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Treatment Options

Medications

Several types of drugs can help relieve pituitary problems. Prolactinomas, for example, respond well to a dopamine agonist drug. If surgery does not remove the entire pituitary gland tumor, somatostatin analogues are used in patients with acromegaly, TSH-secreting tumors, and some cases of Cushing’s disease. Medication is used to lower high hormone levels or to shrink the tumor. Sometimes pegvisomant may be used to block the action of growth hormone. In many cases, drug therapy is combined with surgery and/or radiation treatment, or more than one drug can be used at the same time for combined effects.

Hormone Therapy for Hyposecretion

Sometimes tumors cause a lack of a hormone. Other times, the lack of a hormone is caused by the treatment you have for pituitary tumors. Surgery or radiation therapy, for example, can lead to permanent loss of hormone secretion.  In these cases, hormone replacement therapy is an important part of treatment.

Some types of hormones are necessary for survival. These hormones must be replaced immediately. They include

  • TSH, or thyroid stimulating hormone—regulates thyroid hormone production, which, in turn, regulates metabolism. If a problem with TSH secretion is causing low thyroid hormone levels, you may also need to start thyroid hormone replacement.
  • Antidiruetic hormone (ADH), or vasopressin—controls the body's water balance.

Other hormones, such as estrogen and progesterone in women, and testosterone in men, also may need to be replaced. While they are not vital for survival, they may help you to live a full and healthy life. In addition to reproductive effects, these hormones are important for many functions such as maintaining normal bone and muscle mass.

Estrogen and progesterone hormone replacement in young women is not the same as post-menopausal hormone therapy. In the latter case, hormones are being given at a time in life when they are not normally made. For more information about the pros and cons to estrogen and progesterone replacement during menopause, see the Hormone Health Network section on menopause.

Some hormones may return to normal levels after treatment for a pituitary condition. In other cases, there may be some permanent loss of hormone function. You may need to continue with some type of hormone therapy for many years or the rest of your life. Your doctor will work with you to monitor and adjust your hormone replacement therapy as needed.

Surgery

The most common form of surgery to remove pituitary tumors is transsphenoidal microsurgery. A neurosurgeon approaches the pituitary gland tumor through the nose, in the sphenoid sinus cavity. Using this natural pathway, the surgeon does not need to operate on your skull. With a surgical microscope and special instruments, the surgical goal is to safely remove the tumor without damaging the surrounding pituitary gland.

Radiation therapy

To treat a pituitary gland tumor with radiation, doctors may use a variety of techniques depending on the size and location of the tumor. Conventional radiation covers a wide area in and around the tumor and is usually given daily for several weeks. A number of more focused "radiosurgery" therapies, such as gamma knife and proton beam, may be appropriate.

All radiation therapy works slowly and it may take from six months at a minimum to many years for your condition to improve. This is why radiation therapy is usually used together with other medical therapies to normalize hormone secretion and/or control tumor size.

Editors:

Anne Klibanski, MD
Massachusetts General Hospital 
Harvard Medical School

Nicholas Tritos, MD
Massachusetts General Hospital
Harvard Medical School

Last Review: May 2013