The Pituitary Puzzle: Multidisciplinary Care is the Key to Unlocking Better Diagnosis and Effective Treatment.

For more than 30 years, patients in our clinics have told strikingly similar stories. They've experienced subtle, unexplained changes in their health, often over a long period of time. Sometimes it’s chronic headaches. Others describe blurred vision, a decrease in sex drive, or changes in their appearance.

Usually, these patients have been told these are signs of getting older. Yet they can't shake the feeling that something else is going on. Often, the answer lies in the pituitary gland, a pea-sized organ at the base of the skull that plays an outsized role in our health.

The pituitary is rightly known as the “master gland” because it acts as the conductor of the body's hormonal orchestra. It receives nerve signals and secretes hormones that tell other glands, such as the thyroid and adrenal glands, what to do. 

This system regulates vital functions such as metabolism, growth, stress response, temperature regulation, hunger, thirst and sexual function. But when something goes wrong with the conductor, the orchestra can fall out of tune.

At the MedStar Health Pituitary Center, our team of experts has vast experience helping patients identify pituitary disorders, craft an effective treatment plan, and minimize the chance of recurrence. 

Subtle symptoms, complex conditions.

Pituitary problems can come from a gland that is either making too much hormone (hyper-secreting) or too little (under-secreting). This can be caused by a variety of factors, including autoimmune conditions, genetics, infections, trauma, or certain medications. Sometimes, symptoms are a result of a tumor pushing against the gland or nearby structures. 

An estimated 25% of the population could have a small, benign pituitary tumor that causes no symptoms at all. More than 100,000 people are diagnosed with a pituitary tumor each year, very few of which are cancerous.

Common hyper-secretion syndromes we see include:
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• Prolactinoma: This non-cancerous tumor causes the pituitary gland to make too much prolactin. These are among the most common causes of infertility among women and can cause reproductive symptoms in men and women, such as changes in menstruation, erectile dysfunction, and loss of libido.

• Cushing’s disease: This condition occurs when a tumor causes the pituitary gland to secrete too much adrenocorticotropic hormone (ACTH), which then instructs the adrenal glands to make too much cortisol. This can result in symptoms such as unexplained weight gain, skin changes, and excess hair growth, and can also lead to high blood pressure and diabetes.

• Acromegaly: This less common condition is caused by overproduction of growth hormone, usually from a benign tumor. Too much of this hormone can cause bones, organs, and other tissues to grow, causing an enlarged nose, ears, hands, or feet.

Some pituitary tumors don’t affect hormone production. Instead, these slow-growing non-secreting tumors can press against vital structures such as the optic nerves, which transmit visual information from the eyes to the brain. As the tumor grows, increasing pressure can result in gradual vision loss over time.

With this wide range of potential issues, getting an accurate diagnosis requires an experienced team of specialists. Otherwise, people can live with these slow-growing tumors for many years until they are discovered during a scan for another issue.

Personalized treatment options for each patient.

Patients travel from around the country and the world for comprehensive care from our team of experts. We work together to provide an accurate diagnosis and create a personalized treatment plan tailored to each patient’s unique needs and goals. 

Treatment plans can include:
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• Medication: For some conditions, including many prolactinomas, medication is the first and most effective option, restoring hormonal balance and allowing some patients to avoid surgery altogether.

• Surgery: When surgery is needed, we leverage decades of experience, the latest technologies, and minimally invasive techniques to provide our patients with the best outcomes. We use advanced intraoperative imaging, which enable us to target the tumor with sub-millimeter accuracy. This allows us to remove more of the tumor, increase cure rates, shorten surgical times, and reduce complications. In partnership with our otolaryngology experts, we use an endoscopic approach that leads to faster recoveries.

• Radiation therapy: MedStar Health offers the most advanced radiation therapy options, including stereotactic radiosurgery (CyberKnife®) and proton beam therapy. Often, these precise, painless approaches are used to treat residual or recurring growths.

At MedStar Health, our greatest strength is our team. As the Director of Neurosciences, I’m pleased to work alongside exceptional colleagues, including:
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• Director of Pituitary Endocrinology Dr. Susmeeta Tewari Sharma, whose expertise is essential for accurate diagnosis and interpreting the complex bloodwork that tells us whether and which hormones are being secreted.

• Our Director of Neuro-ophthalmology Dr. Martin Kolsky, who helps us document subtle vision changes to monitor treatment response.

• Skilled otolaryngology experts such as Dr. Stanley Hung-Hsuan Chia, who work with us in the operating room to make our endoscopic surgical approach possible.

Because we are a national referral center and among the largest on the East Coast, we see more patients with pituitary disorders than anyone else in the region. This allows our experts to get even better at their work as we train the next generation of specialists and advance pituitary care.

Related reading: MedStar Pituitary Center: Outstanding Results for Pituitary Surgery.

Don’t settle for unexplained symptoms.

You are the expert in your own health. If you’ve been experiencing unexplained changes, don’t ignore them. It might not just be “getting older” after all. Even if prior treatments for pituitary disorders have failed, we have advanced treatment methods here that may not be available elsewhere.

Pituitary tumors grow slowly, so you have time to gather information and make the best decision about your health and your treatment goals. You don’t have to live with the symptoms of a pituitary disorder or tumor. Working together, our team of experts can help you get advanced treatment and dedicated follow-up for the best outcomes and the lowest chance of recurrence.