Side Effects of Radiation Therapy After Pituitary Tumor Surgery

What are the side effects of radiation therapy after surgery for a pituitary tumor?

My grandfather is 70 years old.
He had a pituitary tumor that was originally 2 centimeters.
After surgery, a follow-up MRI showed it is about 1 centimeter.
The doctor said he needs to undergo radiation therapy.
What are the potential side effects? If he does not undergo radiation therapy, what are the possible long-term effects?

Kang Junwei, 10~19 year old female. Ask Date: 2010/04/19

Dr. Chen Sirong reply Oncology

Hello, Kang.
I believe your doctor has already explained to your parents and grandfather about the pituitary tumor and radiation therapy.
Perhaps you have also searched online for information.
I suggest that if you really want to understand:
1.
First, understand that radiation therapy uses electrons to strike a tungsten target, which produces photons.
These photons are adjusted to different energy levels: low-energy photons are used for X-ray imaging, while high-energy photons are used to irradiate cancerous areas for treatment.
2.
Various machines such as linear accelerators, photon knives, computer-assisted radiosurgery, and helical knives can be used for pituitary tumors, but only the 3D conformal radiation therapy or intensity-modulated radiation therapy (IMRT) from linear accelerators is covered by health insurance.
3.
Essentially, the treatment methods derived from linear accelerators are sufficient.
4.
Different machines use different treatment methods, which can lead to varying side effects.
Therefore, it is important to ask your grandfather which hospital he plans to go to for treatment and what type of machine will be used.
5.
Generally speaking, there are not many severe side effects, and the likelihood of accidentally damaging important nerves is low.
Hair loss may occur but can potentially grow back.
However, the function of the pituitary gland may be affected, and blood tests can be done post-treatment to check for deficiencies.
Most people can manage without supplementation.
6.
If left untreated, the tumor will definitely grow larger, and the chances of successful surgery or radiation therapy may decrease.
I recommend proceeding with radiation therapy now while it is still only one centimeter.
Thank you for your letter.

Sincerely,
Dr.
Chen Si-Rong

Reply Date: 2010/04/19

More Info

Radiation therapy is often recommended after surgery for pituitary tumors, especially when there is residual tumor tissue. In your grandfather's case, with a remaining tumor size of approximately one centimeter after surgery, radiation therapy may be a crucial step in reducing the risk of tumor recurrence. However, it is essential to understand the potential side effects and long-term implications of radiation therapy.

Side Effects of Radiation Therapy
1. Fatigue: One of the most common side effects of radiation therapy is fatigue. Patients often report feeling more tired than usual, which can persist for weeks or even months after treatment.

2. Skin Reactions: The skin in the area being treated may become red, irritated, or sensitive. This is similar to a sunburn and typically resolves after treatment is completed.

3. Hormonal Changes: Since the pituitary gland plays a crucial role in hormone regulation, radiation therapy can affect hormone production. This may lead to conditions such as hypopituitarism, where the pituitary gland does not produce enough hormones, potentially requiring hormone replacement therapy.

4. Neurological Effects: Depending on the radiation field and dose, there may be risks of neurological side effects, including headaches, nausea, or changes in vision. These effects are generally dose-dependent and can vary based on individual sensitivity.

5. Long-term Risks: There is a small risk of developing secondary cancers due to radiation exposure, although this risk is generally low compared to the benefits of treating the tumor.

Consequences of Not Undergoing Radiation Therapy
If your grandfather chooses not to undergo radiation therapy, there are several potential consequences:
1. Tumor Recurrence: The primary concern is the risk of tumor recurrence. Without radiation, the remaining tumor cells may grow back, leading to the need for further surgical intervention or more aggressive treatments in the future.

2. Progressive Symptoms: As the tumor grows, it may cause increased pressure on surrounding structures in the brain, leading to symptoms such as headaches, vision problems, or hormonal imbalances.

3. Impact on Quality of Life: The recurrence of the tumor can significantly affect your grandfather's quality of life, leading to more severe health complications and potentially impacting his overall prognosis.

Conclusion
In summary, while radiation therapy after pituitary tumor surgery can have side effects, the potential benefits often outweigh the risks, especially in preventing tumor recurrence. It is crucial for your grandfather to discuss his concerns and treatment options with his healthcare team, including the radiation oncologist, who can provide detailed information tailored to his specific case. They can also help manage any side effects that may arise during or after treatment, ensuring that your grandfather receives comprehensive care throughout his recovery process.

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