Acromegaly

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Treatment

Surgical removal of the tumour is usual. This can often be achived by an operation through the sinus passages behind the nose. The smaller the tumour the easier it is for the surgeon to remove the whole tumour. It is more difficult to remove large tumours totally and some tissue may be left.

Total removal of the tumour will result in GH and IGF-1 levels in the blood falling quickly and symptoms will start to diminish. IGF-1 will be measured after surgery to assess whether all the tumour was removed.

Sometimes the cells of the pituitary producing other hormones, such as Adrenocorticotrophic hormones (ACTH), thyroid stimulating hormone (TSH), luteinizing hormone (LH) and follicle stimulating hormone (FHS), are affected or removed and secretion of these hormones is lost. The patient will then be required to take hormone supplements such as thyroxine and cortisol depending on which hormones are lost.

In difficult cases or where tumour removal is incomplete further treatment may be used. These include radiation and injections of substances like octreotide which blocks the production of GH or pegvisomant that blocks the action of GH. These latter substances are slow acting and symptoms diminish gradually over the next couple of years.

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