Question: I had a pituitary tumor 15 years ago, have discontinued replacement and overall feel well. Every time I see a new physician, Cushing’s becomes a major topic and I get concerned again. Am I different than the normal population in terms of what I should I watch for to live a healthful life?

Answer: It’s good to hear that overall you are feeling well. When a patient has had Cushing’s disease in the past, physicians usually have three questions. First, is the patient still in remission? The reason this is asked that Cushing’s disease may recur. Although this occurs in a minority of patients, it is important to know whether a person has any symptoms or signs of recurrence. Second, depending on your history and how you have been treated (surgery versus radiation or both for example) the physician will want to make sure that the normal part of your pituitary gland is functioning normally, and if not, hormones needed are being adequately replaced. Third, patients with a history of Cushing’s disease may have chronic consequences of having had high cortisol levels in the past which can put them at higher risk for osteoporosis.

I can well understand how these questions each time cause you concern, but the goal is to keep you healthy and make sure your hormones are normal. In terms of your question on how you are different, you should follow the same guidelines as anyone else; maintaining a normal weight and blood pressure, not smoking, eating a healthy diet and all the other guidelines. You have been in remission for a long time and as long as your hormone levels are normal, the only thing to be screened for is bone loss due to your history of Cushing’s with a simple bone density scan. You should discuss this with your physician to see if indicated, if not already done.

By Dr. Anne Klibanski, Massachusetts General Hospital, Neuroendocrine Center, Winter, 2016