Expert treatment for pituitary tumors in San Diego
Expert treatment for pituitary tumors in San Diego
Scripps MD Anderson Cancer Center diagnoses and treats tumors of the pituitary gland with expertise, compassion and a team approach to care. Our physicians use the most sophisticated treatments, such as robotic surgery and the newest radiation therapy technologies.
Our multidisciplinary, collaborative board of specialists reviews complex care plans to ensure patients receive the best possible care from diagnosis to recovery.
About pituitary tumors
Pituitary tumors fall under the category of endocrine and neuroendocrine cancer. They are abnormal cell growths in the tissues of the pituitary gland, a small gland found inside the skull right below the brain and above the nasal passages. The pituitary gland produces the hormones that control the levels of other hormones made by the body’s endocrine glands.
According to the American Cancer Society, about 10,000 pituitary tumors are diagnosed each year in the United States. Almost all of these tumors are benign (non-cancerous) pituitary adenomas. Cancer of the pituitary gland, or pituitary carcinoma, is very rare. Benign tumors don’t spread to other parts of the body, but they can be a significant health issue because they are located so close to the brain. In addition, they may cause hormonal imbalances in the body.
Types of pituitary tumors
The pituitary gland has two sections:
- Anterior pituitary, which is the larger, front part of the gland and where most pituitary tumors start. The anterior pituitary makes the “master” hormones that control production of other hormones.
- Posterior pituitary, which is the back part of the gland that is connected to the hypothalamus of the brain. It stores hormones made by the hypothalamus before they are released into the bloodstream.
There are several types of pituitary tumors, including pituitary adenomas, pituitary carcinomas and rare tumors, such as teratomas, germinomas and choriocarcinomas.
There are two types of pituitary adenomas:
- Microadenomas are smaller than 1 cm in diameter. It’s unusual for them to damage surrounding tissue, but they can still create a hormone imbalance and cause symptoms.
- Macroadenomas are 1 cm or larger in diameter. These tumors can cause symptoms by pressing on nearby tissues or nerves, as well as by creating a hormone imbalance.
Pituitary adenomas are also categorized by the type and amount of hormone they produce:
- Functional adenomas are tumors that produce too much of a hormone. Most pituitary adenomas are functional. There are several types of functional adenomas based on the hormones they make, which can affect symptoms, diagnosis and treatment.
- Non-functional adenomas are tumors that do not overproduce hormones, but they can cause problems because of their size.
Pituitary carcinomas, or cancerous pituitary tumors, are rare. Pituitary carcinomas and pituitary adenomas look the same under a microscope, and both can produce hormones. But carcinomas can spread to distant parts of the body. Physicians may not be able to tell if a tumor is cancerous until it spreads.
Other pituitary tumors
Other very rare pituitary tumors include teratomas, germinomas and choriocarcinomas. They do not produce hormones, but can grow into the surrounding areas and cause problems.
Pituitary tumor causes, risks and family history
The causes of pituitary tumors are not fully known. While genetics can be a factor in some cases, most people who develop pituitary tumors have no family history of the disease.
The only known pituitary tumor risk factors are inherited gene mutations. People who inherit these mutations from their parents have a significantly higher risk of developing pituitary tumors. Inherited genetic syndromes that raise the risk for pituitary tumors include:
- Multiple endocrine neoplasia, type I (MEN1)
- Multiple endocrine neoplasia, type IV (MEN4)
- McCune-Albright syndrome
- Carney complex
If you believe you may have an inherited syndrome that increases your risk, talk with your doctor about genetic testing.
Pituitary tumor prevention, screenings and early detection
Researchers don’t know how to prevent pituitary tumors. There are no general screening exams or controllable risk factors. But people who have an increased risk of pituitary tumors due to an inherited syndrome may benefit from regular blood tests to measure hormone levels and identify and treat potential problems.
Pituitary tumor symptoms, diagnosis and stages
Pituitary adenomas don’t always cause symptoms. When symptoms do occur, they vary depending on the type of tumor. Learn more about pituitary tumor symptoms, diagnostic testing and stages below.
Pituitary tumor symptoms
Functional tumors create hormone imbalances that may cause symptoms sooner than non-functional tumors, which don’t make hormones. Non-functional tumors generally don’t cause symptoms until they grow large enough (macroadenomas) to put pressure on nearby areas, such as the brain or nerves.
