Acromegaly - Treatment

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Written by Dr. Sangamithra, MBBS | Medically Reviewed by The Medindia Medical Review Team  on Sep 05, 2014
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Acromegaly - Treatment

Treatment options are surgical removal of the tumor, radiation therapy, and injection of a growth hormone blocking drug like bromocriptine.

Treatment of Acromegaly depends on the cause of the disease. The goal of treatment is to restore the pituitary gland to normal function, producing normal levels of growth hormone, and to relieve the pressure that the growing pituitary tumor exerts on the surrounding brain areas. Treatment may include removal of the tumor (surgery), radiation therapy, and injection of a growth hormone blocking drug (drug therapy).

Surgery:

The principal treatment for Acromegaly is surgical resection of the GH secreting pituitary adenoma. It is the most effective and rapid treatment. The surgery relieves the pressure on the surrounding brain regions and leads to lowering of GH levels. If the surgery is successful, facial appearance and soft tissue swelling improves within a few days. Surgical complications includes CSF leak, damage to the surrounding normal pituitary tissue and meningitis.

Radiotherapy:

Radiation therapy has been used both as a primary treatment and combined with surgery or drugs. It is usually reserved for patients who have remnants of the tumor even after surgery. Radiation therapy is given in divided doses over four to six weeks. This treatment lowers GH levels by about 50 percent over 2 to 5 years, but it causes a gradual loss of production of other pituitary hormones. Other rare complications associated with radiation therapy are loss of vision and brain injury.

Drug therapy:

Drugs are basically used to reduce both GH and IGF-1 secretion and tumor size. Bromocriptine (Parlodel) is taken orally and is given in divided doses of about 20 mg daily. Side effects include gastrointestinal upset, nausea, vomiting, light-headedness when standing, and nasal congestion. Octreotide (Sandostatin) and lanreotide (Somatulin) are synthetic forms of a brain hormone resembling somatostatin that stop the production of GH secretion. These drugs must be injected every 2 to 4 weeks for effective long-term treatment. Side effects include digestive problems such as loose stools, nausea, and gas formation, development of gallstones, and in rare cases diabetes.

Growth hormone antagonist (GHA) therapy is a new treatment option. Pegvisomant is both well tolerated and very effective at quickly normalizing GH and IGF-1 levels. It belongs to the family of growth hormone receptor antagonists. It blocks the action of the endogenous growth hormone molecules and thereby is able to control disease activity of acromegaly in virtually all patients.

Acromegaly - Reference:

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Readers may also be interested to read my summary about the latest guidelines for acromegaly. http://doiop.com/AcromegalyGuidelines

Kayla-S-M

I was diagnosed with a pituitary tumor in 2005. It was a late stage macroadenoma. I have had surgery, gamma knife radiation and I have had 2 years of sandostatin. I still never feel good. I have lots of fatigue, muscle weakness and I take a lot of medicine. Can anyone give me any good news on this. My email address is triplejent@hotmail.com. I would love to hear from some other acromegaly patients to hear their stories. Mine has been a nightmare. I was sick and not feeling well for quite sometime, fatigue like no other actually exhaustion to where I was nauseated and sometimes vomiting when I got home from work. Finally told my husband that I either had something wrong with my heart or I had cancer. I was having a lot of palpitations and chest pain so I was sent to a cardiologist my first go around and they didn't pick up on it was going to ablate the areas on my heart that were beating irraticaly. I just need to hear someone elses story. Please email me. Thank you. Kayla

hi Kayla, i too had a macroadenoma which was removed in 06 but did not need drugs however i too have profound fatigue and do not feel good at all. I now have bad joints everywhere and have had 3 total knee replacements and have also got Parkinson's disease. My quality of life is doing down the slippery slope. I am under so many specialists but none seem really interested. It is a lonely battle to get well and sometimes i wonder if i ever will but will not give up! good luck. Where do you live? snurff

You can read longer article here http://www.genericlook.com/diseases/Acromegaly/. Hope it will help you...

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