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Overview

Acromegaly: Treatment, Procedure, Cost and Side Effects

What is the treatment?

Acromegaly (Greek word for "extremities" and "enlargement") is a chronic disorder in adults in which the pituitary gland produces too much growth hormone or GH. It is caused by a somatotroph (growth hormone [GH]-secreting) adenoma of the pituitary gland and is associated with increased morbidity and mortality. This makes parts of the soft tissues of the body swell first, like the hands, feet, and face. This also affects the heart and bones and if left untreated, it can lead to severe illness and death.

Symptoms of acromegaly begin with the swelling and enlargement of hands and feet. The features in the face begin to grow larger, swollen, and broader. Other symptoms of acromegaly may include achy joints, possibly leading to arthritis, hoarser, deeper voice, thick and rough skin, headaches, erectile dysfunction in men and changes in menstrual cycle and breast discharge in women. Acromegaly can also effect heart and body pressure.

Treatment can help the patient with acromegaly, but this condition can't be cured. Treatments for acromegaly will be determined by the physician based on the age, overall health, and medical history, extent of the disease and personal tolerance of medicines and opinions. There are basically three ways to treat acromegaly. These are surgery, medicine and radiation. The doctors first begin with surgery treatment for people with large tumors affecting vital areas. The surgeon will remove the tumor from the base of the brain and this treatment works well in most of the cases for patients to reverse the symptoms of acromegaly. To help bring back the secretion of growth hormone levels back to normal, doctors prescribe medicines like Somatostatin analogs, Growth hormone receptor antagonists or Dopamine agonists. If, even after surgery, parts of the tumor is left, radiation treatment is used. It can help stop the tumor from growing and the body from making too much growth hormone.

How is the treatment done?

The doctor first will diagnose the disease. A thorough check up of the medical history and also physical examinations need to be carried out. The doctor may recommend the following tests like GH and IGF-I measurement, Growth hormone suppression test, etc. Elevated results of these tests indicate acromegaly. Also, imaging procedure, such as magnetic resonance imaging (MRI), help to pinpoint the location and size of a tumor of the pituitary gland.

Treatment of acromegaly focuses on lowering the production of growth hormones in the body, as well as reducing the negative effects of the tumor on the pituitary gland and surrounding tissues. Surgical treatments can be used to remove pituitary tumors, this is called transsphenoidal surgery. In this procedure, your surgeon will make a small cut in the nose or the inside of the upper lip and work through it to extract the pituitary tumor. Removing the tumor can normalize the growth hormone or GH production and eliminate the pressure on the tissues surrounding the pituitary gland. This helps to relieve associated signs and symptoms of acromegaly.

Sometimes when surgical operations leave behind a part of the tumor inside the body, doctors prescribe drugs to help it shrink. Medicines are also taken to control the secretion of hormones from the gland. Somatostatin analogues like octreotide (Sandostatin) and lanreotide (Somatuline Depot) are synthetic versions of the brain hormone somatostatin. They help to produce rapid declines in GH levels by interfering with the excessive secretion of GH by the pituitary gland. Dopamine agonists like cabergoline and bromocriptine (Parlodel) are taken as pills. These drugs can lower levels of GH and IGF-I and aid the decrease in size of the tumor. Growth hormone antagonist like pegvisomant (Somavert) acts to block the effect of GH on body tissues.

Doctors recommend radiation treatment to destroy any remaining tumor cells and slowly reduce GH levels. There are three ways of treating acromegaly with the radiation method and it may take years for this treatment to noticeably improve acromegaly symptoms. The methods include Conventional radiation therapy, Proton beam therapy and tereotactic radiosurgery which is also known as Gamma Knife radiosurgery.

Who is eligible for the treatment? (When is the treatment done?)

A patient should seek medical assistance and treatment when any of the symptoms of acromegaly show up and lasts for more than a few weeks. Serious symptoms such as shortness of breath or chest pain warrant immediate attention.

Who is not eligible for the treatment?

