Pituitary tumors, also called pituitary adenomas, start in the pituitary gland. They almost always are benign (not cancer). However, they can cause other serious medical problems.
These problems can be due to the overproduction or underproduction of hormones or if the tumors grow large enough to press against areas around the pituitary gland, such as the optic nerves, which help you see.
The pituitary gland, which is about the size of a pea, is at the base of the brain. Although it is small, the gland is important and is known as the "master gland." It makes growth hormone (GH), which plays a part in growth in children and metabolism in adults, and prolactin, a hormone important for breast milk production. The pituitary gland also makes hormones that control the function of other glands, including the thyroid, adrenals and gonads (ovaries in women and testes in men).
Types of Pituitary Tumors
Pituitary tumors may occur in up to 15% to 20% of people, but tumors requiring treatment occur less frequently and often are not diagnosed.
There are two main types of pituitary tumors, functioning and non-functioning.
Functioning Tumors: These pituitary tumors cause the body to make too much of certain hormones. Hormones that may be overproduced by such pituitary tumors include:
- Prolactin: Prolactin stimulates breast growth and milk production in women. A pituitary tumor that makes too much of this hormone is called a prolactinoma. This is the most frequent type of pituitary tumor.
- Growth hormone (GH): GH plays a part in height in children and the body's metabolism. Tumors that make too much GH cause acromegaly (gradual enlargement of body parts) in adults and gigantism (abnormally large growth) in children.
- Adrenocorticotropic hormone (ACTH): This hormone tells the adrenal glands to make cortisol, which plays a role in the body's response to stress. It also helps regulate blood pressure and heart function, among other duties. Too much ACTH leads to Cushing's disease.
- Thyroid-stimulating hormone (TSH): Pituitary tumors that make too much of this hormone cause the thyroid to release large amounts of thyroxine, causing hyperthyroidism (overactive thyroid). This is the most rare type of pituitary tumor.
Non-functioning Tumors: This type of pituitary tumor does not make hormones that cause symptoms, and it is the second most frequent type of pituitary tumor. They may cause problems if they grow large and press against other areas, such as the optic nerve or other nerves. Non-functioning pituitary tumors also can interfere with the pituitary gland's normal production of hormones.
Pituitary cancer (carcinoma): In rare cases, the cells in a pituitary tumor can become cancer and metastasize (spread) to other areas of the body. In most cases, pituitary cancers make hormones, usually prolactin and ACTH.
Pituitary Tumor Risk Factors
A risk factor is anything that increases your chance of getting a disease. The only proven risk factor for pituitary tumors is inheriting a condition that makes you more likely to develop a pituitary tumor, such as Multiple Endocrine Neoplasia (MEN1) or Family Isolated Pituitary Adenoma (FIPA).
Not everyone with MEN1or FIPA gets a pituitary tumor. However, if you or someone in your family has this disorder, it¡¯s a good idea to discuss your risk with your doctor.
Learn more about pituitary tumors:
Some cases of pituitary tumors can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.
The pituitary gland is a pea-sized structure at the base of the brain. (Click to enlarge)
Foods to avoid with pituitary tumors
Pituitary tumors grow in the pituitary gland, the pea-sized structure just behind the eyes at the base of the brain. These tumors are almost always noncancerous, but they can cause problems if they create an overproduction of hormones in the body or grow large enough to press against the brain and optic nerves.
If you have a pituitary tumor, you may be wondering if there are any lifestyle changes you should make, such as your diet. We spoke with our clinical dietitians to learn more about diet and nutrition for people with pituitary tumors.
Aim for a healthy, plant-based diet
There¡¯s not enough concrete evidence showing that specific foods are harmful to people with pituitary tumors.
¡°There¡¯s no specific diet to follow if you have a pituitary tumor, so we recommend a healthy diet,¡± says senior clinical dietitian Trisha Rosemond. ¡°Preferably, this is a plant-based diet that includes a variety of fruits, vegetables, whole grains, lean proteins and healthy fats, and limits the amount of processed foods.¡±
This means half of your plate should be filled with fruits and vegetables. Aim to eat two servings of fruit and three servings of vegetables each day. One serving is equivalent to one cup of raw fruits or vegetables and half a cup of cooked fruits or vegetables.
¡°We suggest choosing lean animal proteins, trimming visible fats and removing the skin from poultry,¡± says Rosemond. ¡°Chicken, turkey or fish are preferred over red meat because research studies have shown that a person¡¯s cancer risk increases with a high consumption of red meat, compared to other types of proteins.¡±
Manage treatment side effects with your diet
Treatment for pituitary tumors may include medication to help reduce hormone levels. The drugs commonly used can cause nausea or vomiting. A dietitian can help manage those side effects.
