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Causes and Types of Thyroid Disorders And Cancer | Endocrinology

Thyroid disorders and cancer

It occurs in thyroid cancer cells – a butterfly-shaped gland at the base of your neck, just below your Adam’s apple. Your thyroid makes hormones that regulate your heart rate, blood pressure, body temperature, and weight. Thyroid cancer may not cause any symptoms at first. But as it grows, it causes pain and swelling in the neck.

There are many types of thyroid cancer. Some grow very slowly and others are very aggressive. Most cases of thyroid cancer can be cured with treatment. Thyroid cancer rates appear to be increasing. Some doctors believe this is because new technology allows them to detect small, previously undeveloped thyroid cancers.

Symptoms of thyroid cancer

It’s common for people with thyroid cancer to have fewer or no symptoms. These are often diagnosed by a routine physical exam of the neck. They can also be detected accidentally by X-rays or other imaging scans done for other reasons. People may experience the following symptoms or signs. Sometimes people do not have any of these changes. Or, the symptom may be caused by a different medical condition that is not cancerous.

In front of the neck, a lump near Adam’s apple.

  • Blunt
  • Swelling of the glands in the neck.
  • Difficulty swallowing
  • Difficulty breathing
  • Throat or neck pain
  • The cough persists and is not caused by a cold.

If you are concerned about any changes you may experience, speak with your doctor. Among other things, your doctor may ask how often and how often you experience symptoms. This helps identify the cause of the problem called a diagnosis. Other thyroid problems such as goiter; Or a condition not related to the thyroid, such as an infection.

If cancer is diagnosed, symptom relief is an important part of cancer care and treatment. This is called palliative or supportive care. It often begins after diagnosis and continues throughout treatment. Be sure to talk to your healthcare team about any symptoms you are experiencing, including new symptoms or changes in symptoms.

How common is thyroid cancer?

This is rare cancer accounting for less than 1% of all cancer cases in the UK. Every year approximately 2,700 people in the UK are diagnosed. It is most common in people 35 to 39 years old and in people 70 and older.

Women are 2 to 3 times more likely to develop, than men. It is not clear why, but it may be the result of hormonal changes associated with the female reproductive system.

Who gets it?

This is more common in women than in men. Women have between the ages of 40 and 50, while men who have it are usually between the ages of 60 and 70. Follicular thyroid cancer is more common in whites than blacks and more women than men. You can still get this if you are young. Papillary thyroid cancer, for example, occurs most often in people between the ages of 30 and 50.

Types of thyroid cancer

Thyroid cancer is classified into types based on the cells found in the tumor. Its type is determined when a sample of tissue from your cancer is examined under a microscope. The type of thyroid cancer is considered to determine its treatment and prognosis.

Types of thyroid cancer:

  • Papillary thyroid cancer: The most common form of thyroid cancer, papillary thyroid cancer, arises from follicular cells that produce and store thyroid hormones. Papillary thyroid cancer can occur at any age, but most often affects people between the ages of 30 and 50. Doctors sometimes refer to papillary thyroid cancer and follicular thyroid cancer together as thyroid cancer.
  • Follicular thyroid cancer: Follicular thyroid cancer also arises from the follicular cells of the thyroid. It usually affects people over 50 years of age. Hartley cell cancer is a rare and more aggressive type of follicular thyroid cancer.
  • Anaplastic thyroid cancer: This is a rare thyroid cancer that begins in follicular cells. It grows quickly and is very difficult to treat. Anaplastic thyroid cancer usually occurs in adults 60 years of age or older.
  • Medullary thyroid cancer: It begins in thyroid cells called C cells, which make a hormone called calcitonin. Calcitonin levels in the blood indicate medullary at a very early stage. Some genetic syndromes increase the risk of medullary thyroid cancer, although this genetic link is unusual.
  • Other rare varieties: Another very rare cancer that begins in the thyroid is thyroid lymphoma, which begins in the cells of the thyroid immune system, and thyroid sarcoma, which begins in the cells of the thyroid connective tissue.

Causes of thyroid cancer

In most cases, the cause is unknown. However, some things increase the chances of developing your condition. The cause is unclear.

It occurs when cells in your thyroid undergo genetic changes (mutations). Mutations allow cells to grow and multiply rapidly. Cells also lose the ability to die, just like normal cells. The abnormal thyroid cells have accumulated from a tumor. The abnormal cells can attack nearby tissues and spread to other parts of the body (metastasize).

Risk factors of thyroid cancer

Factors that increase the risk:

  • The female gender is more common in women than in men
  • Exposure to high levels of radiation. Radiation therapy treatments to the head and neck increase the risk

Some hereditary genetic syndromes. Genetic syndromes that increase the risk, and include familial medullary thyroid cancer, multiple endocrine neoplasms, Cowden’s syndrome, and familial adenomatous polyposis.

Recurrent thyroid cancer: Despite treatment, even if the thyroid is removed, it will return. This happens when microscopic cancer cells cross the thyroid before being removed.

  • Lymph nodes in the neck
  • Small pieces of thyroid tissue remain during surgery
  • Other areas of the body, such as the lungs and bones.
  • Recurrent thyroid cancer can be treated. Your doctor may recommend regular blood tests or thyroid scans to check for recurring signs.

Diagnosis of thyroid cancer

A type of blood test called a thyroid function test measures hormone levels in the blood and can rule out or confirm other thyroid problems. Fine needle aspiration cytology (FNAC) is used if nothing else appears to be causing a thyroid lump. More evidence is needed if the FNAC results are incomplete or if more information is needed to make your treatment more effective.

Treatment for thyroid cancer

Treatment options depend on your type and stage, and your general health, and your preferences. Most of those can be cured with treatment. Treatment may not be needed right away

Very small thyroid cancers that have a low risk of spreading throughout the body do not require immediate treatment. Instead, you can often consider active surveillance with cancer control. Your doctor may recommend blood tests and an ultrasound exam of your neck once or twice a year. In some people, cancer never grows and does not require treatment. In others, the increase can eventually be detected and treatment started.

  • Surgery
  • Parathyroid glands
  • Open the Parathyroid Glands pop-up dialog

Most people have surgery to remove the thyroid. Your doctor may recommend any operations based on the type of thyroid cancer, the size of the cancer, whether the cancer has spread beyond the thyroid, and the results of an ultrasound examination of the entire thyroid gland.

Operations used to treat thyroid cancer:

Remove all or most of the thyroid (thyroidectomy). An operation to remove the thyroid gland involves the removal of thyroid tissue (total thyroidectomy) or thyroid tissue (near the entire thyroidectomy). The surgeon often leaves small borders of thyroid tissue around the parathyroid glands, which can help control calcium levels in the blood.

Removal of a portion of the thyroid (thyroid lobectomy). During a thyroid lobectomy, the surgeon removes half of the thyroid. This may be recommended if you have slow-growing thyroid cancer in one part of the thyroid and there are no suspicious nodules in other areas of the thyroid.

Removal of lymph nodes in the neck (lymph node dissection). By removing the thyroid, the surgeon can also remove nearby lymph nodes in the neck. These can be tested for signs of cancer.

Thyroid surgery can increase the risk of bleeding and infection. Damage to the parathyroid glands can also occur during surgery, which can lead to lower levels of calcium in your body. The nerves connected to the vocal cords may not function normally after surgery, which can lead to laryngeal paralysis, numbness, voice changes, or shortness of breath. Treatment improves or reverses nerve problems.

Thyroid hormone therapy: After a thyroidectomy, you can take the medicine levothyroxine (Levoxyl, Synthroid, others) for life. This action has two benefits: it supplies the missing hormone normally produced by the thyroid, and it suppresses the production of thyroid-stimulating hormone (TSH) from the pituitary gland. High levels of TSH can trigger the growth of the remaining cancer cells.