The most common pituitary tumor symptoms include:
- Eye muscle weakness (eyes don't move in the same direction at the same time)
- Blurred or double vision
- Loss of peripheral (side) vision
- Sudden blindness
- Facial numbness or pain
- Loss of consciousness
Macroadenomas and pituitary carcinomas that cause damage to healthy areas of the pituitary gland can interfere with the pituitary gland’s ability to produce certain hormones. Depending on the hormones affected, symptoms may include:
- Unexplained weight loss or weight gain
- Increased growth or loss of body hair
- Feeling cold
- Menstrual changes or loss of menstrual periods in women
- Erectile dysfunction (trouble with erections) in men
- Growth of breast tissue in men
- Decreased interest in sex
Many of these symptoms may be caused by other conditions. But let your doctor know if you’re experiencing anything unusual, so that you can identify and treat potential problems.
If you have pituitary tumor symptoms, your doctor may recommend diagnostic testing. Scripps physicians use several tools to diagnose pituitary tumors.
A blood sample is collected and checked for abnormal levels of hormones that can indicate a problem with the pituitary gland.
A urine sample is collected and checked for abnormal levels of hormones that can indicate a problem with the pituitary gland.
An eye exam can help identify vision problems that may be caused by a pituitary tumor pressing on the optic nerve. Peripheral or side vision is often the first visual field affected.
Venous blood sample
A blood sample from a vein close to the pituitary gland is checked for high levels of specific substances released by nearby organs and tissues that could signal the presence of cancer.
Magnetic resonance imaging (MRI)
MRI uses a powerful magnet, radio waves and advanced digital technology to provide detailed images of organs, bone and soft tissue.
Computed tomography (CT) scan
A CT scan is an imaging test that captures images of the body from different angles. The images are combined to create detailed cross-sectional views of organs, bones and blood vessels.
Pituitary tumor stages
Staging describes how far cancer may have spread. Oncologists use stages to develop a cancer treatment plan and prognosis.
But since most pituitary tumors are not cancerous, they are not staged. Those pituitary tumors that are cancerous (pituitary carcinomas) are so rare that no staging system has been developed.
Instead, physicians consider the following when developing a pituitary tumor treatment plan:
- Whether it is a microadenoma (smaller than 1 cm across) or macroadenoma (1 cm across or larger)
- Whether it has grown into nearby structures
- Whether it is causing symptoms, such as vision changes or headaches
- Whether it is functional (making excess hormones) or non-functional
- If it releases hormones, and which ones
Understanding your diagnosis
Learning all you can about your pituitary tumor diagnosis and your options can help you make informed, confident decisions about the next steps to take.
Questions and considerations
Here are some questions you may want to ask your doctor or health insurance provider regarding your diagnosis:
- Should I get a second opinion?
- How do I find a specialist?
- What is my treatment plan?
- Will I have to miss work/school?
- What are the side effects of treatment?
- How successful is my treatment likely to be?
- What costs will be covered by insurance?
- Which costs will I be responsible for?
Your Scripps MD Anderson cancer team is here to help you find the answers you need to take an active role in your care. In addition, several community resources provide education, information and helpful resources — often at no cost.
Learn more about the many cancer patient resources available to you and your loved ones.
Treatment and clinical trials
When you’ve been diagnosed with a pituitary tumor, you want a team of expert specialists on your side. Our multidisciplinary teams at Scripps MD Anderson use the latest evidence-based treatments and therapies, including minimally invasive surgery and targeted therapy.
Our approach to treating pituitary tumors
Your Scripps MD Anderson care team includes professionals from every area of oncology, including endocrinologists, neurologists, surgeons, radiation oncologists and nurses who specialize in this care.
In addition, our nurse navigators can help coordinate your care and ensure you have support and guidance throughout your treatment and recovery. Learn more about how Scripps puts you at the center of care.
Pituitary tumor treatment options at Scripps MD Anderson
Nearly all pituitary tumors are non-cancerous adenomas. Scripps MD Anderson physicians determine pituitary adenoma treatment depending on the size and type of the tumor, whether it is cancerous and which hormones it may produce.
Treatment options for pituitary tumors may include one or more of the following:
Pituitary tumor surgery
Scripps physicians may use several surgical procedures to treat pituitary tumors.
- Transsphenoidal surgery is the most common surgery for pituitary adenomas. The surgeon removes the tumor through an incision in the upper lip or lower portion of nose between the nostrils.
- Endoscopic transsphenoidal surgery is performed using an endoscope, a thin instrument with a camera at one end, to view the area through a small incision in the back of the septum inside the nose. This eliminates the need for an incision in the upper lip or between the nostrils.
- Craniotomy is when the surgeon removes the tumor through an opening in the skull.
Drug therapy for pituitary tumor
A number of medications may be used to stop a pituitary tumor from producing an abnormal amount of hormones, or in combination with surgery. The exact medications used depend on which hormones the tumor produces.
Radiation therapy for pituitary tumor
External beam radiation therapy may be part of a pituitary tumor treatment plan if surgery is not an option, after surgery if all of the tumor is not removed or to treat symptoms that are not controlled by medication.