¡°Avoid foods that are spicy, fried or fatty because they don¡¯t settle well in the stomach whenever you¡¯re nauseous, and foods that have a strong aroma could also trigger nausea,¡± says Rosemond. ¡°Try eating simple foods that can help ease nausea and settle the stomach, like plain toast or crackers. Ginger also helps.¡±
Rosemond also says eating smaller meals and snacks more frequently may be better than trying to consume big meals.
If you are suffering from fatigue, make sure you¡¯re drinking plenty of fluids to stay hydrated, Rosemond adds.?
Maintaining nutrition with pituitary cancer
Though it¡¯s rare, sometimes pituitary tumors can become cancerous and spread to other areas of the body. When treatment involves radiation therapy or chemotherapy, for example, the focus for dietitians becomes managing the diet and side effects.
¡°Some patients may experience changes in taste from chemotherapy, so finding foods they can tolerate and taste good to them sometimes requires thinking outside the box,¡± says Katie Roberts, clinical dietician at MD Anderson West Houston. ¡°As dietitians, our goal is to ensure patients can eat and maintain their weight, which reduces the risk for malnutrition.¡±
This includes finding ways to incorporate extra, healthy calories in meals. Try adding avocado to your sandwich or drizzling honey on your oatmeal.
¡°We¡¯ll often tell patients to try to eat something every two to three hours, even if it¡¯s just a few bites or a protein shake ¨C anything to get those extra calories in,¡± says Roberts.
Timing of meals is important
If a pituitary tumor is pressing onto the brain, patients may take steroids to reduce swelling.
¡°Steroids can elevate blood glucose levels and make patients very hungry,¡± says senior clinical dietitian Jessica Tilton. ¡°The challenge then becomes making sure they get food frequently but avoiding refined carbohydrates like white rice, white flour, pasta and sweets because those elevate blood glucose.¡±
Make sure you eat plenty of fruits and vegetables ¨C and that you¡¯re eating breakfast, lunch, dinner and multiple snacks throughout the day. Scheduling these meals around medication times is important.
¡°If patients are taking chemotherapy at night, they could get nauseated, so they should eat dinner and take an anti-nausea pill two hours later,¡± says Tilton. ¡°Thirty minutes after that, you can give them the oral chemotherapy medication. You have to be able to time the meals, so you can give the medication on schedule.¡±
Tilton suggests MD Anderson patients request a referral to one of our dietitians so they can develop a plan that works for them.
¡°You want to make sure to eat something at least every three hours,¡± she says. ¡°Plan out your meals ahead of time.¡±
Tilton offers these examples for a day¡¯s meals:
- Breakfast: Eggs, peanut butter on toast with banana OR oatmeal with fruit and lactose-free milk
- Lunch: Salad with soup
- Snack: Fruit with nut butter
- Dinner: Skinless, baked chicken breast with brown rice and broccoli
If you¡¯re undergoing chemotherapy, drink plenty of water before and after treatments to stay hydrated, Tilton says.
Consult MD Anderson for other issues with pituitary tumors
Pituitary tumors don¡¯t only affect the brain. They can also affect your ability to eat.
¡°Depending on the severity of the tumor, sometimes a patient can have difficulty swallowing,¡± says Tilton.
If you¡¯re having trouble swallowing, schedule a visit with a speech pathologist at MD Anderson.
¡°The speech pathologist can evaluate the patient and tell exactly where the swallowing issue lies,¡± Roberts adds. ¡°Plus, they can share what the safest foods and drinks are for the patient.¡± ???
or by calling 1-877-632-6789.
Why choose MD Anderson for pituitary tumor treatment?
The specialists in the Pituitary Tumor Program at MD Anderson's Endocrine Center are among the nation's most experienced and skilled experts in diagnosing and treating pituitary cancer and benign (not cancer) pituitary tumors. Your personal medical team for pituitary tumor care may include endocrinologists, neurosurgeons, neuroradiologists, pathologists, neuro-ophthalmologists and/or radiation oncologists, as well as a specially trained support staff. They communicate and collaborate closely with each other ¨C and with you ¨C to coordinate your treatment.
Comprehensive, Expert Care
Because the pituitary gland is delicate and can be damaged during surgery, it is vital that your surgery be done by a specialized neurosurgeon with a high degree of experience. MD Anderson's surgeons complete many pituitary tumor surgeries each year, and this increases your chance for a successful outcome.
As one of the country's foremost cancer centers, we are constantly researching new advances, and we take part in many multi-center clinical trials. This means we offer clinical trials for new treatments of pituitary tumors, which may be difficult to find elsewhere.
And, at MD Anderson you're surrounded by the strength of one of the nation's largest and most renowned comprehensive cancer centers, which has all the support and wellness services needed to treat the whole person ¨C not just the disease.
6 things to know about pituitary adenomas
Pituitary adenomas, also referred to as pituitary neuroendocrine tumors, are almost always benign tumors that arise from hormone-secreting cells in the pituitary gland.?
