What treatment for acromegaly is most effective?

Diana Meeks
Diana Meeks on behalf of Sigma Nursing
Family Practitioner
Early treatment for acromegaly is a key aspect of managing the disease. Since acromegaly is usually the result of a tumor on the pituitary gland, surgery to remove or minimize the size of the tumor is a good first line of treatment. Radiation or drug therapy may be used after surgery to continue to control the amount of growth hormone in the body. Without treatment, acromegaly can lead to other serious health problems.
Donna Hill Howes, RN
Family Medicine

No single treatment is effective for all patients. Treatment should be individualized, and often combined, depending on a patient's characteristics such as age and tumor size.

If the tumor has not yet invaded surrounding nonpituitary tissues, removal of the pituitary adenoma by an experienced neurosurgeon is usually the first choice. Even if a cure is not possible, surgery may be performed if the patient has symptoms of neurological problems such as loss of peripheral vision or cranial nerve problems. After surgery, hormone levels are measured to determine whether a cure has been achieved. This determination can take up to eight weeks because insulin-like growth factor 1 (IGF-I) lasts a long time in the body's circulation. If cured, a patient must be monitored for a long time for increasing growth hormone (GH) levels.

If surgery does not normalize hormone levels or a relapse occurs, an endocrinologist should recommend additional drug therapy. With each medication, long-term therapy is necessary because their withdrawal can lead to rising GH levels and tumor re-expansion.

Radiation therapy is generally reserved for patients whose tumors are not completely removed by surgery, who are not good candidates for surgery because of other health problems, or who do not respond adequately to surgery and medication.

This answer is based on source information from the National Endocrine and Metabolic Diseases Information Service.

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