Pituitary Tumor Treatment in India- Cost, Best Doctors & Hospitals

Posted on January 7th, 2020 by Ganesh Gopakumar

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What is Pituitary adenoma?

Pituitary adenomas are tumors that form in the pituitary gland. Most of the tumors are benign (non-cancerous). Pituitary adenomas are common, with over 1 million cases in India alone.

Pituitary Gland

Pituitary gland is an endocrine gland  which is present below the hypothalamus, at the base of the skull, sized about a pea. It weighs just 0.5 grams. It has 3 lobes: Anterior lobe, Posterior lobe and Intermediate lobe. The hormones of the anterior lobe include adrenocorticotropin hormones (ACTH), growth hormones (GH), lutienizing hormones (LH), follicle-stimulatinghormoes (FSH), prolactin (PRL),  and thyroid-stimulating hormone (TSH). The posterior lobe stores antidiuretic hormones (ADH) and oxytocin. Melanocyte-stimulating hormone is secreated by the intermediate lobe. It is called ‘the master gland’ since the hormones secreted by it controls the activity of the majority of other glands. It is involved in growth, reproduction, functioning of organs like kidney, breasts, and uterus.

Since most of the tumors are benign (non-cancerous), they aren’t life-threatening. But they can grow big to affect the nearby organs and structures. Eg, they affect the optic nerve (the nerve connecting the eye to the brain)

Pituitary adenoma can be classified

Based on its size:

Pituitary microadenoma: smaller than 10mm in size

Pituitary macroadenoma: larger than 10mm in size

Based on its biological functioning:

Benign adenoma – 65%

Non-cancerous and does not spread to other parts. Still, it can be dangerous as it can lead to hormonal imbalances or blockages of nerves.

Invasive adenoma – 35%

These are not cancerous but aggressively grow to the surrounding regions such as dura mater, sphenoid sinus, and cranial bone.

Carcinoma – 0.1-0.2%

These are cancerous and spread to other regions rapidly. These types of tumors require immediate medical attention and highly dangerous.

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Symptoms of Pituitary adenoma

The symptoms vary from person to person depending upon the hormonal imbalance caused. The size of the tumor also causes symptoms by obstruction.

  • Infertility, nipple discharge, menstrual imbalance or stoppage in females
  • Gigantism in children and acromegaly in adults appears due to an imbalance of growth hormone (GH).
  • Hyperthyroidism may be caused by over secretion of thyroid-stimulating hormone (TSH).
  • Sexual dysfunction and loss of libido.
  • Fatigue
  • Early menopause
  • Muscle weakness
  • Nausea
  • Headache
  • Vision loss

Causes of Pituitary adenoma

The exact cause of the disorder is yet unknown. But changes in DNA lead to the disorder. The condition passes on as hereditary and also happens in a person’s lifetime. Still, scientists believe genetics plays a major role in the cause.

How is pituitary adenoma diagnosed?

  • Blood test: The production of hormones is checked for overproduction/underproduction.
  • CT scan/MRI: To view the internal structure and search for tumors. It also helps to know the size and location of the tumor if any is present.
  • Vision testing: Loss of vision is a major symptom of pituitary adenoma.
  • The doctor might even refer you to an endocrinologist for extensive testing.

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Treatment of pituitary adenoma

Some tumors don’t need treatment. But the ones that affect the vision or messes with the hormones need medical attention. The treatment varies depending upon the size, type, and distance from the brain.

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Medications

Treatment using medications is usually done by preventing the over/under secretion of hormones. Medications can shrink certain types of tumors:

Prolactin-secreting tumors (prolactinomas)

Drugs such as cabergoline and bromocriptine prevent the over secretion of prolactin and help shrink the tumors. There are certain side-effects such as dizziness, nausea, drowsiness, constipation, and depression. 

