What is the treatment for prolactinoma?
Prolactinomas are often highly treatable. Healthcare providers usually prescribe medication to treat them. In rare cases, your provider may recommend surgery or radiation therapy.
Prolactinoma medication
Medications called dopamine agonists are often very effective in shrinking prolactinoma tumors. They can also return your prolactin level to a healthy range.
The two dopamine agonists that healthcare providers prescribe to treat prolactinomas are cabergoline and bromocriptine. Cabergoline is often the first-choice medication because it’s more effective than bromocriptine and has fewer side effects.
Common side effects of dopamine agonists include nausea, vomiting and dizziness.
You’ll likely have to take either of these medications for at least two years to prevent the tumor from growing back, especially if it’s large. After two years, your provider may slowly reduce your dosage and then stop the medication if your prolactin levels are normal and the tumor is no longer visible.
Surgery for prolactinomas
Although it’s rare, you may need to have surgery to treat prolactinoma for any of the following reasons:
- You’re having negative reactions to dopamine agonists.
- The dopamine agonists aren’t working to shrink the tumor.
- You take antipsychotic medications that interact with dopamine agonists.
- You have a large prolactinoma and want to surgically remove it before trying to become pregnant.
Together, you and your healthcare provider will decide if surgery is the best option for you. Surgeons use two types of surgeries to remove prolactinomas, including:
- Transsphenoidal surgery: This is the most common surgery for prolactinomas. A surgeon makes an incision (small cut) at the back of your nasal cavity or under your upper lip to access your pituitary gland and the tumor.
- Transcranial surgery: For this surgery, a surgeon removes the tumor through an opening in your skull. They typically only use this type of surgery if the tumor is very large.
As with all surgeries, there are possible complications and risks associated with prolactinoma surgery. Your provider will go over these risks with you.
Radiation therapy for prolactinomas
Radiation therapy is a rare third option for treating prolactinomas if medications and/or surgery don’t work to reduce your prolactin levels. Depending on the size and location of the tumor, you may receive one radiation dose or multiple doses over several weeks.
