July 13, 2015 | by Denise Heady
When Gilbert Fresquez, 72, lost an excessive amount of weight in late 2012, he didn’t think much of it. He assumed it was a side effect from a recent surgery to remove a carcinoid tumor in his small intestine.
It wasn’t until a couple of years later during a routine doctor’s visit that the retired business owner learned that his weight loss, along with his low production of testosterone, was due to a pituitary tumor, located just below his brain.
Pituitary tumors, which are primarily noncancerous, are known to be slow-growing, and many people can live years with one before having any symptoms. Eventually, however, these tumors can grow large enough to cause significant health problems such as vision loss, dizziness, headaches, unintended weight loss or weight gain, weakness, body hair loss and hormone deficiencies.
Doctors estimated that Fresquez’s tumor had been growing in his pituitary gland for nearly 10 years.
“I told Gil to put his Superman cape back on because I knew we had another battle in front of us,” said Fresquez’s wife, Marianne Nugent.
A neurosurgeon with extensive experience
In November 2014, Fresquez met with an endocrinologist, who told him he would need surgery to remove the tumor. He and Nugent immediately made an appointment with a neurosurgeon, but decided to get a second opinion with another neurosurgeon. They called Behnam Badie, M.D., director of the Brain Tumor Program at City of Hope.
“When we heard Dr. Badie say he loves performing these type of surgeries and that they were 'fun' for him, we knew he was our guy,” Nugent said. “The fact that he has a lot of experience with these tumors made all the difference.”
At City of Hope, Fresquez underwent an endoscopic endonasal transsphenoidal procedure, a type of brain surgery that removes tumors through the nose. This minimally invasive approach unites the visual precision of an endoscope, with the power of a navigation system, magnetic resonance imaging and highly specialized microscopes.
Badie specializes in this type of procedure and has been practicing it for the past two decades – since it was first introduced, in fact.
“It’s amazing to see what a difference surgery can have on a patient’s quality of life,” Badie said. “I’ve had patients come in who were having trouble seeing, and a few weeks after surgery, their vision returned.”
Now, to better serve patients like Fresquez, Badie and endocrinologist Behrouz Salehian, M.D., associate professor in the Department of Clinical Diabetes, Endocrinology & Metabolism, have created a pituitary clinic with a multidisciplinary team of specialists that helps ensure patients receive the most effective treatment for their condition.
A collaborative approach to pituitary diseases
The clinic, which officially opens July 22, will provide comprehensive care for patients every third Wednesday of the month, and is a collaborative effort between the Department of Surgery, Division of Neurosurgery and the Department of Clinical Diabetes, Endocrinology & Metabolism.
The clinic was created to treat all types of diseases related to the pituitary including acromegaly, adrenal insufficiency (Addison disease), craniopharyngiomas, Cushing syndrome, empty sella syndrome, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) tumors, growth hormone deficiency, hypogonadism, hypothyroidism, hypopituitarism, prolactinomas, Rathke's cleft cysts, transsphenoidal surgery and pituicytoma.
“The pituitary is the master conductor of the endocrine orchestra in humans,” Salehian said. “Despite its small size, it maintains the integrity of the endocrine system and is the subject of large number of diseases that can best be managed by a comprehensive multidisciplinary team.”
As for Fresquez, his surgery to remove the pituitary tumor went smoothly, and he's now celebrating three years of clean scans. To commemorate the milestone, he and his wife are headed to Scotland and Ireland.
Learn more about becoming a patient or getting a second opinion at City of Hope by visiting our website or by calling 800-826-HOPE (4673). You may also request a new patient appointment online. City of Hope staff will explain what's required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.