Investigation

In order to build up a picture of your brain, The London Clinic may offer the following:

CT scan: this machine takes a series of x-rays to build up a 3D image of your brain. It takes 10 minutes and is painless, and the radiation level used is very low. You should not eat or drink for four hours beforehand, and you may be given an injection of contrast to allow certain areas to show up more clearly under the CT scanner.

MRI scan: this is similar to a CT scan but uses magnetism rather than x-rays. It can be slightly uncomfortable and noisy, and can make some patients feel claustrophobic: it takes around 30 minutes. You cannot have an MRI if you have a pacemaker or any kind of metal implant in your body.

Treatment

Surgery: Peter Bullock is able to offer endoscopic removal of pituitary tumours – a technique not widely practised in the UK. Using endoscopic / endonasal techniques, ENT consultant surgeon David Roberts, with whom Peter Bullock has worked for over 10 years, will open up the natural pathways in your sinuses and Peter Bullock will use these to gain access to the pituitary tumour and remove it. This causes far less pain and discomfort than the usual method of removal and results in a much quicker recovery time. On average, you will be in hospital for around three to five days.

This kind of surgery is also very safe: a recent study of 821 operations found a mortality rate of only 0.24 per cent.

Radiotherapy: if your tumour cannot be entirely removed by surgery and a small part of it has to be left in place, Peter Bullock can offer state-of-the-art radiotherapy using stereotactic techniques such as the CyberKnife®. This enables him to deliver the radiation dose with pin-point accuracy.

Follow-up: if your pituitary gland has to be removed along with the tumour, you may need hormone treatment. This can be offered by one of Peter Bullock’s colleagues, neuro-endocrinologist Professor John Monson, Professor Besser and Professor Chew.