Re: Prolactinoma
qamyas - 08-17-08 10:23

depend upon the symptoms....

Re: Prolactinoma
Youngdoctor - 10-17-08 17:59

It depends on the size as well. If it is >10mm, then go for Surgery.

Treatments:-

Drugs:-
Dopamine is the chemical that normally inhibits prolactin secretion, so doctors may treat prolactinoma with bromocriptine or cabergoline, drugs that act like dopamine.

This type of drug is called a dopamine agonist. These drugs shrink the tumor and return prolactin levels to normal in approximately 80% of patients.

*Bromocriptine is the only dopamine agonist approved for the treatment of infertility.
*Bromocriptine is associated with side effects such as nausea and dizziness. To avoid these side effects, it is important for bromocriptine treatment to start slowly.
*Bromocriptine treatment should not be interrupted without consulting a qualified endocrinologist. Prolactin levels often rise again in most people when the drug is discontinued. In some, however, prolactin levels remain normal, so the doctor may suggest reducing or discontinuing treatment every two years on a trial basis.

*Cabergoline is also associated with side effects such as nausea and dizziness, but these may be less common and less severe than with bromocriptine. As with bromocriptine therapy, side effects may be avoided if treatment is started slowly. If a patient's prolactin level remains normal for 6 months, a doctor may consider stopping treatment.

*Surgery should be considered if medical therapy cannot be tolerated or if it fails to reduce prolactin levels, restore normal reproduction and pituitary function, and reduce tumor size. If medical therapy is only partially successful, this therapy should continue, possibly combined with surgery or radiation treatment.

Prognosis:-

People with microprolactinoma generally have an excellent prognosis. In 95% of cases the tumor will not show any signs of growth after a 4 to 6 year period.

Macroprolactinomas often require more aggressive treatment otherwise they may continue to grow. There is no way to reliably predict the rate of growth, as it is different for every individual. Regular monitoring by a specialist to detect any major changes in the tumor is recommended.

Re: Prolactinoma
sackatdoc - 10-18-08 02:07

welcome to the gang, young doctor,what is reference of your material, just for my interest,i agree to the facts you have stated,
also you mean to say, treatment with cabergoline is only for 6months and bromocriptine has to be given for 2yrs???

Re: Prolactinoma
mohhaider - 10-18-08 02:21

Yes, youngdoctor is always writing in full details to make things easier to remember .The medical treatment actually is the first line and surgery is better to cure the microadenoma .

Re: Prolactinoma
sackatdoc - 10-18-08 03:45

i want to clarify this difference among the two drugs, kindly if you will make this point of duration of therapy more clear, it would be great

Re: Prolactinoma
mohhaider - 10-20-08 05:31

Sackatdoc ,I don't understand your post ,you said you want to clarify the difference ,so why don't you post the difference ?Or you want someone to clarify that for you ?

Re: Prolactinoma
sackatdoc - 10-20-08 06:23

haider this is in reference to post by young doctor,two drugs that are mentioned,i cant clarify till it is clear that one is for 6months and the other one for 2yrs, is that what is meant in the post?

Re: Prolactinoma
mohhaider - 10-20-08 09:37

Okay ,I see now .We may need Youngdoctor to tell us more about that since he is the guy that posted these drugs ,he is really informative .

Re: Prolactinoma
moazzamhyder - 11-18-08 07:59

medical t/t first line macrodenoma surgery if causing optic compression or other such