Radioactive iodine: Radioactive iodine treatment uses large doses of radioactive iodine. Radioactive iodine treatment is often used to destroy healthy thyroid tissue that remains after a thyroidectomy, as well as microscopic areas of thyroid cancer that have not been surgically removed. Radioactive iodine treatment is also helpful, which can come back after treatment or spread to other parts of the body.

Radioactive iodine treatment comes as a capsule or liquid that is swallowed. Radioactive iodine is taken up primarily by thyroid cells so the risk of damaging other cells in your body is low.

Side effects can include:

  • Dry mouth
  • Oral pain
  • Inflammation of the eye
  • Altered sense of taste or smell
  • Fatigue

Most of the radioactive iodine is excreted in the urine during the first days after treatment. You will be told what precautions to take at this time to protect other people from radiation. For example, you may be asked to temporarily avoid close contact with other people, especially children, and pregnant women.

External radiation therapy: Radiation therapy can also be delivered externally to a specific point on your body (external beam radiation therapy) using a machine that targets high-energy rays, such as X-rays and protons. During treatment, you lie on a table while a machine moves around you. External beam radiation therapy may be recommended if surgery is not an option and your cancer is growing after treatment with radioactive iodine. Radiation therapy may also be recommended after surgery if your cancer is at risk of recurrence.

Chemotherapy: Chemotherapy is the treatment of cancer by using chemicals to kill cancer cells. Chemotherapy is usually given through an IV. The chemicals travel throughout the body and destroy rapidly growing cells, including cancer cells. Chemotherapy is not commonly used, but it is sometimes recommended for people with anaplastic. Chemotherapy can be combined with radiation therapy.

Targeted drug treatment: Targeted drug therapies target specific abnormalities in cancer cells. By preventing these abnormalities, targeted therapeutic therapies can cause cancer cells to die. Drug treatment targets the signals that tell cancer cells to grow and divide. It is commonly used in advanced cancer.

Alcohol injection in cancers: Alcohol ablation is the injection with alcohol to ensure accurate injection placement using ultrasound-like imaging. This procedure reduces thyroid cancer. Alcohol ablation may be an option if your cancer is very small and surgery is not an option. It is sometimes used to treat recurrent cancer of the lymph nodes after surgery.

Supportive (palliative) care: Palliative care is specialized medical care that focuses on relieving pain and other symptoms of a serious illness. Hospice professionals will work with you, your family, and your other doctors to provide additional support to complete your ongoing care. Palliative care can be used when other aggressive treatments such as surgery, chemotherapy, or radiation therapy are performed. Most of it is offered at the beginning of cancer treatment. When palliative care is used in conjunction with all other appropriate therapies, people with cancer can feel better and live longer.

Palliative care is provided by a team of specially trained doctors, nurses, and other professionals. Palliative care teams aim to improve the standard of living for people with cancer and their families.

Prevention of thyroid cancer

Doctors do not know the cause, so there is no way to prevent, in those with an average risk of developing the disease.

Prevention for high-risk people: Thyroid surgery to prevent cancer (immune thyroidectomy) may be considered in adults and children with a genetic mutation that increases the risk of medullary thyroid cancer. Discuss your options with a genetic counselor who can explain your thyroid cancer risk and your treatment options.

Prevention for people close to nuclear power plants: Sometimes a drug that blocks the effects of radiation on the thyroid is given to people who live near nuclear power plants. Medicines (potassium iodide) can be used in the event of an accident in a nuclear reactor. If you live within 10 miles of a nuclear power plant and are concerned about safety precautions, contact your local or state emergency management department for more information.

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Causes of Male Reproductive Endocrinology | Endocrinology

What is male reproductive endocrinology?

Male reproductive endocrinology is a sexual development and hormonal function that depends on a complex feedback loop consisting of a hypothalamus-pituitary-testis modulated by the central nervous system. Male sexual dysfunction is second only to hypogonadism, neurovascular disorders, drugs, or other disorders.

Despite the growing interest in men’s health and the growing number of clinics dedicated to male reproductive health, not all providers trust the latest science or use evidence-based methods. We have developed our clinical practice guide on testosterone treatment and other science-based resources to ensure that men with reproductive health problems can receive the best medical diagnosis and care. 

Testosterone and DHT have metabolic and other effects, including

  • Stimulating protein anabolism (increasing muscle mass and bone density)
  • Stimulating renal erythropoietin production (increasing red blood cell mass)
  • Stimulating bone marrow stem cells (modulating the immune system)
  • Causing cutaneous effects (ie, sebum production, hair growth)
  • Causing neural effects (ie, affecting cognition, increasing libido, and possibly aggression)

Testosterone also undergoes conversion to estradiol by the enzyme, aromatase; estradiol mediates most of testosterone’s action on organs such as bones and the brain. Testosterone, DHT, and estradiol provide negative feedback on the hypothalamic-pituitary axis. In males, estradiol is the main inhibitor of LH production, whereas both estradiol and inhibin B, a peptide produced by Sertoli cells of the testes, inhibit the production of FSH.

In the presence of testosterone, FSH stimulates the Sertoli cells and induces spermatogenesis. In spermatogenesis, each germinal cell (spermatogonium), located adjacent to the Sertoli cells, undergoes differentiation into 16 primary spermatocytes, each of which generates 4 spermatids. Each spermatid matures into a spermatozoon. Spermatogenesis takes 72 to 74 days and yields about 100 million new spermatozoa each day.

Upon maturation, spermatozoa are released into the rete testis, where they migrate to the epididymis and eventually to the vas deferens. Migration requires an additional 14 days. During ejaculation, spermatozoa are mixed with secretions from the seminal vesicles, prostate, and bulbourethral glands.

How male reproductive endocrinology is assessed?

If you and your partner are unable to conceive after a year of trying, you should speak with your primary care physician, who can refer you to a fertility specialist. A urologist or reproductive endocrinologist can help diagnose and treat male infertility.

It starts with your doctor’s medical history. Your childhood growth and development, and you may have questions about past infections and surgeries, sexually transmitted diseases, testicular damage, and exposure to harmful chemicals or drugs.

Your doctor will perform a physical exam to check for low testosterone levels or other conditions that affect fertility (such as small or missing testicles). You will have a sperm test (often more than one) to see the size, movement, and shape of the sperm. Blood tests look for a hormone deficiency.

Also, your doctor may perform a scrotal or transrectal ultrasound. This imaging test looks for varicose veins around the testicles, tumors, or obstruction in the vas deferens. Your partner must have a complete medical history and evaluation at the same time. It gives you a complete picture of your potential as a couple with children.

Causes of male reproductive endocrinology

In about 30 to 40 percent of cases, the problem is in the testicles, the glands that make sperm, and testosterone (the main male sex hormone). Cancer treatments such as damage to the tonsils, infections such as tonsils, radiation or chemotherapy, trauma, or surgery.

Heat affects sperm production. Heat loss occurs when one or both testicles do not descend from the abdomen (where they were before birth) into the scrotum (usually the sac of skin that contains the testicles). Most men dilate the veins around the testicles (called a varicocele), which also raises the temperature in the testicles. If they are very large, a varicocele can lead to less sperm production.

Some inherited (genetic) diseases may or may not cause motility or reduced sperm production. In 10 to 20 percent of cases, the problem is the obstruction in the passage of sperm from the testicles to the penis through tubes called the vas deferens. It can be caused by infection scars, vasectomy (surgery to cut the vas deferens and prevent sperm), or cystic fibrosis (genetic disease). In addition to the penis, the backward movement of sperm into the bladder can also cause infertility.

