estimate. The estimate comes from data based on thousands of people with this tumor in the United States each year. So, your own risk may be different. Doctors cannot say for sure how long anyone will live with a pituitary gland tumor. Also, experts measure the survival statistics every 5 years. This means that the estimate may not show the results of better diagnosis or treatment available for less than 5 years. Learn more about understanding statistics.

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

The next section in this guide is Risk Factors. It explains what factors may increase the chance of developing this disease. Or, use the menu on the side of your screen to choose another section to continue reading this guide.

Pituitary Gland Tumor - Risk Factors

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2016

ON THIS PAGE: You will find out more about the factors that increase the chance of developing a pituitary gland tumor. To see other pages, use the menu.

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 3 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. The Carney complex 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 MEN1, described above, or alone within a family.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems this disease can cause. Or, use the menu to choose another section to continue reading this guide. 

Pituitary Gland Tumor - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2016

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.

People with a pituitary gland tumor may experience the following symptoms or signs. Sometimes, people with a pituitary gland tumor do not have any of these changes. Or, the cause of a symptom may be another medical condition that is not a pituitary gland tumor.

  • Headaches

  • Vision problems

  • Changes in menstrual cycles in women

  • Impotence, which is the inability to achieve or maintain an erection in men and is caused by hormone changes

  • Infertility, meaning 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 that is caused by overproduction of ACTH

  • Acromegaly, the enlargement of the extremities or limbs and thickening of the skull and jaw caused by too much growth hormone

  • Unexplained tiredness

  • Mood changes

  • Irritability

A pituitary tumor causes symptoms in 3 different ways, which are discussed below:

  • By producing too much of 1 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, which is 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. This can lead to nervousness and irritability, fast heart rate and high blood pressure, heart disease, increased sweating, thin skin, and weight loss.

    • Prolactin. Too much prolactin, a hormone that stimulates lactation and the secretion of progesterone, causes inappropriate secretion of breast milk, even in men. It can also cause osteoporosis, which is weakening of the bones; 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. It can also cause high blood pressure, high blood sugar, brittle bones, emotional changes, stretch marks on the skin, and easy bruising.

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

  • By pressing on the pituitary gland, causing it to make too little of 1 or more hormones.

    • Growth hormone. Not enough growth hormone causes late growth in children, poor muscle strength, irritability, weakening of bone strength, and an 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.

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

    • Gonadotropins. Low levels of gonadotropins cause infertility, decrease in sex drive, impotence, and irregular menstrual cycles.

  • By pressing on the optic 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.

If you are concerned about any changes you experience, please talk with your doctor. Your doctor will ask how long and how often you have been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.

If a tumor is diagnosed, relieving symptoms 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 in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Or, use the menu to choose another section to continue reading this guide. 

Pituitary Gland Tumor - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2016

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. To see other pages, use the menu.

Doctors use many tests to find, or diagnose, a tumor. They also do tests to learn if cancer has spread to another part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests can show if the cancer has spread. Imaging tests show pictures of the inside of the body. Doctors may also do tests to learn which treatments could work best.

For most types of tumors, a biopsy is the only sure way for the doctor to know whether an area of the body has a tumor. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

This list describes options for diagnosing this type of tumor, and not all tests listed will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of a tumor suspected

  • Your signs and symptoms

  • Your age and medical condition

  • The results of earlier medical tests

In addition to a physical examination, the following tests may be used to diagnose a pituitary gland tumor. 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, which is described in Signs and Symptoms, is suspected, samples of saliva may be collected as well as one or more 24-hour urine samples. That means 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. MRI can also be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow. MRI is better than a computed tomography scan, which is described 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 3-dimensional picture of the inside of the body using x-rays taken from different angles. 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 special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow.

    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, which is described 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.

    Other diseases can also cause vision loss. That’s why it’s 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 pathologist is 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 Introduction section, with the exception of 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. Tumor markers are 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. This test is rarely needed to help diagnose a pituitary tumor.

After 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 in this guide is Stages. It explains the system doctors use to describe the extent of the disease. Or, use the menu to choose another section to continue reading this guide.  

Pituitary Gland Tumor - Stages

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2016

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.

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 find out 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, which is the chance of recovery. There are different stage descriptions for different types of tumors. Unlike other types of tumors, pituitary tumors that are malignant or noncancerous are not staged and are measured differently by the doctor.

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. This imaging test is described in the Diagnosis section.

  • A microadenoma is small, meaning its 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.

The structure the tumor most commonly grows into is the cavernous sinus. This area near the pituitary gland contains the carotid artery and several important nerves that control eye movement.

Information about the tumor’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. Or, use the menu to choose 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, 03/2016

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.

