DR. ADITYA GUPTA
Shalini Verma, a 45-year-old woman,
began experiencing severe headaches, blurred vision, and unexplained weight
gain. After several visits to different specialists, an MRI scan revealed a
tumor in her pituitary gland. The tumor's location made it challenging to
access, and traditional surgery posed significant risks, includ ing damage to
nearby structures like the optic nerve. Verma Verma was wast referred to
Artemis Hospital, Gurugram. After a thorough evaluation, she was recom mended
Cyberknife Radiosurgery, a state-of-the-art, non-invasive treat-ment that could
precisely target the tumor without the need for traditional surgery.
Verma underwent Cyberknife treat
ment, which involved several sessions over the course of a week. The pro cedure
was painless, and she experi enced minimal side effects. A follow-up MRI six
months later showed a significant reduction in the tumor size, and her symptoms
had almost completely resolved.
The treatment journey of Mrs Verma
showcases the effectiveness of Cyberknife Radiosurgery, especially for tumors
in complex locations like the pinuitary gland, where traditional surgery might
be risky or impossible. Our team's expertise in using this advanced technology
provided Mrs. Verma with a safe and effective treat ment option, allowing her
to return to her normal life withou the long recor ery time associated with
conventional surgery.
What is a pituitary gland tumor?
Pituitary gland, which is also known as the master gland has the most important function of producing hormones that regulates the critical organs of the body including thyroid, adrenal glands, ovaries and testes. It is a small pen-size gland located behind the eyes and below the front of the brain. Improper functioning of the gland usually results in excess or under production of hormones that leads to a formation of mass called tumor, which can be benign or malig nant. Such tumors in this gland can create numerous serious medical con-ditions by interfering with the normal functioning of the endocrine system and pituitary gland, Somerumors pro-duce hormones known as functional tumors, and others can cause the glands to secrete too few or too many hormones. Also if the tumor pressed on the nearby structure, for instance the optic nerve, can also limit a per son's vision.
Though the occurrence of tumor is
more likely after the age of 50 years, it still can impact at an early age. The
survival rates of tumor due to its com pilicated location also depend on other
factors like the patient's age, type and size of tumor.
What causes a pituitary gland tumor?
Mostly, pituitary gland tumors are non cancerous but the exact causes are unknown. Some of them are herxlitary and some are caused by a rare genetic disorder called as multiple endocrine neoplasia type 1. This disorder can also lead to over-activity or enlargement of 3 different endocrine-related glands, which also includes the pituitary gland. Many researches are still underway to know the exact cause of such uncontrolled growth of certain cells that leads to a pituitary tumor.
What are the symptoms?
Depending upon the hormonal variations in the body, there can be a variety of symptoms. The most common symptoms include Head-aches, vision problem, tiredness, mood changes, irritability, changes in menstrual cycle in women, impo tence, infertility, Inappropriate breast growth or production of breast milk, Cushing's syndrome which is a com bination of weight gain, high blood pressure, diabetes, and easy bruising, the enlargement of the extremities ar limbs, thickening of the skull and jaw caused by too much growth hormone. Treatment for Pituitary gland tumor Diagnosis at an early stage can help the treatment procedure to be totally non-invasive with the use of advances technology called as Cyberknife. Cyberknife which is the most advanced radiation therapy is completely non-invasive therapy avall able for the treatment of benign as well as malignant tumors.
Highlighis of the
therapy being ease of access to any complex location without the need to use
the surgical knife, precision of the beam with high dose radiation to the tumor
location, and the safety. It is a day care procedure without pain and risk, and
the partent can get back to daily chores as soon as the session gets over which
depends on the tumor 20 minutes to 1 hour) and hence eliminates the requirement
of any hospital stay. Moreover the pro cedure makes use of the most sophis
ticated image guidance technique to focus high doses of radiation directly to
the tumor spot which eliminates the chances to damage the healthy cells as in
any other methods of treatment.
This therapy works the best for
tumors that are upto 1-3 cm in size (for pinudiary tumors, this figure is even
smaller) and is a very powerful and effective technique for treating patients
suffering from early stage primary and medically inoper able tumors.
The treatment is safe to adminis
tor and also offers a new option in patients with recurrent pituitary tumors,
those that cannot be operated, or those involving the cavernous sinus (an area
difficult to reach and com-pletely remove tumors from, without side effects.
Phasing of the cyberknife procedure:
1. Planning-To have enough time
with the surgeon to design and finalize a customized treatment plan, imaging is
performed a few days in advance.
bod 2. Treatment Once the plan is
set in place, aplace, the patient will return for a non-invasive, pain-free
treatment experience. Using advanced tumor-tracking technology, the CyberKnife
system is able to deliver either one single high-dose treatment, or smaller
doses (upto 5) over the course of two to five days, depending on the plan gener
ated. This approach limits side effects and enables most patients to return to
their regular routine the same day.
Each session of treatment usu ally
lasts for about 30-50 min and is cost effective with a success rate of 98% in
such complicated tumors. Patients with pituitary adenomas receive stereotactic
radio surgery with CyberKnife and are followed up for more than 12 months.
After 6 months of therapy patients are monitored for positive responses and
ensure there is no recurrence of any mass. Typically MRI is doing 6 monthly for
the first year, and then yearly for at least 5 years.
Pituitary tumors that are larger,
and create pressure on the optic nerves are better dealt by endoscopic removal
of the tumor through the nose.
(Author is Chief Neurosurgery & CNS Radiosurgery & Co-Chief Cyberknife centre, Artemis Hospital Gurugram)