ACTH-producing tumors (Cushing syndrome)

Mifepristone is the drug mainly given for patients with Cushing syndrome with type-2 diabetics or glucose intolerance. It does not decrease cortisol production but reduces its effect on cells. Fatigue, nausea, muscle aches, high blood pressure are some side-effects of the drug. 

Pasireotide (Signifor) is the latest drug that reduces cortisol production from the pituitary gland itself. It is given intravenously twice a day. 

Growth Hormone secreting tumors

Somavert is a drug used to block the effect of GH on the body cells. Sandostatin is another drug which decreases the production of GH by the pituitary gland and may finally lead to the shrinking of the tumor. Nausea, vomiting, stomach pain, dizziness and headache are experienced by people taking this drug.

Surgery

Surgery is usually done if the tumor is pressing on the optic nerves or if the tumor is overproducing hormones. There are two methods of surgery.

Endoscopic transnasal transsphenoidal approach.

The surgery is carried out through the nose and sinuses without an incision. There would not be any scar. The only issue is that large tumors cannot be removed by this method. The tumors which have affected the nearby areas are also difficult to remove by this method.

Transcranial approach (craniotomy)

It is the surgical removal of the tumor via an incision made in the scalp. Large and complicated tumors can be removed by this procedure.

Radiotherapy

It uses high energy radiation to destroy tumor cells. It can be opted when surgery cannot be performed. This method doesn’t need an incision.

Stereotactic radiosurgery

The radiation is delivered as a single focussed dose to the tumor with sophisticated technology such as gamma knife radiosurgery or cyberknife. It does not require an incision. The tumor site and size is determined using an MRI scan or CT scan prior to the procedure. This method has a minimum radiation dose to the surrounding healthy tissue.

Proton beam therapy

The procedure uses high energy positively charged particles (protons) delivered to the site of the tumor. Protons are not radioactive and stop after hitting the target, unlike x-rays. This is totally safe and does not affect the surrounding healthy tissue.

Intensity Modulated Radiation Therapy (IMRT)

The doctor uses a computer to modulate the direction and intensity of the radiation beam used. This makes sure that the surrounding tissues receive minimal radiation dose.

External beam therapy 

The procedure is done over many sessions using small increments of radiation to the tumor site. Usually done for 5 days over 5-6 weeks. But it takes up to 1 year for the tumor to completely disappear. The procedure is less preferred to the other procedure as it can harm and destroy the surrounding tissue to a small extent.

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Best Doctors in India for Pituitary Adenoma

  1. Dr. VP Singh
  2. Dr. Aditya Gupta
  3. Dr. MR Sivakumar
  4. Dr. Paneer A
  5. Dr. Rajendran S
  6. Dr. Rajeev Anand
  7. Dr. Sangeetha Ravat
  8. Dr. Sreekanta Swamy
  9. Dr. Chandran Gnanamuthu
  10. Dr. Prathipa Singhi

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Best Hospitals in India for Pituitary Adenoma

  1. Paras Hospital, Gurgaon
  2. Medanta Hospital, New Delhi
  3. Artemis Hospital, Delhi
  4. Max Hospital, New Delhi
  5. Nanavati Hospital, Mumbai
  6. BLK Super Speciality Hospital, New Delhi
  7. Indraprastha Apollo Hospital, New Delhi
  8. Artemis Hospital, Gurgaon
  9. Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, New Delhi
  10. Max Super Specialty Hospital, Gurgaon
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FAQ

Is pituitary tumor a brain tumor?

No, the pituitary gland is situated close to the brain and people often mistake it to be a brain tumor. Actually pituitary gland is totally different from the brain cells.

Is pituitary tumor cancer?

99% of the time, the tumor is benign. Even though it ain’t cancer, it can cause other issues like loss of eyesight, hormonal imbalances, and headache.

Does pituitary tumor reduce life expectancy?

It should not reduce life expectancy if treated properly. It can be easily and successfully cured by either medication or radiosurgery.

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