Pituitary Cancer - Causes, Types, Symptoms, Risk Factors, Diagnosis, and Treatment

What Is the Pituitary Gland?

The pituitary gland is a vital, very small gland that helps the functioning of all endocrine glands. It is known as the master gland and is a major part of the system of the endocrine glands. The pituitary gland is located on the back portion of the nostrils and is involved in reproductive functioning, thyroid disorders, and the functioning of the adrenals.

What Is Pituitary Cancer?

A tumor or cancer occurring in the pituitary gland is called pituitary cancer. It will contribute to severe alterations in hormones. Most of the tumors occurring in the pituitary gland are not cancerous. These non-cancerous types are referred to as adenomas. The adenomas do not tend to spread to the other tissues. The diagnosis of this tumor requires specialized tools that the doctor recommends. The treatment is planned and executed after the results of diagnostic reports.

What Are the Causes of Pituitary Cancer?

In most pituitary cancer patients, the cause is not known. Alterations in the genetic makeup can result in genetic mutations and can result in pituitary cancer.

What Are the Types of Pituitary Cancer?

The benign condition of the pituitary tumor is referred to as a pituitary adenoma, and the malignant ones are referred to as pituitary carcinomas.

1. Pituitary Adenoma:

Pituitary adenomas are categorized into two types based on size:

• Microadenoma: Micradenomas are tiny tours that are less than one centimeter. They do not cause great damage to the nearby tissues. However, alterations in the hormonal level will be seen.

• Macroadenoma: The tumor is more than one centimeter in size in macroadenoma. Damages to the optic nerve are seen in this type of tumor.

The pituitary adenomas are further categorized into two types based on their functions. If the pituitary gland still functions by secreting the hormones, it is a functional adenoma. If a complete loss of gland function is noted, it is called a non-functional adenoma.

• Functional Adenoma: A high hormone level can be identified in blood examination. A severe change in symptoms is noted in functional adenoma.

• Non-Functional Adenoma: It is a very rare type, and it usually occurs as a macroadenoma.

2. Pituitary Carcinoma:

In a microscopic examination, most of the pituitary carcinomas resemble pituitary adenoma. This type of pituitary cancer is very rare. It is usually found in older people. This cancer can spread to the spinal cord, brain, and bones that are found near the pituitary gland.

What Are the Symptoms of Pituitary Cancer?

The symptoms of pituitary cancer can happen due to the altered and increased level of pressure created by the tumor. The common symptoms experienced due to the pressure changes are loss of vision and headaches. The symptoms can also happen due to an imbalance in the hormonal levels.

If there is a deficiency of pituitary hormones, the following symptoms could be noted.

• Weakness.

• Nausea and vomiting.

• Unexplained weight gain or weight loss.

• Irregular menstrual periods.

• Sensitivity to cold.

• Increased urinary output.

• Loss of libido and sexual functions.

If there is excessive production of pituitary hormones, abnormal symptoms could be noted.

Adrenocorticotropic hormones are altered due to the occurrence of tumors. They show the following tumors.

• Exaggerated facial roundness.

• Excessive accumulation of fat.

• High blood pressure.

• Thinning of the legs and arms with muscle weakness.

• Irritability.

• High blood sugar.

• Bone weakening.

• Anxiety and depression.

• Acne.

• Stretch marks.

• Bruising.

If the growth hormones are disturbed, the below symptoms are noted.

• Enlarged hands and feet.

• Abnormal facial features.

• Heart problems.

• Excess sweating.

• Misaligned teeth.

• Joint pain.

• Abnormally fast growth in children and adolescents.

• Increased body hair.

If the thyroid hormones are disturbed, the below symptoms are noted.

• Increase in a heartbeat.

• Weight loss.

• Excessive sweating.

• Abnormal bowel movements.

• Nervousness or irritability.

Symptoms are caused by changes in the male and female hormones.

In women, the following symptoms are seen.

• Amenorrhea. Lack of menstrual periods

• Oligomenorrhea. Irregular menstrual periods

• Milky white discharge from the breasts

In men, the following symptoms are seen.

• Breast growth in men.

• Loss of sex drive.

• Reduced sperm count.

• Erectile dysfunction.

What Are the Risk Factors of Pituitary Cancer?

The risk factors associated with pituitary cancer are:

• Family history: Having a positive history in the family can elevate the risk for pituitary cancer.

• Multiple endocrine neoplasias, type IV (MEN4).

• Multiple endocrine neoplasias, type I (MEN1).

• Carney complex.

• McCune-Albright syndrome.

How Is Pituitary Cancer Diagnosed?

The problem with pituitary cancer is that, in most cases, pituitary cancer is not precisely diagnosed. They are accidentally found on diagnosis for any other illness. A detailed patient history is required in the first diagnosis process. After this, the doctor should conduct a clinical examination to discover the abnormal symptoms. One will require help from an endocrinologist to make an accurate diagnosis.

The other diagnostic methods for detecting the cancer are:

• Imaging of the Brain: The brain can be diagnosed for any abnormalities, such as tumors in the pituitary gland, with the help of a computer tomography (CT) scan or magnetic resonance imaging (MRI) scan.

• Routine Blood Examination: A blood test will help identify the level of hormones in the blood.

• Urine Test: The deficient level of hormones secreted by the pituitary gland can be identified by analyzing the quantity and composition of the urine.

• Vision Testing: The disturbances in the eyesight can be identified with the help of this test.

What Are the Treatment Options for Pituitary Cancer?

Treatment for pituitary cancer involves both medical and surgical options. Radiotherapy treatment and medications might be recommended.

• Medications: Medications are given to shrink the tumors and block the excess levels of hormones. The size of the tumor is reduced with the help of medications like Bromocriptine and Cabergoline. It also reduces the secretion of prolactin. Osilodrostat is recommended to decrease the production of cortisol. Mifepristone is recommended for Cushing syndrome patients. Medications can be given as injections to normalize the production of growth hormones. The excess of growth hormones can be controlled by the usage of drugs like pegvisomant.

• Radiation Therapy: Four types of radiation therapy can be used for the treatment of pituitary cancer. They are:

  • External beam radiation method.

  • Stereotactic radiosurgery.

  • Intensity-modulated radiation therapy (IMRT).

  • Proton beam therapy.

• Surgery: Different surgical treatment options for pituitary cancer are:

  • Craniotomy.

  • Endoscopic transnasal transsphenoidal approach.

What Happens Post-treatment?

After the treatment, there is no chance the person will not worry about the tumor reoccurring. Even after years, the person should visit the doctor for every follow-up visit. Initially, the visits will be every few months, and as the year passes and the person is tumor-free, the visits will gradually decrease. Even after the treatment, lab tests may be recommended to ensure there is no sign of a tumor. Based on the tumor and the treatment, the doctor may recommend tests.

Conclusion

Pituitary tumors are unusual growths in the pituitary gland, which is present at the base of the brain and produces hormones. When a tumor occurs, the pituitary gland produces too much of the hormones that control important body functions. This condition can be treated through many methods, and the tumor can be removed with surgery.