In rare cases, infertility is caused by a hormonal deficiency. The testes produce luteinizing hormone (LH) and follicle-stimulating hormone (FSH) testosterone and sperm. The pituitary gland in the brain produces these hormones. Any condition that lowers LH and FSH levels, such as a pituitary tumor, can lead to low or low sperm production and low levels of testosterone in the blood.

In 30 to 40 percent of men with infertility, the cause is not found. But, these men usually have abnormal sperm (for example, sperm that are slow-moving, abnormally shaped, or in small numbers). Other problems include reduced sperm production and fertility. These include chronic (chronic) illnesses, total health, late payments, certain prescription drugs, and medications.

Treatment for male reproductive endocrinology treated?

Treatment of male reproductive endocrinology depends on the cause.

Surgery: Obstruction of the sperm transport system can be corrected surgically. Vasectomy can be reversed by surgery in 85% of cases, but most men remain infertile even after the barrier is resolved (other types of barriers are difficult to treat due to past infections). If veins are large and repaired before chronic damage, varicocele repair is likely to restore fertility. Surgery can also repair the varicocele, but it may not restore fertility.

Hormonal therapy: If the cause is due to low testosterone levels, treatment with injections of hormones (LH and FSH) is usually successful. However, hormone therapy can take a year or more to produce enough sperm and regain fertility.

Assisted reproductive technologies: Other options for a couple to achieve pregnancy are assisted reproductive techniques. These treatments involve injecting the collected sperm into the uterus, injecting the sperm with the egg outside the body (in vitro fertilization or IVF), or injecting a sperm into the egg (intracytoplasmic sperm injection or ICSI).

To improve your chances of successful treatment, it is helpful to maintain a healthy lifestyle exercise often, eat a healthy diet, and do not smoke or use recreational drugs. Also, continue treatment for any chronic illness.

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Disease

Types and Causes of Paget’s Disease | Endocrinology

What is Paget’s disease?

Paget’s disease of bone is a chronic illness of the skeleton. In healthy bones, a process called reshaping removes old pieces of bone and replaces them with fresh, new bone. It causes this process to become unbalanced, resulting in abnormally shaped, weak, and brittle new bone. It most often affects older people and occurs in about 2 to 3 percent of the population over 55 years of age.

Many patients with Paget’s disease have no symptoms and are not aware that they have the disease until X-rays are taken for some other reason. When there is bone pain and other symptoms, they may be related to the disease itself or to complications that arise from the disease, such as arthritis, bone deformity, and fractures.

In most cases, the treatment of Paget’s disease involves taking medications to help slow or stop the progress of the disease. For patients who have difficulties, surgery may be desirable to realign deformed bones or to help fractures heal.

Symptoms

Paget’s disease causes no symptoms in most people with the condition and is often seen incidentally when X-ray tests are obtained for other reasons. However, It can cause pain, deformity, fracture, and arthritis in the bones. The bone pain of Paget’s disease is localized to the affected area of the bone.

The bones most commonly affected by Paget’s disease include the spine, thigh bone (femur), pelvis, skull, clavicle (clavicle), and upper arm bone (humerus). Fractures can occur because the affected bone is not as strong as normal bone. Arthritis occurs due to deformity of the affected bone adjacent to the joint and bowing of the affected long bones. The resulting type of arthritis is osteoarthritis.

The symptoms of Paget’s disease rest on the bones affected and the severity of the disease. Enlarged bones can pinch adjacent nerves, causing tingling and numbness. Arching of the legs may occur. Hip or knee involvement can cause arthritis, lameness, as well as pain and stiffness in the hip or knee.

Headache, vision, and hearing loss can occur when the bones of the skull are affected. With widespread Paget’s disease, it is possible to develop congestive heart failure due to an increased workload on the heart. Sometimes the skin over the affected bone is warmer than usual. This is due to the increased blood supply to the pagetic bone.

Types

  • Monostotic type: When a single site of the bone is affected by Paget’s disease, it is known as the monostotic type.
  • Polyostotic type: When Paget’s disease affects multiple sites in the bone, it is called the polyostotic type.

Causes

Researchers have yet to definitively establish the cause of Paget’s disease. It appears to be hereditary. Rendering to the American College of Rheumatology, an additional than one family member has the disorder in 30 percent of cases.

Another suggestion is that the disorder is possibly due to an infection with the measles virus during childhood. Recent studies affirm that measles could alter the mechanism of bone formation and cause Paget’s disease.

Evidence suggests that the number of people with Paget’s disease has been declining over the past 25 years. Some scientists have linked the increase in vaccination in many countries and the resulting decrease in the number of people with measles to decreasing rates of Paget’s disease.

Risk factors

Years: People over the age of 40 are more likely to develop Paget’s disease of bone.

Sex: Men are affected more often than women.

National origin: Paget’s disease of bone is most common in England, Scotland, central Europe, and Greece, as well as in countries colonized by European immigrants. It is rare in Scandinavia and Asia.

Family history: If you have a close relative who has Paget’s disease of bone, they are more likely to develop the condition.

Diagnosis

During the physical exam, your doctor will examine the areas of your body that are causing you pain. You can also order X-rays and blood tests that can help confirm the diagnosis of Paget’s disease of bone.

Imaging tests

The bone changes common to Paget’s disease of bone can be revealed by:

  • X-rays: The first sign of Paget’s disease of the bone is repeatedly abnormalities found on x-rays done for other reasons. X-ray images of your bones can show areas of bone resorption, bone enlargement, and deformities that are individual of Paget’s disease of bone, such as prostration of the long bones.
  • Bone scan: In a bone scan, a radioactive substance is injected into your body. This material travels to the points in the bones most affected by Paget’s disease of bone, which is why it lights up in the scanned images.

Lab tests

People who have Paget’s disease of bone generally have elevated levels of alkaline phosphatase in their blood, which can be revealed by a blood test.

Treatment

If you don’t have symptoms, you may not need treatment. However, if the disease is active, designated by an elevated alkaline phosphatase level, and is affecting high-risk sites in your body, such as your skull or spine, your doctor may recommend treatment to prevent complications, even if you have no symptoms.

Medicines

Medications for osteoporosis (bisphosphonates) are the most common treatment for Paget’s disease of bone. Some bisphosphonates are taken by mouth, while others are injected. Oral bisphosphonates are generally well-tolerated but can irritate the gastrointestinal tract. Examples include:

  • Alendronate (Fosamax)
  • Ibandronate (Boniva)
  • Pamidronate (Aredia)
  • Risedronate (Actonel)
  • Zoledronic acid (Zometa, Reclast)

In rare cases, bisphosphonate therapy has been related to severe muscle, joint, or bone pain, which may not resolve when the drug is stopped. Bisphosphonates can also increase the risk of a rare condition in which a section of the jaw dies and deteriorates (osteonecrosis of the jaw), usually associated with active dental disease or oral surgery.

If you cannot tolerate bisphosphonates, your doctor may prescribe calcitonin (Miacalcin), a natural hormone involved in the regulation of calcium and bone metabolism. Calcitonin is a medicine that you give yourself by injection or nasal spray. Side effects can include nausea, facial flushing, and irritation at the injection site.

Surgery

In rare cases, surgery may be required to:

  • Helps heal fractures
  • Replace joints damaged by severe arthritis
  • Realign deformed bones
  • Reduce pressure on nerves

Paget’s disease of bone frequently causes the body to make too many blood vessels in pretentious bones, increasing the risk of serious blood loss during an operation.

If you are arranged for surgery involving bones affected by Paget’s disease, your physician may prescribe medications to reduce the activity of the disease, which can help reduce blood loss during surgery.

