Knowing what to expect during and after treatment can help you prepare and reduce any anxiety that you may be feeling. The following information has been put together to help you understand your radiation therapy treatment, and we hope to reduce any concerns you have. It does not replace discussion with your doctor, or the advice of your care team specific to your needs.
Stereotactic radiation therapy for pituitary adenoma
Stereotactic radiation therapy is a highly specialised, non-invasive form of radiation therapy which utilises state-of-the-art 3D technology. Multiple high energy x-rays are delivered from many different angles precisely focusing on the abnormal cells within the brain. The aim of this treatment is to inactivate or destroy the abnormal cells, while minimising the impact on the surrounding normal brain tissue. It works because abnormal cells are more sensitive to radiation than normal cells. The high energy x-rays damage the DNA (genetic code) in the cells, making the cells unable to grow or divide, causing cell death. Normal cells can recover from radiation, but abnormal cells cannot.
Stereotactic radiation therapy can be used with the aim to slow or stop the growth of an acoustic neuroma. In some cases, the tumour may shrink in size. Depending on the size and location of the abnormality, stereotactic radiation therapy can be delivered in one session – stereotactic radiosurgery (SRS), or over a course of several treatment sessions – stereotactic radiotherapy (SRT).
Stereotactic radiation therapy may be used on its own or together with other types of treatment, such as surgery, chemotherapy or a combination of all of these options.
A pituitary adenoma is a benign (non-cancerous), slow growing tumour that arises from the cells of the pituitary gland. The pituitary gland is a small structure that lies at the base of the brain, just behind the bridge of the nose.
Pituitary adenomas vary greatly. While many are simply a mass which grows in the pituitary (non-functioning adenoma), several types actually secrete pituitary hormones (functioning adenoma) in excessive amounts. This abnormal secretion can lead to very specific clinical syndromes related to that hormone. Pituitary adenomas may also create pressure on surrounding structures, most commonly the normal pituitary gland or the nerves of vision.
If you have a cavernous sinus meningioma, you may experience additional side effects because of the closeness to nerve and vascular structures. Your radiation oncologist will let you know if this is likely to impact you.
Prescriptions and vitamins
Continue to take any prescribed medications. Please inform your nurse if you are taking vitamins, antioxidants or herbal supplements, or if you start any new medications during your treatment.
If you are currently taking dexamethasone, please continue to take the dosage prescribed by your radiation oncologist/medical oncologist. Do not cease dexamethasone without doctor’s orders.
In some cases, your radiation oncologist may prescribe dexamethasone as a pre-medication [to start on the day of treatment]. Your nurse will discuss this with you on your first day of treatment.
If you have any questions regarding medications, please discuss this with your radiation oncologist or nurse.
Stereotactic radiation therapy has relatively few side effects. Everyone is different and side effects will vary depending upon the size of the abnormality, how close the surrounding structures are, and the dosage of your radiation therapy treatment. Side effects are manageable. Please discuss any changes or new symptoms with your nurse.
Stereotactic radiation therapy does not make you radioactive and it is safe to be around others, including children and pregnant women during and after your treatment. There is no restriction on physical contact with others.
We encourage you to talk to us about any side effects that worry you. We are here to help you find ways to manage any side effects that you experience.
Short-term side effects may include:
You may experience headaches, or if you already suffer from headaches, you might find they increase in intensity.
Nausea and vomiting
Nausea and vomiting is a less common side effect but it can occur for some people. You’re more likely to experience nausea if the treatment is directed at an area close to the back of the brain that controls nausea and vomiting. Your nurse will let you know if this applies to you.
Visual disturbances such as double vision and a reduced ability to see fine details [decreased visual acuity] may occur because of the proximity of the optic nerve. This is a rare side effect.
You may feel tired or lack energy for daily activities during your treatment. You may become increasingly tired as you progress towards the end of your treatment. This is a normal reaction to the radiation therapy and each person is affected in varying degrees. Fatigue usually eases a few weeks after treatment finishes. Finding a balance between rest and activity will help you manage daily life.
Often there is no visible skin reaction from stereotactic radiation therapy. However, if your treatment area is close to the scalp, your skin may become pink, dry or sensitive a few weeks after treatment begins. This is a temporary reaction that usually goes away without any treatment.
Stereotactic treatment to the head may cause patchy hair loss or thinning in areas where radiation is directed. Hair loss caused by stereotactic radiation therapy is usually temporary and is uncommon with a single session of treatment. Hair loss is more likely to occur when multiple treatment sessions are given or when the abnormality is located closer to the scalp.
If hair loss does occur, it usually happens a few weeks after treatment begins. Hair will usually regrow within three to six months. The colour or texture may be different, and it may grow back thinner or patchy.
Radiation therapy can damage the function of the normal pituitary gland. Hormone deficiencies can occur many years after treatment and you may require hormone replace treatment by an endocrinologist (doctor specialising in hormones).
Your radiation oncologist will talk to you about any long-term side effects that relate to your treatment.
Avoid frequent shampooing. You may wash your hair with warm water and a mild, non-perfumed shampoo. Dry your hair gently, avoiding hair dryers, curling irons and straighteners. Continue this routine for two weeks after completing treatment or until there are no signs of irritation.
Avoid hair products, cosmetics and perfumes
Avoid using hair spray, gels or styling products including; cosmetics, perfumes or other lotions on your head. These products can increase the skin irritation caused by radiation.
Do not colour or perm your hair until four weeks after your treatment is complete.
Avoid excessive temperatures
Avoid exposing the treatment area to excessive temperatures such as direct sunlight, heat packs, ice packs, saunas or hot spas.
Protect your head in the sun
Wear a wide brimmed soft hat at all times when outdoors.
Frequently asked questions
You may continue your usual work and daily activities, but you may need to rest more than usual due to tiredness or fatigue during treatment. Unless otherwise advised, you can eat and drink normally. Alcohol consumption in moderation is permitted, and you can continue to take any prescribed medications.
Reviews and follow-up appointments will be discussed and organised by your care team prior to completing treatment.
Radiation therapy treatment keeps working even after you have stopped coming in for regular treatment. This means symptoms may get a little worse before they get better. Generally, side effects will settle within four to six weeks of finishing your treatment.