Cancer screening exams can help find pituitary tumors at their earliest stage when the chances for successful treatment, optimal outcomes and fewer side effects are greatest. These tests are usually done when a patient is healthy and has no specific symptoms.
Not only are expert cancer researchers at the OSUCCC – James continually working to detect and diagnose pituitary tumor early, but they are also developing additional tests to detect and diagnose cancer even earlier, leading to improved outcomes, faster responses and fewer side effects.
Currently, for people at low risk for the pituitary tumors, there are no recommended screening tests.
Pituitary Tumor Risk Factors
A risk factor is anything that increases your chances of developing pituitary tumors. The following factors may play a role in the development of pituitary tumors:
- Multiple endocrine neoplasia type 1 (MEN1) syndrome
- Carney complex
- Isolated familial acromegaly
(Source: National Cancer Institute)
If you or anyone in your family has any of the above genetic conditions, or has previously been diagnosed with any of these genetic conditions, you should ask your doctor about getting a blood test to further test for the presence of pituitary tumors.
Not everyone with risk factors will get pituitary tumors. But having certain risk factors appears to increase your risk of developing the disease. If you are at high risk for pituitary tumors, talk to your doctor about tests to detect early signs of the disease.
Diagnosing Pituitary Tumors
If symptoms suggest you might have pituitary tumors, your doctor will give you a thorough physical examination and record your medical history, including information about symptoms and any risk factors you may have.
The following tests or procedures can help detect and diagnose pituitary tumors:
During a physical exam, the doctor examines the body carefully for any signs of disease. The patient is asked about their medical history, lifestyle, any past disease, treatments and family history.
Eye Exam and Visual Field Exam
This is an exam in which the vision and general health of the eyes are checked. A person’s total field of vision is tested by measuring how much a person can see when looking straight ahead versus in all other directions.
During this exam, a series of questions and tests checks the patient’s brain, spinal cord and nerve function. The doctor will check the patient’s mental status, capability, how well they are coordinated and how all the muscles, reflexes and general five senses are working.
Magnetic Resonance Imaging (MRI) with Gadolinium
MRI scans use radio waves and strong magnets instead of X-rays. MRI scans are helpful when the doctor may need to see inside the brain and spinal cord. A radioactive substance (gadolinium) is injected into a vein before this imaging test. This substance will collect around cancer cells and may help the doctor determine if a tumor is present.
Blood Chemistry Study
This is a type of blood test in which the blood is checked for certain chemicals, such as hormones or glucose levels, released by cells into the body. A higher or lower amount of these substances can be an indicator of disease in whatever organ or tissue normally makes those chemicals.
A test in which a sample of blood is taken to measure the levels of the sex hormones testosterone or estrogen. Since the pituitary glands control these hormones, a higher or lower amount may signal disease.
Twenty-Four-Hour Urine Test
This test requires a sample of urine to be collected over a 24-hour period to measure the amounts of certain substances. Having too much or not enough of a particular hormone called cortisol may be a sign of pituitary tumor and Cushing syndrome — a condition that occurs when the body is exposed to high levels of cortisol over time.
High-dose and Low-Dose Dexamethasone Suppression Test
A test in which one or more high or low doses of dexamethasone — a hormone produced by the adrenal glands — are given. After three days, a sample of blood or urine is checked for levels of cortisol. A high level of cortisol may indicate Cushing’s syndrome.
Venous Sampling for Pituitary Tumors
A doctor may recommend this test if imaging tests indicate a normal pituitary gland but blood tests indicate that a tumor may be overproducing adrenocorticotropic hormone (ACTH). A sample of blood is taken from the veins leading out of the pituitary gland and measured for levels of ACTH.
This test measures how much ACTH is being released into the blood by the pituitary gland.
A biopsy is a procedure in which a small piece of tissue is removed for analysis under a microscope. A pathologist will check the cells for the presence of cancer. A biopsy can confirm a diagnosis and help the doctor determine what type of cancer it is.
The following tests may be done on the sample of tissue that is removed:
Immunohistochemistry or Immunocytochemistry
Tests in which a radioactive antibody is used to check for certain antigens. Cancer cells that produce this antigen are distinguishable under a microscope and help your doctors determine the type of cancer present.
Light and Electron Microscopy
A laboratory test in which a high-powered microscope is used to examine cells to look for certain changes that may indicate cancer.
Staging Pituitary Tumors
If you receive a pituitary tumor diagnosis, staging is a way of determining the amount and location of your cancer. Staging also helps doctors choose treatment options.
There is no staging system for pituitary tumors because most often they are benign (noncancerous). These tumors are instead described by their size and grade, whether or not they make extra hormones and whether the tumor has spread to other parts of the body.
The following sizes are used to help with the diagnosis:
- Microadenoma: The tumor is smaller than 1 centimeter. Most pituitary tumors are of this type
- Macroadenoma: The tumor is 1 centimeter or larger
The grade of a pituitary tumor is based on how far it has grown into the surrounding area of the brain, including the sella — the bone at the base of the skull, where the pituitary gland sits.
(Source: National Cancer Institute)
If you have received a pituitary tumor diagnosis, or if you want a second opinion or just want to speak to a pituitary tumor specialist, we are here to help you. Call 800-293-5066 or 614-293-5066 to make an appointment.