Quality of Life in Patients with a Pituitary Adenoma

Abstract

A validated quality of life (QOL) measure, the SF-36 questionnaire, was used to assess patients' perception of the impact of a pituitary adenoma, prior to treatment, on his or her physical and mental functioning. Of 270 new patients evaluated for pituitary disease at the University of Virginia Pituitary Clinic, 168 met the criteria for inclusion (pituitary hormone hypersecretion and/or pituitary adenoma) into this prospective study. Results of the SF-26 questionnaire in 36 patients with acromegaly, 42 patients with Cushing's disease, 39 patients with a prolactinoma and 51 patients with a non functioning macroadenoma prior to treatment were compared with those of the normal population; a comparison of results among patients with different types of pituitary adenomas was also performed. Patients with a pituitary adenoma had a significantly decreased QOL compared with the normal population in both physical and mental measures (p < 0.05). There were different degrees of perceived impairment depending on the type of pituitary adenoma. Patients with acromegaly had impairment in measures of physical function while patient with Cushing's disease had impairment in all but one measures compared with the normal population and with patients with other types of pituitary adenomas. Patients with a prolactinoma had impairment in mental measures and patients with a non-functioning adenoma had impairment in both physical and mental measures compared with the normal population. Patients with a pituitary adenoma have an impaired quality of life that should be routinely assessed in conjunction with endocrine and anatomic studies before and after treatment.

MANAGEMENT OF ENDOCRINE DISEASE: Quality of life tools for the management of pituitary disease

“…Although most reports on QoL using generic questionnaires in NFPA describe a low QoL after treatment (7,11,41,75,76), there are also descriptions of normalization of QoL, after successful treatment, attaining scores comparable to those seen in a healthy population (77,78). As already mentioned, compared to that of other pituitary adenoma patients, QoL of NFPA patients was similar to that of patients treated for prolactinoma, and better than that of patients diagnosed with CD and acromegaly (11,39,79,80).…”

“…Having undergone treatment with radiotherapy is also associated with worse QoL scores in acromegaly, although it is unknown whether this is due to a more aggressive disease requiring multimodal treatment for control, or due to the irradiation effect itself (41,42). Other parameters identified as markers of worse QoL in acromegaly are being older (10, 43), being female rather than male (44), having coexisting diabetes mellitus (43), having a higher BMI (10), having a longer disease duration (10), or becoming GH-deficient after the treatment for acromegaly, usually induced by prior radiotherapy (43,45).…”

The natural course of non-functioning pituitary macroadenomas

“…Johnson et al (26) have shown that quality of life is decreased in non-operated NFMA patients. From the current literature, it is unclear whether treatment of pituitary tumor will improve the quality of life.…”

The ‘bio-assay’ quality of life might be a better marker of disease activity in acromegalic patients than serum total IGF-I concentrations

“…They clearly found that patients with a pituitary adenoma do have an impaired QoL that should be routinely assessed in conjunction with endocrine and anatomic studies before and after treatment (4).…”