Prolactinomas are benign tumors that grow on the pituitary gland, a region of the brain that generates and secretes hormones. Prolactinoma tumor cells secrete a hormone called prolactin, a protein that plays a role in fertility and lactation. The tumor leads to symptoms throughout the body as a result of hormone imbalance from prolactin secretion. Headaches and vision disturbances can result from the tumor putting pressure on surrounding tissue. There are a number of treatment options for prolactinoma.
Medical Therapy
In many cases, the first line treatment for a prolactinoma is drug therapy, since this form of therapy is less risky and invasive than other treatments. St. John's Health Center reports that in many cases, medication is sufficient to lower prolactin levels and shrink the tumor. Medications commonly used to treat prolactinoma are dopamine agonists--chemicals that mimic dopamine and promote dopamine signaling within the brain to treat the tumor. St. John's indicates that the most commonly prescribed medication for prolactinoma is cabergoline, trade name Dostinex. Most women prescribed Dostinex will see a return of menstrual regularity, and both men and women will quickly see a decrease in other symptoms associated with prolactinoma.
Surgery
Since prolactinomas are benign tumors, with no ability to invade neighboring tissue, surgery can be used to treat the tumor, especially if it diagnosed early. Surgery is generally a second-line form of treatment, which means that is used after other treatments, such as medication, have failed. The surgery involves removing the tumor, as well as removing some normal pituitary gland tissue.
Albemarle Pulmonary Medicine Associates indicates that surgery to remove a prolactinoma has a number of dangerous risk factors, such as bleeding, leakage of spinal fluid or infection. Patients undergoing surgery also risk adverse reactions to anesthesia, which is a risk factor in any surgery. Since the surgery removes some healthy pituitary tissue, patients may suffer from symptoms as a result of an under-active pituitary after surgery. Patients may also experience tumor recurrence in the remaining pituitary tissue.
Radiation Treatment
In some cases, prolactinoma may be treated with radiation therapy to kill remaining tumor cells. This type of therapy is usually administered as a second line treatment if drug therapy fails, or after pituitary-removal surgery to kill any remaining tumor cells. A method of radiation treatment for prolactinoma is gamma knife radiosurgery, which involves administering a focused dose of radiation to the tumor site. The University of Virginia School of Medicine indicates that a single dose of radiation is usually sufficient to treat pituitary tumors like prolactinoma. The use of radiation in conjunction with surgery reduces the risk of tumor recurrence.
