Christopher S. Hong, Timothy R. Smith
Abstract
Patients with pituitary tumors may experience persistent fatigue and reduced physical activity, based on subjective measures after treatment. These symptoms may persist despite gross total resection of their tumors and biochemical normalization of pituitary function. While reduced quality of life has been commonly acknowledged in pituitary tumor patients, there is a lack of studies on what interventions may be best implemented to ameliorate these issues, particularly when hormonal levels have otherwise normalized. Aerobic exercise programs have been previously described to ameliorate symptoms of chronic fatigue and reduced physical capacity across a variety of pathologies in the literature.
Introduction
Patients with pituitary tumors can suffer from a variety of symptoms due to the many complex functions of the pituitary gland. While there are clear cut indications for surgical and/or medical intervention in biochemically proven cases of hormonal excess or deficiency, as well as visual compromise, patients often report more subjective complaints related to an overall diminished quality of life, citing factors ranging from undue fatigue, increased anxiety, depression, poor sleep, and worsened cognition. In many cases, despite normalization of the hormonal axis through surgery and/or a medical prescription, patients continue to experience decreased quality of life parameters, compared to healthy individuals.
Materials and method
A literature search was performed utilizing the PubMed index and was queried with the following search terms: “aerobic exercise”, “physical exercise”, “pituitary”, “sellar”, “suprasellar”. Exclusion criteria included studies of patients with absent pituitary or sellar pathologies and a lack of an implemented aerobic exercise intervention. After an initial search result of 1963 studies, 225 were further reviewed, based on screening the titles.
Results
Patients with pituitary tumors frequently experience difficulties with quality of life related to physical and mental fatigue, despite normal hormonal levels. Two prospective studies of patients treated for pituitary tumors and biochemical normalization of hormonal levels still demonstrated reduced quality of life metrics and undue fatigue, based on validated health-related questionnaires (Sickness Impact Profile [10], Hospital Anxiety and Depression Scale [11], Multidimensional Fatigue Index [12], Nottingham Health Profile [13], Shorter Form-36 [14]) [15, 16].
Discussion
Although our review of the literature found very few studies reporting aerobic exercise interventions in patients with pituitary tumors, these studies demonstrated such an intervention may lead to improvements in a patient population that is already predisposed to impaired quality of life.
Conclusions
Taken together, persistent fatigue, reduced activity levels, and overall impaired quality of life remain problematic for patients with pituitary tumors despite adequate treatment. Aerobic exercise interventions have been widely studied across many disease states to alleviate these complaints but remain lacking in the pituitary tumor patient population. The handful of existing studies, as summarized in this review, suggest there is great potential for such interventions to positively impact these patients. However, in patients with pituitary disorders, the aerobic exercise regimen must be tailored to specific individual, taking into consideration the hormonal profile of the pituitary adenoma and the degree to which biochemical control has been achieved.
Citation: Hong CS, Smith TR (2023) Aerobic exercise interventions to address impaired quality of life in patients with pituitary tumors. PLoS ONE 18(12): e0295907. https://doi.org/10.1371/journal.pone.0295907
Editor: Tanja Grubić Kezele, University of Rijeka Faculty of Medicine: Sveuciliste u Rijeci Medicinski fakultet, CROATIA
Received: August 31, 2023; Accepted: December 1, 2023; Published: December 15, 2023
Copyright: © 2023 Hong, Smith. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: The article does not report data and the data availability policy is not applicable.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0295907#sec007