This section tells you the treatments that are the standard of care for this type of cancer. “Standard of care” means the best treatments known. When making treatment plan decisions, patients are also encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn if it is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Your doctor can help you consider all your treatment options. To learn more about clinical trials, see the About 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. Cancer care teams also include a variety of other health care professionals, including physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Any patient with a pituitary tumor should be seen by an endocrinologist, a doctor who specializes in problems with glands and the endocrine system. In addition, patients should be examined 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 tumor

  • Possible side effects

  • The patient’s preferences

  • The patient’s overall health

Your care plan may also include treatment for symptoms and side effects, an important part of medical care. Take time to learn about all of 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 some surrounding healthy tissue during an operation. It is the most common treatment for a pituitary gland tumor.  Surgery, which is performed by a surgical oncologist, a doctor who specializes in treating a tumor using surgery, is often successful in removing the entire tumor.

About 95% of surgeries to remove pituitary gland tumors are done by the transsphenoidal route. That means going through the nasal passage and along the septum that separates the 2 nostrils. Then the surgeon goes 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 an opening in the skull called a craniotomy. This can be done using a microscope or an endoscope, which is 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 the basics of 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), which is your treatment plan, usually consists of a specific number of treatments given over a set period of time.

For some patients, stereotactic radiation therapy is used when any part of the tumor is left after surgery. This kind of radiation therapy delivers a high dose of radiation directly to the tumor. Not all patients with part of a tumor remaining after surgery need radiation therapy. That’s 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 may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. 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 changes, meaning the thought process is affected. However, the risk of developing vision problems or short-term memory or cognitive changes from radiation treatment is small.  

Advances in external-beam radiation therapy allow doctors to aim the radiation more directly at the pituitary gland, sparing more of the surrounding healthy 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 may be needed. See below for more information. Talk with your doctor about what to expect based on your specific radiation treatment and how side effects will be managed.

Learn more about the basics of 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 hormones

  • Adrenal hormones

  • Growth hormone

  • Testosterone in men

  • 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. 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 have 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 is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of a tumor, may receive palliative care. It works best when palliative care is started as early as needed in the tumor treatment process.

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, emotional support and other therapies. You may also receive palliative treatments similar to those meant to eliminate the tumor, such as surgery or 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 palliative 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 can be addressed as quickly as possible.

Learn more about palliative care.

Aggressive pituitary gland tumor

If a tumor spreads to another part in the body from where it started, doctors call it a metastatic tumor. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Also, clinical trials might be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your treatment plan chosen.

If a tumor grows quickly in the pituitary gland and spreads into nearby structures, it is called a locally invasive tumor. Both metastatic and locally invasive tumors can be aggressive, growing and spreading quickly. They 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.

Your treatment plan may include a combination of surgery and radiation therapy. Palliative 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.

Remission and the chance of recurrence

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

A remission may be temporary or permanent. This uncertainty causes many people to worry 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 your 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. After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the treatments described above, such as surgery and radiation therapy. However, 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.

Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

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.

If treatment fails

Recovery from a tumor is not always possible. If the tumor cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and advanced tumor 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 6 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 loss.

The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. Or, use the menu to choose 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, 03/2016

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.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for patients with a pituitary gland tumor. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. In fact, every drug that is now approved by the U.S. Food and Drug Administration (FDA) was tested in clinical trials.

Many clinical trials focus on new treatments. Researchers want to learn if a new treatment is safe, effective, and possibly better than the treatment doctors use now. 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 can be some of the first to get a treatment before it is available to the public. However, there is no guarantee that the new treatment will be safe, effective, or better than what doctors use now.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects. There are also clinical trials studying ways to prevent cancer.

Deciding to join a clinical trial

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, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” However, placebos are usually combined with standard treatment in most cancer clinical trials. 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.

Patient safety and informed consent

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.

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.

Finding a clinical trial

Research through clinical trials is ongoing for all types of tumors. For specific topics being studied for pituitary gland tumors, learn more in the Latest Research section.

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.

In addition, this website offers free access to a video-based educational program about cancer clinical trials, located outside of this guide.

The next section in this guide is Latest Research. It explains areas of scientific research currently going on for this type of tumor. Or, use the menu to choose 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, 03/2016

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.

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 them. 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. They may need further treatment, such as 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 healthy 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.

  • Palliative care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current pituitary gland tumor treatments 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 in this guide is Coping with Treatment. It offers some guidance in how to cope with the physical, emotional, and social changes that cancer and its treatment can bring. Or, use the menu to choose another section to continue reading this guide.  

Pituitary Gland Tumor - Coping with Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2016

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of a pituitary gland tumor and its treatment. This page includes several links outside of this guide to other sections of this website. To see other pages, use the menu.

Every treatment can cause side effects or changes to your body and how you feel. For many reasons, people don’t experience the same side effects even when given the same treatment for the same type of tumor. This can make it hard to predict how you will feel during treatment.

As you prepare to start treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. Doctors call this part of treatment “palliative care.” It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for a pituitary gland tumor are described within the Treatment Options section. Learn more about side effects of this disease and its treatment, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the tumor’s size, the length and dose of treatment, and your general health.

Sometimes, physical side effects can last after treatment ends. Doctors call these long-term side effects. They call side effects that occur months or years after treatment late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

Coping with emotional and social effects

You can have emotional and social effects as well as physical effects after a diagnosis. This may include dealing with difficult emotions, such as anxiety or anger, or managing your stress level. Sometimes, patients have problems expressing how they feel to their loved ones, or people don’t know what to say in return.

