Pituitary Tumor Treatment

Pituitary adenomas, also referred to as pituitary neuroendocrine tumors, are almost always benign tumors that arise from hormone-secreting cells in the pituitary gland. 

This gland is situated at the base of the brain, just behind the bridge of the nose, inside a bony cave called the sella turcica. The pituitary gland is considered the “master” gland because it controls all the other hormone-producing glands in the body. 

But are pituitary adenomas ever cancerous? What are their symptoms? And, how are they typically treated? Keep reading to learn the answers to these and other questions I sometimes hear about pituitary adenomas. 

Are pituitary adenomas ever cancerous?  

Pituitary adenomas are benign by definition. That means they are not cancerous. And, despite their location, they are not considered a type of brain tumor.

Very rarely, pituitary adenomas can spread to other parts of the body. At that point, though, they are called something else: pituitary carcinomas. 

Do pituitary adenomas ever cause symptoms? 

Yes. There are two broad categories of pituitary adenomas: functioning and non-functioning.  

Functioning tumors  

These make too much of certain hormones that travel to other glands and affect how they behave. People’s symptoms vary based on the type of hormone being produced. 

• Prolactinoma: Prolactin, also known as “the breast milk hormone,” can suppress the function of the gonads (ovaries in women and testes in men). Too much of it may cause decreased libido (chiefly men) and infertility (both sexes), missed periods (women), milky breast discharge (women, and very rarely men), and impotence and loss of body hair (men). 
• Adrenocorticotropic hormone (ACTH): Too much ACTH leads to excessive production of cortisol, a condition called Cushing disease. Too much cortisol can cause weight gain (especially in the center part of the body), excessive fat deposits above the collar bones and upper back, a rounded face, thin skin, easy bruising, stretch marks, ankle swelling, osteoporosis, diabetes, and high blood pressure.
• Growth hormone: Too much of this hormone can lead to a condition called acromegaly, in which the soft tissues in the hands and feet become abnormally large. Other issues include facial and jaw changes, excessive sweating, heart disease, high blood pressure, joint pains/arthritis, sleep apnea, and diabetes.  
• Thyroid-stimulating hormone (TSH): Too much of this hormone can cause weight loss, anxiety, trouble sleeping, feeling too hot, and a rapid and sometimes irregular heartbeat. 

Non-functioning tumors  

These pituitary adenomas don’t secrete any hormones, so they’re considered “silent.” Once a non-functioning pituitary adenoma gets large enough, however, it can start compressing the optic chiasm. This may cause vision changes, especially along the sides of the visual fields, also known as peripheral vision. 

Non-functioning tumors may also cause headaches and abnormally low hormone levels. 

How are pituitary adenomas usually diagnosed? 

Most patients with functioning pituitary adenomas are diagnosed when they start to experience symptoms and physical changes that lead to an assessment by a doctor. Then, imaging finds the tumor.  

Patients with non-functioning pituitary adenomas, on the other hand, typically notice peripheral vision loss, headaches, or symptoms of low hormone levels first, which then leads to a brain MRI that reveals the tumor.  

Finally, some people only find out they have a pituitary adenoma by accident when they’re getting a brain scan for some other reason. This is called an incidental finding. 

How are pituitary adenomas typically treated? Do they have to be removed? 

Pituitary adenomas are not life-threatening. Depending on their type, they can be treated with surgery, medication, and sometimes radiation therapy. 

Prolactinomas, for example, can usually be treated with medicine alone. Surgery is another good option for people with small prolactinomas who prefer surgery over medication and for those who do not tolerate medication very well. 

For all other functioning tumors, surgery is usually considered first, followed by additional treatment to lower hormone levels if surgery is not curative.   

For non-functioning tumors, surgery is usually undertaken to improve vision and alleviate headaches. However, small, incidentally discovered non-functioning tumors may be monitored without therapy in patients who display no symptoms. 

Finally, radiation therapy is sometimes needed to control tumor growth and/or treat excessive hormone production when other treatments don’t work.

 What is the life expectancy of a person with pituitary adenoma? 

Pituitary adenomas can lead to a shorter lifespan if the hormonal problems they cause are not well-controlled. However, with proper treatment, life expectancy for patients with pituitary adenomas is the same as anyone else’s.

What’s the most important thing to know about pituitary adenomas? 

Pituitary adenomas and carcinomas are unique tumors that often require multidisciplinary expertise to treat them. Therefore, it is vital for every patient diagnosed with a pituitary tumor to consider being treated at a pituitary tumor center of excellence, such as MD Anderson.

A lot of people don’t realize this, simply because our name contains the word “cancer,” but MD Anderson also provides excellent care to patients with benign tumors.  

Steven Waguespack, M.D., is an endocrinologist specializing in pituitary tumors, thyroid cancer and multiple endocrine neoplasia.  

Request an appointment at MD Anderson online or call 1-877-632-6789.

