The protocol since my radiotherapy in 2012 has been to monitor tumor growth via MRI and pituitary function through lab work every six months. Instead of returning to MD Anderson Cancer Center this year, I followed up with my neurosurgeon in California. The MRI report describes the residual tumor in my left cavernous as inconspicuous. When comparing the results to previous MRIs, it appears to have melted away (time will tell if it has). There is still a remnant of tumor on the right side of the sella floor that is visible, but this, too, is shrinking and possibly half the size it was before radiation. The tumor is responding to proton radiation treatment.
My pituitary gland does not look normal, though it hasn't looked normal for some time. It is still functioning even though it is smaller and flat on the sellar floor. Apparently, the position of the pituitary is irrelevant so long as the labs continue to show the gland is functioning fine. As of today, this is the case. I still retain the complete gland function and am not on any hormone replacement now. My prolactin level continues to climb but remains within normal limits (high normal). I don't know when/if or which hormones will take the plunge first, but there is a hint that my gland may be struggling; my last IGF-1 was 66. After radiation treatment, my IGF-1 was 190. Since then, my level continues to drop and stay below 100 this past year. For the most part, I don't feel different post-radiation. The main symptoms I've had since my treatment ended are increasingly low energy and mild weight gain. My headache problem is gone. I don't think the lower growth hormone level entirely causes fatigue or weight gain. It could be a contributing factor, but it's only one of many. Other causes could be age, stress, lack of exercise, and diet.
In May, my energy returned, and warmer weather settled in. I'd had enough of the weight gain and was determined to implement changes to my daily routine and began running 2-3 days a week. Also, I cut back on the number of carbohydrates I ingest. The simple changes I employed made a difference and are helping. I've lost over 10 pounds since June and feel pretty good these days.
I follow-up with my endocrinologist in a few weeks and will continue to do so every six months. I do not have to return for a MRI for two years.
