Is A Pituitary Tumor A Brain Tumor
The pituitary gland is NOT in the brain and pituitary tissue is different from brain tissue. Since the pituitary gland is located at the base of the brain and is connected to the brain by a thin stalk, there is often confusion, particularly by insurance companies, about the classification of a pituitary tumor. A pituitary tumor is NOT a brain tumor.
Childhood And Adolescent Pituitary Disorders
Although a pituitary tumor is more common in adults, children and adolescents may also have this problem. The most common types of tumors in the pituitary region in this age group are a craniopharyngioma or a Rathkes cleft cyst . The hallmark of any type of a pituitary problem in children and adolescents is failure to grow, slowing of the growth rate and/or failure of sexual development . This emphasizes the need to monitor growth regularly. There is a condition known as constitutional delay of growth and puberty that may be assumed to be the problem. Constitutional delay of growth and puberty means that during adolescence the patient does not have the expected normal growth spurt or begin puberty until age 15 or 16. Constitutional delay of growth and puberty may be familial meaning that there is a family history of late development, usually in a parent. However, this disorder cannot be diagnosed without appropriate hormone studies and an MRI study of the pituitary gland and brain to make sure that there is not a pituitary tumor or craniopharyngioma or Rathkes cleft cyst causing this delay in growth or puberty.
Avoiding Physical Stresses And Strains
Immediately following discharge, the organs and tissues involved in the surgery are still healing and remain vulnerable to straining. To prevent tearing the; incision ;or damaging internal organs on which surgery was performed, men should be very careful not to lift heavy loads or put strain on their abdominal and pelvic regions during the first few weeks after surgery.
Complete healing may take two or more months. During this time:
- Avoid heavy lifting
- Avoid straining when moving the bowels
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Does Infertility Cause Prostate Cancer
Listen up, men! Those of you who have current infertility issues may end up with the more aggressive types of prostate cancer in the future. A recent study found that infertile men who later developed prostate cancer were as much as 200% more likely to develop a higher level prostate cancer, which in turn can both grow and spread more quickly than prostate cancer in fertile man.
Currently, prostate cancer is the most common type of male cancer in the United States. One study evaluated a large group of men in California who were currently being evaluated or treated for infertility. The study lasted over thirty years, and the results backed up other similar studies, finding infertile men were around 2.6 times as likely to eventually be diagnosed with a more aggressive form of prostate cancer or testicular cancer.
What Is The Most Common Approach
A technique called transurethral resection of the prostate is considered to be the standard surgical approach. This procedure involves inserting a thin tube called a resectoscope into the urethra and guiding it through to the prostate. The resectoscope is equipped with a tiny camera and an electrical loop that is used to mechanically remove prostate tissue. The loop produces heat at the same time, which quickly seals off the blood vessels. The resectoscope also has valves that regulate the release of fluid to flush the removed tissue out. TURP takes about 90 minutes and is done under local or general anesthetic. Men who have had this procedure usually need to have a urinary for a few days after, and generally stay in the hospital for two to seven days. They then have to rest and take it easy for a few weeks.
Some variations of TURP are also considered to be standard treatments and have similar outcomes and consequences to conventional TURP. These include transurethral electrovaporization , transurethral vaporesection and plasmakinetic enucleation of the prostate .
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What If I Am No Longer Fertile But Banked Sperm Before Treatment
To use the sperm you froze before treatment, you and your partner will need to work with a reproductive endocrinologist . The method used to fertilize your female partners eggs will be based on the quality of the specimens you were able to freeze before treatment.
- Intra-uterine insemination : One or 2 vials of your sperm are thawed and drawn up into a thin, soft catheter. This is placed in your female partners uterus and the sperm are released. This is done around the time she ovulates .
- It takes most women 3 to 6 attempts at IUI before they are successful, so most patients who sperm banked will not have enough sperm to use this method. However, it may be a good option for you if your partner is young and has no fertility problems, and if you have many vials of sperm with high sperm counts and good motility.
Surgery Effect On Ejaculation
Surgery can affect ejaculation in different ways. For example, if surgery removes the prostate and seminal vesicles, a man can no longer make semen. Surgery might also damage the nerves that come from the spine and control emission . Note that these are not the same nerve bundles that pass next to the prostate and control erections . The surgeries that cause ejaculation problems are discussed in more detail here.
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Sex After Surgery To The Prostate Gland
When your prostate gland is removed, you will still make sperm, but it wonât come out through your penis. It will be absorbed back into the body. You may also have problems with erections or lose interest in sex after prostate surgery. Although you may feel embarrassed, doctors who deal with prostate cancer are very used to talking about these issues and will be able to give you advice. There are treatments that can help with this.