Pituitary tumors grow in the pituitary gland, the pea-sized structure just behind the eyes at the base of the brain. These tumors are almost always noncancerous, but they can cause problems if they create an overproduction of hormones in the body or grow large enough to press against the brain and optic nerves.

If you have a pituitary tumor, you may be wondering if there are any lifestyle changes you should make, such as your diet. We spoke with our clinical dietitians to learn more about diet and nutrition for people with pituitary tumors.

Aim for a healthy, plant-based diet

There’s not enough concrete evidence showing that specific foods are harmful to people with pituitary tumors.

“There’s no specific diet to follow if you have a pituitary tumor, so we recommend a healthy diet,” says senior clinical dietitian Trisha Rosemond. “Preferably, this is a plant-based diet that includes a variety of fruits, vegetables, whole grains, lean proteins and healthy fats, and limits the amount of processed foods.”

This means half of your plate should be filled with fruits and vegetables. Aim to eat two servings of fruit and three servings of vegetables each day. One serving is equivalent to one cup of raw fruits or vegetables and half a cup of cooked fruits or vegetables.

“We suggest choosing lean animal proteins, trimming visible fats and removing the skin from poultry,” says Rosemond. “Chicken, turkey or fish are preferred over red meat because research studies have shown that a person’s cancer risk increases with a high consumption of red meat, compared to other types of proteins.”

Manage treatment side effects with your diet

Treatment for pituitary tumors may include medication to help reduce hormone levels. The drugs commonly used can cause nausea or vomiting. A dietitian can help manage those side effects.

“Avoid foods that are spicy, fried or fatty because they don’t settle well in the stomach whenever you’re nauseous, and foods that have a strong aroma could also trigger nausea,” says Rosemond. “Try eating simple foods that can help ease nausea and settle the stomach, like plain toast or crackers. Ginger also helps.”

Rosemond also says eating smaller meals and snacks more frequently may be better than trying to consume big meals.

If you are suffering from fatigue, make sure you’re drinking plenty of fluids to stay hydrated, Rosemond adds. 

Maintaining nutrition with pituitary cancer

Though it’s rare, sometimes pituitary tumors can become cancerous and spread to other areas of the body. When treatment involves radiation therapy or chemotherapy, for example, the focus for dietitians becomes managing the diet and side effects.

“Some patients may experience changes in taste from chemotherapy, so finding foods they can tolerate and taste good to them sometimes requires thinking outside the box,” says Katie Roberts, clinical dietician at MD Anderson West Houston. “As dietitians, our goal is to ensure patients can eat and maintain their weight, which reduces the risk for malnutrition.”

This includes finding ways to incorporate extra, healthy calories in meals. Try adding avocado to your sandwich or drizzling honey on your oatmeal.

“We’ll often tell patients to try to eat something every two to three hours, even if it’s just a few bites or a protein shake – anything to get those extra calories in,” says Roberts.

Timing of meals is important

If a pituitary tumor is pressing onto the brain, patients may take steroids to reduce swelling.

“Steroids can elevate blood glucose levels and make patients very hungry,” says senior clinical dietitian Jessica Tilton. “The challenge then becomes making sure they get food frequently but avoiding refined carbohydrates like white rice, white flour, pasta and sweets because those elevate blood glucose.”

Make sure you eat plenty of fruits and vegetables – and that you’re eating breakfast, lunch, dinner and multiple snacks throughout the day. Scheduling these meals around medication times is important.

“If patients are taking chemotherapy at night, they could get nauseated, so they should eat dinner and take an anti-nausea pill two hours later,” says Tilton. “Thirty minutes after that, you can give them the oral chemotherapy medication. You have to be able to time the meals, so you can give the medication on schedule.”

Tilton suggests MD Anderson patients request a referral to one of our dietitians so they can develop a plan that works for them.

“You want to make sure to eat something at least every three hours,” she says. “Plan out your meals ahead of time.”

Tilton offers these examples for a day’s meals:

• Breakfast: Eggs, peanut butter on toast with banana OR oatmeal with fruit and lactose-free milk
• Lunch: Salad with soup
• Snack: Fruit with nut butter
• Dinner: Skinless, baked chicken breast with brown rice and broccoli

If you’re undergoing chemotherapy, drink plenty of water before and after treatments to stay hydrated, Tilton says.

Consult MD Anderson for other issues with pituitary tumors

Pituitary tumors don’t only affect the brain. They can also affect your ability to eat.

“Depending on the severity of the tumor, sometimes a patient can have difficulty swallowing,” says Tilton.

If you’re having trouble swallowing, schedule a visit with a speech pathologist at MD Anderson.

“The speech pathologist can evaluate the patient and tell exactly where the swallowing issue lies,” Roberts adds. “Plus, they can share what the safest foods and drinks are for the patient.”    

Request an appointment at MD Anderson online or by calling 1-877-632-6789.