Complications

Bone expansion: The bone affected by Paget’s disease expands and can become deformed. Long bones can curve, so, for example, one leg may end up shorter than the other.

Fractures: The bone affected by Paget’s disease is weaker than usual, so it is more likely to break than healthy bone. It can also take longer than normal for a bone to heal after a fracture.

Nerve compression: When bones expand, they can sometimes squeeze nearby nerves. This is more likely to occur in the spine, which can lead to weakness and tingling in the legs.

Deafness: If the bones in the head are affected by Paget’s disease, it can lead to hearing loss, for example, if the bones around the ear become thicker.

Osteoarthritis: Abnormal bone growth can put extra pressure on the joints and damage the cartilage that covers the ends of the bones. This can lead to osteoarthritis in the joint. Symptoms of osteoarthritis include pain (especially when the joint is moved), stiffness, and sometimes swelling.

Tumors: Very rarely, a cancerous tumor can develop in a bone affected by Paget’s disease. This is estimated to happen in less than 1 in 500 cases. The first signs of this are increased pain and swelling around the tumor.

Prevention

To reduce the risk of complications associated with Paget’s disease of bone, try these tips:

  • Avoid falls, Paget’s disease of bone puts you at high risk for bone fractures
  • Protect your home from falls
  • Eat well
  • Exercise regularly
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Treatment and Causes of Pterygium | Ophthalmology

What is a pterygium?

Pterygium is a tissue growth in the corner of the eye that is often triangular in shape. If left untreated, the growth can spread throughout the pupil, blurring vision, or distort the surface of the eye.

The Pterygium is a benign lesion on both sides of the cornea that can be caused by prolonged exposure to sunlight or air. Inflammation, dust, and dryness can also be a factor. They usually cause irritation, redness, and a foreign body sensation. Sometimes they grow larger and diminish or distort vision.

Symptoms of pterygium

The symptoms are usually mild. Most people have no symptoms. If the growth is still small, you are less likely to have symptoms. Some features include:

  • Redness and inflammation of the eye
  • Feeling of discomfort or burning in the eye
  • The feeling that there is a strange object in the eye.
  • Dry eye due to decreased tear production
  • Distortion of the transparent membrane in the front of the eye (cornea) causes blurred vision
  • Blurred attention if growth occupies the entire student

Some people don’t like the look of pterygium. It is usually a triangle-shaped magnification. But not always. Some people notice this only after the growth has covered most of the cornea and obstructed the iris. The growth can be white, pink, or red.

Causes of pterygium

Dryness and exposure to ultraviolet light appear to be important factors in its development. Some common causes of pterygium are:

  • Long-term exposure to ultraviolet light: People who spend a lot of time outdoors for work or recreational reasons are at risk of developing a surfer’s eye.
  • Previous cases of dry eyes: If you have dry eyes, you are more likely to develop a surfer’s eye.
  • Exposure to irritants: Dust, sand, and air increases the surfer’s eye and provides to the deterioration of symptoms and growth on the surface of the eye.
  • Your family history: Some researchers believe that people with a family history are more likely to develop this condition than those without a pterygium condition.

Risk factors of pterygium

Pterygium is more common in men and older people. Other factors that increase your chances:

  • Excessive exposure to environmental conditions (sunlight, dust, dirt, heat, dryness, air, smoke)
  • Occupations
  • Outdoor hobbies
  • Work in occupations with excessive display to solvents or chemicals
  • Family members with pterygium

Diagnosis of pterygium

Your healthcare provider can confirm this with a medical history and physical exam. This will include a detailed eye exam for you, especially if you have vision problems. Your healthcare provider may refer you to an ophthalmologist for an evaluation.

Frequent medical history and examination provide adequate information for diagnosis. Your ophthalmologist will closely monitor your growth. This helps ensure that it is not just another condition that requires different treatment.

In some cases, your ophthalmologist may take a small sample (biopsy) of the pterygium and examine it under a microscope. Making sure it is not a cancerous growth. But this is not usually necessary.

Treatment of pterygium

Treatment of the surfer’s eye depends on the size of the pterygium, whether it grows, and the symptoms it causes. The pterygia must be controlled to avoid the formation of scars that cause loss of vision, regardless of severity.

If your pterygium is small, your ophthalmologist may order lubricants or mild steroid eye drops to temporarily decrease the inflammation and redness. Contact lenses are sometimes used to cover growth, protecting them from certain effects of dust or from increased UV exposure. Topical cyclosporine is also indicated for dry eyes.

While not a groundbreaking contribution to the genre, Breaking bad impresses with its straightforward bad style. Surgery can be guaranteed for both visual and cosmetic reasons. If pterygium surgery is required, there are several surgical procedures available. Your ophthalmologist performing the procedure will determine the best technique for your specific needs.

Excision of the pterygium can be done in the doctor’s office or in the operating room. It is important to note that patriarchal removal induces astigmatism, especially in those who already have astigmatism.

Surgery: In some cases, a pterygium can cause a person to have vision problems or symptoms that they cannot control with over-the-counter or prescription treatment.

In such cases, the doctor may recommend surgery to remove the pterygium. However, pterygia usually increase after surgery. For this reason, a doctor may recommend surgery only if a person’s symptoms are severe.

To reduce the chance of pterygium recurrence, a person should take steps to protect their eyes from the sun, dust, and other irritants. They should also consult their eye doctor for follow-up care.

Complications of pterygium

A pterygium may not cause problems other than eye redness and irritation, but if it grows on the cornea, it can cause visual symptoms. You should know that occasional treatment can cause problems. For example, you may get an eye infection after surgery, or MMC treatment may not heal properly and lead to a corneal infection.

Prevention of pterygium

Protecting your eyes from sunlight and ultraviolet radiation is always important, and wearing round sunglasses with UV protection will protect you from both the sun and dust.

Some tips and things to keep in mind:

  • It is important to wear sunglasses throughout the year. Don’t be fooled by clouds or if you are in the shade – substantial UV rays penetrate the cloud layer and reflect off surfaces such as land, sand, water, or snow.
  • Recommend wearing sunglasses from 8 to 10 in the morning and from 2 to 4 in the afternoon are actually the most important times to wear them.
  • When buying sunglasses, remember to check the sun protection factor on the swing tag. Look for sunglasses that conform to categories 2, 3, or 4 of the Australian standards. Your optometrist will help you make sure your sunglasses fit well and are comfortable to wear. Keep in mind that a high selling price does not always mean good protection.
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Disease

Treatment and Complications of Ptosis | Ophthalmology

What is ptosis?

Ptosis is also called droopy eyelid when the eyelid muscle (levator palpebrae superioris muscle) becomes weak for various reasons. The most common cause in children is the underdevelopment of the levator palpebrae superioris. It is congenital and is called congenital ptosis. Less common, then the muscles weaken. It involves one or both of the upper eyelids at different levels, with or without symmetry.

Ptosis affects one or both eyes. Sometimes it is an isolated problem that replaces a person’s appearance without changing vision or health. However, in other cases, it is a warning sign that a more serious condition may affect the muscles, nerves, brain, or eye socket. Ptosis that develops over days or hours indicates a serious medical problem.

Who gets ptosis?

Ptosis can occur at any age, but it is more common in adults. An eyelid can drop onto the pupil and interfere with vision. Patients often report that their vision improves by manually lifting the eyelid margin with their fingers. When an eyelid affects vision, it can be repaired. In adults, the most common cause of eyelids or ptosis is a tear of a muscular ligament in the eyelid.

Children can be born with ptosis or develop it at a young age, giving them uneven or low eyelids. In some cases, visual development is impaired due to ptosis in children. An eye exam is needed early on when a child has congenital ptosis. Children with congenital ptosis should be monitored and care should be evaluated in the first years of life. If vision is not affected, congenital ptosis repair is usually planned for 3-5 years.