Sometimes patients with a pituitary gland tumor have cognitive changes or experience depression. Talk with your health care team if you experience any of these changes.

Patients and their families are encouraged to share their feelings with a member of their health care team. You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Coping with financial effects

Treatment can be expensive. It is often a big source of stress and anxiety for patients and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost stops them from following or completing their treatment plan. This can put their health at risk and may lead to higher costs in the future. Learn more about managing financial considerations, in a separate part of this website.

Caring for a loved one with cancer

Family members and friends often play an important role in taking care of a person with a pituitary gland tumor. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away.

Caregivers may have a range of responsibilities on a daily or as-needed basis. Below are some of the responsibilities caregivers take care of:

  • Providing support and encouragement

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

Learn more about caregiving.

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they are likely to happen?

  • What can we do to prevent or relieve them?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you don’t think the side effects are serious. This discussion should include physical, emotional, and social effects of a tumor.

Also, ask how much care you may need at home and with daily tasks during and after treatment. This can help you make a caregiving plan.

The next section in this guide is Follow-up Care. It explains the importance of check-ups after you finish treatment. Or, use the menu to choose another section to continue reading this guide.  

Pituitary Gland Tumor - Follow-Up Care

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2016

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.  

Pituitary Gland Tumor - Survivorship

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2016

ON THIS PAGE: You will read about how to with challenges in everyday life after a diagnosis. To see other pages, use the menu.

What is survivorship?

The word “survivorship” means different things to different people. Common definitions include:

  • Having no signs of a tumor after finishing treatment.

  • Living with, through, and beyond this diagnosis. According to this definition, survivorship begins at diagnosis and includes people who continue to have treatment over the long term, to either reduce the risk of recurrence or to manage chronic disease.

Survivorship is one of the most complicated parts of medical care. This is because it is different for everyone.

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain of how to cope with everyday life.

Survivors may feel some stress when frequent visits to the health care team end following treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true as new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexuality and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing,

  • Thinking through solutions,

  • Asking for and allowing the support of others, and

  • Feeling comfortable with the course of action you choose.

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the center where you received treatment.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with a tumor, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving in this article.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make positive lifestyle changes.

People recovering from a pituitary gland tumor are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

In addition, it is important to have recommended medical check-ups and tests (see Follow-up Care) to take care of your health. Rehabilitation may also be recommended, and this could mean any of a wide range of services such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent and productive as possible.

Talk with your doctor to develop a survivorship care plan that is best for your needs.

Looking for More Survivorship Resources?

For more information about survivorship, explore these related items. Please note these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: Get this 44-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The booklet is available as a PDF, so it is easy to print out.

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert that provides information about what comes next after finishing treatment.

  • Survivorship Resources: Cancer.Net offers an entire area of this website with resources to help survivors, including for survivors in different age groups.

The next section offers Questions to Ask the Doctor to help start conversations with your health care team. Or, use the menu to choose 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, 03/2016

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.

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.

Questions to ask after getting a diagnosis

  • Is my tumor cancerous?

  • Is the tumor still making hormones? What does this mean?

  • Can you explain my pathology report, or laboratory test results, to me?

Questions to ask about choosing a treatment and managing side effects

  • 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 clinical trials are available for me? Where are they located, and how do I find out more about them?

  • What treatment plan do you recommend? Why?

  • Should I get a second opinion?

  • What is the goal of each treatment? Is it to eliminate the tumor, help me feel better, or both?

  • What are the possible side effects of each treatment, both in the short term and the long term?

  • Who will be part of my health care team, and what does each member do?

  • Who will be leading my overall treatment?

  • Are you willing to follow my case if I have my treatments provided in another center?

  • 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 am worried about managing the costs of medical care, who can help me?

  • What support services are available to me? To my family?

  • Whom should I call for questions or problems?

  • Is there anything else I should be asking?

  • Do you have reading material that would help me understand my disease?

Questions to ask about having surgery?

  • What type of surgery will I have? Will lymph nodes be removed?

  • How experienced is the surgeon with this specific type of surgery?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • What are the possible long-term effects of having this surgery?

  • How successful is surgery to remove this type of tumor?

  • Do you recommend additional treatment after surgery?

Questions to ask about having radiation therapy, chemotherapy, or other treatment

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • What side effects can I expect during treatment?

  • What are the possible long-term effects of having this treatment?

  • What can be done to relieve the side effects?

Questions to ask about planning follow-up care

  • What is the risk of the tumor returning?

  • What long-term side effects or late effects are possible based on the treatment I received?

  • What follow-up tests will I need, and how often will I need them?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family? 

The next section in this guide is Additional Resources. It offers some more resources on this website beyond this guide that may be helpful to you. Or, use the menu to choose 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, 03/2016

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.

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.

Beyond this guide, here are a few links to help you explore other parts of Cancer.Net:

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