The short answer
Treatment may involve observation, medicines, surgery, radiation, and hormone replacement depending on the tumor, but the right discussion depends on hormone activity, size, symptoms, growth, vision, and pituitary function.
Treatment categories may include observation, medicines, surgery, radiation, and hormone replacement depending on the tumor.
The plan depends on hormone activity, size, symptoms, growth, vision, and pituitary function.
Whether the tumor makes extra hormones (functioning) or not (nonfunctioning) shapes the plan more than almost anything else.
Treatment can leave hormone levels too low. NCI's clinician summary puts the risk of low pituitary hormones after radiation at about 30% at 10 years. Ask how hormone levels will be checked.
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The short answer
Pituitary tumors grow in the pituitary gland. This is a small gland at the base of your brain. It controls many of your body's hormones. Some tumors make extra hormones; doctors call these functioning tumors. Others do not; these are called nonfunctioning. Your treatment plan depends heavily on which type you have. Tumor size and location matter too.
Surgery: often the first step, but not for every type
NCI lists surgery, when it is possible, as the treatment for nonfunctioning tumors, often followed by watchful waiting. NCI also lists surgery for hormone-making tumors, sometimes combined with radiation or medicine. There is one big exception. For a prolactin-producing tumor, NCI puts drug therapy first, and reserves surgery for tumors that do not respond to the drug or for people who cannot take it. So confirm which hormone your tumor makes before assuming an operation is coming.
NCI lists three surgical approaches. In one, the surgeon goes in through a cut under the upper lip or at the bottom of the nose. This is called transsphenoidal surgery. In the endoscopic version, a thin tube with a camera goes in through a cut at the back of the inside of the nose. NCI's clinician summary says this version is used more and more. It lets the surgeon see the whole surgical field. A craniotomy opens the skull to reach the tumor directly. Ask your surgeon which approach fits your tumor and why.
Radiation therapy
Radiation uses high-energy rays to target the tumor. One specialized form is stereotactic radiosurgery. NCI says a machine aims a single large dose of radiation directly at the tumor. This procedure does not involve surgery. NCI's clinician summary says radiation has been given after surgery when scans show residual or recurrent tumor.
Medicines for hormone-producing tumors
If your tumor is functioning, meaning it makes extra hormones, medicine may be used to stop it from overproducing them. This can be the main treatment for some tumor types. It can also be used alongside surgery or radiation. Which drug fits depends on which hormone your tumor is making. Ask your endocrinologist to explain your specific hormone levels and what the medicine is meant to do.
Chemotherapy for advanced disease
NCI says chemotherapy may be used as palliative treatment for pituitary carcinoma, a rare form. The goal is to relieve symptoms and improve quality of life. NCI's clinician summary calls chemotherapy for pituitary carcinoma of little benefit.
Why hormone monitoring matters so much here
NCI's clinician summary says radiation carries a substantial risk of hypopituitarism. The risk is about 30% at 10 years. This means the pituitary makes too little of some hormones. MedlinePlus says it usually needs lifelong hormone medicines. Its symptoms include fatigue, weakness, and feeling cold. They also include a lot of urination and thirst, and weight loss. Contact your provider if you develop them. Ask your team how your hormone levels will be checked.
Nonfunctioning tumors cause problems too
A nonfunctioning tumor does not make extra hormones, but it can still cause trouble. As it grows, it can press on nearby structures, including the nerves that carry vision from your eyes to your brain. NCI's clinician summary says gaps in the field of vision are a common sign of pituitary tumors. NCI lists surgery first for nonfunctioning tumors when it is possible. It says surgery eases headache and pressure on the nerves for vision.
Which symptoms cannot wait
- Call 911 or go to the nearest emergency department right away for a sudden severe headache, sudden vision loss or major vision changes, or sudden confusion. These can point to bleeding into the tumor. NCI's clinician summary calls this pituitary apoplexy. It lists headache, vomiting and gaps in the field of vision among the signs. NCI gives no urgency level, so this is an emergency trip, not a callback.
- Follow any emergency instructions your team has given you on the way in.
Follow-up care after treatment
NCI says some tests done to diagnose the tumor may be repeated to see how well treatment is working. Follow-up may also include hormone checks, since hypopituitarism can follow treatment. Ask your team how often you will be seen and what tests each visit will include.
What to ask your care team
- Is my tumor functioning or nonfunctioning, and how does that shape my treatment plan?
- Which surgical approach do you recommend, and why?
- Will I need hormone replacement after treatment, and how will you monitor for that?
- What symptoms should prompt a right-away call rather than waiting for my next appointment?
Sources
Common questions
What is the difference between a functioning and a nonfunctioning tumor?
Pituitary tumors grow in the pituitary gland, a small gland at the base of your brain that controls many of your body's hormones. Some tumors make extra hormones, and doctors call these functioning tumors. Others do not, and are called nonfunctioning. Your treatment plan depends heavily on which type you have, and tumor size and location matter too.
What surgery is used for these tumors?
NCI lists surgery, when it is possible, as the treatment for nonfunctioning tumors, often followed by watchful waiting. NCI also lists surgery for hormone-making tumors, sometimes with radiation or medicine. NCI puts drug therapy first for prolactin-producing tumors and turns to surgery if the drug does not work or cannot be taken. NCI lists transsphenoidal surgery, where the surgeon goes through a cut under the upper lip or at the bottom of the nose. It also lists endoscopic transsphenoidal surgery, which uses an endoscope through a cut at the back of the inside of the nose. NCI's clinician summary says endoscopic surgery lets the surgeon view the whole surgical field. A craniotomy opens the skull to reach the tumor directly. Ask your surgeon which approach fits your specific tumor and why.
What does radiation involve here?
Radiation uses high-energy rays to target the tumor. One specialized form is stereotactic radiosurgery. NCI says a machine aims a single large dose of radiation directly at the tumor, and this procedure does not involve surgery. NCI's clinician summary says radiation has been given after surgery when scans show residual or recurrent tumor.
Why does hormone monitoring matter so much?
NCI's clinician summary says radiation carries a substantial risk of hypopituitarism, about 30% at 10 years. Hypopituitarism means the pituitary makes too little of some hormones. MedlinePlus lists fatigue, weakness, sensitivity to cold, excessive urination and thirst, and weight loss among the symptoms, and says to contact your provider if you develop them. It also says hypopituitarism usually needs lifelong hormone medicines.
Which symptoms cannot wait for a routine visit?
Call 911 or go to the nearest emergency department right away for a sudden severe headache, sudden vision loss or major vision changes, or sudden confusion. NCI's clinician summary describes pituitary apoplexy as sudden bleeding or loss of blood supply in a pituitary tumor, and lists headache, vomiting and visual field defects among its signs. NCI gives no urgency level, so the emergency route is the cautious choice. Follow any emergency instructions your team has given you on the way in.
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Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes, and this is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. It is not a medical review, and it does not confirm the page is complete or right for your situation.
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