This gland is situated at the base of the brain, just behind the bridge of the nose, inside a bony cave called the sella turcica. The pituitary gland is considered the ¡°master¡± gland because it controls all the other hormone-producing glands in the body.?
But are pituitary adenomas ever cancerous? What are their symptoms? And, how are they typically treated??Keep reading to learn the answers to these and other questions I sometimes hear about pituitary adenomas.?
Are pituitary adenomas ever cancerous???
Pituitary adenomas are benign by definition. That means they are not cancerous.?And, despite their location, they are not considered a type of brain tumor.
Very rarely, pituitary adenomas can spread to other parts of the body. At that point, though, they are called something else: pituitary carcinomas.?
Do pituitary adenomas ever cause symptoms??
Yes. There are two broad categories of pituitary adenomas: functioning and non-functioning. ?
Functioning tumors ?
These make too much of certain hormones that travel to other glands and affect how they behave. People¡¯s symptoms vary based on the type of hormone being produced.?
- Prolactinoma: Prolactin, also known as ¡°the breast milk hormone,¡± can suppress the function of the gonads (ovaries in women and testes in men). Too much of it may cause decreased libido (chiefly men) and infertility (both sexes), missed periods (women), milky breast discharge (women, and very rarely men), and impotence and loss of body hair (men).?
- Adrenocorticotropic hormone (ACTH): Too much ACTH leads to excessive production of cortisol, a condition called Cushing disease. Too much cortisol can cause weight gain (especially in the center part of the body), excessive fat deposits above the collar bones and upper back, a rounded face, thin skin, easy bruising, stretch marks, ankle swelling, osteoporosis, diabetes, and high blood pressure.
- Growth hormone: Too much of this hormone can lead to a condition called acromegaly, in which the soft tissues in the hands and feet become abnormally large. Other issues include facial and jaw changes, excessive sweating, heart disease, high blood pressure, joint pains/arthritis, sleep apnea, and diabetes. ?
- Thyroid-stimulating hormone (TSH): Too much of this hormone can cause weight loss, anxiety, trouble sleeping, feeling too hot, and a rapid and sometimes irregular heartbeat.?
Non-functioning tumors ?
These pituitary adenomas don¡¯t secrete any hormones, so they¡¯re considered ¡°silent.¡± Once a non-functioning pituitary adenoma gets large enough, however, it can start compressing the optic chiasm. This may cause vision changes, especially along the sides of the visual fields, also known as peripheral vision.?
Non-functioning tumors may also cause headaches and abnormally low hormone levels.?
How are pituitary adenomas usually diagnosed??
Most patients with functioning pituitary adenomas are diagnosed when they start to experience symptoms and physical changes that lead to an assessment by a doctor. Then, imaging finds the tumor. ?
Patients with non-functioning pituitary adenomas, on the other hand, typically notice peripheral vision loss, headaches, or symptoms of low hormone levels first, which then leads to a brain MRI that reveals the tumor. ?
Finally, some people only find out they have a pituitary adenoma by accident when they¡¯re getting a brain scan for some other reason. This is called an incidental finding.?
How are pituitary adenomas typically treated? Do they have to be removed??
Pituitary adenomas are not life-threatening. Depending on their type, they can be treated with surgery, medication, and sometimes radiation therapy.?
Prolactinomas, for example, can usually be treated with medicine alone. Surgery is another good option for people with small prolactinomas who prefer surgery over medication and for those who do not tolerate medication very well.?
For all other functioning tumors, surgery is usually considered first, followed by additional treatment to lower hormone levels if surgery is not curative. ??
For non-functioning tumors, surgery is usually undertaken to improve vision and alleviate headaches. However, small, incidentally discovered non-functioning tumors may be monitored without therapy in patients who display no symptoms.?
Finally, radiation therapy is sometimes needed to control tumor growth and/or treat excessive hormone production when other treatments don¡¯t work.
?What is the life expectancy of a person with pituitary adenoma??
Pituitary adenomas can lead to a shorter lifespan if the hormonal problems they cause are not well-controlled. However, with proper treatment, life expectancy for patients with pituitary adenomas is the same as anyone else¡¯s.
What¡¯s the most important thing to know about pituitary adenomas??
Pituitary adenomas and carcinomas are unique tumors that often require multidisciplinary expertise to treat them. Therefore, it is vital for every patient diagnosed with a pituitary tumor to consider being treated at a pituitary tumor center of excellence, such as MD Anderson.
A lot of people don¡¯t realize this, simply because our name contains the word ¡°cancer,¡± but MD Anderson also provides excellent care to patients with benign tumors. ?
, is an endocrinologist specializing in pituitary tumors, thyroid cancer?and multiple endocrine neoplasia. ?
or call 1-877-632-6789.