Pituitary Tumor Treatment Options

Surgery is commonly used to treat patients with pituitary tumors. When applicable, our specialists utilize minimally invasive surgery with advanced technologies such as laparoscopy and the da Vinci S Surgical System with robotic capabilities that allows for greater precision. These surgeries feature small incisions. The result is less discomfort and blood loss with faster recovery and fewer complications.

One of the following surgical procedures may be used:
  • Endonasal transsphenoidal surgery:  Surgeons operate on the brain through the nose to remove pituitary tumors as gently as possible. This endonasal approach, developed within the last decade, unites the visual precision of a slim, tiny camera, called an endoscope, with the power of a navigation system, magnetic resonance imaging and highly specialized microscopes.
  • Endoscopic surgery:  Certain procedures may be performed through an endoscope  a thin, lighted tube that requires a small opening and accommodates tiny surgical tools. Smaller openings minimize post-operative discomfort and risk of infection. City of Hope researchers are working to develop a miniaturized surgical system that will allow brain surgeries to be even less invasive, with an even lower risk of complications.
  • Intraoperative cortical mapping:  This technology gives the surgeon a computerized map of key brain regions, including speech, motor and sensory centers. By avoiding these critical areas, the risk of neurological damage is minimized while allowing as much of the tumor to be removed as possible.
  • Image-guided surgical navigation:  In certain cases, City of Hope surgeons use this technology to guide the removal of tumors that are difficult to visualize or are located in high-risk areas. Using preoperative magnetic resonance images, this highly accurate system allows for more complete removal of the tumor.

Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells. Our Division of Radiation Oncology was the first in the western United States to offer the Helical TomoTherapy Hi-Art System, one of the first radiation therapy systems of its kind to integrate radiation therapy and tumor imaging capabilities comparable to a diagnostic computed tomography (CT) scan.

The Helical TomoTherapy Hi-Art system integrates two types of technology  spiral CT scaning and intensity modulated radiation therapy, or IMRT, that produces hundreds of pencil beams of radiation (each varying in intensity) that rotate spirally around a tumor. The high dose region of radiation can be shaped or sculpted to fit the exact shape of each patients tumor, resulting in more effective and potentially curative doses to the cancer. This, in turn, reduces damage to normal tissues and offers fewer complications.

TomoTherapy is particularly useful in treating children with certain pituitary tumors. Because it operates with absolute precision, normal tissue is protected, reducing the risk of long-term cognitive problems.

Chemotherapy the use of anticancer medicines is another strategy used to combat pituitary tumors. Drugs may be given alone, or in combination with surgery and radiation therapy.

Generally, pituitary tumors are more difficult to treat with drugs than other cancers. This is because most drugs cannot cross the blood-brain barrier, a natural wall that prevents toxic chemicals from reaching certain cells. However, new drugs are being developed that can either cross the barrier or be delivered directly to the brain.