Pituitary tumor

[DevanDevan]

Hi,

My dad was diagnosed with pituitary tumor, technically it is a cyst. Cyst is not secretary by itself, according to hormone tests. It is also not disturbing the optic nerve according to MRI and field tests. Currently my dad is taking hormones in low doses as pituitary is not producing required hormones. Some doctors said, he can continue the medication and no need to go for a surgery. But, in another hospital, doctor advised surgery to drain the cyst and fix hole. (Sorry, I don't remember the technical term, but just cementing the opening after draining it)

The reasons for the surgery are as follows:
1. As it is pushing pituitary stock, gland could not function properly and so patient has to continue with the medication life long.
2. If we drain cyst, pituitary gland might start functioning normally and we can gradually stop taking drugs.

My questions:
1. Will pituitary function normally after the surgery? (Please give your answer from Definitely NO to definitely YES,  ranging from 1 to 10. That is, 1 means definitely NO and 10 means definitely YES.) Also reason, if you have one. Reason can be logical or survey or statistical finding.
2. Is there any other methods or medicines to drain the cyst? like osmosis or something?
3. As we are planning a surgery, do we need to go for a robotic surgery? does that precision offered by the robot really matters?


Awaiting your response,

Thanks
Devan

[rumpled]

Weird. I responded the other day and it is not here.
In my experience as a patient, robotic surgery is not an option yet. Endoscopic is the best option thru the nose. Thru the lip is old.

I attend patient/doctor conferences and as well have a network of new and old patients where we discuss treatments to help people so we are layman and you should research, we are pretty up on things but may not be on top since we are not doctors, but we are always at them. So I have never heard of robotic for pituitary. When I checked the da Vinci site, the tumors and sites covered are not pituitary. Maybe you are thinking radiation?

[DevanDevan]

Hi,
Thank you  Rumpled.

Sure. We will connect with a neuro- endocrinologist soon. He does not have CSF leak. confirmed.

As you said, skill of the surgeon matters the most.

Cyst is not growing as per two different MRI reports - dated 18 months in between.

I need one more favor from your end. Why do feel that, Robotic surgery is not a must? If it is your subjective understanding, could you pen down your assumptions and intuitions. If you have some other source saying  applicable locations most apt for robotic surgery, I would like to go through that as well.

Looking forward to your response.

regards,
Devan

[rumpled]

Did you get copies of everything?

The cyst is typically in the pituitary not on it, look up rathke's cleft cyst.  I am guessing your father may also have a CSF leak as well?

I am just a patient but here is my advice. Your dad needs a specialist called a neuro- endocrinologist and they can be found at larger hospitals or a university. Don't listen to a neurologist or a regular endocrinologist as they don't have the training to make the call.

As for your questions, impossible to call. Two factors are at play. The skill of the surgeon which can be controlled (get the best) and the second is the nature of the cyst or tumor, which is not controllable by anyone.

In reality, most patients have to be on something post op. Usually temporary you have to be on a few things, but forever one has to be on at least thyroid. If you have to be on more maybe and it can and will change over time... Or he may need nothing.

The location of the tumor is not conducive to robit surgery now, and it will not go away. Your best bet is a very experienced pituitary surgeon from a very busy pituitary place.

Get copies of everything and read up. An educated patient gets better care.