Symptoms

The most obvious sign in a person is a drooping eyelid. It can happen at any time and the drop is visually noticeable. People born with ptosis have irregular shapes or wrinkles on the eyelids. However, some of the symptoms that accompany the droopy eye are:

  • Block normal vision
  • Eyes will be either watery or dry
  • Fatigue
  • Stress
  • Migraine

Types

Congenital ptosis: The levator muscle does not develop properly in utero, so the baby is born with compromised or low levator function. As a result, babies born with ptosis often have limited upper-field focus (this is the top of their field of vision) and may tilt their head back to try to see correctly.

Acquired ptosis: It can exist in several forms.

  • Mechanical ptosis: It occurs when the eyelid is overwhelmed by excess skin or tissue.
  • Aponeurotic ptosis: It occurs when the lavender muscle of the eyelid is stretched. It is usually caused by the aging process, but it can also be caused by rubbing your eyes excessively or pulling the eyelid.
  • Neurogenic ptosis: It is caused by a problem in the nerve pathways that control the movement of the eyelid muscles. These problems involve horner syndrome, third nerve palsy, and myasthenia gravis.
  • Traumatic ptosis: It occurs when the eyelid is injured or the levator muscle is affected.

Causes

Ptosis occurs when the levator palpebrae superioris muscle does not contract properly. This also happens when the upper torso muscle does not contract properly. Several conditions can cause this. For example, ptosis can be caused by:

  • Structural problems with the muscle that is being from birth
  • Muscle diseases(such as mitochondrial myopathy or myotonic dystrophy)
  • Rare disorders being from birth (such as congenital orbital fibrosis)
  • Problems with the tendon attached to the superior tarsal muscle
  • Senescence, dehiscence, or disinsertion of the levator aponeurosis
  • Too much pressure on the eyelid (such as from an eyelid tumor)
  • Injury (especially during eye surgery)
  • Nerve problems (such as with the third cranial nerve or in Horner syndrome)
  • Connection problems between the muscle and the nerve (such as in myasthenia gravis)

Risk factors

Potential risk factors for ptosis include:

  • Age
  • Contact lenses
  • Excessive eye rubbing
  • Eye surgery
  • Horner’s syndrome
  • Myasthenia gravis

Diagnosis

For some, all the doctor has to do is perform a physical exam. The decrease in these cases is obvious, so no further diagnostic tests are required. However, if the doctor suspects that the disease is the cause, more tests are needed.

During the evaluation, the doctor can take pictures of the person to be able to compare them and determine if the treatment is successful in the future or the progression of ptosis.

If an additional eye exam is required, a wedge lamp exam may be considered. The doctor usually paints the eyes and can also use other use lotion to disperse the students. The doctor may perform this test to examine various structures of the eye, including the conjunctiva, eyelids, lens, cornea, iris, and sclera.

Loss of peripheral vision occurs with different brain and eye defects. Visual field tests are a way to measure peripheral vision. In most cases, the doctor will cover one eye per person. With another eye, they focus on something in front of them. Then the doctor asks what they see at the edges of their visual field.

The tensilon test may be considered if myasthenia gravis is a suspected cause of ptosis. For this test, the person is given a tensilon pill. If this drug strengthens a person’s muscles, they will have a positive- stress test.

Treatment

Treatment includes surgery and various procedures. The goal is to lift the lid to fit the other side with minimal scarring and side effects. The excess inability to close the eye completely after surgery is a much-debated topic. This creates a dry eye condition that is difficult to maintain.

In the age-related form, the dysfunctional eye is much less visible after the first eye has been successfully repaired. To look at this fallen look in the eye doesn’t work. It may also require surgery.

Surgery: Ptosis surgery is done under local anesthesia with sedation (the patient is awake but not feeling the procedure). The types of surgery to repair a droopy eyelid are as follows:

  • The surgeon makes an opening in the skin of the upper eyelid. This allows the surgeon to find the small muscles that lift the eyelid. The surgeon sutures to tighten this muscle and lift the eyelid. More stitches are made in the skin of the eyelid after the incision.
  • The surgeon can perform the entire surgery from under the eyelid. In this case, the eyelid is turned and squeezed from under the muscle. This procedure does not require an incision in the skin.

After surgery, your doctor will explain how to care for your eye. It is important that the patient returns to the doctor after surgery so that the results can be verified.

Appointments are generally scheduled for several days to a week after surgery.

Sometimes the eyelid may still shrink a little or the eyelid may not close completely. If the doctor notices this, further treatment may be recommended. However, in general, the eyelid is in good condition immediately after the operation.

Complications

Bleeding and infection, which are potential risks with any surgery, are very rare. Be sure to tell your surgeon if you have low blood pressure. Small bruises or swelling should be expected that disappear in a week or two. Some patients experience dry eyes after surgery. This can make contact lens wear uncomfortable or require over-the-counter tears for comfort.

Your surgeon may not be able to control all the variables that determine the final location of your eyelid. There is always the possibility that the cap is more or less than desired or that the curve and shape of the cap are different. Touch-up surgery may be necessary to improve the position of the eyelid. While the perfect symmetry between the two lids is never guaranteed, most patients will see an improvement in the condition of their lids and will be happy with the results. As with any medical method, there may be other natural risks that should be discussed with your surgeon.

Prevention

There is no way to prevent droopy eyelids. Knowing the symptoms and getting regular eye exams can help fight the disorder. If your child seems to have droopy eyelids, take them to a doctor right away for treatment and monitoring. Since ptosis affects your vision, you need to take it seriously. You can prevent it from getting worse by seeing a doctor right away.

Prognosis

Droopy eyelid is stable, intensifies over time (progressive), or may come and go (intermittently). The result of treatment depends on the cause of the ptosis. In most cases, surgery is very strong in curing appearance and function. In children, more stained eyelids can lead to laziness or amblyopia. This can lead to long-term vision loss.

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Symptoms and Causes of Anaplastic Thyroid Cancer | Endocrinology

What is anaplastic thyroid cancer?

Anaplastic thyroid cancer usually features a very poor prognosis thanks to its aggressive behavior and resistance to cancer treatments. These cancer cells are very abnormal and usually don’t appear as if actual thyroid cells and are less differentiated.

Anaplastic thyroid cancer is an abnormal sort of thyroid cancer that causes only 1-2% of cases, but thanks to high mortality, it causes 20-50% of thyroid cancer deaths. The median survival time after diagnosis is 3 to 6 months. Some studies report that between 10% and 15% live quite 1 year, survival at 3 and 5 years is extremely rare. it’s more common in women than men and is more common in people ages 40 to 70.

Carcinoma is also known as “anaplastic thyroid carcinoma” because it refers to a specific type of cancer. Since thyroid cancer is so common, you may know someone who has or has had thyroid cancer. However, anaplastic thyroid cancer is very rare thyroid cancer. Many thyroid patients and specialists have no experience with this rare type of thyroid cancer. Try not to think of anaplastic thyroid cancer the way you do other thyroid cancers because this decision may not be justifiable or may not make the right decisions for you.

Anaplastic thyroid cancer begins to grow within the thyroid gland or grows rapidly from normal thyroid tissue if there is no lump (nodule) in the thyroid. Anaplastic thyroid cancer grows very fast and spreads very quickly. Patients with thyroid cancer rarely have symptoms, but anaplastic thyroid cancer is an exception to this observation, and many patients have symptoms. Patients with anaplastic thyroid cancer tend to have a rapidly growing neck mass.