Why Should A Man Take Testosterone Treatment
Testosterone is not only necessary for sexual function, it is important to protect the bones against osteoporosis , to preserve normal muscle mass and strength and normal blood production by the bone marrow . The effects of long-term testosterone deficiency include a higher risk of bone fracture, loss of muscle mass and muscle strength and low red blood cell count as well as loss of interest in sex and loss of sexual function . Every man receiving testosterone replacement should have a prostate exam and a blood PSA test at least once a year. Testosterone does not cause prostate cancer, but if a man has undiagnosed prostate cancer, testosterone treatment may promote growth of the cancer, which emphasizes the need for regular prostate examinations and the blood PSA test.
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What If I Have Retrograde Ejaculation
Some cancer treatments cause injury to or removal of the nerves and muscles that control ejaculation. With retrograde ejaculation, the semen passes into the bladder instead of coming out through the penis. If you have retrograde ejaculation, but are still producing sperm, there are methods to get sperm to attempt pregnancy, including:
- Taking medication to tighten the muscles at the opening of the bladder. This allows the semen to pass forward out through the penis instead of into the bladder.
- Collecting a sample of urine after you stimulate yourself to ejaculate. This is done at a sperm bank, where they can remove the sperm from the urine.
If youre interested in either of these options, ask your doctor for a referral to a reproductive urologist.
Urine Leakage During Ejaculation
Climacturia is the term used to describe the leakage of urine during orgasm. This is fairly common after prostate surgery, but it might not even be noticed. The amount of urine varies widely anywhere from a few drops to more than an ounce. It may be more common in men who also have stress incontinence.
Urine is not dangerous to the sexual partner, though it may be a bother during sex. The leakage tends to get better over time, and condoms and constriction bands can help. If you or your partner is bothered by climacturia, talk to your doctor to learn what you can do about it.
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How Long Will Recovery Take
You will likely spend one night in the hospital after the operation and then be discharged home with a urinary catheter in place for seven to 10 days. The catheter is not painful, but may feel uncomfortable, says Dr. Mohler. Many men can barely tell theyve had an operation except for the catheter. Restrictions are similar to other pelvic surgery: no lifting more than five pounds for six weeks. No straining to lift for six months. Men can resume sex and activities such as walking or swimming immediately. More strenuous exercise should wait at least six weeks.
Surgery To Remove Your Prostate Gland
You might have surgery to remove your prostate gland ;if:
- your cancer hasn’t;spread outside the prostate gland
- you are younger and have a fast growing tumour
- as part of;treatment for locally advanced or high risk localised;prostate cancer
The aim of a radical prostatectomy operation;is to cure prostate cancer. It;is major surgery with some possible side effects. If you’re an older man with a slow growing prostate cancer, this type of surgery may not be necessary for you. This is because your cancer might grow so slowly that you’re more likely to die of old age or other causes than from prostate cancer.
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Changes In Penis Size
Some men notice that their penis is shorter after;surgery;. Some men notice other changes such as a curve in their penis or a narrower area. We don’t know for certain why these changes happen, but it could be because of low oxygen levels in the penis, caused by not having erections. Other treatments such as hormone therapy with radiotherapy may also cause changes to the size of your penis.
Encouraging blood flow to the penis after surgery may help prevent this. In particular, using a vacuum pump, either on its own or with PDE5 inhibitor tablets could help maintain your penis size and improve erections.
Keeping your penis active after surgery
Although you may not be ready or recovered enough for sex, you can still start treatment for erection problems in the weeks immediately after surgery. It could be taking a low-dose PDE5 tablet once a day or using a vacuum pump, or sometimes both together. The treatment along with masturbation encourages blood flow to the penis. This can help keep your penis healthy. You may hear this called;penile rehabilitation. Think of it in the same way as having physiotherapy if you had injured your arm or leg. Starting treatment soon after surgery may help improve your chance of getting and keeping an erection. But it may not work for every man.
Why Dont These Medications Always Reduce Prolactin To Normal
Although these medications are effective in lowering prolactin and reducing tumor size, the prolactin level may not decrease to normal . Why?
With a large tumor and very high prolactin level , the medication may lower prolactin by 90%; if the level before treatment level is 10,000, a 90% reduction lowers prolactin to 1,000, certainly not normal , but a substantial reduction. The tumor size is decreased but the tumor does not disappear. The medications do not destroy the tumor. An elevated prolactin may be acceptable if there are no other ill effects of the tumor such as headache or loss of vision. The most frequent hormonal problem resulting from an elevated prolactin is hypogonadism . Hypogonadism in a pre-menopausal woman results in loss of menstrual periods and difficulty becoming pregnant. Hypogonadism in men causes a low blood testosterone level, loss of sexual interest, impotence and infertility. Hypogonadism is treatable with hormone replacement, testosterone in men, estrogen and progesterone in women. Restoration of fertility may require additional treatments with injections of the pituitary hormones, LH and FSH.
