Effective treatment of acromegaly aims to reduce or control tumor mass, regulate hypersecretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1), and alleviate the signs and symptoms of the disease. To achieve these goals, your healthcare professional may utilize various treatment options, including surgery, medical therapy, and/or radiation.
According the to the American Association of Clinical Endocrinologists (AACE) Guidelines, surgery is the "first management option" for nearly everyone with acromegaly. However, in those cases where surgery is not possible, medical therapy may be used as first-line treatment.
- Surgery – The goal of surgical treatment for acromegaly is to remove the pituitary tumor, reducing the associated symptoms such as headache, and normalize GH and IGF-1 levels. This type of surgery is called transsphenoidal. With this type of procedure, the surgeon reaches the pituitary through the nose (transnasal) or through an incision in the upper lip (translabial) and is able to remove the tumor, relieving pressure and immediately reducing GH levels.
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Medical Therapy – Three different medical treatments are used to treat acromegaly.
- Somatostatin analogues (SSAs) work directly at the site of the pituitary tumor and shut off GH production. As a result, these drugs are proven to lower GH and IGF-1 levels in 50 to 70 percent of patients.
- GH receptor agonists (GHRAs) are designed to interfere with the action of GH and normalize IGF-1 levels, however they do not lower GH levels.
- Dopamine agonists have not been proven as effective as somatostatin analogues and GH receptor agonists at lowering GH or IGF-1 levels, and they only normalize IGF-1 in some patients.
- Radiation Therapy – Radiation is most commonly used as adjuvant therapy (following surgery) in those cases where some tumor is still present and medications are not working. The full effect of this therapy may not occur for many years.
Everyone responds to treatment differently, so you and your healthcare professional should work together to determine which treatment option or combination of approaches is right for you.
Talk to your doctor and ask about treatment that's right for you