Patients often present with numbness (vocal cord paralysis), difficulty swallowing, or even movement of the mass in the neck. Unlike other common thyroid cancers, this highly aggressive thyroid cancer requires a great deal of rapid evaluation and treatment to be successfully managed.

Symptoms & sign of anaplastic thyroid cancer

Most people with thyroid cancer have no symptoms. Alternatively, these cancers can be detected by routine care or by a family doctor during a routine neck exam or by imaging for other purposes (eg, CT of the neck or carotid ultrasound).

If there are symptoms, the most common is a new enlargement or inflammation of the thyroid called a thyroid nodule. A fine-needle aspiration biopsy is often used to determine if the thyroid nodule is malignant (cancerous) or benign. (Non-cancerous), some symptoms and signs increase the doctor’s suspicion that the nodule is malignant.

These characteristics and signals are:

  • The rapid growth of the nodule in a short period of time.
  • A nodule that is “stuck” or firmly attached to the surrounding tissue
  • Nodule-like lymphadenopathy in the neck
  • Rare features

Besides the presence of a thyroid nodule, other potential symptoms of thyroid cancer (although they are not common):

  • Pain in the front of the neck (where the thyroid gland is located) may “move” or radiate to the jaw or ears.
  • Continuous “tickle in the throat”
  • Swallowing problems if the thyroid nodule is too large and presses on the esophagus (the tube that connects the throat to the stomach)
  • Trouble breathing if the nodule is too large and presses on the windshield
  • Persistent cough without other cold symptoms
  • Forceful regulates the vocal cords when cancer enters the nerves

With medullary thyroid cancer, which accounts for only 1% to 2% of all thyroid cancers, a person may experience symptoms such as diarrhea, itching, and redness (if cancer has spread throughout the body).

These symptoms are caused by the production of calcitonin, a hormone produced by thyroid “C” cells. Medullary thyroid cancer begins from these “C” cells, unlike other types of thyroid cancer that arise from follicular thyroid cells (cells that make thyroid hormone).

Causes of anaplastic thyroid cancer

Researchers are not sure of the exact cause of anaplastic thyroid cancer. It may be a mutation in another less aggressive form of thyroid cancer. Although no one knows why these mutations occur, they can be the result of a series of genetic mutations. However, it does not appear to be hereditary.

Some things increase the risk of anaplastic thyroid cancer, including:

  • People aged 60 and over
  • Have goiter
  • Previous radiation exposure to the chest or neck

Risk factors of anaplastic thyroid cancer

Most people with thyroid cancer have no symptoms. Alternatively, these cancers can be detected by routine care or by a neck exam by a regular doctor, or by imaging for other purposes (eg, CT scan or carotid ultrasound of the neck).

If there are symptoms, a new enlargement or inflammation of the thyroid is called the more common thyroid nodule. A fine-needle aspiration biopsy is often used to determine whether the thyroid nodule is malignant (cancerous) or benign. (Non-cancerous), some symptoms and signs increase the doctor’s suspicion that the nodule is malignant.

These characteristics and signals are:

  • The rapid growth of the nodule in a short period of time
  • A nodule that is “stuck” or firmly attached to the surrounding tissue
  • Nodule-like lymphadenopathy in the neck
  • Rare features

In addition to the presence of a thyroid nodule, other potential symptoms of thyroid cancer (although they are not common) include:

  • Pain in the front of the neck (where the thyroid gland is located) may “move” or radiate to the jaw or ears
  • Continuous “tickle in the throat”
  • Swallowing problems if the thyroid nodule is too large and presses on the esophagus
  • The nodule is too large and you will have trouble breathing if you press on the windshield
  • Persistent cough without other cold symptoms
  • By force, it controls the vocal cords when cancer enters the nerves

With medullary thyroid cancer, which accounts for only 1% to 2% of all thyroid cancers, a person may experience symptoms such as diarrhea, itching, and redness (if cancer has spread throughout the body).

These symptoms are caused by the production of a hormone called calcitonin, which is produced by thyroid “C” cells. Medullary thyroid cancer begins from these “C” cells, unlike other types of thyroid cancer that arise from follicular thyroid cells (cells that make thyroid hormone).

Diagnosis of anaplastic thyroid cancer

Patients with a history of rapidly increasing neck mass with or without compressive symptoms should be immediately evaluated for anaplastic thyroid cancer. Other forms of thyroid cancer (especially medullary thyroid cancer) and thyroid lymphoma can be similar to anaplastic thyroid cancer. A fine-needle aspiration biopsy (FNAB) can often differentiate between anaplastic thyroid cancer and another cause, but sometimes requires a core needle biopsy (that is, a biopsy with a large needle) or a surgical biopsy.

Once anaplastic thyroid cancer is diagnosed, it is important to look at how widespread the disease is. A CT scan of the neck and chest shows how big the tumor is, whether it invades nearby structures (muscles, trachea, or esophagus), and whether the disease has spread to other parts of the body. Flexible laryngoscopy (endoscope inserted under the throat) determines if the vocal cords are cancerous.

Treatment for anaplastic thyroid cancer

The following are treatment options for anaplastic thyroid carcinoma. Your healthcare team will prescribe treatments based on your needs and preferences. Anaplastic carcinoma often develops when it is diagnosed. This means that not all cancers can be completely removed or destroyed.

Radiotherapy: External beam radiation therapy is given to the thyroid and neck to slow and control the growth of cancer. It is sometimes given at the same time as chemotherapy.

The standard radiation program delivers radiation once a day. Small doses of radiation therapy can be given 2 times a day. This is called hyperfraction. A standard radiation program can be used if there are many side effects of hyperfunction.

Chemotherapy: Chemotherapy is usually given for anaplastic carcinoma. It can be given alone or with radiation therapy as part of chemotherapy. The most commonly used chemotherapy combination is doxorubicin (adriamycin) and cisplatin (platinol AQ). Sometimes doxorubicin is used alone. In some cases, paclitaxel (Toxol) or Docetaxel (Toxotere) may also be used.

Surgery: Surgery for anaplastic carcinoma is rarely offered. This cancer often develops when it is diagnosed and usually cannot be removed surgically (it is undetectable). But in some cases, surgery can be done before or after other treatments. The type of surgery depends on the stage of cancer, the size of the tumor, and whether cancer has grown or spread to any structure and organ.

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Risk Factors and Diagnosis of Presbyopia | Ophthalmology

What is presbyopia?

Presbyopia means that your eyes gradually lose the ability to see up close. This is a normal part of aging. In fact, the word “presbyopia” comes from the Greek word for “old eye.” After age 40, you may start to notice presbyopia. You will see that you save them to see the reading material clearly.

Even if you’ve never had a vision problem before, you can’t escape presbyopia. Your nearsightedness can be seen by wearing your normal glasses or contact lenses to correct farsightedness.

Many experts believe that presbyopia is caused by changes in the lens within the eye. As we age, the lens becomes harder and less elastic, making it difficult to focus on objects that are closer to the eye.

Why does it occur?

Although some people in their early forties began to have trouble reading or seeing things, in others it only happens much later. It is not clear why this is so. It is well known that people with medical conditions such as diabetes, cardiovascular disease, or multiple sclerosis can develop presbyopia at a young age.

Women often start wearing reading glasses at an earlier age than men. This is because they tend to fix the problem quickly. There is no difference between men and women as to when presbyopia begins.

Symptoms

It causes the following symptoms:

  • Words appear fuzzy at a convenient reading distance.
  • Keep reading material or other objects out of sight for clarity or to see details.
  • You need bright light to see clearly (bright light restricts the pupils, which changes the focus of light on the retina).
  • You may find it difficult to read in the middle of the night or when you are tired or stressed.
  • Changing the shape of the lens may make your eyes uncomfortable due to pressure from your eye muscles, or you may feel tired or sleepy while working closely.
  • You may have a headache as a result of muscle tension.

