The New England Pituitary Treatment Center offers a multidisciplinary evaluation and treatment for patients with disorders of the pituitary and hypothalamus. Clinical services are provided by neurosurgery, neuroendocrinology, neuro-ophthalmology and radiation oncology. The center is organized to provide integrated comprehensive care of the pituitary patient. The center can provide expertise in the management of hypercortisolism of pituitary or adrenal origin, other pituitary tumors, including prolactinomas, growth hormone secreting tumors resulting in acromegaly, nonfunctional tumors, recurrent pituitary adenomas, and in the treatment of any pituitary deficiency state. Specially trained personnel at the center can perform dynamic endocrine function studies, including Cortrosyn stimulation tests, CRH stimulation tests, insulin induced hypoglycemia tests, other provocative growth hormone tests, and tests for urine concentrating or diluting ability. Patients can be referred for a second opinion, exclusively to provide dynamic pituitary function studies for an internist or endocrinologist, or for a comprehensive treatment plan to be implemented in conjunction with primary care physicians.
Neuroendocrinological consultations are provided by a board-certified endocrinologist. Neuroendocrine consultations include a comprehensive history and physical examination, review of relevant medical records, imaging studies, and laboratory data. Additional studies are obtained as indicated. Optimal treatment strategies are developed in collaboration with neurosurgery and radiation oncology colleagues. Long term endocrine follow-up of patients with pituitary tumors, hypopituitarism, and co-morbidities resulting from pituitary disease can be managed at the center or their care can be outlined for the referring physicians.
The center 's neurosurgeons are members of New England Neurological Associates. They have extensive expertise in the surgical management of pituitary and hypothalamic disorders. The neurosurgery department helps coordinate the evaluation of patients referred to the center with pituitary and parasellar lesions, for neuroendocrine evaluation, possible surgery and stereotactic radiosurgery. When surgery is necessary, they perform transsphenoidal or transcranial procedures to treat pituitary adenomas, craniopharyngiomas, meningiomas or other lesions of the hypothalamic/pituitary area. Surgery is done at Holy Family Hospital in Methuen where the specialized facility, allied surgical staff and up-to-date surgical equipment are available.
Consultations with the neurosurgeons include a comprehensive history and physical examination, review of medical records, laboratory data, and imaging studies. Special imaging studies are done as necessary. Integrated multidisciplinary treatment programs are individually devised. Neuroendocrine evaluation will generally occur pre- and post-operatively. Referral to radiation oncology is done if appropriate. All radiological studies are reviewed by a dedicated neuroradiologist. Long term follow-up care is provided to give continuity of care, which is of the utmost importance.
The radiation oncology department at Holy Family is recognized as a leading provider of high-energy external beam radiation and programs in brachytherapy. It is staffed by board- certified radiation oncologists who also have faculty positions at academic centers in Boston. The program is accredited by the American College of Surgeons and American College of Radiology.
The department is equipped with state-of-the-art technology including an 18Mv linear accelerator and a 6Mv accelerator that is specifically designed and dedicated for Linac-based x-knife stereotactic radiosurgery. The radiosurgery program was started in 1996 with the team efforts of neurosurgeons, radiation oncologists, neuroradiologists and physicists. Since then, over 600 procedures have been performed with excellent results. In addition to the linear accelerators, the radiation oncology department is equipped with three, 3-D computers including RSA X-knife system and also special software for MRI and CT image fusions technique for precise localization and planning in the treatment of pituitary and other brain tumors. The department has a special GTC frame for repeat localization and fractionated stereotactic radiosurgery, also provides conventional and 3-D conformal radiation treatments. On average, 37,000 treatments are done per year and 70 patients are treated per day.
Radiation oncology is staffed by radiation therapists, physicists and nurses. The radiation oncologists participate in multidisciplinary tumor boards and in national research protocols. Quality improvement meetings are done on a quarterly basis. Social service and nutritional service support is available.
The Neuro-Ophthalmolgy Department offers a comprehensive assessment of the visual process as it relates to various abnormalities of the brain and nervous system, and in particular, to diseases of the pituitary. Also, eye movement disorders, double vision, as well as optic neuropathy are thoroughly evaluated. Careful interpretation of visual field testing is emphasized, all within the context of a complete neurological examination. Such an evaluation leads to proper management of neuro-ophthalmic problems, including appropriate imaging and treatment in coordination with neuroendocrine and neurosurgical specialties.
New England Pituitary Treatment Center
70 East Street
Methuen, MA 01844
978-687-0156, ext. 2748/2021