Pituitary tumor clinical trials
Some pituitary tumor treatment plans may involve clinical trials. Talk to your physician about whether a clinical trial is right for you.
For a list of clinical trials that are currently enrolling patients, see our current list of clinical trials.
Your custom treatment plan
Your Scripps MD Anderson cancer team will develop a customized treatment plan outlining the treatments and therapies we recommend for your care. Before you begin treatment, you and your physician will review your plan together and discuss any questions or concerns you may have.
Your pituitary tumor treatment plan generally includes:
- Family and medical history
- A summary of your diagnosis and staging information
- Diagnostic testing completed (e.g., imaging, lab tests)
- Plans for surgery, radiation, chemotherapy and/or other treatments
- Potential side effects of treatments
- Contact information for your care team members
Along with helping you understand your course of treatment and encouraging discussion between you and your physician, your plan helps your team coordinate your care. You also can share your treatment plan with other providers who may be involved in your medical care.
Your cancer care team
Your pituitary tumor care team includes health and medical professionals from a wide range of specialties. Scripps MD Anderson will customize your team to ensure you have the expertise and support you need.
Your team may include:
- Surgeons and surgical oncologists
- Radiation oncologists
- Medical oncologists
- Registered nurses
- Nurse navigators
- Oncology social workers
Visit your cancer care team for more on our multidisciplinary approach to treatment.
Pituitary tumor treatment locations
Scripps MD Anderson diagnoses and treats pituitary tumors at numerous locations throughout San Diego County. From Chula Vista and La Jolla to Encinitas and beyond, our extensive network of Southern California cancer care centers includes:
- Four Scripps hospitals on five campuses
- Outpatient clinics
- Specialty cancer treatment centers
For details on specific centers and their services, visit cancer care locations.
Support groups, services and resources
As leaders in pituitary tumor care, we know what it takes to fight a winning battle. That’s why we equip our patients with the support and resources necessary to achieve their best possible outcome. From connecting you with support groups and services to empowering you with the latest resources and research, Scripps MD Anderson offers a comprehensive lineup to help you along every step of your journey.
Pituitary tumor support groups for patients, family members and survivors
In support of our patients, survivors, their family members and the community, we host a handful of cancer support groups as well as a range of free workshops and health and wellness events on a number of topics, such as:
- Expressive writing
Check the current list of support offerings or contact your oncology social worker or cancer care coordinator.
For info about other cancer support groups in the San Diego community, call the American Cancer Society at 800-227-2345.
Support services for cancer patients
We are here for you — not only as your oncologists, but as a robust multidisciplinary team of experts who understands that your cancer journey is about much more than your medical treatment. Specifically, Scripps MD Anderson offers a variety of patient support services to ensure your physical, psychological and emotional well-being as well as resources for dealing with the logistical and financial aspects of cancer care. Our services and resources include:
- Oncology nurses and nurse navigators with extensive clinical expertise in cancer care to help guide you and your caregivers to make informed decisions and ensure your optimal care.
- Palliative care to provide an extra layer of supportive care to manage pain and relieve symptoms, offer emotional and spiritual support, and improve your quality of life.
- Oncology social workers specially trained to provide counseling, connect you with community and medical resources, assist with transportation and housing and coordinate care after discharge.
- Our registered dietitian nutritionists offer individualized nutrition support for patients whose efforts to optimize their nutrition may be affected by cancer symptoms or treatment side effects.
- Referrals and professional care from experts in psychology, psychiatry and emotional health, including individual and family counseling to help with the emotional challenges of cancer.
- Physical rehabilitation and occupational therapy services, including wound care, voice therapy and swallowing therapy, lymphedema therapy, balance and vestibular rehabilitation, yoga and more.
- Scripps Center for Integrative Medicine for patients interested in mind-body healing through acupuncture, biofeedback, herbal nutrition, massage therapy, integrative cancer care and more.
- Nondenominational spiritual care offered by our chaplains to help coordinate spiritual care with your own clergy, rabbi or spiritual advisor.
- Visiting patient services if you reside beyond San Diego and want help arranging appointments or learning more about short-term lodging.
For the full spectrum of offerings, please visit our cancer patient support services section.
Additional resources for patients, caregivers and family members
Patient education is an integral part of understanding and coping with your cancer diagnosis and treatment. To stay informed, we encourage our patients, along with their caregivers and family members, to:
- Bookmark the Scripps glossary of cancer terms for easy referencing.
- Download the appointment form and list of medications form on our resources page.
- Consult your oncology team for educational materials and a list of trusted online sources beyond the Scripps site.
Navigating cancer might seem overwhelming — especially with so much information online. To ensure you receive the most accurate details, always look to your multidisciplinary team of cancer care experts first.