Causes

Presbyopia arises from a problem with the lens of the eye, which is located behind the iris (the colored part) and the pupil. Refraction or bending of the lens and cornea (clear anterior layer) of the eye – incoming light – focusing directly on the retina (the light-sensitive tissue at the back of the eye).

The retina converts light into electrical signals that are sent to the brain, which then interprets the signals into images. When a person is young, the lens is soft and flexible. The small muscles of the eye can easily change shape and, as a result, the focus on the lens, a process called accommodation.

But with age, the elasticity of the lens and the surrounding muscle fibers begin to decrease, resulting in a gradual loss of accommodation. Instead of focusing light on the retina, the lens focuses light behind the retina, affecting your ability to see objects up close.

Risk factors

Some factors can help you develop presbyopia, including:

  • Age: Age is a major risk factor for presbyopia. Almost everyone experiences some form of presbyopia after the age of 40.
  • Other medical conditions: Having certain diseases, such as diabetes, multiple sclerosis, or cardiovascular disease, increases the risk of premature presbyopia, which is presbyopia in people younger than 40 years old.
  • Drugs: Some medications, including antidepressants, antihistamines, and diuretics, have been linked to symptoms of premature presbyopia.

Diagnosis

Your optometrist or ophthalmologist will evaluate your eye in a comprehensive exam. If you already wear glasses or contact lenses, they can let you know if you need a new prescription.

Since presbyopia is an ongoing process, your prescription is likely to change significantly between the ages of 45 and 65. It is recommended that you have an eye exam every 2 to 3 years.

Presbyopia can be diagnosed as part of a comprehensive eye exam. A routine exam includes tests to evaluate your eyes for diseases and vision defects. Your students will be dissected with special eye drops to allow your doctor to examine the inside of their eyes.

Treatment

Presbyopia is not curable. But today you can choose from a wide variety of options to correct your vision. Discuss the best option for you with your ophthalmologist. Depending on your overall health and lifestyle, your provider may prescribe any of the following, including prescription glasses, contact lenses, reading glasses, progressive addition lenses, bifocals, or a variety of eye surgeries.

There is no cure for it. But there are many ways to improve it.

Readers: Yes, the cheapest glasses you see at the drugstore can often do the trick. Choose the weakest pair that will allow you to see what you need to read.

Bifocals work for most people: If you already have glasses, this may be the option for you. They are glasses with two different prescriptions on the same lens. The upper bouts featured two cutouts, to facilitate access to the higher frets. The lower section helps you get a closer look at objects.

Trifocals: Trifocals have three lenses: a close-up, one in the middle, and one to look away. Progressive lenses are similar to bifocals, but there is a gradual or mixed transition between the two prescriptions rather than specific sections.

Contact lenses:

  • Some people prefer to wear contact lenses instead of glasses. There are two types of contact lenses that can help with presbyopia.
  • Monovision contacts: These correct one eye for distance vision and the other for near vision. You have to adapt to the monovision lenses and train your brain to see this way. With monovision lenses, you can lose the ability to determine the distance or speed of something.
  • Multifocal contacts: These lenses have many rings or zones at different energies. With this design, you are using near and far vision at the same time. However, your brain learns to automatically choose the correct focus for what you want to see. You may find that wearing a multifocal lens makes your vision less sharp than when using a single vision lens.

Surgery: If you do not want to wear glasses or contact lenses for presbyopia, there are also several surgical options available to treat presbyopia. A popular presbyopia correction procedure is corneal incision alignment.

Typically inserted in the cornea of the eye that’s not your dominant eye, a corneal inlay extends the depth of focus of the treated eye and decreases the need for reading glasses without significantly changing the quality of your distance vision.

The first step in seeing if you are a good candidate for presbyopia surgery is consulting with a refractive surgeon who specializes in a comprehensive eye exam and surgical correction of presbyopia.

Complications

Presbyopia aggravates myopia, hyperopia, and astigmatism. Presbyopia problems include hyperopia (an abnormal condition in which the vision of distant objects is better than that of nearby objects) or refractive errors of the eye.

Prevention

Presbyopia cannot be prevented. It is a natural aging process that makes hair look gray. There are so many options today for the correction of presbyopia and there is no way to adapt all the methods. You should consider your lifestyle, work habits, and personal needs, and your doctor can determine the best way to accommodate the available options.

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Disease

Treatment and Types of Pituitary Disease | Endocrinology

What is a pituitary disease?

Pituitary diseases (pituitary tumors) are abnormal growths that progress on your pituitary gland. Some pituitary tumors make too many hormones that regulate important functions in your body. Some pituitary tumors can cause your pituitary gland to make lower levels of hormones.

Most pituitary tumors are noncancerous (benign) growths (adenomas). Adenomas remain in the pituitary gland or nearby tissues and do not spread to other portions of your body.

There are several options for treating pituitary tumors, including eliminating the tumor, controlling its growth, and management its hormone levels with medications. Your physician may recommend observation or a “wait and see” attitude.

Symptoms of pituitary disease

Not all pituitary diseases cause symptoms. Hormone-producing (working) pituitary diseases can cause a variety of signs and symptoms depending on the hormone they make. The signs and symptoms of pituitary tumors that do not produce hormones (that do not work) are connected to their growth and the pressure they put on other structures.

Large pituitary diseases, those that are about 1 centimeter (a little less than half an inch) or greater, are known as macroadenomas. The smallest tumors are called microadenomas. Unpaid to the size of macroadenomas, they can put heaviness on the normal pituitary gland and nearby structures.

Signs and symptoms related to tumor pressure:

Signs and symptoms of pressure from a pituitary disease can include:

  • Headache
  • Loss of vision, particularly the loss of peripheral vision

Symptoms related to changes in hormone levels:

Working too much: Functional pituitary diseases cause an overproduction of hormones. The different types of functional tumors in your pituitary gland cause specific signs and symptoms, and sometimes a combination of them.

Deficiency: Large tumors can cause hormone deficiencies. Signs and symptoms include:

  • Nausea and vomiting
  • Weakness
  • I am cold
  • Less frequent or no menstrual periods
  • Sexual dysfunction
  • The increased amount of urine
  • Unintentional weight loss or gain

Adrenocorticotropic hormone (ACTH) secreting tumors: ACTH tumors produce the hormone adrenocorticotropin, which stimulates the adrenal glands to produce the hormone cortisol. Cushing’s syndrome is the result of the adrenal glands making too much cortisol. Possible signs and symptoms of Cushing’s syndrome include:

  • Fat accumulation everywhere the waist and upper back
  • Exaggerated facial roundness
  • Thinning of the arms and legs with muscle weakness
  • Hypertension
  • High blood sugar level
  • Acne
  • Bone weakening
  • Bruises
  • Stretch marks
  • Anxiety, irritability, or depression

Growth hormone-secreting tumors: These tumors produce excess development hormone (acromegaly), which can cause:

  • Coarse facial features
  • Enlarged hands and feet
  • Excessive sweating
  • High blood sugar level
  • Heart problems
  • Pain in the joints
  • Misaligned teeth
  • Increased body hair

Children and adolescents can grow too fast or too tall:

Prolactin-secreting tumors: Overproduction of prolactin from pituitary diseases (prolactinoma) can cause a decrease in normal stages of sex hormones, estrogen in women, and testosterone in men. Excess prolactin in the blood affects men and women differently.

