How is an overactive pituitary treated?
The treatment will depend on the underlying cause.
- Surgery: A procedure called a transsphenoidal adenomectomy is usually recommended for patients with acromegaly or Cushing’s disease. The surgeon makes a small incision through the nose or upper lip to reach the pituitary and remove the tumor. Although this procedure is very delicate, it has a success rate higher than 80% when performed by experienced surgeons. Transsphenoidal surgery is most effective for small tumors (under 10 mm in diameter). Potential drawbacks include long-term dependence on pituitary hormone replacement therapy and cerebrospinal fluid leakage.
- Medication: Drugs may be used to shrink large tumors before surgery or in cases where surgery is not an option. Medication to reduce prolactin levels is usually the preferred treatment for patients with a prolactinoma. Patients with acromegaly may be treated with drugs used to lower growth hormone levels and shrink tumors.
- Radiation: Radiation may be used to treat patients who cannot undergo surgery or who have some residual tumor tissue after surgery and do not respond to medication. There are two approaches to radiation, conventional and stereotactic therapies:
- Conventional radiation therapy is administered in small doses over a period of 4 to 6 weeks. One drawback is that radiation treatments can damage normal tissue surrounding the tumor.
- Stereotactic therapy provides a high-dose beam of radiation targeted at the tumor. It may be completed in one session, resulting in less damage to surrounding tissue. Most patients that undergo radiation treatment require hormone replacement therapy due to a gradual decline in the secretion of other pituitary hormones.