Thyrotroph pituitary neuroendocrine tumour: the decisions you may face

Cancer page →Second-opinion finder →

1 treatment setting, 1 with more than one named option. Each section lays out the options the standard of care names, what each is for, the trials behind them with their recorded results, the side effects and cautions on record, and questions to ask. Built from the cancer page's standard-of-care rows; nothing here is advice for your case.

Other settings

All cases

2 options

Transsphenoidal surgery after achieving euthyroidism; somatostatin analogues for residual disease; radiotherapy where medical control fails (ETA 2013).

The options, in plain words

PasireotideApprovedMultireceptor somatostatin analogue (subcutaneous or monthly depot)

Pasireotide is a second-generation somatostatin analogue that hits more receptor types than octreotide. It is approved for Cushing's disease and acromegaly caused by pituitary tumours when surgery has not cured them, at the cost of frequent high blood sugar.

Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS)Established

A single very high dose, or a few doses, aimed at a small brain or spine target with millimetre precision, replacing whole-brain radiotherapy for most brain metastases.

One to five sessions
Spares healthy brain
Treats targets surgery cannot reach

Also referenced:Pituitary tumours (pituitary neuroendocrine tumours) and pituitary carcinoma

The evidence behind it

No trial record is attached to this row yet. The trials tab lists what is recruiting and the landmark trials for this cancer.

The main trade-offs on record

Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS)

Limited to small targets
Radiation necrosis in a minority
Needs precise imaging and immobilisation

Questions to ask about this decision

Between Pasireotide and Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS), which do you recommend for me, and what about my case would make you choose differently?
Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?
Why: The aim shapes how much side effect and disruption is worth accepting.
What happens if I delay, or decline this step for now? Is the decision reversible?
Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
For my situation (all cases), which of the standard options do you recommend and why?
Why: Guideline options include: Transsphenoidal surgery after achieving euthyroidism; somatostatin analogues for residual disease; radiotherapy where medical control fails (ETA 2013).
Am I a candidate for Pasireotide, and what side effects should I expect?
Why: Knowing the expected toxicities helps you plan work, family, and supportive care.

Add these to your appointment list, or take the full question set for this cancer.

How to read this page. Options and results come from OnCo records with their sources; the settings are the standard-of-care rows on the cancer page, and the lines of therapy are on the sequencing grid. Where a setting names one path, the choice is usually about timing, trials and where to be treated: see expert centres. OnCo is orientation, not medical advice.

Living with cancer·Standard of care