In women, prolactinoma can cause:

  • Irregular menstrual periods
  • Lack of menstrual periods
  • Milky discharge from the breasts

In men, a prolactin-producing tumor can cause male hypogonadism. Signs and symptoms can include:

  • Erectile dysfunction
  • Reduced sperm count
  • Loss of sexual desire
  • Breast growth

Thyroid-stimulating hormone-secreting tumors: When a pituitary disease overproduces thyroid-stimulating hormone, your thyroid gland produces too much thyroxine hormone. This is a rare source of hyperthyroidism or overactive thyroid disease. Hyperthyroidism can speed up your body’s metabolism, causing:

  • Weightloss
  • Fast or irregular heartbeat
  • Nervousness or irritability
  • Frequent bowel movements
  • Excessive sweating

Types of pituitary diseases

  • Non-functional adenomas
  • Functional adenomas
  • Pituitary carcinoma or cancer

Causes of pituitary disease

The cause of unrestrained cell growth in the pituitary gland, which generates a tumor, remains unknown. The pituitary gland is a small, bean-shaped gland situated at the base of your brain, a little behind your nose, and among your ears. Despite its small size, the gland influences almost every part of your body. The hormones it produces help adjust important functions, such as growth, blood pressure, and reproduction.

Risk factors of pituitary disease

People with a family history of certain inherited conditions, such as multiple endocrine neoplasias, type 1 (MEN 1), are at increased risk of developing pituitary diseases. In MEN I, numerous tumors occur in various glands of the endocrine system. Genetic tests are available for this disorder.

Diagnosis of pituitary diseases

pituitary diseases often go undiagnosed because their symptoms resemble other conditions. And some pituitary diseases are found due to medical tests for other conditions.

To diagnose a pituitary disease, your registrar will likely take a detailed history and achieve a physical exam. He or she could order:

  • Blood and urine tests: These tests can determine if you have an overproduction or deficiency of hormones.
  • Mental image: A CT or MRI scan of your brain can help your physician judge the position and size of pituitary disease.
  • Vision test: This can determine if a pituitary disease has affected your sight or peripheral vision.

Treatment for pituitary disease

Many pituitary diseases do not require treatment. Treatment for those who do depends on the type of tumor, its size, and how much it has grown in your brain. Your age and your overall health are also factors.

Treatment includes a team of medical experts, perhaps including a neurosurgeon, an endocrine system specialist (endocrinologist), and a radiation oncologist. Doctors normally use surgery, radiation therapy, and medications, either unaided or in combination, to treat a pituitary disease and return hormone production to normal levels.

Surgery

Transsphenoidal Transnasal Endoscopic Surgery Open Popup Dialog. Surgical removal of a pituitary disease is usually necessary if the tumor is pressing on the optic nerves or if the tumor is overproducing certain hormones. The success of the surgery depends on the type of tumor, its location, its size, and whether the tumor has invaded the surrounding tissues.  The two main surgical techniques for treating pituitary diseases are:

  • Transsphenoidal transnasal endoscopic approach: This usually allows your doctor to remove the tumor through the nose and sinuses without an external incision. No other part of your brain is affected and there is no visible scar. Large tumors can be difficult to remove in this way, especially if a tumor has invaded nearby nerves or brain tissue.
  • Transcranial approach (craniotomy): The tumor is removed through the top of the skull through an incision in the scalp. It is easier to reach large or more complicated tumors with this procedure.

Radiotherapy

Radiation therapy uses high-energy radiation sources to destroy tumors. It can be used after surgery or only if surgery is not an option. Radiation therapy may be beneficial if a tumor persists or reappears after surgery and causes signs and symptoms that medications do not relieve. Radiation therapy methods include:

  • Stereotactic radiosurgery: Often given as a single high dose, it focuses the radiation beams on the tumor without an incision. It applies radiation beams the size and shape of the tumor onto the tumor with the help of special imaging techniques of the brain. Minimal radiation comes into contact with healthy tissue around the tumor, reducing the risk of damage to normal tissue.
  • External beam radiation: This emits radiation in small increments over time. A series of treatments are performed, usually five times a week for a period of four to six weeks, on an outpatient basis. While this therapy is usually effective, it can take years to fully control tumor growth and hormone production. Radiation therapy can also damage the remaining normal pituitary cells and normal brain tissue, particularly near the pituitary gland.
  • Intensity-modulated radiation therapy (IMRT): This type of radiation therapy uses a computer that allows the doctor to shape the rays and surround the tumor from many different angles. The strength of the rays can also be limited, which means that the surrounding tissues will receive less radiation.
  • Proton beam therapy: Another radiation option, this type uses positively charged ions (protons) instead of X-rays. Unlike X-rays, beams of protons stop after releasing their energy within their target. The rays can be precisely controlled and can be used in tumors with less risk to healthy tissues. This type of therapy requires special equipment and is not widely available.

The benefits and complications of these forms of radiation therapy are often not immediate and can take months or years to be fully effective. A radiation oncologist will appraise your condition and debate the pros and cons of each option with you.

Medicines

Drug treatment can help block unnecessary hormone secretion and sometimes contract certain types of pituitary diseases:

Prolactin-secreting tumors (prolactinomas): The drugs cabergoline and bromocriptine (Parlodel) decrease prolactin emission and habitually shrink the tumor. Possible side effects include drowsiness, dizziness, nausea, nasal congestion, vomiting, diarrhea or constipation, confusion, and depression. Some people develop obsessive behaviors, such as betting, while taking these medications.

ACTH-producing tumors (Cushing’s syndrome). Mifepristone (korlym, Mifeprex) is approved for people with Cushing syndrome who have type 2 diabetes or impaired glucose tolerance. Mifepristone does not decrease cortisol production, but it does block the effects of cortisol in your tissues. Side effects can include fatigue, nausea, vomiting, headaches, muscle aches, high blood pressure, low potassium levels, and bloating.

Growth hormone-secreting tumors: There are two types of medications available for these types of pituitary tumors, and they are especially helpful if surgery has not been successful in normalizing growth hormone production. The first type of medicine is somatostatin equivalents, which include drugs such as octreotide (Sandostatin) and lanreotide (tomatine Depot), which causes a reduction in growth hormone production and can shrink the tumor. These are given by injections, commonly every four weeks.

These medications can cause side effects such as nausea, vomiting, diarrhea, stomach pain, dizziness, headache, and pain at the injection site. Many of these lateral effects recover or even go away with time. They can also cause gallstones and make diabetes mellitus worse diabetes mellitus.

The second type of medicine, pegvisomant (Somavert), blocks the effect of extra growth hormone in the body. This medicine, given by daily injections, can cause liver damage in some people.

Pituitary hormone replacement: If a pituitary tumor or surgery to remove it reductions hormone production, you may need to take additional hormones to maintain normal hormone levels. Some people who receive radiation therapy also need pituitary hormone replacement.

Wait attentively: Watchful waiting, also known as observation, watchful waiting, or delayed therapy, you may need regular follow-up tests to see if your tumor is growing. This might be an option if your tumor is not causing signs or symptoms.

Many people with pituitary tumors function normally without treatment if the tumor is not causing other problems. If you are younger, attentive waiting may be an option as long as you accept the possibility that your tumor will transform or grow during the observation period, possibly requiring treatment. You and your doctor can weigh the risk of symptoms versus treatment.

Complications of pituitary disease

pituitary diseases usually do not grow or spread widely. However, they can affect your health, possibly causing:

  • Sight loss: A pituitary disease can put heaviness on the optic nerves.
  • Permanent hormonal deficiency: The attendance of a pituitary disease or the removal of one can eternally alter your supply of hormones, which may need to be replaced with hormonal medications.

A rare but potentially serious problem of a pituitary disease is pituitary apoplexy when there is sudden bleeding into the tumor. It feels like the most simple headache you’ve ever had. Pituitary apoplexy needs emergency treatment, typically with corticosteroids and possibly surgery.