Repeat pituitary ablation for advanced prostatic cancer

An elderly male patient with advanced prostatic adenocarcinoma, requiring increasing analgesia, underwent interstitial pituitary irradiation by implantation of yttrium-90. He was temporarily relieved of his pain. Assessment of his anterior pituitary function showed only partial ablation. He therefore underwent a second implantation. This achieved complete ablation, and only when this was achieved did he experience full and sustained pain relief. We recommend assessment of anterior pituitary function in patients treated by pituitary ablation for carcinoma of the prostate, and especially in those in whom the disease progresses after initial success response.