Brain tumor is a mass or growth of abnormal cells in brain. It occurs when abnormal cells form within the brain. Brain tumors can be of 2 types: malignant or cancerous tumors and benign tumors. Further brain tumors can be divided into Primary Tumors (which start within the brain), and Secondary or Metastatic Tumors (which begin in other parts of your body and spread to brain).
How quickly a brain tumor grows varies greatly and depends on many factors. The growth rate and the location of brain tumor determines how it will affect the function of nervous system. All types of brain tumors produce symptoms that vary depending on the part of the brain involved.
Brain tumors may grow from pituitary gland (craniopharyngioma or pituitary adenoma), nerves (neuroma), dura (meningioma). They may also grow from the brain tissue itself (glioma). As they grow, they may compress normal tissue and cause various symptoms.
Brain tumor treatment options depend on the type of brain tumor, as well as its size and location. Treatment goals may focus on relieving symptoms or be curative.
Symptoms experienced due to pituitary tumors depend on their size and the hormones they release. Some common symptoms include :
Pituitary tumors often go undiagnosed because of their symptoms which resemble similar to other conditions. And sometimes pituitary tumors are found because of medical tests for other medical conditions.
To diagnose a pituitary tumor, doctor will likely take a detailed history and perform a physical exam or order below mentioned tests :
- Blood and urine tests – These tests can determine whether one has an over production or deficiency of hormones.
- Brain imaging – A CT scan or MRI scan of brain can help doctor judge the location and size of a pituitary tumor.
- Vision testing -This can determine if a pituitary tumor has impaired sight or peripheral vision.
In addition, doctor might refer patient to an endocrinologist for more-extensive testing.
Pituitary Tumor Treatment
Many pituitary tumors do not need treatment. For those requiring treatment, options depend on type of tumor, its size and how far it has grown into brain. Age and overall health are also important factors to consider.
Treatment options include :
- Medication or Drug Therapy – Drug therapies are used to shrink and destroy the tumor or decrease the amount of hormones the tumor is producing.
- Surgery – Surgery removes the pituitary gland.
- Radiation therapy – It is used to kill tumor cells.
These options are considered either alone or in combination, to treat a pituitary tumor and return hormone production to normal levels.
This approach usually enables the doctor to remove the tumor through nose and sinuses without an external incision. No other part of the brain is affected, and there’s no visible scar.
Large tumors may be difficult to remove this way, especially if a tumor has invaded nearby nerves or brain tissue.
Craniotomy is an operation in which a surgeon removes a piece of the skull to expose the brain. During this procedure, we remove part of the bone from the skull that is referred to as the ‘bone flap’.
This temporary method of opening the skull gives access to the brain, so we can either remove a tumor or treat the affected area. Some of these operation may be done while you are awake so the surgeon can check your speech and movement.
After pituitary tumor surgery, it will take time for the patient to return to his/her usual level of energy. Regular checkups may be required post-surgery. Extra rest would be required for healing.
Generally, patient will see the neurosurgeon two weeks after the surgery and the endocrinologist six weeks post-surgery. An MRI scan will usually be done around three months after surgery. The recovery period may vary ranging from 4-6 weeks to approximately 6 months.
Treatment cost of pituitary tumor surgery
|Sr.No.||Procedures||Cost in India (USD)|
|1||Investigations||800 – 1000|
|2||Endoscopic trans-nasal transsphenoidal approach||6000 – 7500|
|3||Transcranial approach (craniotomy)||7000 – 8000|
Frequently Asked Questions and patient concerns:
1. How is a pituitary tumor diagnosed?
The diagnosis is made either by an imaging study (MRI, CT scan) that shows pituitary gland growth from a hormone tests to determine pituitary function, including overproduction of pituitary hormones, or vision loss.
2. Do pituitary tumors affect pregnancy?
Pituitary tumors sometimes cause pregnancy complications, depending on their form and size. Pregnancy may sometimes cause tumors to increase, making symptoms more imminent. The risk of diabetes and high blood pressure can be increased by some tumor forms.
Doctors typically prescribe that when they become pregnant, women avoid taking tumor medicines. However, it is possible to take such drugs during pregnancy if signs of pituitary tumors arise. The fetus does not seem to be affected by most drugs.
3. Is a pituitary tumor a brain tumor?
The pituitary gland is NOT in the brain, and the brain tissue varies from the pituitary tissue. Since the pituitary gland is located at the base of the brain and is connected by a thin stalk to the brain, the definition of a pituitary tumor is often misunderstood, especially by insurance companies. A pituitary tumor is NOT a tumor of the brain.
4. Is a pituitary tumor cancer?
No, this is NOT cancer in over 99 percent of patients; it is benign. Although the tumor is benign, because of its size, it can cause complications, causing vision loss, loss of normal pituitary function (hypopituitarism) and/or headache, or due to the tumor’s excessive hormone output.
5. What is the best treatment for a pituitary tumor?
It depends on the type of pituitary tumor which treatment approach is carried out. Tumors containing prolactin are treated most successfully with medical therapy (pills). Medical therapy (pills) lowers tumor size and blood prolactin levels in over 90 percent of patients. Medical care is not sufficiently successful in about 8-10 percent of patients, and surgery, and likely radiation therapy, may be required.
The best cure for other pituitary tumor types is tumor removal by a skilled neurosurgeon who regularly performs pituitary surgery. While most neurosurgeons have some pituitary surgery experience, only a handful have dedicated their careers to pituitary surgery and have the best performance records.
6. If a tumor was successfully removed why are regular visits, blood tests and MRI scans necessary?
The desired objective is complete removal of a tumor. A proportion of patients with a pituitary tumor, however, may have a tumor recurrence. Approximately 16 percent of non-functioning tumor patients will have a tumor recurrence within 10 years and 10 percent will need further care within 10 years (surgery, pituitary radiation). Because it is not possible to predict which tumor will recur, all patients require routine medical follow-up.
7. Will there be much pain or discomfort?
For several days after surgery, most patients experience mild to moderate pain. The amount of discomfort ranges from patient to patient, with some requiring a day or two of only moderate pain medication, while a minority of patients need several weeks of pain medication.
8. What restrictions will I have when I go home?
For several weeks after the procedure, you will need to take it easy. At the time of discharge, we will give you specific instructions, but in general, for at least 4 weeks after surgery, we ask most patients not to lift anything bulky and avoid any activity that can be exhausting.
9. When will I be able to return to work?
4 weeks after surgery, most patients are able to return to full-time jobs. Depending on your age, general physical state, and type of work you do this time span can differ.
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