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External Beam Radiation Therapy
In EBRT, beams of radiation are focused on the prostate gland from a machine outside the body. This type of radiation can be used to try to cure earlier stage cancers, or to help relieve symptoms such as bone pain if the cancer has spread to a specific area of bone.
You will usually go for treatment;5 days a week in an outpatient center for at least several weeks, depending on why the radiation is being given. Each treatment is much like getting an x-ray. The radiation is stronger than that used for an x-ray, but the procedure typically is painless. Each treatment lasts only a few minutes, although the setup time getting you into place for treatment takes longer.
Newer EBRT techniques focus the radiation more precisely on the tumor. This lets doctors give higher doses of radiation to the tumor while reducing the radiation exposure to nearby healthy tissues.
What Are The Prostate Cancer Treatment Side Effects Of A Prostatectomy
The primary prostate cancer treatment side effects after a radical prostatectomy are incontinence and erectile dysfunction. These side effects are a product of the location of the prostate and the type of surgery performed. The prostate gland lies deep within the pelvis behind the pubic bone and in front of the rectum. The urinary bladder lies just above the prostate, the urinary sphincter control muscle is located just below it, and the erectile nerves lie just outside the prostate on either side. A patients age and overall health also influence the potential risks of radical prostatectomy just as it does with any major operation. Such risks include cardiac or pulmonary events, infections, blood clots, or injuries to structures around the prostate.
SHORT TERM
Following surgery, all men will have some urinary leakage. A good amount of bladder control is often regained within 12 weeks and continues to improve over 12 months. Multiple studies have shown that there is often a several month interval before a patient recovers normal erections, even with bilateral nerve-sparing surgery. Advantages to;the Robot Assisted Laparoscopic Prostatectomy technique are a reduced risk of intra-operative bleeding and a shortened hospital stay.
LONG TERM
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Effects Of Cancer Treatment On Fertility
Cancer treatments may cause fertility problems affecting your ability to father a biologic child, including:
- Inability to produce sperm.
- Damage to nerves and blood vessels needed for erection and ejaculation.
- Inability to produce hormones that stimulate sperm production.
Not all cancer treatments cause fertility problems. It depends on:
- Your fertility before treatment.
- The type of surgery you had.
- The type and dose of chemotherapy you received.
- The area of your body treated with radiation and the dose of radiation you received.
Fertility problems from cancer treatment may be temporary or permanent. Some men regain the ability to produce sperm after treatment. This generally takes 1 to 3 years, but can sometimes take longer. Some men have only partial recovery, with low sperm counts, and some men never recover sperm production.
Because of the many factors that affect fertility, its hard to predict how any one person will be affected by treatment. We cant know for sure who will regain fertility after treatment is completed and who wont.
Are There Any Medical Treatments For Acth Producing Tumors
Yes and no. There are medications that can reduce cortisol production by the adrenal glands, but medication doesnot have any effect on the pituitary overproduction of the hormone ACTH . Thus, medication is used to control adrenal gland cortisol overproduction, but does not treat the source of the problem the pituitary gland. Ketoconazole is a medication that reduces adrenal gland cortisol production. This medication is most often used in patients who have persistent Cushings after surgery and/or radiation, while waiting for the radiation to become effective. If a drug to lower cortisol is prescribed, careful monitoring is necessary to determine if the dose is effective , to make sure it does not reduce cortisol to below normal and to make sure there is no ill effect on the liver. Another medication that reduces cortisol production by the adrenal glands is mitotane . Mitotane is used to treat patients with cancer of the adrenal glands, but is also effective in reducing cortisol production in patients with pituitary Cushings.
There are some experiments in mice that suggest that the diabetes medication, rosiglitazone, may reduce the size of implanted ACTH producing tumors and reduce cortisol production. This treatment is now under investigation in patients with Cushings disease, but early results have not yet shown that this is an effective treatment in most patients. This is a potentially exciting area of research, but it is currently a research project.
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Bone Marrow Or Stem Cell Transplant
Having a bone marrow or stem cell transplant usually involves receiving;high doses of chemo and sometimes radiation to the whole body before the procedure. In most cases, these procedures have the side of effect of permanently preventing a male’s ability to make;sperm. This results in lifelong changes to fertility.; If you’d like to learn more, see Stem Cell Transplant.