If there are no symptoms of acromegaly and the person is fit and fine even with greater height than average, then there lies no need to go for a treatment. Many people have a higher secretion rate of growth hormones, but there may occur no severity because of it. Then it is not required for the person to undergo any treatment.

Are there any side effects?

Treatment of acromegaly do not cause major side effects. Long term medications may cause some side effects in people but they don't last long. The most common side effects are constipation, dizziness, diarrhea, gas, and nausea, lightheadedness, headaches etc. Some people may develop compulsive behaviors, such as gambling, while taking these medications. These fade away with time when the body gets used to the drugs.

What are the post-treatment guidelines?

Acromegaly is a lifelong disease and cannot be cured permanently. Hence, even after successful therapy, the person will need to see his or her health care provider regularly to have the levels of growth hormone and IGF-1 checked. Also, medicines should be followed and taken as advised.

How long does it take to recover?

Time to recover after the treatment of acromegaly varies depending on the type of treatment. It is not curable and lasts life-long but its symptoms can be reduced. The full effect of conventional radiation therapy may require 10 or more years after treatment to give the necessary results. Proton beam therapy requires less time for recovery while stereotactic radiosurgery may bring growth hormone levels back to normal within three to five years.

What is the price of the treatment in India?

Treatment of acromegaly may require a long time and thus, the usual expenditure is pretty high. Treatments of pituitary gland tumors require surgeries and radiation therapies apart from drugs. Thus, the cost of treating acromegaly is higher than average.

Are the results of the treatment permanent?

Acromegaly is a chronic disorder and cannot be cured permanently. However, the symptoms can be lessened and patients can be restored to normal health after treatment. Treatments usually take a little longer time to enact fully and effectively but benefits from surgery and drug therapy are often seen within days or weeks. After successful treatment, the person will find his or her hands and feet becoming less swollen and it will also decrease in size gradually. Headaches and other symptoms of acromegaly are also brought under control.

What are the alternatives to the treatment?

There is no alternate way to treat acromegaly. Homeopathy medicines can help treat the end results of the disease process but it does not effectively help in treating the symptoms of acromegaly. The best way to treat this chronic hormonal disorder is to undergo surgeries and therapies.

Safety: Low Effectiveness: Medium Timeliness: High Relative Risk: High Side Effects: Medium Time For Recovery: High Price Range:

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Popular Questions & Answers

Hello!sir,i amfrom in India my question is What is the best treatment of Acromegaly?

AUTLS, CCEDM, MD - Internal Medicine, MBBS
General Physician, Faridabad
acromegally usually caused by tumor of pituitary gland which requires removal surgically by a neurosurgeon

I am neeraj singhal, I am 34 yrs. I am suffering from acromegaly, a 5 mm. Tumor in pitutary gland produce excess growth harmone.

AUTLS, CCEDM, MD - Internal Medicine, MBBS
General Physician, Faridabad
if you are having regular headaches and overgrowth symptoms then the tumor needs removal ..consult a neurosurgeon immediately

My brother is 17 years, 6'1 height. He takes. Eptoin 100 mg twice in past he used to take desval and eptoin. He is thin and suspects that he has acromegaly. He is very frightened of his height of increasing in height any more. Can you please advise him something?

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Navi Mumbai
Hi, your height can grow till 25 years of age. If you haven't yet reached the age, you may try the following remedies - 1. Take flax seed powder - 1 tablespoon after lunch and dinner with warm water. 2. Take lakshadi guggul - 2 tablets, twice a da...

My sister's daughter is having acromegaly disease and has been directed to undergo operation through the nose. Is there any chance of getting it treated through ayurvedic medicines?

Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Ayurveda
Ayurveda, Mumbai
Acromegaly is caused by over secretion of the pitutary gland in the brain, she has been diagnosed with secretory adenoma of the ant pitutary. The problem is she might have other hormonal over secretions too. Yes ayurvedic medications can be tried ...
1 person found this helpful

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?