The most reliable way to diagnose any kind of brain tumour is initially by an MRI scan and then by taking a biopsy (a small sample of the tumour, removed during neurosurgery) for analysis in a laboratory. The presence of a pituitary tumour can also be indicated by tests that measure the levels of specific hormones within the blood.

Research is underway to understand more about the genetic mutations that influence the development of this tumour type. Most seem to arrive with no clear cause, although there are a few cases of pituitary tumours appearing within a family group.

There are certain hereditary conditions which give an increased risk of pituitary tumours, the most common one being multiple endocrine neoplasia, type 1 (MEN 1), for which there is a genetic test to establish if this is the case.  MEN I causes multiple tumours to arise in various glands of the endocrine system, not just the pituitary gland. 

As astrocytoma progresses, especially in advanced stages or high-grade tumours, individuals may experience end-of-life symptoms. These symptoms can vary depending on factors such as the tumour location, size, and individual variations. It's important to note that each person's experience may differ, and not all symptoms may be present. Here are some common end-of-life symptoms associated with astrocytoma:

Neurological Decline: Astrocytomas can cause progressive neurological decline as the tumour affects brain function. This may manifest as worsening cognitive impairment, confusion, memory loss, difficulty speaking or understanding, and changes in behavior or personality.

Seizures: Seizures are common in individuals with astrocytoma. As the tumour progresses, seizures may become more frequent and severe, sometimes leading to status epilepticus, a prolonged seizure activity that requires immediate medical attention.

Headaches: Headaches are a common symptom of astrocytoma. They may become more intense and resistant to treatment as the tumour progresses. The headaches may be accompanied by nausea and vomiting.

Increased Intracranial Pressure: As the tumour grows, it can cause an increase in intracranial pressure. This can result in symptoms such as persistent headaches, drowsiness, confusion, changes in vision, difficulty with balance and coordination, and in severe cases, coma.

Decline in Physical Functioning: Astrocytomas can affect motor function, leading to weakness, difficulty with movement, coordination problems, and paralysis in some cases. This decline in physical functioning can affect mobility, self-care, and overall independence.

Fatigue and Weakness: Advanced astrocytoma can cause profound fatigue and weakness. Individuals may experience extreme tiredness, reduced energy levels, and a general decline in physical strength.

Changes in Sleep Patterns: Individuals with astrocytoma may experience disruptions in their sleep patterns. This can include difficulty falling asleep, staying asleep, or excessive sleepiness.

Loss of Appetite and Weight Loss: Loss of appetite and unintentional weight loss are common in end-stage astrocytoma. The tumour's effects on the brain and changes in overall health can lead to reduced interest in food and difficulty with eating.

Difficulty Swallowing and Speaking: As the tumour affects the areas of the brain responsible for swallowing and speaking, individuals may experience difficulty swallowing (dysphagia) and speech problems (dysarthria).

Respiratory Distress: In advanced stages of astrocytoma, individuals may experience respiratory symptoms such as shortness of breath, labored breathing, or irregular breathing patterns.

It's important to note that the presence of these symptoms does not necessarily mean immediate end-of-life is imminent. However, if you or a loved one are experiencing these symptoms or have concerns about end-of-life care, it's essential to consult with a healthcare professional, such as a palliative care specialist or hospice team. They can provide guidance, support, and appropriate interventions to manage symptoms and improve quality of life during this stage.

The treatment options for pituitary adenomas include surgery, drugs and a form of radiotherapy called stereotactic radiotherapy.  

Neurosurgery for pituitary adenomas

Endoscopic transsphenoidal pituitary adenoma resection is carried out under general anaesthetic.  An endoscope (a tiny light and camera on a long tube) is inserted into the nostril towards the base of the tumour. Surgical instruments are then inserted next to the endoscope through the same nostril. The tumour is removed and the bony floor of the space occupied by the pituitary is closed.
Patients usually undergo this procedure via the right nostril, however surgery is sometimes done via the left nostril, depending on the location of the tumour.

Stereotactic radiotherapy for pituitary adenomas

Stereotactic radiotherapy (SRT) is sometimes used for small brain tumours, usually those that are only 3-4cm across and in an easily accessible part of the brain, relatively close to the skull. It consists of very precisely focused gamma ray or x-ray beams at higher doses than are used in standard radiotherapy. 
The advantage of this treatment is that is can be more closely targeted at a brain tumour than standard radiotherapy and surrounding healthy tissue can be spared, hence reducing the side effects of the treatment.

 

Chemotherapy for pituitary adenomas

Certain types of pituitary adenoma exhibit more aggressive behaviour than others, and these would be treated with chemotherapy drugs. However because this is so unusual, there is no standard chemotherapy treatment.  The choice of drugs is therefore guided by the genetic profile of the tumour in each individual case, although temozolomide (Temodar) is likely to be considered.

Research we are funding across all of our dedicated Research Centres will help lead towards finding a cure for a wide range of brain tumours.

Our team at the University of Plymouth Low-Grade Brain Tumour Research Centre are researching a number of molecular pathways that influence immune system function, tumour metabolism and tumour growth in a range of low-grade brain tumours in children and adults. 

The team of research and clinical experts in our Research Centre at Imperial College, London, are studying the way in which the ketogenic diet works in brain cancer, which may have the potential to influence a wide range of brain tumours.

Pioneering research at our Brain Tumour Research Centre at Queen Mary University of London is focused on using GBM stem cells to help develop unique, patient-specific treatments. Their findings are expected to translate into other types of adult and paediatric brain tumours.

We also fund BRAIN UK at Southampton University, the country’s only national tissue bank registry providing crucial access to brain tumour samples for researchers from all clinical neuroscience centres in the UK, effectively covering about 90% of the UK population, and an essential component in the fight to find a cure for pituitary brain tumours.