Hypophysectomy for Relief of Bone Pain in Breast Cancer

To the Editor: The article by LaRossa et al. in the June 15 issue of the Journal raises two important issues. There have previously been reports that partial destruction of the pituitary relieves pain, and it is now surmised that this phenomenon is in some way related to the opioid peptides contained within the pituitary peptide, β-lipotropin. Whatever the mechanism, there are two problems with this approach to the treatment of pain. In the first place, procedures designed to interfere in some way with central pain processing should be reserved for patients whose primary pathologic processes are refractory to treatment,.