DR. ADITYA GUPTA
Shalini Verma, a 45-year-old woman, began experiencing severe
headaches, blurred vision, and unexplained weight gain. After several S 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 was referred to Artemis Hospital, Gurugram. Afiora thorough
evaluation, she was recom mended Cyberknife Radiosurgery, a state-of-the-art,
non-invasive treat-ment that could precisely target the cumor 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 pituitary 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 without the long recov 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 estes. It is
a small pea-sire gland located behind the eyes and below the front of the
brain. Improper functioning of the gland usually results in exсень ог 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 creme numerous serious medical con ditions by interfering with the normal
functioning of the endocrine system and pituitary gland. Some rumors 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 om 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 hereditary and some are caused by a
rare genetic disorder called as multiple endocrine neoplasta 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
or 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 Highlighus 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 parlent can get back to daily
chores as soon as the session gets over which depends on the tumor (30 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 pituitary 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 rumors from, without side effects).
Phasing of the cyberknife pro-cedure
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.
2. Treatment Once the plan is set in place, 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 firm 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 contre)