I have been experiencing a dull but localized pain in my head above and behind my right ear. It is throbbing, but not stabbing and is on and off rather than constant. It seems to be increasing in occurance. It also emites heat in a specific spot. Any ideas?
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.
Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.
Your question may be best served asked in the oncology section or radiation section of medhelp; however, I will provide what information I do know. Cabergoline is a dopamine agonist which can effectively suppress prolactin levels for about 2 weeks and can reduce the size of the prolactinoma in most patients (~70%). In about 5% of patients, the prolactinoma may resolve completely. However, some patients may need to have prolonged treatment or increase in dosage for treatment if the prolactinoma fails to respond or recurs. The medicine will need to be titrated to achieve maximal prolatin suppression. It is important to note that a normalized prolactin level does not ensure reduced tumor size. The usual dose may be increased every four weeks. And as you said, 1mg twice weekly is the stated maximum dose. Side effects to the medicine do occur and you should be aware of these. They include constipation, nasal stuffiness, dry mouth, nightmares, insomnia, and vertigo (dizziness). If your prolacintoma fails to respond to the maximum dose of cabergoline, you may need to discuss surgery with your oncologist.
One thing about prolactinomas is that you will need to be monitored closely for visual disturbance. Also, disorders of menses and fertility may occur with prolactinomas.
I advise you to discuss this with your oncologist. It would be recommended to discuss future plans if you do not respond to the 2mg weekly dosing.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.